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Gunterstockman BM, Carmel J, Bechard L, Yoder A, Farrokhi S. Rearfoot Strike Run Retraining for Achilles Tendon Pain: A Two-patient Case Series. Mil Med 2024; 189:e942-e947. [PMID: 37975221 DOI: 10.1093/milmed/usad436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/25/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Running-related injuries are prevalent in the military and are often related to physical fitness test training. Non-rearfoot striking while running is known to increase the risk of Achilles tendon injuries because of the high eccentric energy absorption by the elastic components of the planarflexor muscle-tendon complex. However, there is limited evidence to suggest benefits of converting runners with Achilles tendon pain to use a rearfoot strike. METHODS This is a case series of two active-duty Service members with chronic, running-related Achilles tendon pain that utilized a natural non-rearfoot strike pattern. Both patients were trained to utilize a rearfoot strike while running through the use of real-time visual feedback from wearable sensors. RESULTS The trained rearfoot strike pattern was retained for over one month after the intervention, and both patients reported improvements in pain and self-reported function. CONCLUSIONS This case series demonstrated the clinical utility of converting two non-rearfoot strike runners to a rearfoot strike pattern to decrease eccentric demands on the plantarflexors and reduce Achilles tendon pain while running.
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Affiliation(s)
| | | | - Laura Bechard
- Naval Medical Center San Diego, San Diego, CA 92134, USA
- Henry Jackson Foundation, Bethesda, MD 20817, USA
| | - Adam Yoder
- Henry Jackson Foundation, Bethesda, MD 20817, USA
- DoD-VA Extremity Trauma and Amputation Center of Excellence, San Diego, CA 92134, USA
| | - Shawn Farrokhi
- Naval Medical Center San Diego, San Diego, CA 92134, USA
- DoD-VA Extremity Trauma and Amputation Center of Excellence, San Diego, CA 92134, USA
- Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA
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Yawar A, Lieberman DE. Biomechanical Tradeoffs in Foot Function From Variations in Shoe Design. Exerc Sport Sci Rev 2023; 51:128-139. [PMID: 37220782 DOI: 10.1249/jes.0000000000000322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
There is debate and confusion over how to evaluate the biomechanical effects of running shoe design. Here, we use an evolutionary perspective to analyze how key design features of running shoes alter the evolved biomechanics of the foot, creating a range of tradeoffs in force production and transmission that may affect performance and vulnerability to injury.
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Affiliation(s)
- Ali Yawar
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA
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Mo S, Chan ZYS, Lai KKY, Chan PPK, Wei RXY, Yung PSH, Shum G, Cheung RTH. Effect of minimalist and maximalist shoes on impact loading and footstrike pattern in habitual rearfoot strike trail runners: An in-field study. Eur J Sport Sci 2020; 21:183-191. [PMID: 32126931 DOI: 10.1080/17461391.2020.1738559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Running-related injuries among trail runners are very common and footwear selection may modulate the injury risk. However, most previous studies were conducted in a laboratory environment. The objective of this study was to examine the effects of two contrasting footwear designs, minimalist (MIN) and maximalist shoes (MAX), on the running biomechanics of trail runners during running on a natural trail. Eighteen habitual rearfoot strike trail runners completed level, uphill and downhill running at their preferred speeds in both shod conditions. Peak tibial acceleration, strike index and footstrike pattern were compared between the two footwear and slopes. Interactions of footwear and slope were not detected for all the selected variables. There was no significant effect from footwear (F = 1.23, p = 0.27) and slope (F = 2.49, p = 0.09) on peak tibial acceleration and there was no footwear effect on strike index (F = 3.82, p = 0.056). A significant main effect of slope on strike index (F = 13.24, p < 0.001) was found. Strike index during uphill running was significantly greater (i.e. landing with a more anterior foot strike) when compared with level (p < 0.001, Cohen's d = 1.72) or downhill running (p < 0.001, Cohen's d = 1.44) in either MIN or MAX. The majority of habitual rearfoot strike runners switched to midfoot strike during uphill running while maintaining a rearfoot strike pattern during level or downhill running. In summary, wearing either one of the two contrasting footwear (MIN or MAX) demonstrated no effect on impact loading and footstrike pattern in habitual rearfoot strike trail runners running on a natural trail with different slopes.
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Affiliation(s)
- Shiwei Mo
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,Division of Sports Science and Physical Education, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Zoe Y S Chan
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Kenneth K Y Lai
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Peter Pak-Kwan Chan
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Rachel Xiao-Yu Wei
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Gary Shum
- School of Sport, Health and Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Roy Tsz-Hei Cheung
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.,School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
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