The association between eccentric hip abduction strength and hip and knee angular movements in recreational male runners: An explorative study

Running-Related Overuse Injuries and Their Relationship with Run and Resistance Training Characteristics in Adult Recreational Runners: A Cross-Sectional Study

This study aimed to characterize running-related injuries (RRIs), explore their relationship with run and resistance training (RT) parameters, and identify perceived prevention measures among adult recreational runners. An anonymous online survey was designed and distributed via social media and email. Data were analyzed with chi-square, t-test, or analysis of variance (ANOVA), with significance accepted at p ≤ 0.05. Data from 616 participants (76.8% female, age: 42.3 ± 10.5 y) were analyzed. Most runners (84.4%) had an injury history, with 44.6% experiencing one in the past year. The most common RRI sites included the foot/ankle (30.9%) and knee (22.2%). RRI prevalence was higher in those running >19 miles weekly (48.4%, p = 0.05), but there were no differences based on RT participation status. Among those using RT, relatively more RRIs were observed in runners who trained the hip musculature (50.3%, p = 0.005) and did not include the upper body (61.6%, p < 0.001). A disproportionately high RRI prevalence was found for several of the other risk-reduction strategies. RRIs remain a substantial problem, particularly around the ankle/foot and knee. Higher run volume and performance motives were positively associated with RRIs. Most runners incorporated RRI risk-reduction techniques, with over half using RT. The current study did not determine whether preventative strategies were implemented before or after injury; therefore, prospective studies controlling for previous injuries are required to evaluate the effectiveness of RT in preventing future RRIs.

Nielsen R, Rasmussen J, Nielsen MS, Andersen CH, de Zee M. How Precisely Can Easily Accessible Variables Predict Achilles and Patellar Tendon Forces during Running?

Patellar and Achilles tendinopathy commonly affect runners. Developing algorithms to predict cumulative force in these structures may help prevent these injuries. Importantly, such algorithms should be fueled with data that are easily accessible while completing a running session outside a biomechanical laboratory. Therefore, the main objective of this study was to investigate whether algorithms can be developed for predicting patellar and Achilles tendon force and impulse during running using measures that can be easily collected by runners using commercially available devices. A secondary objective was to evaluate the predictive performance of the algorithms against the commonly used running distance. Trials of 24 recreational runners were collected with an Xsens suit and a Garmin Forerunner 735XT at three different intended running speeds. Data were analyzed using a mixed-effects multiple regression model, which was used to model the association between the estimated forces in anatomical structures and the training load variables during the fixed running speeds. This provides twelve algorithms for predicting patellar or Achilles tendon peak force and impulse per stride. The algorithms developed in the current study were always superior to the running distance algorithm.

Trunk, pelvis, and knee kinematics during running in females with and without patellofemoral pain

BACKGROUND

Females are two times more likely to develop patellofemoral pain (PFP) than males. Abnormal trunk and pelvis kinematics are thought to contribute to the pathomechanics of this condition. However, there is a scarcity of evidence investigating proximal segments kinematics in females with PFP.

RESEARCH QUESTION

The purpose of this study was to investigate whether females with PFP demonstrate altered trunk, pelvis, and knee joint kinematics compared with healthy controls during running.

METHODS

Thirty-four females (17 PFP, 17 controls) underwent a 3-dimensional motion analysis during treadmill running at preferred and fixed speeds, each trial for 30 s. Variables of interest included magnitudes of peak angles for trunk (forward flexion, ipsilateral trunk lean), pelvis (anterior tilt, contralateral drop), knee (flexion, valgus, internal rotation), range of motion (RoM) of trunk and pelvis in sagittal and frontal planes and RoM of knee joint in the three cardinal planes of motion. Kinematic data were compared between groups using mixed model repeated measure analysis of variance with the trial as the repeated measure.

RESULTS

The PFP group displayed significantly less pelvis frontal plane RoM, greater knee frontal plane RoM, and less knee sagittal plane RoM during running compared with controls, irrespective of running trial. No differences were found in peak kinematic variables between PFP and healthy groups.

SIGNIFICANCE

These results may suggest a rigid stabilization strategy at the pelvis, which the body has adapted to prevent further frontal plane knee malalignment. Less knee sagittal plane RoM may be indicative of another protective strategy in the PFP group to avoid patellofemoral joint reaction force. Clinical assessments and rehabilitative treatments may benefit from considering a global program with focus on pelvis kinematics in addition to the knee joint in females with PFP.

Relationships between Fitness Status and Match Running Performance in Adult Women Soccer Players: A Cohort Study

Background and Objectives: The aim of this study was twofold: (i) to analyze the relationships between fitness status (repeated-sprint ability (RSA), aerobic performance, vertical height jump, and hip adductor and abductor strength) and match running performance in adult women soccer players and (ii) to explain variations in standardized total distance, HSR, and sprinting distances based on players' fitness status. Materials and Methods: The study followed a cohort design. Twenty-two Portuguese women soccer players competing at the first-league level were monitored for 22 weeks. These players were tested three times during the cohort period. The measured parameters included isometric strength (hip adductor and abductor), vertical jump (squat and countermovement jump), linear sprint (10 and 30 m), change-of-direction (COD), repeated sprints (6 × 35 m), and intermittent endurance (Yo-Yo intermittent recovery test level 1). Data were also collected for several match running performance indicators (total distance covered and distance at different speed zones, accelerations/decelerations, maximum sprinting speed, and number of sprints) in 10 matches during the cohort. Results: Maximal linear sprint bouts presented large to very large correlations with explosive match-play actions (accelerations, decelerations, and sprint occurrences; r = -0.80 to -0.61). In addition, jump modalities and COD ability significantly predicted, respectively, in-game high-intensity accelerations (r = 0.69 to 0.75; R2 = 25%) and decelerations (r = -0.78 to -0.50; R2 = 23-24%). Furthermore, COD had significant explanatory power related to match running performance variance regardless of whether the testing and match performance outcomes were computed a few or several days apart. Conclusion: The present investigation can help conditioning professionals working with senior women soccer players to prescribe effective fitness tests to improve their forecasts of locomotor performance.

Association Between Knee- and Hip-Extensor Strength and Running-Related Injury Biomechanics in Collegiate Distance Runners

CONTEXT

Running-related injuries are common in distance runners. Strength training is used for performance enhancement and injury prevention. However, the association between maximal strength and distance-running biomechanics is unclear.

OBJECTIVE

To determine the relationship between maximal knee- and hip-extensor strength and running biomechanics previously associated with injury risk.

DESIGN

Cross-sectional study.

SETTING

Research laboratory.

PATIENTS OR OTHER PARTICIPANTS

A total of 36 collegiate distance runners (26 men, 10 women; age = 20.0 ± 1.5 years, height = 1.74 ± 0.09 m, mass = 61.97 ± 8.26 kg).

MAIN OUTCOME MEASURE(S)

Strength was assessed using the 1-repetition maximum (1RM) back squat and maximal voluntary isometric contractions of the knee extensors and hip extensors. Three-dimensional running biomechanics were assessed overground at a self-selected speed. Running variables were the peak instantaneous vertical loading rate; peak forward trunk-lean angle; knee-flexion, internal-rotation, and -abduction angles and internal moments; and hip-extension, internal-rotation, and -adduction angles and internal moments. Separate stepwise linear regression models were used to examine the associations between strength and biomechanical outcomes (ΔR2) after accounting for sex, running speed, and foot-strike index.

RESULTS

Greater 1RM back-squat strength was associated with a larger peak knee-flexion angle (ΔR2 = 0.110, ΔP = .045) and smaller peak knee internal-rotation angle (ΔR2 = 0.127, ΔP = .03) and internal-rotation moment (ΔR2 = 0.129, ΔP = .03) after accounting for sex, speed, and foot-strike index. No associations were found between 1RM back-squat strength and vertical loading rate, trunk lean, or hip kinematics and kinetics. Hip- and knee-extensor maximal voluntary isometric contractions were also not associated with any biomechanical variables.

CONCLUSIONS

Greater 1RM back-squat strength was weakly associated with a larger peak knee-flexion angle and smaller knee internal-rotation angle and moment in collegiate distance runners. Runners who are weaker in the back-squat exercise may exhibit running biomechanics associated with the development of knee-related injuries.

Sex-dependent differences in single-leg squat kinematics and their relationship to squat depth in physically active individuals

The purpose of this study is to compare recreationally physically active females and males with regard to spine, pelvis and lower limb joints peak angles in each plane of motion during a single leg squat (SLS). The second aim is to investigate the relationship between kinematics and SLS depth in females and males. Fifty-eight healthy, young adults performed 5 repetitions of a single right leg squat to maximal depth while keeping their balance. Kinematic data were obtained using an optical motion capture system. At the hip, greater adduction and greater internal rotation were observed in females than in males. Females had more extended spines and less outward bended knees throughout the SLS than did men. In males, squat depth was significantly, positively correlated with the maximal angle of the ankle (r = 0.60, p < 0.001), the knee (r = 0.87, p < 0.001), the hip (r = 0.73, p < 0.001) and the pelvis (r = 0.40, p = 0.02) in the sagittal plane. A positive significant correlation was found between SLS depth and maximal angle of the knee (r = 0.88, p < 0.001) and the ankle (r = 0.53, p = 0.01) in the sagittal plane in females. Males and females used different motor strategies at all levels of the kinematic chain during SLS.

Relationships of hip abductor strength, neuromuscular control, and hip width to femoral length ratio with peak hip adduction angle in healthy female runners

A large peak hip adduction angle during running is a risk factor for several overuse injuries in women. The purpose of this study was to determine if female runners with a large peak hip adduction angle have differences in eccentric hip abductor muscle strength, hip neuromuscular control, and/or hip width to femoral length ratio (HW:FL) compared to those with a small angle. Hip adduction during running, hip strength, hip control, and HW:FL were measured in sixty healthy female runners (1.66 ± 0.06 m; 63.2 ± 8.3 kg; 27 ± 6 years). Data from twenty runners with the largest and twenty with the smallest peak hip adduction angles were analysed. Between-group differences in hip strength, control, and HW:FL were determined using independent t-tests (p < 0.05). Variables that were significantly different between groups were entered into a regression model. Runners in both groups had similar hip strength (p = 0.90) and control (p = 0.65). HW:FL was greater in the large peak angle group (p = 0.04), but only explained a small amount of peak hip adduction angle variance for all sixty runners (R² = 0.05). Alarge peak hip adduction angle in some healthy female runners may simply be instinctive as there were no deficiencies in the strength or neuromuscular control constructs assessed.

Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis

INTRODUCTION

Abnormal kinematics have been implicated as one of the major risk factors for lower limb tendinopathy (LLT).

OBJECTIVE

To systematically review evidence for kinematic risk factors for LLT in runners.

METHODS

Individual electronic searches in PubMed, EMBASE and Web of Science were conducted. Two reviewers screened studies to identify observational studies reporting kinematic risk factors in runners with LLT compared to healthy controls. The Down and Black appraisal scale was applied to assess quality. A meta-analysis was performed provided that at least two studies with similar methodology reported the same factor.

RESULTS

Twenty-eight studies were included: Achilles tendinopathy (AT) (9), iliotibial band syndrome (ITBS) (17), plantar fasciopathy (PF) (2), patellar tendinopathy (PT) (1), posterior tibial tendon dysfunction (PTTD) (1). Eighteen studies were rated high-quality and ten medium-quality. The meta-analyses revealed strong evidence of higher peak knee internal rotation, moderate evidence of lower peak rearfoot eversion and knee flexion at heel strike and greater peak hip adduction in runners with ITBS. Very limited evidence revealed higher peak ankle eversion in runners with PF and PTTD or higher peak hip adduction in PT.

SIGNIFICANCE

Peak rearfoot eversion was the only factor reported in all included LLTs; it is a significant factor in ITBS, PT and PTTD but not in AT and PF. More prospective studies are needed to accurately evaluate the role of kinematic risk factors as a cause of LLT. Taken together, addressing rearfoot kinematic and kinematic chain movements accompanied by peak eversion should be considered in the prevention and management of LLT.