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Fraser JJ, Pommier R, MacGregor AJ, Silder A, Sander TC. Does policy that provides choice in athletic footwear affect musculoskeletal injury risk in US Coast Guard recruits? BMJ Mil Health 2024; 170:290-295. [PMID: 36175029 DOI: 10.1136/military-2022-002211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/09/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Musculoskeletal injuries (MSKIs) are ubiquitous during initial entry military training, with overuse injuries the most common. A common injury mechanism is running, an activity that is integral to US Coast Guard (USCG) training and a requirement for graduation. The purpose of this study was to assess the effects of a policy that allowed for athletic footwear choice on risk of lower quarter MSKI in USCG recruits. METHODS A retrospective cohort study was performed that included 1230 recruits (1040 men, 190 women) who trained under a policy that allowed self-selection of athletic footwear and 2951 recruits (2329 men, 622 women) who trained under a policy that mandated use of prescribed uniform athletic shoes and served as controls. Demographic data and physical performance were derived from administrative records. Injury data were abstracted from a medical tracking database. Unadjusted risk calculations and multivariable logistic regression assessing the effects of group, age, sex, height, body mass and 2.4 km run times on MSKI were performed. RESULTS Ankle-foot, leg, knee and lumbopelvic-hip complex injuries were ubiquitous in both groups (experimental: 13.13 per 1000 person-weeks; control: 11.69 per 1000 person-weeks). Group was not a significant factor for any of the injuries assessed in either the unadjusted or adjusted analysis, despite widespread reports of pain (58.6%), perceived injury attribution (15.7%), perceived deleterious effect on performance (25.3%), general dissatisfaction (46.3%) and intended discontinuance of use following graduation (87.7%). CONCLUSION MSKI continues to be a major source of morbidity in the recruit training population. The policy that allowed USCG recruits to self-select athletic footwear did not decrease or increase the risk of MSKI. While regulations pertaining to footwear choice did not influence injury outcomes, there was general dissatisfaction with the prescribed uniform athletic footwear conveyed by the recruits and widespread reports of discomfort, perceived deleterious effects from wear and intended discontinued use following training completion.
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Affiliation(s)
- John J Fraser
- Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, California, USA
- Warfighter Performance Department, Naval Health Research Center, San Diego, California, USA
| | - R Pommier
- Samuel J Call Health Services Center, US Coast Guard Training Center, Cape May, New Jersey, USA
| | - A J MacGregor
- Medical Modelling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, California, USA
| | - A Silder
- Warfighter Performance Department, Naval Health Research Center, San Diego, California, USA
| | - T C Sander
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, Michigan, USA
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Nguyen AP, Gillain L, Delieux L, Detrembleur C, Mahaudens P, Esculier JF. Opinions about running shoes in runners and non-runners. FOOTWEAR SCIENCE 2022. [DOI: 10.1080/19424280.2022.2144468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Anh Phong Nguyen
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
- The Running Clinic, Quebec, Canada
| | - Loris Gillain
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
| | - Louise Delieux
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
| | - Christine Detrembleur
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
| | - Philippe Mahaudens
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
- Service d’orthopédie et de traumatologie de l’appareil locomoteur, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Service de médecine physique et réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Jean-François Esculier
- The Running Clinic, Quebec, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
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3
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Alexander JLN, Culvenor AG, Johnston RRT, Ezzat AM, Barton CJ. Strategies to prevent and manage running-related knee injuries: a systematic review of randomised controlled trials. Br J Sports Med 2022; 56:1307-1319. [PMID: 36150753 DOI: 10.1136/bjsports-2022-105553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of interventions to prevent and manage knee injuries in runners. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus up to May 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials (RCTs) with a primary aim of evaluating the effectiveness of intervention(s) to prevent or manage running-related knee injury. RESULTS Thirty RCTs (18 prevention, 12 management) analysed multiple interventions in novice and recreational running populations. Low-certainty evidence (one trial, 320 participants) indicated that running technique retraining (to land softer) reduced the risk of knee injury compared with control treadmill running (risk ratio (RR) 0.32, 95% CI 0.16 to 0.63). Very low-certainty to low-certainty evidence from 17 other prevention trials (participant range: 24 -3287) indicated that various footwear options, multicomponent exercise therapy, graduated running programmes and online and in person injury prevention education programmes did not influence knee injury risk (RR range: 0.55-1.06). In runners with patellofemoral pain, very low-certainty to low-certainty evidence indicated that running technique retraining strategies, medial-wedged foot orthoses, multicomponent exercise therapy and osteopathic manipulation can reduce knee pain in the short-term (standardised mean difference range: -4.96 to -0.90). CONCLUSION There is low-certainty evidence that running technique retraining to land softer may reduce knee injury risk by two-thirds. Very low-certainty to low-certainty evidence suggests that running-related patellofemoral pain may be effectively managed through a variety of active (eg, running technique retraining, multicomponent exercise therapy) and passive interventions (eg, foot orthoses, osteopathic manipulation). PROSPERO REGISTRATION NUMBER CRD42020150630.
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Affiliation(s)
- James L N Alexander
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Evado Studios, Nelson Bay, New South Wales, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Richard R T Johnston
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Allison M Ezzat
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia .,Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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A step towards dynamic foot classification: Functional grouping using ankle joint frontal plane motion in running. Gait Posture 2022; 97:35-39. [PMID: 35868095 DOI: 10.1016/j.gaitpost.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/10/2022] [Accepted: 07/07/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The premise behind static foot classification suggests structure dictate's function. However, the validity of this has been challenged, as weak association between static foot type and dynamic motion exists. This has led to calls for dynamic assessments and classification of feet based on functional motion, yet methods to do this have been seldom explored. RESEARCH QUESTION Within a group of runners do homogenous sub-groups of ankle joint complex (AJC) frontal plane motion exist? METHODS A k means clustering analysis was conducted on the frontal plane AJC motion patterns of a group of healthy adults running barefoot (n = 42) to identify functional movement groups. Once identified, statistical parametric mapping was employed to determine the differences between clusters across stance. The identified clusters were used to determine dynamic foot type; an agreement analysis was conducted between the newly defined foot types and the Foot Posture Index (FPI-6). RESULTS Two distinct clusters were identified. Waveform analysis identified that cluster 1 displayed significantly (p < 0.001) less AJC eversion between 0% and 97% of the stance phase compared to cluster 2, with the differences between clusters associated with large effect sizes (g > 1). Based on the displayed kinematic profiles, cluster 1 was defined as a Neutral Dynamic Foot Type (NeutralDFT), and cluster 2 a Pronated Dynamic Foot Type (Pronated DynamicDFT). The newly defined foot type measure had only a slight agreement (κ = 0.08) with the FPI-6. SIGNIFICANCE We demonstrated a protocol to classify a runner's foot type derived directly from AJC motion during running. Poor agreement between the dynamic and static classification measures further evidence that these assessments are not analogous. Our results question the validity of static classification when looking to characterise the foot during running, suggesting dynamic assessments are more appropriate to reflect the foots functional response.
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Relph N, Greaves H, Armstrong R, Prior TD, Spencer S, Griffiths IB, Dey P, Langley B. Running shoes for preventing lower limb running injuries in adults. Cochrane Database Syst Rev 2022; 8:CD013368. [PMID: 35993829 PMCID: PMC9394464 DOI: 10.1002/14651858.cd013368.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Lower-limb running injuries are common. Running shoes have been proposed as one means of reducing injury risk. However, there is uncertainty as to how effective running shoes are for the prevention of injury. It is also unclear how the effects of different characteristics of running shoes prevent injury. OBJECTIVES To assess the effects (benefits and harms) of running shoes for preventing lower-limb running injuries in adult runners. SEARCH METHODS We searched the following databases: CENTRAL, MEDLINE, Embase, AMED, CINAHL Plus and SPORTDiscus plus trial registers WHO ICTRP and ClinicalTrials.gov. We also searched additional sources for published and unpublished trials. The date of the search was June 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs involving runners or military personnel in basic training that either compared a) a running shoe with a non-running shoe; b) different types of running shoes (minimalist, neutral/cushioned, motion control, stability, soft midsole, hard midsole); or c) footwear recommended and selected on foot posture versus footwear not recommended and not selected on foot posture for preventing lower-limb running injuries. Our primary outcomes were number of people sustaining a lower-limb running injury and number of lower-limb running injuries. Our secondary outcomes were number of runners who failed to return to running or their previous level of running, runner satisfaction with footwear, adverse events other than musculoskeletal injuries, and number of runners requiring hospital admission or surgery, or both, for musculoskeletal injury or adverse event. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility and performed data extraction and risk of bias assessment. The certainty of the included evidence was assessed using GRADE methodology. MAIN RESULTS We included 12 trials in the analysis which included a total of 11,240 participants, in trials that lasted from 6 to 26 weeks and were carried out in North America, Europe, Australia and South Africa. Most of the evidence was low or very low certainty as it was not possible to blind runners to their allocated running shoe, there was variation in the definition of an injury and characteristics of footwear, and there were too few studies for most comparisons. We did not find any trials that compared running shoes with non-running shoes. Neutral/cushioned versus minimalist (5 studies, 766 participants) Neutral/cushioned shoes may make little or no difference to the number of runners sustaining a lower-limb running injuries when compared with minimalist shoes (low-certainty evidence) (risk ratio (RR) 0.77, 95% confidence interval (CI) 0.59 to 1.01). One trial reported that 67% and 92% of runners were satisfied with their neutral/cushioned or minimalist running shoes, respectively (RR 0.73, 95% CI 0.47 to 1.12). Another trial reported mean satisfaction scores ranged from 4.0 to 4.3 in the neutral/ cushioned group and 3.6 to 3.9 in the minimalist running shoe group out of a total of 5. Hence neutral/cushioned running shoes may make little or no difference to runner satisfaction with footwear (low-certainty evidence). Motion control versus neutral / cushioned (2 studies, 421 participants) It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower-limb running injuries when compared with neutral / cushioned shoes because the quality of the evidence has been assessed as very low certainty (RR 0.92, 95% CI 0.30 to 2.81). Soft midsole versus hard midsole (2 studies, 1095 participants) Soft midsole shoes may make little or no difference to the number of runners sustaining a lower-limb running injuries when compared with hard midsole shoes (low-certainty of evidence) (RR 0.82, 95% CI 0.61 to 1.10). Stability versus neutral / cushioned (1 study, 57 participants) It is uncertain whether or not stability shoes reduce the number of runners sustaining a lower-limb running injuries when compared with neutral/cushioned shoes because the quality of the evidence has been assessed as very low certainty (RR 0.49, 95% CI 0.18 to 1.31). Motion control versus stability (1 study, 56 participants) It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower-limb running injuries when compared with stability shoes because the quality of the evidence has been assessed as very low certainty (RR 3.47, 95% CI 1.43 to 8.40). Running shoes prescribed and selected on foot posture (3 studies, 7203 participants) There was no evidence that running shoes prescribed based on static foot posture reduced the number of injuries compared with those who received a shoe not prescribed based on foot posture in military recruits (Rate Ratio 1.03, 95% CI 0.94 to 1.13). Subgroup analysis confirmed these findings were consistent between males and females. Therefore, prescribing running shoes and selecting on foot posture probably makes little or no difference to lower-limb running injuries (moderate-certainty evidence). Data were not available for all other review outcomes. AUTHORS' CONCLUSIONS Most evidence demonstrates no reduction in lower-limb running injuries in adults when comparing different types of running shoes. Overall, the certainty of the evidence determining whether different types of running shoes influence running injury rates was very low to low, and as such we are uncertain as to the true effects of different types of running shoes upon injury rates. There is no evidence that prescribing footwear based on foot type reduces running-related lower-limb injures in adults. The evidence for this comparison was rated as moderate and as such we can have more certainty when interpreting these findings. However, all three trials included in this comparison used military populations and as such the findings may differ in recreational runners. Future researchers should develop a consensus definition of running shoe design to help standardise classification. The definition of a running injury should also be used consistently and confirmed via health practitioners. More researchers should consider a RCT design to increase the evidence in this area. Lastly, future work should look to explore the influence of different types or running shoes upon injury rates in specific subgroups.
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Affiliation(s)
- Nicola Relph
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | | | - Ross Armstrong
- Institute of Health, University of Cumbria, Carlisle, UK
| | - Trevor D Prior
- Podiatric Surgery, Homerton University Hospital, London, UK
| | - Sally Spencer
- Health Research Institute, Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | | | - Paola Dey
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Ben Langley
- Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
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Agresta C, Giacomazzi C, Harrast M, Zendler J. 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. Front Sports Act Living 2022; 4:815675. [PMID: 35356094 PMCID: PMC8959543 DOI: 10.3389/fspor.2022.815675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/10/2022] [Indexed: 11/22/2022] Open
Abstract
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.
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Affiliation(s)
- Cristine Agresta
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
- *Correspondence: Cristine Agresta
| | - Christina Giacomazzi
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Mark Harrast
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
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Napier C, Willy RW. The Prevention and Treatment of Running Injuries: A State of the Art. Int J Sports Phys Ther 2021; 16:968-970. [PMID: 34386275 PMCID: PMC8329326 DOI: 10.26603/001c.25754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/14/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- Christopher Napier
- Department of Physical Therapy, University of British Columbia; Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University
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Hamstra-Wright KL, Huxel Bliven KC, Napier C. Training Load Capacity, Cumulative Risk, and Bone Stress Injuries: A Narrative Review of a Holistic Approach. Front Sports Act Living 2021; 3:665683. [PMID: 34124660 PMCID: PMC8192811 DOI: 10.3389/fspor.2021.665683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/14/2021] [Indexed: 01/09/2023] Open
Abstract
Bone stress injuries (BSIs) are a common orthopedic injury with short-term, and potentially long-term, effects. Training load capacity, influenced by risk factors, plays a critical role in the occurrence of BSIs. Many factors determine how one's body responds to repetitive loads that have the potential to increase the risk of a BSI. As a scientific community, we have identified numerous isolated BSI risk factors. However, we have not adequately analyzed the integrative, holistic, and cumulative nature of the risk factors, which is essential to determine an individual's specific capacity. In this narrative review, we advocate for a personalized approach to monitor training load so that individuals can optimize their health and performance. We define “cumulative risk profile” as a subjective clinical determination of the number of risk factors with thoughtful consideration of their interaction and propose that athletes have their own cumulative risk profile that influences their capacity to withstand specific training loads. In our narrative review, we outline BSI risk factors, discuss the relationship between BSIs and training load, highlight the importance of individualizing training load, and emphasize the use of a holistic assessment as a training load guide.
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Affiliation(s)
- Karrie L Hamstra-Wright
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, United States
| | - Kellie C Huxel Bliven
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States
| | - Christopher Napier
- Menrva Research Group, Faculty of Applied Science, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Vancouver, BC, Canada.,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Malisoux L, Theisen D. Can the "Appropriate" Footwear Prevent Injury in Leisure-Time Running? Evidence Versus Beliefs. J Athl Train 2021; 55:1215-1223. [PMID: 33064799 DOI: 10.4085/1062-6050-523-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Leisure-time running is one of the most popular forms of physical activity around the world. It can be practiced almost everywhere and requires mainly a pair of "appropriate" running shoes. However, the term appropriate is ambiguous, and the properties of running footwear have always generated hot debates among clinicians, coaches, and athletes, whatever the level of practice. As the main interface between the runner's foot and the ground, the shoe potentially plays an important role in managing repetitive external mechanical loads applied to the musculoskeletal system and, thus, in injury prevention. Consequently, over the last decades, running shoes have been prescribed based on matching shoe features to foot morphology. This strategy aligns with the popular belief that footwear is one of the main extrinsic factors influencing running-related injury risk. Despite a seemingly sound strategy for shoe prescription and constant progress in running-footwear technology, the injury rate remains high. Therefore, our aim in this narrative literature review is to clarify whether the prescription of appropriate footwear to prevent injury in running is evidence based, the result of logical fallacy, or just a myth. The literature presented in this review is based on a nonsystematic search of the MEDLINE database and focuses on work investigating the effect of shoe features on injury risk in runners. In addition, key elements for a proper understanding of the literature on running footwear and injury risk are addressed. In this literature review, we outline (1) the main risk factors and the mechanisms underlying the occurrence of running-related injury, (2) important methodologic considerations for generating high-level evidence, (3) the evidence regarding the influence of running-shoe features on injury risk, (4) future directions for research, and (5) final general recommendations.
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport and Health Research Group, Luxembourg Institute of Health
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10
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Abstract
Patellofemoral pain (PFP) is among the most common injuries in recreational runners. Current evidence does not identify alignment, muscle weakness, and patellar maltracking or a combination of these as causes of PFP. Rather than solely investigating biomechanics, we suggest a holistic approach to address the causes of PFP. Both external loads, such as changes in training parameters and biomechanics, and internal loads, such as sleep and psychological stress, should be considered. As for the management of runners with PFP, recent research suggested that various interventions can be considered to help symptoms, even if these interventions target biomechanical factors that may not have caused the injury in the first place. In this Current Concepts article, we describe how the latest evidence on education about training modifications, strengthening exercises, gait and footwear modifications, and psychosocial factors can be applied when treating runners with PFP. The importance of maintaining relative homeostasis between load and capacity will be emphasized. Recommendations for temporary or longer-term interventions will be discussed. A holistic, evidence-based approach should consist of a graded exposure to load, including movement, exercise, and running, while considering the capacity of the individual, including sleep and psychosocial factors. Cost, accessibility, and the personal preferences of patients should also be considered.
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Affiliation(s)
- Jean-Francois Esculier
- The Running Clinic, Lac Beauport, QC, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- MoveMed Physiotherapy, Kelowna, BC, Canada
| | - Kevin Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Lively Health Clinic, Gainesville, VA
| | - Ellora Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Peak Performance Care Physical Therapy, Sonora, CA
| | - Blaise Dubois
- The Running Clinic, Lac Beauport, QC, Canada
- Physiothérapie et médecine du sport PCN, Quebec City, QC, Canada
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11
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Malisoux L, Delattre N, Meyer C, Gette P, Urhausen A, Theisen D. Effect of shoe cushioning on landing impact forces and spatiotemporal parameters during running: results from a randomized trial including 800+ recreational runners. Eur J Sport Sci 2020; 21:985-993. [PMID: 32781913 DOI: 10.1080/17461391.2020.1809713] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractIn a recent randomized trial including 800+ recreational runners, injury risk was lower in those who received the Soft shoe version compared to those using the Hard version (Hazard ratio = 1.52; 95% Confidence Interval = 1.07-2.16). Here, we investigated the effect of shoe cushioning on ground reaction forces (GRF) and spatiotemporal parameters in the same cohort, with a special focus on Vertical Impact Peak Force (VIPF) and Vertical Instantaneous Loading Rate (VILR). Healthy runners (n = 848) randomly received one of two shoe prototypes that differed only in their cushioning properties (Global stiffness: 61 ± 3 and 95 ± 6 N/mm in the Soft and Hard versions, respectively). Participants were tested on an instrumented treadmill at their preferred running speed. GRF data was recorded over 2 min. VIPF was higher in the Soft shoe group compared to the Hard shoe group (1.53 ± 0.21 vs. 1.44 ± 0.23 BW, respectively; p < 0.001). However, the proportion of steps with detectable VIPF was lower in the Soft shoe group (84 vs. 97%, respectively; p < 0.001) and Time to VIPF was longer (46.9 ± 8.5 vs. 43.4 ± 7.4 milliseconds, respectively; p < 0.001). No significant differences were observed for VILR (60.1 ± 13.8 vs. 58.9 ± 15.6 BW/s for Soft and Hard shoe group, respectively; p = 0.070) or any other kinetic variable. These results show that the beneficial effect of greater shoe cushioning on injury risk in the present cohort is not associated with attenuated VIPF and VILR. These GRF metrics may be inappropriate markers of the shoe cushioning-injury risk relationship, while delayed VIPF and the proportion of steps displaying a VIPF could be more relevant.Trial registration: ClinicalTrials.gov identifier: NCT03115437..
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport & Health research group, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Nicolas Delattre
- Movement Sciences Department, Decathlon Sports Lab, Villeneuve d'Ascq, France
| | - Christophe Meyer
- Human motion, Orthopaedic, Sports medicine and Digital methods unit, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Paul Gette
- Human motion, Orthopaedic, Sports medicine and Digital methods unit, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Axel Urhausen
- Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Grand-Duchy of Luxembourg
| | - Daniel Theisen
- ALAN - Maladies Rares Luxembourg, Bascharage, Grand-Duchy of Luxembourg
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Rhim HC, Kim SJ, Jeon JS, Nam HW, Jang KM. Prevalence and risk factors of running-related injuries in Korean non-elite runners: a cross-sectional survey study. J Sports Med Phys Fitness 2020; 61:413-419. [PMID: 32744044 DOI: 10.23736/s0022-4707.20.11223-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Due to the lack of consensus definition of running-related injuries, the prevalence and incidence of running-related injuries had been reported to vary between 19% and 92%. Moreover, the epidemiology of running-related injuries in Asian populations has been rarely investigated. The purpose of this study was to use the consensus definition of running-related injuries and investigate the epidemiology of running-related injuries in a Korean population. METHODS Using the cross-sectional design, an online survey was circulated among various running communities in Korea. The questionnaire contained information on the presence and location of pain attributed to running, demographic characteristics, weekly running mileage, participation in high-intensity training, running pace, the longest running event participated, the type of shoes, foot strike, the reason for running, and exercise experience prior to running. RESULTS Among 1046 runners (male=624, female=422) who responded, 94.7% experienced pain while running, but only 37% were categorized as having running-related injuries. The most common site of injury was the knee followed by the ankle. Exercise experience prior to running (OR=1.57 95% CI: 1.13-2.21), setting specific running goals (OR=1.57 95% CI: 1.08-2.27), increases in weekly running mileage (OR=1.66 95% CI: 1.05-2.62), and the longest running event participated (OR=2.15 95% CI: 1.22-4.05) were associated with significant increases in running-related injuries. CONCLUSIONS To avoid running-related injuries, runners should be careful when increasing weekly mileage. Moreover, runners with previous exercise experience may need to approach running more cautiously. Setting goals and pursuing longer-distance running events may be motivating, but at the same time, can increase the risk of running-related injuries.
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Affiliation(s)
- Hye C Rhim
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sung J Kim
- Korea University College of Medicine, Seoul, South Korea
| | - Jin S Jeon
- Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hyuk W Nam
- Nam's Orthopedic Clinic, Seoul, South Korea
| | - Ki-Mo Jang
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea -
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13
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Dhillon GK, Hunt MA, Reid AL, Esculier JF. What are the perceptions of runners and healthcare professionals on footwear and running injury risk? BMJ Open Sport Exerc Med 2020; 6:e000767. [PMID: 32626599 PMCID: PMC7328975 DOI: 10.1136/bmjsem-2020-000767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives There is a gap in research exploring perceptions of runners and healthcare professionals (HCPs) about running footwear and injury risk. The objectives of this study were: (1) to document factors considered by runners when selecting footwear; (2) to compare perceptions on footwear and injury risk in runners and HCPs; and (3) to evaluate the perceived usefulness of an online educational module. Methods Using an online survey, we collected information on demographics and perceptions about footwear and injury risk. Runners reported their footwear selection strategy, and HCPs their typical recommendations. An evidence-based educational module was presented, and participants rated its usefulness. Results The survey was completed by 2442 participants, of which 1035 completed the optional postmodule questions. Runners reported relying mostly on comfort and advice from retailers when selecting shoes. Perceptions regarding the effects of specific footwear types (minimalist, maximalist), characteristics (softness, drop) and selection strategy (foot type, transition) on biomechanics and injury risk were different between HCPs and runners. Overall, runners perceived footwear as more important to prevent injury than did HCPs (7.6/10, 99% CI 7.4 to 7.7 vs 6.2/10, 99% CI 6.0 to 6.5; p<0.001). Both runners (8.1/10, 99% CI 7.9 to 8.3) and HCPs (8.7/10, 99% CI 8.6 to 8.9) found the educational module useful. A majority of respondents indicated the module changed their perceptions. Conclusion Footwear is perceived as important in reducing running injury risk. This online module was deemed useful in educating about footwear evidence. Future studies should evaluate if changes in perceptions can translate to behaviour change and, ultimately, reduced injury risk.
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Affiliation(s)
- Gurmeet K Dhillon
- Allan McGavin Sports Medicine Clinic, Vancouver, British Columbia, Canada
| | - Michael A Hunt
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada.,Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea L Reid
- Allan McGavin Sports Medicine Clinic, Vancouver, British Columbia, Canada.,Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jean-Francois Esculier
- Allan McGavin Sports Medicine Clinic, Vancouver, British Columbia, Canada.,Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada.,Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, British Columbia, Canada.,The Running Clinic, Lac-Beauport, Quebec, Canada
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14
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Fokkema T, de Vos RJ, Visser E, Krastman P, IJzerman J, Koes BW, Verhaar JAN, Bierma-Zeinstra SMA, van Middelkoop M. Enhanced injury prevention programme for recreational runners (the SPRINT study): design of a randomised controlled trial. BMJ Open Sport Exerc Med 2020; 6:e000780. [PMID: 32577303 PMCID: PMC7299036 DOI: 10.1136/bmjsem-2020-000780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Running-related injuries (RRIs) are frequent, but no effective injury prevention measures have been identified yet. Therefore, we have set up the INSPIRE trial in 2017, in which the effectiveness of an online injury prevention programme was tested. Although this programme was not effective in reducing the number of RRIs, we gained new insights from this study, which we used to design an enhanced, online multidisciplinary injury prevention programme. The aim of this study is to test the effectiveness of this enhanced injury prevention programme in a group of recreational runners. Methods and analysis For this randomised controlled trial, we aim to include 3394 recreational runners aged 18 years or older who register for a running event (distances 10 to 42.2 km). During the preparation for the running event, runners in the intervention group get access to the enhanced online injury prevention programme. This online programme consists of 10 steps, all covering separate items of RRI prevention. Runners in the control group will follow their regular preparation. With three follow-up questionnaires (1 month before, 1 week before and 1 month after the running event), the proportions of self-reported RRIs in the intervention group and the control group are compared. Ethics and dissemination An exemption for a comprehensive application has been obtained by the Medical Ethical Committee of the Erasmus MC University Medical Center, Rotterdam, the Netherlands. The results of the study will be disseminated among the running population, published in peer-reviewed international journals and presented on international conferences. Trial registration number NL7694
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Affiliation(s)
- Tryntsje Fokkema
- Department of General Practice, Erasmus MC Medical University Center, Rotterdam, The Netherlands
| | - Robert-Jan de Vos
- Department of Orthopaedics, Erasmus MC Medical University Center, Rotterdam, The Netherlands
| | - Edwin Visser
- Department of Physiotherapy, Sport Medical Center 'Sportgeneeskunde Rotterdam', Rotterdam, The Netherlands
| | - Patrick Krastman
- Department of General Practice, Erasmus MC Medical University Center, Rotterdam, The Netherlands.,Rotterdam Marathon Study Group, Rotterdam, The Netherlands
| | | | - Bart W Koes
- Department of General Practice, Erasmus MC Medical University Center, Rotterdam, The Netherlands.,Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - Jan A N Verhaar
- Department of Orthopaedics, Erasmus MC Medical University Center, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC Medical University Center, Rotterdam, The Netherlands.,Department of Orthopaedics, Erasmus MC Medical University Center, Rotterdam, The Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC Medical University Center, Rotterdam, The Netherlands
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15
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Wolthon A, Nielsen RO, Willy RW, Taylor-Haas JA, Paquette MR. Running shoes, pronation, and injuries: do beliefs of injury risk factors among running shoe salespersons and physiotherapy students align with current aetiology frameworks? FOOTWEAR SCIENCE 2020. [DOI: 10.1080/19424280.2020.1734869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Alexander Wolthon
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Huddinge, Sweden
- Department of Sport and Health Sciences, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Rasmus Oestergaard Nielsen
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Richard W. Willy
- School of Physical Therapy and Rehabilitation Sciences, University of Montana, Missoula, MT, USA
| | - Jeffery A. Taylor-Haas
- Division of Occupational Therapy & Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Max R. Paquette
- School of Health Studies, University of Memphis, Memphis, Tennessee, USA
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16
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Malisoux L, Delattre N, Urhausen A, Theisen D. Shoe Cushioning Influences the Running Injury Risk According to Body Mass: A Randomized Controlled Trial Involving 848 Recreational Runners. Am J Sports Med 2020; 48:473-480. [PMID: 31877062 DOI: 10.1177/0363546519892578] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Shoe cushioning is expected to protect runners against repetitive loading of the musculoskeletal system and therefore running-related injuries. Also, it is a common belief that heavier runners should use footwear with increased shock absorption properties to prevent injuries. PURPOSE The aim of this study was to determine if shoe cushioning influences the injury risk in recreational runners and whether the association depends on the runner's body mass. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Healthy runners (n = 848) randomly received 1 of 2 shoe prototypes that only differed in their cushioning properties. Global stiffness was 61.3 ± 2.7 and 94.9 ± 5.9 N/mm in the soft and hard versions, respectively. Participants were classified as light or heavy according to their body mass using the median as a cut-off (78.2 and 62.8 kg in male and female runners, respectively). They were followed over 6 months regarding running activity and injury (any physical complaint reducing/interrupting running activity for at least 7 days). Data were analyzed through time-to-event models with the subhazard rate ratio (SHR) and their 95% confidence interval (CI) as measures of association. A stratified analysis was conducted to investigate the effect of shoe cushioning on the injury risk in lighter and heavier runners. RESULTS The runners who had received the hard shoes had a higher injury risk (SHR, 1.52 [95% CI, 1.07-2.16]), while body mass was not associated with the injury risk (SHR, 1.00 [95% CI, 0.99-1.01]). However, after stratification according to body mass, results showed that lighter runners had a higher injury risk in hard shoes (SHR, 1.80 [95% CI, 1.09-2.98]) while heavier runners did not (SHR, 1.23 [95% CI, 0.75-2.03]). CONCLUSION The injury risk was higher in participants running in the hard shoes compared with those using the soft shoes. However, the relative protective effect of greater shoe cushioning was found only in lighter runners. REGISTRATION NCT03115437 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Laurent Malisoux
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg
| | - Nicolas Delattre
- Movement Sciences Department, Decathlon SportsLab, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg.,Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Grand Duchy of Luxembourg
| | - Daniel Theisen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg.,ALAN-Maladies Rares Luxembourg, Bascharage, Grand Duchy of Luxembourg
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17
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Hofstede H, Franke TPC, van Eijk RPA, Backx FJG, Kemler E, Huisstede BMA. In training for a marathon: Runners and running-related injury prevention. Phys Ther Sport 2019; 41:80-86. [PMID: 31783257 DOI: 10.1016/j.ptsp.2019.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate which preventive measures runners use when preparing for a half- or full-marathon and whether the use of these measures at baseline and during the preparation-period differs between runners who sustained no/non-substantial running-related injuries (NSIRs) or substantial running-related injuries (SIRs). DESIGN Prospective cohort study. SETTING 16-week period before the Utrecht Marathon. PARTICIPANTS Runners who subscribed for the half- or full-marathon. MAIN OUTCOME MEASURES The occurrence of RRIs was registered every 2-weeks, using the Dutch version of the Oslo Sport Trauma Research Center (OSTRC) questionnaire on Health Problems. The OSTRC was used to differentiate between runners with SIRs (question 2/3 score>12) and NSIRs (question 2/3 score<13). The use of different preventive measures, was registered every 4-weeks. RESULTS 51.6% of the runners reported at least one RRI in the 12-months prior to this study (history of RRIs). The SIRs with a history of RRIs more often asked for running shoe advice than NSIRs with a history of RRIs (67.9%vs43.4%, P < 0.05); 18.9% of the SIRs with a history of RRIs used supportive materials for knee and/or ankle versus 0% of NSIRs with a history of RRIs (P < 0.05). CONCLUSION SIRs with a history of RRIs might be using their preventive measures for symptom reduction or secondary prevention.
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Affiliation(s)
- H Hofstede
- Brain Center, Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - T P C Franke
- Brain Center, Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - R P A van Eijk
- Brain Center, Department of Neurology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - F J G Backx
- Brain Center, Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - E Kemler
- Consumer Safety Institute (VeiligheidNL), Amsterdam, the Netherlands
| | - B M A Huisstede
- Brain Center, Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
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18
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Abstract
BACKGROUND Effective injury prevention measures for running-related injuries (RRIs) have not yet been identified. More insight into the opinions of runners about injury prevention might help to develop effective injury prevention programs that are supported by the target population. OBJECTIVES To describe the opinions of recreational runners on different components of injury prevention, and to identify the barriers to and facilitators of injury prevention in adult recreational runners. METHODS In this comparative cross-sectional study, a single questionnaire was sent to 2378 recreational runners. The questionnaire contained questions about their interests, actions undertaken, and perceived barriers to and facilitators of injury prevention. Descriptive analyses were used to examine differences with regard to sex, age, and previous RRIs. RESULTS One thousand thirty-four adult recreational runners (43.5%) responded to the questionnaire. Runners with previous RRIs were more likely to rate injury prevention as very useful than runners who had never sustained an RRI (76.8% versus 63.6%, P<.001). In total, 81.8% of the participants indicated that they already performed preventive measures, including changes to training schedules (65.4%) and warming up and cooling down (57.8%). Most frequently reported barriers to injury prevention were "not knowing what to do" (45.2%) and "no history of RRI" (34.6%). The most important facilitator was an injury (60.1%). Women more often preferred information via a trainer or running store than did men, while men more frequently preferred websites or e-mail. CONCLUSION The majority of runners rated injury prevention as important. To increase effectiveness, future prevention programs should be developed with an awareness of the barriers and facilitators experienced by adult runners. J Orthop Sports Phys Ther 2019;49(10):736-742. Epub 23 Aug 2019. doi:10.2519/jospt.2019.9029.
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19
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Relph N, Greaves H, Armstrong R, Gichuru P, Prior TD, Griffiths IB, Spencer S, Dey P, Langley B. Running shoes for preventing lower limb running injuries in adults. Hippokratia 2019. [DOI: 10.1002/14651858.cd013368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Nicola Relph
- Edge Hill University; Faculty of Health and Social Care; Ormskirk UK
| | - Henrike Greaves
- Liverpool John Moores University; Tom Reilly Building, Byrom Street, Liverpool UK L3 3AF
| | - Ross Armstrong
- Edge Hill University; Department of Sport & Physical Activity; St Helens Road Ormskirk UK L39 4QP
| | - Phillip Gichuru
- Edge Hill University; Faculty of Health and Social Care; Ormskirk UK
| | - Trevor D Prior
- Homerton University Hospital; Podiatric Surgery; Homerton Row London UK E9 6SR
| | - Ian B Griffiths
- Pure Sports Medicine; Level 2 Cabot Place West Canary Wharf London London UK E14 4QT
| | - Sally Spencer
- Edge Hill University; Postgraduate Medical Institute; St Helens Road Ormskirk Lancashire UK L39 4QP
| | - Paola Dey
- Edge Hill University; Faculty of Health and Social Care; Ormskirk UK
| | - Ben Langley
- Edge Hill University; Department of Sport & Physical Activity; St Helens Road Ormskirk UK L39 4QP
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20
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Jafarnezhadgero A, Alavi-Mehr SM, Granacher U. Effects of anti-pronation shoes on lower limb kinematics and kinetics in female runners with pronated feet: The role of physical fatigue. PLoS One 2019; 14:e0216818. [PMID: 31086402 PMCID: PMC6516670 DOI: 10.1371/journal.pone.0216818] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/29/2019] [Indexed: 11/18/2022] Open
Abstract
Physical fatigue and pronated feet constitute two risk factors for running-related lower limb injuries. Accordingly, different running shoe companies designed anti-pronation shoes with medial support to limit over pronation in runners. However, there is little evidence on the effectiveness and clinical relevance of anti-pronation shoes. This study examined lower limb kinematics and kinetics in young female runners with pronated feet during running with anti-pronation versus regular (neutral) running shoes in unfatigued and fatigued condition. Twenty-six female runners aged 24.1±5.6 years with pronated feet volunteered to participate in this study. Kinetic (3D Kistler force plate) and kinematic analyses (Vicon motion analysis system) were conducted to record participants’ ground reaction forces and joint kinematics when running with anti-pronation compared with neutral running shoes. Physical fatigue was induced through an individualized submaximal running protocol on a motorized treadmill using rate of perceived exertion and heart rate monitoring. The statistical analyses indicated significant main effects of “footwear” for peak ankle inversion, peak ankle eversion, and peak hip internal rotation angles (p<0.03; d = 0.46–0.95). Pair-wise comparisons revealed a significantly greater peak ankle inversion angle (p<0.03; d = 0.95; 2.70°) and smaller peak eversion angle (p<0.03; d = 0.46; 2.53°) when running with anti-pronation shoes compared with neutral shoes. For kinetic data, significant main effects of “footwear” were found for peak ankle dorsiflexor moment, peak knee extensor moment, peak hip flexor moment, peak hip extensor moment, peak hip abductor moment, and peak hip internal rotator moment (p<0.02; d = 1.00–1.79). For peak positive hip power in sagittal and frontal planes and peak negative hip power in horizontal plane, we observed significant main effects of “footwear” (p<0.03; d = 0.92–1.06). Pairwise comparisons revealed that peak positive hip power in sagittal plane (p<0.03; d = 0.98; 2.39 w/kg), peak positive hip power in frontal plane (p = 0.014; d = 1.06; 0.54 w/kg), and peak negative hip power in horizontal plane (p<0.03; d = 0.92; 0.43 w/kg) were greater with anti-pronation shoes. Furthermore, the statistical analyses indicated significant main effects of “Fatigue” for peak ankle inversion, peak ankle eversion, and peak knee external rotation angles. Pair-wise comparisons revealed a fatigue-induced decrease in peak ankle inversion angle (p<0.01; d = 1.23; 2.69°) and a fatigue-induced increase in peak knee external rotation angle (p<0.05; d = 0.83; 5.40°). In addition, a fatigue-related increase was found for peak ankle eversion (p<0.01; d = 1.24; 2.67°). For kinetic data, we observed a significant main effect of “Fatigue” for knee flexor moment, knee internal rotator moment, and hip extensor moment (p<0.05; d = 0.83–1.01). The statistical analyses indicated significant a main effect of “Fatigue” for peak negative ankle power in sagittal plane (p<0.01; d = 1.25). Finally, we could not detect any significant footwear by fatigue interaction effects for all measures of joint kinetics and kinematics. Running in anti-pronation compared with neutral running shoes produced lower peak moments and powers in lower limb joints and better control in rear foot eversion. Physical fatigue increased peak moments and powers in lower limb joints irrespective of the type of footwear.
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Affiliation(s)
- AmirAli Jafarnezhadgero
- Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Seyed Majid Alavi-Mehr
- Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
- * E-mail:
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