Background Running has been critical to human survival. Therefore, the high rate of injuries experienced by modern day runners is puzzling. Landing on the heel, as most modern day shod runners do, results in a distinct vertical impact force that has been shown to be associated with running-related injuries. However, these injury studies were retrospective in nature and do not establish cause and effect. Objective To determine whether runners with high impacts are at greater risk for developing medically diagnosed injuries. Methods 249 female runners underwent a gait analysis to measure vertical instantaneous loading rate, vertical average loading rate (VALR), vertical impact peak (VIP) and peak vertical force. Participants then recorded their mileage and any running-related injuries monthly in a web-based, database programme. Variables were first compared between the entire injured (INJ; n=144) and uninjured (n=105) groups. However, the focus of this study was on those injured runners seeking medical attention (n=103) and those who had never injured (n=21). Results There were no differences between the entire group of injured and uninjured groups. However, all impact-related variables were higher in those with medically diagnosed injuries compared with those who had never been injured. (effect size (ES) 0.4–0.59). When VALR was >66.0 body weight (BW)/s, the odds of being DX_INJ were 2.72 (95% CI 1.0 to 7.4). Impact loading was associated with bony and soft-tissue injuries. Conclusions Vertical average loading rate was lower in female runners classified as ‘never injured’ compared with those who had been injured and sought medical attention.

https://bjsm.bmj.com/content/bjsports/early/2016/01/07/bjsports-2015-094579.full.pdf

Greater vertical impact loading in female runners with medically diagnosed injuries: a prospective investigation

PURPOSE Based on mass alone, one might intuit that running barefoot would exact a lower metabolic cost than running in shoes. Numerous studies have shown that adding mass to shoes increases submaximal oxygen uptake (V˙O(2)) by approximately 1% per 100 g per shoe. However, only two of the seven studies on the topic have found a statistically significant difference in V˙O(2) between barefoot and shod running. The lack of difference found in these studies suggests that factors other than shoe mass (e.g., barefoot running experience, foot strike pattern, shoe construction) may play important roles in determining the metabolic cost of barefoot versus shod running. Our goal was to quantify the metabolic effects of adding mass to the feet and compare oxygen uptake and metabolic power during barefoot versus shod running while controlling for barefoot running experience, foot strike pattern, and footwear. METHODS Twelve males with substantial barefoot running experience ran at 3.35 m·s with a midfoot strike pattern on a motorized treadmill, both barefoot and in lightweight cushioned shoes (∼150 g per shoe). In additional trials, we attached small lead strips to each foot/shoe (∼150, ∼300, and ∼450 g). For each condition, we measured the subjects' rates of oxygen consumption and carbon dioxide production and calculated metabolic power. RESULTS V˙O(2) increased by approximately 1% for each 100 g added per foot, whether barefoot or shod (P < 0.001). However, barefoot and shod running did not significantly differ in V˙O(2) or metabolic power. A consequence of these two findings was that for footwear conditions of equal mass, shod running had ∼3%-4% lower V˙O(2) and metabolic power demand than barefoot running (P < 0.05). CONCLUSIONS Running barefoot offers no metabolic advantage over running in lightweight, cushioned shoes.

Metabolic Cost of Running Barefoot Versus Shod: Is Lighter Better?

Study Design Systematic review with meta-analysis. Objectives To determine the biomechanical differences between foot-strike patterns used when running. Background Strike patterns during running have received attention in the recent literature due to their potential mechanical differences and associated injury risks. Methods Electronic databases (MEDLINE, Embase, LILACS, SciELO, and SPORTDiscus) were searched through July 2014. Studies (cross-sectional, case-control, prospective, and retrospective) comparing the biomechanical characteristics of foot-strike patterns during running in distance runners at least 18 years of age were included in this review. Two independent reviewers evaluated the risk of bias. A meta-analysis with a random-effects model was used to combine the data from the included studies. Results Sixteen studies were included in the final analysis. In the meta-analyses of kinematic variables, significant differences between forefoot and rearfoot strikers were found for foot and knee angle ...

Biomechanical Differences of Foot-Strike Patterns During Running: A Systematic Review With Meta-analysis

Synopsis Bone stress injury (BSI) represents the inability of bone to withstand repetitive loading, which results in structural fatigue and localized bone pain and tenderness. A BSI occurs along a pathology continuum that begins with a stress reaction, which can progress to a stress fracture and, ultimately, a complete bone fracture. Bone stress injuries are a source of concern in long-distance runners, not only because of their frequency and the morbidity they cause but also because of their tendency to recur. While most BSIs readily heal following a period of modified loading and a progressive return to running activities, the high recurrence rate of BSIs signals a need to address their underlying causative factors. A BSI results from disruption of the homeostasis between microdamage formation and its removal. Microdamage accumulation and subsequent risk for development of a BSI are related both to the load applied to a bone and to the ability of the bone to resist load. The former is more amenable to i...

https://www.jospt.org/doi/pdf/10.2519/jospt.2014.5334

Management and Prevention of Bone Stress Injuries in Long-Distance Runners

In this study we compared Achilles tendon loading parameters during barefoot running among females with different foot strike patterns using open-source computer muscle modeling software to provide dynamic simulations of running. Muscle forces of the gastrocnemius and soleus were estimated from experimental data collected in a motion capture laboratory during barefoot running for 11 runners utilizing a rearfoot strike (RFS) and 8 runners utilizing a non-RFS (NRFS) pattern. Our results show that peak Achilles tendon force occurred earlier in stance phase (p = 0.007), which contributed to a 15% increase in average Achilles tendon loading rate among participants adopting a NRFS pattern (p = 0.06). Stance time, step length, and the estimated number of steps per mile were similar between groups. However, runners with a NRFS pattern experienced 11% greater Achilles tendon impulse each step (p = 0.05) and nearly significantly greater Achilles tendon impulse per mile run (p = 0.06). This difference equates to an additional 47.7 body weights for each mile run with a NRFS pattern. Runners considering a NRFS pattern may want to account for these novel stressors and adapt training programs accordingly.

The Effect of Foot Strike Pattern on Achilles Tendon Load During Running

Although the biomechanical properties of the various types of running foot strike (rearfoot, midfoot, and forefoot) have been studied extensively in the laboratory, only a few studies have attempted to quantify the frequency of running foot strike variants among runners in competitive road races. We classified the left and right foot strike patterns of 936 distance runners, most of whom would be considered of recreational or sub-elite ability, at the 10 km point of a half-marathon/marathon road race. We classified 88.9% of runners at the 10 km point as rearfoot strikers, 3.4% as midfoot strikers, 1.8% as forefoot strikers, and 5.9% of runners exhibited discrete foot strike asymmetry. Rearfoot striking was more common among our sample of mostly recreational distance runners than has been previously reported for samples of faster runners. We also compared foot strike patterns of 286 individual marathon runners between the 10 km and 32 km race locations and observed increased frequency of rearfoot s...

/pdf/foot-strike-patterns-of-recreational-and-sub-elite-runners-2ba420kkbv.pdf

Tamara Decker

Papers

Foot strike patterns of recreational and sub-elite runners in a long-distance road race