The habitual motion path theory: Evidence from cartilage volume reductions in the knee joint after 75 minutes of running

Towards functionally individualised designed footwear recommendation for overuse injury prevention: a scoping review

Injury prevention is essential in running due to the risk of overuse injury development. Tailoring running shoes to individual needs may be a promising strategy to reduce this risk. Novel manufacturing processes allow the production of individualised running shoes that incorporate features that meet individual biomechanical and experiential needs. However, specific ways to individualise footwear to reduce injury risk are poorly understood. Therefore, this scoping review provides an overview of (1) footwear design features that have the potential for individualisation; and (2) the literature on the differential responses to footwear design features between selected groups of individuals. These purposes focus exclusively on reducing the risk of overuse injuries. We included studies in the English language on adults that analysed: (1) potential interaction effects between footwear design features and subgroups of runners or covariates (e.g., age, sex) for running-related biomechanical risk factors or injury incidences; (2) footwear comfort perception for a systematically modified footwear design feature. Most of the included articles (n = 107) analysed male runners. Female runners may be more susceptible to footwear-induced changes and overuse injury development; future research should target more heterogonous sampling. Several footwear design features (e.g., midsole characteristics, upper, outsole profile) show potential for individualisation. However, the literature addressing individualised footwear solutions and the potential to reduce biomechanical risk factors is limited. Future studies should leverage more extensive data collections considering relevant covariates and subgroups while systematically modifying isolated footwear design features to inform footwear individualisation.

Identification of subject-specific responses to footwear during running

Placing a stronger focus on subject-specific responses to footwear may lead to a better functional understanding of footwear's effect on running and its influence on comfort perception, performance, and pathogenesis of injuries. We investigated subject-specific responses to different footwear conditions within ground reaction force (GRF) data during running using a machine learning-based approach. We conducted our investigation in three steps, guided by the following hypotheses: (I) For each subject x footwear combination, unique GRF patterns can be identified. (II) For each subject, unique GRF characteristics can be identified across footwear conditions. (III) For each footwear condition, unique GRF characteristics can be identified across subjects. Thirty male subjects ran ten times at their preferred (self-selected) speed on a level and approximately 15 m long runway in four footwear conditions (barefoot and three standardised running shoes). We recorded three-dimensional GRFs for one right-foot stance phase per running trial and classified the GRFs using support vector machines. The highest median prediction accuracy of 96.2% was found for the subject x footwear classification (hypothesis I). Across footwear conditions, subjects could be discriminated with a median prediction accuracy of 80.0%. Across subjects, footwear conditions could be discriminated with a median prediction accuracy of 87.8%. Our results suggest that, during running, responses to footwear are unique to each subject and footwear design. As a result, considering subject-specific responses can contribute to a more differentiated functional understanding of footwear effects. Incorporating holistic analyses of biomechanical data is auspicious for the evaluation of (subject-specific) footwear effects, as unique interactions between subjects and footwear manifest in versatile ways. The applied machine learning methods have demonstrated their great potential to fathom subject-specific responses when evaluating and recommending footwear.

Fatigue related changes in rearfoot eversion: a means of functionally grouping runners?

Fatigue alters rearfoot kinematics on an individual basis and may offer a means of functionally grouping runners. This proof of concept study aimed to determine whether fatigue related changes in rearfoot eversion could be used to functionally group runners. Sixteen male recreational runners had their frontal plane rearfoot kinematics recorded by a three-dimensional motion capture system before and after a 5km run. The magnitude of change in frontal plane rearfoot kinematics pre- to post-fatigue was calculated and K-means clustering used to identify functional groups based upon these changes. T-tests with statistical parametric mapping were used to compare fatigue related changes both within and between clusters. Two clusters or functional groups were evident within the data set. Nine participants were allocated to cluster 1 and displayed small and insignificant changes in frontal plane rearfoot motion post-fatigue. In contrast, the remaining seven participants were assigned to cluster 2 and displayed significant increases in rearfoot eversion between 3 and 84% of the stance phase post-fatigue. These findings prove the concept that fatigue related changes in rearfoot eversion can be used to functionally group participants. Additionally, the differing fatigue related changes reported by each group may alter the injury risk, training and footwear needs of each group. HighlightsFatigue related changes in frontal plane rearfoot motion can be used to functionally group individuals.Cluster 1 display small and insignificant fatigue related changes, which suggests they can maintain their habitual movement pathway.Cluster 2 displayed significant increases in rearfoot eversion for the majority of the stance phase, suggesting an inability to maintain their habitual movement pathway, which may increase injury risk.

2021 ISB World Athletics Award for Biomechanics: The Subtalar Joint Maintains "Spring-Like" Function While Running in Footwear That Perturbs Foot Pronation

Humans have the remarkable ability to run over variable terrains. During locomotion, however, humans are unstable in the mediolateral direction and this instability must be controlled actively-a goal that could be achieved in more ways than one. Walking research indicates that the subtalar joint absorbs energy in early stance and returns it in late stance, an attribute that is credited to the tibialis posterior muscle-tendon unit. The purpose of this study was to determine how humans (n = 11) adapt to mediolateral perturbations induced by custom-made 3D-printed "footwear" that either enhanced or reduced pronation of the subtalar joint (modeled as motion in 3 planes) while running (3 m/s). In all conditions, the subtalar joint absorbed energy (ie, negative mechanical work) in early stance followed by an immediate return of energy (ie, positive mechanical work) in late stance, demonstrating a "spring-like" behavior. These effects increased and decreased in footwear conditions that enhanced or reduced pronation (P ≤ .05), respectively. Of the recorded muscles, the tibialis posterior (P ≤ .05) appeared to actively change its activation in concert with the changes in joint energetics. We suggest that the "spring-like" behavior of the subtalar joint may be an inherent function that enables the lower limb to respond to mediolateral instabilities during running.

Acute changes in knee cartilage and meniscus following long-distance running in habituate runners: a systematic review on studies using quantitative magnetic resonance imaging

OBJECTIVE

Running is among the most popular recreational activities; nonetheless, the acute post-race changes of cartilage or meniscus have rarely been determined. The current study aimed to review the acute changes in knee cartilage and meniscus among habituate runners following long-distance running detected by using quantitative magnetic resonance imaging (MRI).

MATERIALS AND METHODS

Systematic literature search was performed on those dominate clinical databases which including MEDLINE, Cochrane, Embase, ScienceDirect, and Web of Science. Included studies should be conducted on healthy marathon runners, and the participants should be examined before and after running by using MRI. Intervention studies were excluded.

RESULTS

A total number of 14 studies were finally included in this review which all examined the cartilage or meniscus by using MRI functional sequences. Among them, six studies quantitatively measured the changes regarding volume of the knee cartilage or/and meniscus. Five studies found that the volume would decrease initially after running. Ten studies reported T2 (T2*) would decrease after running and returned to the baseline in a short term, while T1ρ may remain increased in months. Five studies measured subareas for T2 (T2*) value, and found that the superficial and medial subarea changed more vastly than other regions after running.

CONCLUSION

Runners experience transient changes in the volume and signals of knee cartilage and meniscus after long-distance running. A liquid exchange and material interaction in cartilage and meniscus was observed after running. Superficial and medial areas of knee cartilage and meniscus might be more susceptible to mechanical loading.

Running Injury Paradigms and Their Influence on Footwear Design Features and Runner Assessment Methods: A Focused Review to Advance Evidence-Based Practice for Running Medicine Clinicians

Many runners seek health professional advice regarding footwear recommendations to reduce injury risk. Unfortunately, many clinicians, as well as runners, have ideas about how to select running footwear that are not scientifically supported. This is likely because much of the research on running footwear has not been highly accessible outside of the technical footwear research circle. Therefore, the purpose of this narrative review is to update clinical readers on the state of the science for assessing runners and recommending running footwear that facilitate the goals of the runner. We begin with a review of basic footwear construction and the features thought to influence biomechanics relevant to the running medicine practitioner. Subsequently, we review the four main paradigms that have driven footwear design and recommendation with respect to injury risk reduction: Pronation Control, Impact Force Modification, Habitual Joint (Motion) Path, and Comfort Filter. We find that evidence in support of any paradigm is generally limited. In the absence of a clearly supported paradigm, we propose that in general clinicians should recommend footwear that is lightweight, comfortable, and has minimal pronation control technology. We further encourage clinicians to arm themselves with the basic understanding of the known effects of specific footwear features on biomechanics in order to better recommend footwear on a patient-by-patient basis.

Influence of running shoes on muscle activity

Studies on the paradigm of the preferred movement path are scarce, and as a result, many aspects of the paradigm remain elusive. It remains unknown, for instance, how muscle activity adapts when differences in joint kinematics, due to altered running conditions, are of low / high magnitudes. Therefore, the purpose of this work was to investigate changes in muscle activity of the lower extremities in runners with minimal (≤ 3°) or substantial (> 3°) mean absolute differences in the ankle and knee joint angle trajectories when subjected to different running footwear. Mean absolute differences in the integral of the muscle activity were quantified for the tibialis anterior (TA), peroneus longus (PL), gastrocnemius medialis (GM), soleus (SO), vastus lateralis (VL), and biceps femoris (BF) muscles during over ground running. In runners with minimal changes in 3D joint angle trajectories (≤ 3°), muscle activity was found to change drastically when comparing barefoot to shod running (TA: 35%; PL: 11%; GM: 17%; SO: 10%; VL: 27%; BF: 16%), and minimally when comparing shod to shod running (TA: 10%; PL: 9%; GM: 13%; SO: 8%; VL: 8%; BF: 12%). For runners who showed substantial changes in joint angle trajectories (> 3°), muscle activity changed drastically in barefoot to shod comparisons (TA: 39%; PL: 14%; GM: 16%; SO: 16%; VL: 25%; BF: 24%). It was concluded that a movement path can be maintained with small adaptations in muscle activation when running conditions are similar, while large adaptations in muscle activation are needed when running conditions are substantially different.