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Haghverdian JC, Hsu AR. Maximalist Shoes: Separating Science From Hype. Foot Ankle Spec 2023:19386400231218334. [PMID: 38124257 DOI: 10.1177/19386400231218334] [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] [Indexed: 12/23/2023]
Abstract
One of the most discussed but misunderstood topics in foot and ankle is shoe wear choices and the purported benefits of each type of shoe versus their actual scientific advantages. All foot and ankle care providers should be familiar with the various shoe wear types available to patients to improve their overall foot health. Recently, mainstream popularity and media coverage of maximalist shoes has created increased interest in the science and potential clinical benefits of maximalist shoes. The purpose of this review is to present the current biomechanical evidence of maximalist shoes and to help inform the foot and ankle community of their potential therapeutic applications.Levels of Evidence: Level V.
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Affiliation(s)
- Justin C Haghverdian
- Department of Orthopaedic Surgery, University of California, Irvine, Orange, California
| | - Andrew R Hsu
- Department of Orthopaedic Surgery, University of California, Irvine, Orange, California
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Mai P, Robertz L, Robbin J, Bill K, Weir G, Kurz M, Trudeau MB, Hollander K, Hamill J, Willwacher S. Towards functionally individualised designed footwear recommendation for overuse injury prevention: a scoping review. BMC Sports Sci Med Rehabil 2023; 15:152. [PMID: 37951935 PMCID: PMC10638717 DOI: 10.1186/s13102-023-00760-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
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.
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Affiliation(s)
- Patrick Mai
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg, Germany.
- Department of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway.
| | - Leon Robertz
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Johanna Robbin
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg, Germany
| | - Kevin Bill
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Gillian Weir
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
| | - Markus Kurz
- Sports Tech Research Centre, Mid Sweden University, Östersund, Sweden
| | | | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts Amherst, Amherst, MA, USA
| | - Steffen Willwacher
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg, Germany
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Quan W, Gao L, Xu D, Zhou H, Korim T, Shao S, Baker JS, Gu Y. Simulation of Lower Limb Muscle Activation Using Running Shoes with Different Heel-to-Toe Drops Using Opensim. Healthcare (Basel) 2023; 11:healthcare11091243. [PMID: 37174785 PMCID: PMC10178672 DOI: 10.3390/healthcare11091243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Although numerous studies have been conducted to investigate the acute effects of shoe drops on running kinematics and kinetic variables, their effects on muscle forces remain unknown. Thus, the primary aim of this study was to compare the muscle force, kinematics, and kinetic variables of habitually rearfoot runners with heel-to-toe drops of negative 8 mm shoes (minimalist shoes) and positive 9 mm shoes (normal shoes) during the running stance phase by using musculoskeletal modeling and simulation techniques. METHODS Experimental data of lower limb kinematics, ground reaction force, and muscle activation from 16 healthy runners with rearfoot strike patterns were collected and analyzed in OpenSim. Using Matlab, the statistical parameter mapping paired t-test was used to compare the joint angle, moment, and muscle force waveform. RESULTS The results revealed differences in the sagittal ankle and hip angles and sagittal knee moments between the different heel-to-toe drops of running shoes. Specifically, it showed that the negative 8 mm running shoes led to significantly smaller values than the positive 9 mm running shoes in terms of the angle of ankle dorsiflexion, ankle eversion, knee flexion, hip flexion, and hip internal and hip external rotation. The peak ankle dorsiflexion moment, ankle plantarflexion moment, ankle eversion moment, knee flexion moment, knee abduction moment, and knee internal rotation also decreased obviously with the minimalist running shoes, while the lateral gastrocnemius, Achilleas tendon, and extensor hallucis longus muscles were obviously greater in the minimalist shoes compared to normal shoes. The vastus medialis, vastus lateralis and extensor digitorum longus muscles force were smaller in the minimalist shoes. CONCLUSIONS Runners may shift to a midfoot strike pattern when wearing negative running shoes. High muscle forces in the gastrocnemius lateral, Achilleas tendon, and flexor hallucis longus muscles may also indicate an increased risk of Achilleas tendonitis and ankle flexor injuries.
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Affiliation(s)
- Wenjing Quan
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Department of Materials Engineering, Faculty of Engineering, University of Pannonia, H-8201 Veszprem, Hungary
| | - Linna Gao
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Department of Materials Engineering, Faculty of Engineering, University of Pannonia, H-8201 Veszprem, Hungary
| | - Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- School of Health and Life Sciences, University of the West of Scotland, Glasgow G72 0LH, UK
| | - Tamás Korim
- Department of Materials Engineering, Faculty of Engineering, University of Pannonia, H-8201 Veszprem, Hungary
| | - Shirui Shao
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
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Sánchez-Ramírez C, Ramsey C, Palma-Oyarce V, Herrera-Hernández E, Aedo-Muñoz E. Heel-to-toe drop of running shoes: a systematic review of its biomechanical effects. FOOTWEAR SCIENCE 2023. [DOI: 10.1080/19424280.2023.2180542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Affiliation(s)
- Celso Sánchez-Ramírez
- Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile
| | - Codi Ramsey
- Institute of Sport, Exercise, and Health, Otago Polytechnic, Dunedin, New Zealand
| | - Valentina Palma-Oyarce
- Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile
| | - Eduardo Herrera-Hernández
- Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile
| | - Esteban Aedo-Muñoz
- Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile
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Zhang M, Cui J, Liu H. Effect of Flat Running Shoes on Hip Kinematics in Male Recreational Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16473. [PMID: 36554352 PMCID: PMC9778694 DOI: 10.3390/ijerph192416473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Patellofemoral joint pain and iliotibial band syndrome are very common running-related injuries. Excessive contralateral pelvic drop, hip adduction, and hip internal rotation have been suggested to be associated with the two injuries. The purpose of this repeated measures and the cross-sectional study was to investigate the effect of flat running shoes on these kinematic variables compared with that of conventional running shoes with a 10 mm drop. Eighteen male recreational runners were recruited to run in flat shoes and conventional shoes with a 10 mm drop, in random order. Impact force data and lower extremity kinematics were synchronously obtained using two Kistler force plates and eight motion infrared cameras, whereas differences in the impact force and hip kinematics were compared using statistical parametric mapping. Regarding hip kinematics, the hip flexion (p = 0.004) and adduction angles (p = 0.004) decreased significantly at 30-70% and 62-85% of the stance phase, respectively, while wearing flat running shoes; the contralateral pelvic drop angle (p = 0.001) decreased significantly at 31-75% of the stance phase while wearing flat running shoes. The knee internal rotation angle (p = 0.035) decreased significantly at 8-17% of the stance phase while wearing flat running shoes compared with conventional running shoes. Given that these kinematic variables are associated with patellofemoral joint pain and iliotibial band syndrome, flat running shoes may have potential benefits for the prevention or treatment of knee injuries.
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Affiliation(s)
- Masen Zhang
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Jing Cui
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Hui Liu
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
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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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Andrade RÉ, Santos TRT. A escolha do calçado por corredores amadores: caracterização e associação com o histórico de lesão auto reportada. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22016129042022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
RESUMO O calçado é um elemento importante para a prática de corrida. As evidências sobre os impactos das características do calçado e de sua prescrição nas lesões de corredores são restritas. Dessa forma, os objetivos deste estudo foram investigar o processo de escolha do calçado por corredores e verificar se variáveis relacionadas ao calçado e seu processo de escolha estavam associadas à presença e recorrência de lesão no último ano. Foi realizado um estudo observacional com 254 corredores que responderam um questionário autoadministrado sobre características demográficas, a prática esportiva, o calçado e o processo de sua escolha, e lesões ocorridas nos últimos 12 meses. O teste qui-quadrado foi empregado para verificar se havia diferença na distribuição das respostas de cada questão, enquanto o teste de regressão logística para verificar se as variáveis relacionadas ao calçado e ao processo de escolha predizem a presença e recorrência de lesão no último ano. Os resultados indicaram que a maioria dos corredores possui tênis específico para a prática esportiva e considera algumas características ao adquiri-lo, como o amortecimento intermediário e a diferença na altura do solado entre a parte posterior e a anterior de aproximadamente 10mm. A maioria indica conhecer seu tipo de pisada, mas não a considera na escolha do calçado. Além disso, a maioria não usa palmilha e não recebeu orientação para a escolha do calçado. O modelo obtido com a regressão não foi significativo. Assim, apesar de os corredores considerarem as características do calçado ao adquiri-lo, essas características e o processo de escolha não foram associados à presença e recorrência de lesão nos últimos 12 meses.
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Andrade RÉ, Santos TRT. Selection of running shoes by amateur runners: characterization and association with the self-reported history of injury. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22016129042022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
ABSTRACT Running shoes are an essential element for sports practice. Evidence on the effect of the shoe characteristics and prescription in running injuries are scarce. Thus, this study aimed to investigate runners's process of choosing running shoes and to verify whether the variables related to running shoes and their selection process are associated with the presence and recurrence of injuries in the previous year. An observational study was conducted with 254 runners who answered a self-reported questionnaire about demographics, sports practice, shoe characteristics and selection criteria, and injuries in the last 12 months. The chi-square test evaluated whether there was a difference in the distribution of answers to each question. The logistic regression evaluated whether the variables related to shoes and selection criteria predicted injury’s presence and recurrence in the previous year. The results showed that most runners had specific shoes for sports practice and considered some characteristics of the shoes to choose them, including intermediate cushioning and a difference in the heel-to-toe drop of approximately 10mm. Most respondents indicated knowing their foot type but not considering it when choosing shoes. Besides, most individuals did not use foot orthotics and did not receive guidance to select their shoes. The model obtained with the regression was not significant. Therefore, despite considering shoe characteristics when choosing it, these features and the selection criteria were not associated with the presence and recurrence of injuries in the previous 12 months.
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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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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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Fu F, Guo L, Tang X, Wang J, Xie Z, Fekete G, Cai Y, Hu Q, Gu Y. Effect of the Innovative Running Shoes With the Special Midsole Structure on the Female Runners’ Lower Limb Biomechanics. Front Bioeng Biotechnol 2022; 10:866321. [PMID: 35733527 PMCID: PMC9208082 DOI: 10.3389/fbioe.2022.866321] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/27/2022] [Indexed: 11/21/2022] Open
Abstract
The study aimed to research the effects of innovative running shoes (a high heel-to-toe drop and special structure of midsole) on the biomechanics of the lower limbs and perceptual sensitivity in female runners. Fifteen healthy female runners were recruited to run through a 145-m runway with planted force plates at one peculiar speed (3.6 m/s ± 5%) with two kinds of shoe conditions (innovative running shoes vs. normal running shoes) while getting biomechanical data. The perception of shoe characteristics was assessed simultaneously through a 15-cm visual analog scale. The statistical parametric mapping technique calculated the time-series parameters. Regarding 0D parameters, the ankle dorsiflexion angle of innovative running shoes at touchdown was higher, and the peak dorsiflexion angle, range of motion, peak dorsiflexion velocity, and plantarflexion moment on the metatarsophalangeal joint of innovative running shoes during running were significantly smaller than those of normal running shoes (all p < 0.001). In addition, the braking phase and the time of peak vertical force 1 of innovative running shoes were found to be longer than those of normal running shoes (both p < 0.05). Meanwhile, the average vertical loading rate 1, peak vertical loading rate 1, peak braking force, and peak vertical force 1 in the innovative running shoes were lower than those of the normal running shoes during running (both p < 0.01). The statistical parametric mapping analysis exhibited a higher ankle dorsiflexion angle (0–4%, p < 0.05), a smaller knee internal rotation angle (0–6%, p < 0.05) (63–72%, p < 0.05), a decreased vertical ground reaction force (11–17%, p = 0.009), and braking anteroposterior ground reaction force (22–27%, p = 0.043) for innovative running shoes than normal running shoes. Runners were able to perceive the cushioning of innovative running shoes was better than that of normal running shoes. These findings suggested combining the high offset and structure of the midsole would benefit the industrial utilization of shoe producers in light of reducing the risk of running injuries for female runners.
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Affiliation(s)
- Fengqin Fu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Doctoral School on Safety and Security Sciences, Óbuda University, Budapest, Hungary
- Science Laboratory, Innovation center of Xtep Co., Ltd., Xiamen, China
| | - Lianming Guo
- Science Laboratory, Innovation center of Xtep Co., Ltd., Xiamen, China
| | - Xunfei Tang
- Science Laboratory, Innovation center of Xtep Co., Ltd., Xiamen, China
| | - Jiayu Wang
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Zhihao Xie
- Science Laboratory, Innovation center of Xtep Co., Ltd., Xiamen, China
| | - Gusztáv Fekete
- Savaria Institute of Technology, Eötvös Loránd University, Budapest, Hungary
| | - Yuhui Cai
- Science Laboratory, Innovation center of Xtep Co., Ltd., Xiamen, China
| | - Qiuli Hu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- *Correspondence: Yaodong Gu,
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12
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Roggio F, Trovato B, Zanghì M, Petrigna L, Testa G, Pavone V, Musumeci G. Running Footwear and Impact Peak Differences in Recreational Runners. BIOLOGY 2022; 11:biology11060818. [PMID: 35741339 PMCID: PMC9219650 DOI: 10.3390/biology11060818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary Running is a physical activity practiced by many people to maintain good levels of movement. Recreational runners commonly strike the ground with the postero–lateral zone of the foot, which may be associated with a higher biomechanical load on the lower limb, called impact peak. Different running shoes with specific cushioning are available to overcome the biomechanical load, e.g., shoes with a thickness difference between the forefoot and heel parts of the sole, called heel-to-toe drop. Analyzing the running pattern of recreational runners may be challenging because biomechanics laboratories mainly analyze these characteristics in individuals with visible alterations. To overcome these limitations, we employed a 3D markerless system; furthermore, we investigated footwear use. These parameters were studied to understand the behavior of those runners with and without a higher impact peak. Thirty participants underwent a running analysis and a questionnaire about their footwear. The study’s main finding highlighted kinematic and spatiotemporal differences between the runners presenting a higher impact peak and those without it. Furthermore, we observed that runners without an impact peak prefer shoes with a lower heel-to-toe drop, while the other group prefers shoes with a higher heel-to-toe drop. Investigating biomechanics characteristics is essential to reduce possible injury. Abstract Running is a physical activity and the investigation of its biomechanical aspects is crucial both to avoid injuries and enhance performance. Recreational runners may be liable to increased stress over the body, particularly to lower limb joints. This study investigates the different running patterns of recreational runners by analyzing characteristics of the footwear impact peak, spatiotemporal, and kinematic parameters among those that present with a peak impact and those that do not, with a 3D markerless system. Thirty recreational runners were divided into two groups: impact peak group (IP) (n = 16) and no impact peak group (n = 14) (n-IP). Kinematic and spatiotemporal parameters showed a large Cohen’s d effect size between the groups. The mean hip flexion was IP 40.40° versus n-IP 32.30° (d = −0.82). Hip extension was IP 30.20° versus n-IP 27.70° (d = −0.58), and ankle dorsiflexion was IP 20.80°, versus n-IP 13.37° (d = −1.17). Stride length was IP 117.90 cm versus n-IP 105.50 cm (d = −0.84). Steps per minute was IP group 170 spm, versus n-IP 163 spm (d = −0.51). The heel-to-toe drop was mainly 10–12 mm for the IP group and 4–6 mm for the n-IP group. Recreational runners whose hip extension is around 40°, ankle dorsiflexion around 20°, and initial foot contact around 14°, may be predisposed to the presence of an impact peak.
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Affiliation(s)
- Federico Roggio
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Bruno Trovato
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
| | - Marta Zanghì
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
| | - Luca Petrigna
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
| | - Gianluca Testa
- Section of Orthopaedics and Traumatology, Department of General Surgery and Medical Surgical Specialties, University Hospital Policlinico “Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.T.); (V.P.)
| | - Vito Pavone
- Section of Orthopaedics and Traumatology, Department of General Surgery and Medical Surgical Specialties, University Hospital Policlinico “Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.T.); (V.P.)
| | - Giuseppe Musumeci
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
- Correspondence: ; Tel.: +39-095-378-2043
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13
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Ramsey CA, Lamb P, Ribeiro DC. Factors Influencing Runner's Choices of Footwear. Front Sports Act Living 2022; 4:829514. [PMID: 35434615 PMCID: PMC9008269 DOI: 10.3389/fspor.2022.829514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Until the mid-2000s, qualitative research has been virtually absent from running injury research. A handful of studies have been recently published regarding the attitudes and perceptions of runners and coaches toward injury development. Footwear is frequently perceived as a risk factor for running related injuries, but empeirical evidence fails to support such beliefs. The reasons why runners choose specific footwear warrants formal investigation to further understand the links between footwear and running related injuries. This study aimed to investigate the factors influencing runners choices of footwear. Interviews were conducted with 12 runners. Recordings from the interviews were transcribed verbatim and themes were developed using thematic analysis. Findings revealed 15 unique factors that influence runner's choices of footwear for running. These factors were grouped into three main themes: personal footwear characteristic preferences, other people and economic considerations. Runners largely gather information about their footwear choices from past experiences and people they trust and admire. They also emphasized the complexity of footwear choices due to availability and the constant changes preset within the footwear industry. This research adds to the growing body of knowledge to better understand the wider running injury system. Further studies are needed to establish how runners perceptions of their footwear impact injury rates and to develop effective injury prevention strategies.
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Affiliation(s)
- Codi A. Ramsey
- Institute of Sport, Exercise and Health, Otago Polytechnic, Dunedin, New Zealand
- *Correspondence: Codi A. Ramsey
| | - Peter Lamb
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Daniel Cury Ribeiro
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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14
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Zhang M, Zhou X, Zhang L, Liu H, Yu B. The effect of heel-to-toe drop of running shoes on patellofemoral joint stress during running. Gait Posture 2022; 93:230-234. [PMID: 35183841 DOI: 10.1016/j.gaitpost.2022.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 01/09/2022] [Accepted: 02/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Traditional running shoes with heel-to-toe drops is thought to be a contributor to increased patellofemoral joint stress, which is proposed as a mechanism of patellofemoral pain. RESEARCH QUESTION Is there an increase in patellofemoral joint stress when running in shoes with drops compared to running in shoes without a drop? METHODS Lower limbs kinematics and ground reaction force were collected from eighteen healthy runners during over-ground running in shoes with 15 mm, 10 mm, 5 mm drops, and without a drop. Patellofemoral joint force and stress were calculated from the kinematic and kinetic data using a biomechanical model of the patellofemoral joint. RESULTS The peak patellofemoral joint stress was increased by more than 15% when running in shoes with 15 mm and 10 mm drops compared to running in shoes without a drop (p = 0.003, p = 0.001). The knee flexion angle was significantly increased when running in shoes with 15 mm, 10 mm and 5 mm drops (p = 0.014, p = 0.003, p = 0.002), the knee extension moment (p = 0.009, p = 0.002) and patellofemoral joint force (p = 0.003, p = 0.001) were increased when running in shoes with 15 mm and 10 mm drops, compared to running in shoes without a drop. SIGNIFICANCE Compared to running in shoes without a drop, running in shoes with drops > 5 mm increase the peak patellofemoral joint stress significantly, which is mainly due to the increased knee extension moment.
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Affiliation(s)
- Masen Zhang
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing, China
| | - Xinglong Zhou
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing, China
| | - Liwen Zhang
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hui Liu
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.
| | - Bing Yu
- Center for Human Movement Science, Division of Physical Therapy, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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15
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Yu P, He Y, Gu Y, Liu Y, Xuan R, Fernandez J. Acute Effects of Heel-to-Toe Drop and Speed on Running Biomechanics and Strike Pattern in Male Recreational Runners: Application of Statistical Nonparametric Mapping in Lower Limb Biomechanics. Front Bioeng Biotechnol 2022; 9:821530. [PMID: 35155415 PMCID: PMC8833076 DOI: 10.3389/fbioe.2021.821530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022] Open
Abstract
With the increased popularity of running, many studies have been conducted into footwears that are highly related to running performance and running-related injuries. Previous studies investigated different shoe types and running shoes with different heel-to-toe drops (HTDs). However, no research was found in investigating shoes with negative values with HTD. Therefore, the aim of this study was to determine the acute effect of HTD and running speed on lower limb biomechanics and strike pattern in recreational runners. Thirteen male recreational runners wearing shoes with two different HTDs (−8 and 8 mm) performed running at three different speeds (preferred speed [PS], 90% of PS, 110% of PS). Lower extremity kinematics and ground reaction forces were synchronously captured via Vicon motion analysis system and AMTI force platform. Strike index (SI), vertical average loading rate (VALR), vertical instantaneous loading rate (VILR), excursion, eversion duration, joint angles, and range of motion (ROM) of metatarsophalangeal (MTP), ankle, knee, and hip joints were calculated. Joint angles during the entire stance phase were analyzed applying the statistical nonparametric mapping (SnPM) method. SI and VILR in shoes with −8 mm HTD significantly increased by 18.99% and 31.836 BW/s compared to those with 8 mm HTD (SI: p = 0.002; VILR: p < 0.001). Significant alterations of ROM occurred in the MTP, ankle, and knee joints (p < 0.05), and HTD factor primarily accounted for these changes. Joint angles (MTP, knee, and hip) during the entire stance phase altered due to HTD and speed factors. Running speed primarily influenced the kinematics parameters of knee and hip joints, increasing knee angles in the frontal plane and hip angle in the horizontal plane at PS (p > 0.05). Compared to shoes with 8 mm HTD, shoes with −8 mm HTD may be useful to storage and return energy because of the increased ROM of MTP in the sagittal plane. Besides, forefoot strike gait retraining was recommended before transition from normal running shoes to running shoes with −8 mm HTD.
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Affiliation(s)
- Peimin Yu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Yuhuan He
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- *Correspondence: Yaodong Gu, ; Rongrong Xuan,
| | - Yuwei Liu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Rongrong Xuan
- Obsterical Department, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
- *Correspondence: Yaodong Gu, ; Rongrong Xuan,
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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16
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Bermon S. Evolution of distance running shoes: performance, injuries, and rules. J Sports Med Phys Fitness 2021; 61:1073-1080. [PMID: 34256537 DOI: 10.23736/s0022-4707.21.12728-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over the last 50 years, the development of running shoes has been mainly focused on improving the protection and comfort of the runner and her/his foot. Although there have been tentative attempts by companies to make shoes a tool for improving athletic performance, this goal has only recently been achieved. Indeed, the year 2016 was a real turning point when Nike launched its first shoe benefiting from the advanced footwear technology. Advanced footwear technology (AFT) mostly consists of an increased sole thickness, a curved and stiff plate embedded or below the shoe midsole, and an outsole with a marked concave shape. This innovation turned to a game changer in the world of distances running performance. Indeed, between 2016 and 2019, many male and female runners broke personal best times, national records, area, and world records in distance from 5 km to the marathon. The present article aimed at describing the magnitude of these performance enhancements in distance running as well as and the possible underlying performance-enhancement mechanisms associated with the advanced footwear technology. It also reviewed the existing literature on the safety aspects of "classical" construction shoes and AFT shoes. It concluded on a possible shoe mechanical tests-based protocol to maintain fair distance running competitions while not totally preventing manufacturers to innovate, and some thoughts on the nature and goals of further studies to be conducted to assess the safety (macro- and micro-traumatic) AFT in both elite and recreational runner populations.
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Affiliation(s)
- Stéphane Bermon
- Laboratory of Human Motricity, Expertise, Sport, Health, Côte d'Azur University, Nice, France -
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17
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Blazey P, Michie TV, Napier C. A narrative review of running wearable measurement system accuracy and reliability: can we make running shoe prescription objective? FOOTWEAR SCIENCE 2021. [DOI: 10.1080/19424280.2021.1878287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Paul Blazey
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Christopher Napier
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Burnaby,Canada
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18
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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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19
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What are the Benefits and Risks Associated with Changing Foot Strike Pattern During Running? A Systematic Review and Meta-analysis of Injury, Running Economy, and Biomechanics. Sports Med 2021; 50:885-917. [PMID: 31823338 DOI: 10.1007/s40279-019-01238-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Running participation continues to increase. The ideal strike pattern during running is a controversial topic. Many coaches and therapists promote non-rearfoot strike (NRFS) running with a belief that it can treat and prevent injury, and improve running economy. OBJECTIVE The aims of this review were to synthesise the evidence comparing NRFS with rearfoot strike (RFS) running patterns in relation to injury and running economy (primary aim), and biomechanics (secondary aim). DESIGN Systematic review and meta-analysis. Consideration was given to within participant, between participant, retrospective, and prospective study designs. DATA SOURCES MEDLINE, EMBASE, CINAHL, and SPORTDiscus. RESULTS Fifty-three studies were included. Limited evidence indicated that NRFS running is retrospectively associated with lower reported rates of mild (standard mean difference (SMD), 95% CI 3.25, 2.37-4.12), moderate (3.65, 2.71-4.59) and severe (0.93, 0.32-1.55) repetitive stress injury. Studies prospectively comparing injury risk between strike patterns are lacking. Limited evidence indicated that running economy did not differ between habitual RFS and habitual NRFS runners at slow (10.8-11.0 km/h), moderate (12.6-13.5 km/h), and fast (14.0-15.0 km/h) speeds, and was reduced in the immediate term when an NRFS-running pattern was imposed on habitual RFS runners at slow (10.8 km/h; SMD = - 1.67, - 2.82 to - 0.52) and moderate (12.6 km/h; - 1.26, - 2.42 to - 0.10) speeds. Key biomechanical findings, consistently including both comparison between habitual strike patterns and following immediate transition from RFS to NRFS running, indicated that NRFS running was associated with lower average and peak vertical loading rate (limited-moderate evidence; SMDs = 0.72-2.15); lower knee flexion range of motion (moderate-strong evidence; SMDs = 0.76-0.88); reduced patellofemoral joint stress (limited evidence; SMDs = 0.63-0.68); and greater peak internal ankle plantar flexor moment (limited evidence; SMDs = 0.73-1.33). CONCLUSION The relationship between strike pattern and injury risk could not be determined, as current evidence is limited to retrospective findings. Considering the lack of evidence to support any improvements in running economy, combined with the associated shift in loading profile (i.e., greater ankle and plantarflexor loading) found in this review, changing strike pattern cannot be recommended for an uninjured RFS runner. PROSPERO REGISTRATION CRD42015024523.
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20
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Honert EC, Mohr M, Lam WK, Nigg S. Shoe feature recommendations for different running levels: A Delphi study. PLoS One 2020; 15:e0236047. [PMID: 32673375 PMCID: PMC7365446 DOI: 10.1371/journal.pone.0236047] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022] Open
Abstract
Providing runners with footwear that match their functional needs has the potential to improve footwear comfort, enhance running performance and reduce the risk of overuse injuries. It is currently not known how footwear experts make decisions about different shoe features and their properties for runners of different levels. We performed a Delphi study in order to understand: 1) definitions of different runner levels, 2) which footwear features are considered important and 3) how these features should be prescribed for runners of different levels. Experienced academics, journalists, coaches, bloggers and physicians that examine the effects of footwear on running were recruited to participate in three rounds of a Delphi study. Three runner level definitions were refined throughout this study based on expert feedback. Experts were also provided a list of 20 different footwear features. They were asked which features were important and what the properties of those features should be. Twenty-four experts, most with 10+ years of experience, completed all three rounds of this study. These experts came to a consensus for the characteristics of three different running levels. They indicated that 12 of the 20 footwear features initially proposed were important for footwear design. Of these 12 features, experts came to a consensus on how to apply five footwear feature properties for all three different running levels. These features were: upper breathability, forefoot bending stiffness, heel-to-toe drop, torsional bending stiffness and crash pad. Interestingly, the experts were not able to come to a consensus on one of the most researched footwear features, rearfoot midsole hardness. These recommendations can provide a starting point for further biomechanical studies, especially for features that are considered as important, but have not yet been examined experimentally.
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Affiliation(s)
- Eric C. Honert
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - Maurice Mohr
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Institue of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China
- Department of Kinesiology, Shenyang Sport University, Shenyang, China
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods company, Beijing, China
| | - Sandro Nigg
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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21
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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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22
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Hoitz F, Mohr M, Asmussen M, Lam WK, Nigg S, Nigg B. The effects of systematically altered footwear features on biomechanics, injury, performance, and preference in runners of different skill level: a systematic review. FOOTWEAR SCIENCE 2020. [DOI: 10.1080/19424280.2020.1773936] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Fabian Hoitz
- Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, University of Calgary, Calgary, Alberta, Canada
| | - Maurice Mohr
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Sports Science, University of Innsbruck, Innsbruck, Austria
| | - Michael Asmussen
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Health and Physical Education, Mount Royal University, Calgary, Alberta, Canada
| | - Wing-Kai Lam
- Li Ning Sports Science Research Center, Beijing, China
| | - Sandro Nigg
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Benno Nigg
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Marchena-Rodriguez A, Ortega-Avila AB, Cervera-Garvi P, Cabello-Manrique D, Gijon-Nogueron G. Review of Terms and Definitions Used in Descriptions of Running Shoes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103562. [PMID: 32438717 PMCID: PMC7277478 DOI: 10.3390/ijerph17103562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Our study aim is to identify and describe the definitions used for different types of running shoes. In addition, we highlight the existence of gaps in these concepts and propose possible new approaches. Methods: This review was undertaken in line with the guidelines proposed by Green et al., based on a literature search (until December 2019) of the PubMed, Web of Science, Scopus, SPORTDiscus and Google Scholar databases. A total of 23 papers met the inclusion criteria applied to identify the definition of running shoes. RESULTS Although there is a certain consensus on the characteristics of minimalist footwear, it is also described by other terms, such as barefoot-style or barefoot-simulating. Diverse terms are also used to describe other types of footwear, and in these cases, there is little or no consensus regarding their characteristics. CONCLUSIONS The terms barefoot-simulated footwear, barefoot-style footwear, lightweight shoes and full minimalist shoes are all used to describe minimalist footwear. The expressions partial minimalist, uncushioned minimalist and transition shoes are used to describe footwear with non-consensual characteristics. Finally, labels such as shod shoes, standard cushioned running shoes, modern shoes, neutral protective running shoes, conventional, standardised, stability style or motion control shoes span a large group of footwear styles presenting different properties.
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Affiliation(s)
- Ana Marchena-Rodriguez
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain; (A.M.-R.); (P.C.-G.); (G.G.-N.)
| | - Ana Belen Ortega-Avila
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain; (A.M.-R.); (P.C.-G.); (G.G.-N.)
- Correspondence:
| | - Pablo Cervera-Garvi
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain; (A.M.-R.); (P.C.-G.); (G.G.-N.)
| | - David Cabello-Manrique
- Department of Physical Education and Sports, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain;
| | - Gabriel Gijon-Nogueron
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain; (A.M.-R.); (P.C.-G.); (G.G.-N.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain
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Mo S, Lam WK, Ching ECK, Chan ZYS, Zhang JH, Cheung RTH. Effects of heel-toe drop on running biomechanics and perceived comfort of rearfoot strikers in standard cushioned running shoes. FOOTWEAR SCIENCE 2020. [DOI: 10.1080/19424280.2020.1734868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Shiwei Mo
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, China
| | - Wing-Kai Lam
- Department of Kinesiology, Shenyang Sport University, Shenyang, China
- Guandong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China
- Li Ning Sports Research Center, Li Ning (China) Sports Goods Co. Ltd, Beijing, China
| | - Eric C. K. Ching
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, China
| | - Zoe Y. S. Chan
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, China
| | - Janet H. Zhang
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, China
| | - Roy T. H. Cheung
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, China
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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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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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Toresdahl BG, McElheny K, Metzl J, Ammerman B, Chang B, Kinderknecht J. A Randomized Study of a Strength Training Program to Prevent Injuries in Runners of the New York City Marathon. Sports Health 2019; 12:74-79. [PMID: 31642726 DOI: 10.1177/1941738119877180] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Lower extremity overuse injuries are common among runners, especially first-time marathoners. Hip abductor and quadriceps strengthening is often recommended to reduce running-related injuries. HYPOTHESIS A 12-week strength training program would decrease the rate of overuse injuries resulting in marathon noncompletion and improve race finishing time. STUDY DESIGN Randomized trial. LEVEL OF EVIDENCE Level 2. METHODS Twelve weeks before the New York City Marathon, first-time marathon runners age 18 years and older were randomized into a strength training group or an observation group. The strength training group was instructed to perform a 10-minute program 3 times weekly using written and video instruction. This program targeted the quadriceps, hip abductor, and core muscle groups. Injuries were self-reported through biweekly surveys, with major injuries being those that resulted in marathon noncompletion and minor injuries being those that impaired training or race performance. RESULTS A total of 720 runners were enrolled (mean age, 35.9 ± 9.4 years; 69.4% female), of whom 583 runners started the marathon and 579 completed it. The incidence of major injury was 8.9% and minor injury was 48.5%. Fifty two of 64 major injuries were overuse, of which 20 were bone stress injuries. The incidence of overuse injury resulting in marathon noncompletion was 7.1% in the strength training group and 7.3% in the observation group (risk ratio, 0.97; 95% CI, 0.57-1.63; P = 0.90). The mean finishing time was 5 hours 1 ± 60 minutes in the strength training group and 4 hours 58 ± 55 minutes in the observation group (P = 0.35). CONCLUSION There is a high prevalence of injury among first-time marathon runners, but this self-directed strength training program did not decrease overuse injury incidence resulting in marathon noncompletion. CLINICAL RELEVANCE Prevention strategies such as strength training need to be developed and evaluated through clinical trials to reduce the high prevalence of overuse injuries in runners, especially for high-risk populations such as first-time marathon runners.
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Affiliation(s)
- Brett G Toresdahl
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, New York
| | - Kathryn McElheny
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, New York
| | - Jordan Metzl
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, New York
| | | | | | - James Kinderknecht
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, New York
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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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Nielsen RO, Bertelsen ML, Ramskov D, Damsted C, Verhagen E, Bredeweg SW, Theisen D, Malisoux L. Randomised controlled trials (RCTs) in sports injury research: authors—please report the compliance with the intervention. Br J Sports Med 2019; 54:51-57. [DOI: 10.1136/bjsports-2019-100858] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2019] [Indexed: 11/03/2022]
Abstract
BackgroundIn randomised controlled trials (RCTs) of interventions that aim to prevent sports injuries, the intention-to-treat principle is a recommended analysis method and one emphasised in the Consolidated Standards of Reporting Trials (CONSORT) statement that guides quality reporting of such trials. However, an important element of injury prevention trials—compliance with the intervention—is not always well-reported. The purpose of the present educational review was to describe the compliance during follow-up in eight large-scale sports injury trials and address compliance issues that surfaced. Then, we discuss how readers and researchers might consider interpreting results from intention-to-treat analyses depending on the observed compliance with the intervention.MethodsData from seven different randomised trials and one experimental study were included in the present educational review. In the trials that used training programme as an intervention, we defined full compliance as having completed the programme within ±10% of the prescribed running distance (ProjectRun21 (PR21), RUNCLEVER, Start 2 Run) or time-spent-running in minutes (Groningen Novice Running (GRONORUN)) for each planned training session. In the trials using running shoes as the intervention, full compliance was defined as wearing the prescribed running shoe in all running sessions the participants completed during follow-up.ResultsIn the trials that used a running programme intervention, the number of participants who had been fully compliant was 0 of 839 (0%) at 24-week follow-up in RUNCLEVER, 0 of 612 (0%) at 14-week follow-up in PR21, 12 of 56 (21%) at 4-week follow-up in Start 2 Run and 8 of 532 (1%) at 8-week follow-up in GRONORUN. In the trials using a shoe-related intervention, the numbers of participants who had been fully compliant at the end of follow-up were 207 of 304 (68%) in the 21 week trial, and 322 of 423 (76%), 521 of 577 (90%), 753 of 874 (86%) after 24-week follow-up in the other three trials, respectively.ConclusionThe proportion of runners compliant at the end of follow-up ranged from 0% to 21% in the trials using running programme as intervention and from 68% to 90% in the trials using running shoes as intervention. We encourage sports injury researchers to carefully assess and report the compliance with intervention in their articles, use appropriate analytical approaches and take compliance into account when drawing study conclusions. In studies with low compliance, G-estimation may be a useful analytical tool provided certain assumptions are met.
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Nielsen RØ, Bertelsen ML, Ramskov D, Damsted C, Brund RK, Parner ET, Sørensen H, Rasmussen S, Kjærgaard S. The Garmin-RUNSAFE Running Health Study on the aetiology of running-related injuries: rationale and design of an 18-month prospective cohort study including runners worldwide. BMJ Open 2019; 9:e032627. [PMID: 31494626 PMCID: PMC6731941 DOI: 10.1136/bmjopen-2019-032627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Running injuries affect millions of persons every year and have become a substantial public health issue owing to the popularity of running. To ensure adherence to running, it is important to prevent injuries and to have an in-depth understanding of the aetiology of running injuries. The main purpose of the present paper was to describe the design of a future prospective cohort study exploring if a dose-response relationship exists between changes in training load and running injury occurrence, and how this association is modified by other variables. METHODS AND ANALYSIS In this protocol, the design of an 18-month observational prospective cohort study is described that will include a minimum of 20 000 consenting runners who upload their running data to Garmin Connect and volunteer to be a part of the study. The primary outcome is running-related injuries categorised into the following states: (1) no injury; (2) a problem; and (3) injury. The primary exposure is change in training load (eg, running distance and the cumulative training load based on the number of strides, ground contact time, vertical oscillation and body weight). The change in training load is a time-dependent exposure in the sense that progression or regression can change many times during follow-up. Effect-measure modifiers include, but is not limited to, other types of sports activity, activity of daily living and demographics, and are assessed through questionnaires and/or by Garmin devices. ETHICS AND DISSEMINATION The study design, procedures and informed consent have been evaluated by the Ethics Committee of the Central Denmark Region (Request number: 227/2016 - Record number: 1-10-72-189-16).
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Affiliation(s)
| | | | - Daniel Ramskov
- Section for Sports Science, Department of Public Health, Aarhus Universitet, Aarhus, Denmark
| | - Camma Damsted
- Section for Sports Science, Department of Public Health, Aarhus Universitet, Aarhus, Denmark
| | | | - Erik Thorlund Parner
- Department of Public Health, Aarhus University, Section for Biostatistics, Aarhus, Denmark
| | - Henrik Sørensen
- Section of Sports, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Sten Rasmussen
- Orthopaedic Surgery Research Unit, Aarhus University Hospital - Aalborg Hospital, Aalborg, Denmark
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Søren Kjærgaard
- Section for Environment, Occupation and Health, Department of Public Health, Aarhus Universitet, Aarhus, Denmark
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Richert FC, Stein T, Ringhof S, Stetter BJ. The effect of the heel-to-toe drop of standard running shoes on lower limb biomechanics. FOOTWEAR SCIENCE 2019. [DOI: 10.1080/19424280.2019.1630016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Florian C. Richert
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Thorsten Stein
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Steffen Ringhof
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Bernd J. Stetter
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Korsgaard Brund R, Nielsen RO, Parner E, Rasmussen S, Voigt M. Changes in the running-related injury incidence rate ratio in a 1000-km explorative prospective cohort study involving two unspecific shoe changes. FOOTWEAR SCIENCE 2019. [DOI: 10.1080/19424280.2018.1529063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- René Korsgaard Brund
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | | | - Erik Parner
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Sten Rasmussen
- Orthopaedic Surgery Research Unit, Science and Innovation Center, Aalborg, Denmark
| | - Michael Voigt
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Besson T, Morio C, Millet GY, Rossi J. Influence of shoe drop on running kinematics and kinetics in female runners. Eur J Sport Sci 2019; 19:1320-1327. [DOI: 10.1080/17461391.2019.1603327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Thibault Besson
- Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Saint Etienne, France
| | - Cédric Morio
- Decathlon SportsLab, Movement Sciences Department, Villeneuve d’Ascq, France
| | - Guillaume Y. Millet
- Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Saint Etienne, France
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Jérémy Rossi
- Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Saint Etienne, France
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Fokkema T, de Vos RJ, van Ochten JM, Verhaar JAN, Davis IS, Bindels PJE, Bierma-Zeinstra SMA, van Middelkoop M. Online multifactorial prevention programme has no effect on the number of running-related injuries: a randomised controlled trial. Br J Sports Med 2019; 53:1479-1485. [PMID: 30954948 PMCID: PMC6900232 DOI: 10.1136/bjsports-2018-099744] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 01/23/2019] [Accepted: 03/19/2019] [Indexed: 12/01/2022]
Abstract
Objective To examine the effect of a multifactorial, online injury prevention programme on the number of running-related injuries (RRIs) in recreational runners. Methods Adult recreational runners who registered for a running event (distances 5 km up to 42.195 km) were randomised into the intervention group or control group. Participants in the intervention group were given access to the online injury prevention programme, which consisted of information on evidence-based risk factors and advices to reduce the injury risk. Participants in the control group followed their regular preparation for the running event. The primary outcome measure was the number of self-reported RRIs in the time frame between registration for a running event and 1 month after the running event. Results This trial included 2378 recreational runners (1252 men; mean [SD] age 41.2 [11.9] years), of which 1196 were allocated to the intervention group and 1182 to the control group. Of the participants in the intervention group 37.5% (95% CI 34.8 to 40.4) sustained a new RRI during follow-up, compared with 36.7% (95% CI 34.0 to 39.6) in the control group. Univariate logistic regression analysis showed no significant difference between the intervention and control group (OR 1.08; 95% CI 0.90 to 1.30). Furthermore, the prevention programme seemed to have a negative impact on the occurrence of new RRIs in the subgroup of runners with no injuries in the 12 months preceding the trial (OR 1.30; 95% CI 0.99 to 1.70). Conclusion A multifactorial, online injury prevention programme did not decrease the total number of RRIs in recreational runners. Trial registration number NTR5998.
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Affiliation(s)
- Tryntsje Fokkema
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Robert-Jan de Vos
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - John M van Ochten
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jan A N Verhaar
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Irene S Davis
- Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Damsted C, Parner ET, Sørensen H, Malisoux L, Nielsen RO. ProjectRun21: Do running experience and running pace influence the risk of running injury—A 14-week prospective cohort study. J Sci Med Sport 2019; 22:281-287. [DOI: 10.1016/j.jsams.2018.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 08/13/2018] [Accepted: 08/16/2018] [Indexed: 12/25/2022]
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Nielsen RO, Bertelsen ML, Ramskov D, Møller M, Hulme A, Theisen D, Finch CF, Fortington LV, Mansournia MA, Parner ET. Time-to-event analysis for sports injury research part 2: time-varying outcomes. Br J Sports Med 2018; 53:70-78. [PMID: 30413427 PMCID: PMC6317441 DOI: 10.1136/bjsports-2018-100000] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Time-to-event modelling is underutilised in sports injury research. Still, sports injury researchers have been encouraged to consider time-to-event analyses as a powerful alternative to other statistical methods. Therefore, it is important to shed light on statistical approaches suitable for analysing training load related key-questions within the sports injury domain. CONTENT In the present article, we illuminate: (i) the possibilities of including time-varying outcomes in time-to-event analyses, (ii) how to deal with a situation where different types of sports injuries are included in the analyses (ie, competing risks), and (iii) how to deal with the situation where multiple subsequent injuries occur in the same athlete. CONCLUSION Time-to-event analyses can handle time-varying outcomes, competing risk and multiple subsequent injuries. Although powerful, time-to-event has important requirements: researchers are encouraged to carefully consider prior to any data collection that five injuries per exposure state or transition is needed to avoid conducting statistical analyses on time-to-event data leading to biased results. This requirement becomes particularly difficult to accommodate when a stratified analysis is required as the number of variables increases exponentially for each additional strata included. In future sports injury research, we need stratified analyses if the target of our research is to respond to the question: 'how much change in training load is too much before injury is sustained, among athletes with different characteristics?' Responding to this question using multiple time-varying exposures (and outcomes) requires millions of injuries. This should not be a barrier for future research, but collaborations across borders to collecting the amount of data needed seems to be an important step forward.
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Affiliation(s)
| | | | - Daniel Ramskov
- Department of Public Health, Section for Sports Science, Aarhus University, Aarhus, Denmark.,Department of Physiotherapy, University College Northern Denmark, Aalborg, Denmark
| | - Merete Møller
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Adam Hulme
- Centre for Human Factors and Sociotechnical Systems, Faculty of Arts, Business and Law, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - Daniel Theisen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Caroline F Finch
- Australian Centre for Research into Injury in Sport and its Prevention, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Lauren Victoria Fortington
- Australian Centre for Research into Injury in Sport and its Prevention, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,Faculty of Science and Technology, Federation University Australia, Ballarat, Victoria, Australia
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.,Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Erik Thorlund Parner
- Department of Public Health, Section for Biostatistics, Aarhus University, Aarhus, Denmark
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Law MHC, Choi EMF, Law SHY, Chan SSC, Wong SMS, Ching ECK, Chan ZYS, Zhang JH, Lam GWK, Lau FOY, Cheung RTH. Effects of footwear midsole thickness on running biomechanics. J Sports Sci 2018; 37:1004-1010. [PMID: 30358487 DOI: 10.1080/02640414.2018.1538066] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Shoe manufacturers launch running shoes with increased (e.g., maximalists) or decreased (e.g., minimalists) midsole thickness and claim that they may prevent running injury. Previous studies tested footwear models with different midsole thicknesses on the market but the shoe construct was not strictly comparable. Therefore, in the present study, we examined the effect of midsole thickness, from 1-mm to 29-mm, in a standard test shoe prototype on the vertical loading rates, footstrike angle and temporal spatial parameters in distance runners. Fifteen male habitual rearfoot strikers were recruited from local running clubs. They were asked to run on an instrumented treadmill in shoes with different midsole thicknesses. We found significant interactions between midsole thickness with vertical loading rates (p < 0.001), footstrike angle (p = 0.013), contact time (p < 0.001), cadence (p = 0.003), and stride length (p = 0.004). Specifically, shoes with thinner midsole (1- and 5-mm) significantly increased the vertical loading rates and shortened the contact time, when compared with thicker midsole shoes (25- and 29-mm). However, we did not observe any substantial differences in the footstrike angle, cadence and stride length between other shod conditions. The present study provides biomechanical data regarding the relationship between full spectrum midsole thicknesses and running biomechanics in a group of rearfoot strikers.
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Affiliation(s)
- Mark H C Law
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
| | - Eric M F Choi
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
| | - Stephanie H Y Law
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
| | - Subrina S C Chan
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
| | - Sonia M S Wong
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
| | - Eric C K Ching
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
| | - Zoe Y S Chan
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
| | - Janet H Zhang
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
| | - Gilbert W K Lam
- b Department of Kinesiology , Shenyang Sport University , Shenyang , China.,c Li Ning Sports Research Center , Beijing , China
| | - Fannie O Y Lau
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China.,d Department of Orthopaedics & Traumatology , The Chinese University of Hong , Hong Kong , China
| | - Roy T H Cheung
- a Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences , The Hong Kong Polytechnic University , Hong Kong, China
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Napier C, Willy RW. Logical fallacies in the running shoe debate: let the evidence guide prescription. Br J Sports Med 2018; 52:1552-1553. [PMID: 30352861 DOI: 10.1136/bjsports-2018-100117] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Christopher Napier
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,The UBC Run Clinic, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Richard W Willy
- Division of Physical Therapy and Health Sciences, University of Montana, Missoula, Montana, USA
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Damsted C, Parner ET, Sørensen H, Malisoux L, Nielsen RO. Design of ProjectRun21: a 14-week prospective cohort study of the influence of running experience and running pace on running-related injury in half-marathoners. Inj Epidemiol 2017; 4:30. [PMID: 29105001 PMCID: PMC5673057 DOI: 10.1186/s40621-017-0124-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/10/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Participation in half-marathon has been steeply increasing during the past decade. In line, a vast number of half-marathon running schedules has surfaced. Unfortunately, the injury incidence proportion for half-marathoners has been found to exceed 30% during 1-year follow-up. The majority of running-related injuries are suggested to develop as overuse injuries, which leads to injury if the cumulative training load over one or more training sessions exceeds the runners' load capacity for adaptive tissue repair. Owing to an increase of load capacity along with adaptive running training, the runners' running experience and pace abilities can be used as estimates for load capacity. Since no evidence-based knowledge exist of how to plan appropriate half-marathon running schedules considering the level of running experience and running pace, the aim of ProjectRun21 is to investigate the association between running experience or running pace and the risk of running-related injury. METHODS Healthy runners using Global Positioning System (GPS) watch between 18 and 65 years will be invited to participate in this 14-week prospective cohort study. Runners will be allowed to self-select one of three half-marathon running schedules developed for the study. Running data will be collected objectively by GPS. Injury will be based on the consensus-based time loss definition by Yamato et al.: "Running-related (training or competition) musculoskeletal pain in the lower limbs that causes a restriction on or stoppage of running (distance, speed, duration, or training) for at least 7 days or 3 consecutive scheduled training sessions, or that requires the runner to consult a physician or other health professional". Running experience and running pace will be included as primary exposures, while the exposure to running is pre-fixed in the running schedules and thereby conditioned by design. Time-to-event models will be used for analytical purposes. DISCUSSION ProjectRun21 will examine if particular subgroups of runners with certain running experiences and running paces seem to sustain more running-related injuries compared with other subgroups of runners. This will enable sport coaches, physiotherapists as well as the runners to evaluate their injury risk of taking up a 14-week running schedule for half-marathon.
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Affiliation(s)
- Camma Damsted
- Section of Sport Science, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000 Aarhus C, DK Denmark
| | - Erik Thorlund Parner
- Section of Biostatistics, Department of Public Health, Aarhus University, 8000 Aarhus, DK Denmark
| | - Henrik Sørensen
- Section of Sport Science, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000 Aarhus C, DK Denmark
| | - Laurent Malisoux
- Sports Medicine Research Laboratory, Department of Population Health, Luxembourg Institute of Health, L-1460 Luxembourg, Luxembourg
| | - Rasmus Oestergaard Nielsen
- Section of Sport Science, Department of Public Health, Aarhus University, Dalgas Avenue 4, 8000 Aarhus C, DK Denmark
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Besson T, Morio C, Rossi J. Effects of shoe drop on running mechanics in women. Comput Methods Biomech Biomed Engin 2017; 20:19-20. [PMID: 29088632 DOI: 10.1080/10255842.2017.1382840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- T Besson
- a Inter-university Laboratory of Human Movement Biology (EA 7424 ), University of Lyon, University Jean Monnet , Saint-Etienne , France
| | - C Morio
- b Decathlon SportsLab, Movement Sciences Department , Villeneuve d'Ascq , France
| | - J Rossi
- a Inter-university Laboratory of Human Movement Biology (EA 7424 ), University of Lyon, University Jean Monnet , Saint-Etienne , France
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Malisoux L, Delattre N, Urhausen A, Theisen D. Shoe cushioning, body mass and running biomechanics as risk factors for running injury: a study protocol for a randomised controlled trial. BMJ Open 2017; 7:e017379. [PMID: 28827268 PMCID: PMC5724138 DOI: 10.1136/bmjopen-2017-017379] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Repetitive loading of the musculoskeletal system is suggested to be involved in the underlying mechanism of the majority of running-related injuries (RRIs). Accordingly, heavier runners are assumed to be at a higher risk of RRI. The cushioning system of modern running shoes is expected to protect runners again high impact forces, and therefore, RRI. However, the role of shoe cushioning in injury prevention remains unclear. The main aim of this study is to investigate the influence of shoe cushioning and body mass on RRI risk, while exploring simultaneously the association between running technique and RRI risk. METHODS AND ANALYSIS This double-blinded randomised controlled trial will involve about 800 healthy leisure-time runners. They will randomly receive one of two running shoe models that will differ in their cushioning properties (ie, stiffness) by ~35%. The participants will perform a running test on an instrumented treadmill at their preferred running speed at baseline. Then they will be followed up prospectively over a 6-month period, during which they will self-report all their sports activities as well as any injury in an internet-based database TIPPS (Training and Injury Prevention Platform for Sports). Cox regression analyses will be used to compare injury risk between the study groups and to investigate the association among training, biomechanical and anatomical risk factors, and injury risk. ETHICS AND DISSEMINATION The study was approved by the National Ethics Committee for Research (Ref: 201701/02 v1.1). Outcomes will be disseminated through publications in peer-reviewed journals, presentations at international conferences, as well as articles in popular magazines and on specialised websites. TRIAL REGISTRATION NUMBER NCT03115437, Pre-results.
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Affiliation(s)
- Laurent Malisoux
- Luxembourg Institute of Health, Sports Medicine Research Laboratory, Grand-Duchy of Luxembourg, Luxembourg
| | - Nicolas Delattre
- Decathlon Sports Lab, Movement Sciences Department, Villeneuve d’Ascq, France
| | - Axel Urhausen
- Luxembourg Institute of Health, Sports Medicine Research Laboratory, Grand-Duchy of Luxembourg, Luxembourg
- Sports Clinic, Centre Hospitalier de Luxembourg, Grand-Duchy of Luxembourg, Luxembourg
- International University of Health, Exercise and Sports (LUNEX), Grand-Duchy of Luxembourg, Luxembourg
| | - Daniel Theisen
- Luxembourg Institute of Health, Sports Medicine Research Laboratory, Grand-Duchy of Luxembourg, Luxembourg
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Malisoux L, Gette P, Chambon N, Urhausen A, Theisen D. Adaptation of running pattern to the drop of standard cushioned shoes: A randomised controlled trial with a 6-month follow-up. J Sci Med Sport 2017; 20:734-739. [DOI: 10.1016/j.jsams.2017.01.238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 11/02/2016] [Accepted: 01/17/2017] [Indexed: 11/24/2022]
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Fokkema T, de Vos RJ, van Ochten JM, Verhaar JA, Davis IS, Bindels PJ, Bierma-Zeinstra SM, van Middelkoop M. Preventing running-related injuries using evidence-based online advice: the design of a randomised-controlled trial. BMJ Open Sport Exerc Med 2017; 3:e000265. [PMID: 28761721 PMCID: PMC5530119 DOI: 10.1136/bmjsem-2017-000265] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2017] [Indexed: 12/04/2022] Open
Abstract
Introduction Running-related injuries (RRIs) are frequent and can lead to cessation of health promoting activities. Several risk factors for RRIs have been identified. However, no successful injury prevention programme has been developed so far. Therefore, the aim of the present study is to investigate the effect of an evidence-based online injury prevention programme on the number of RRIs. Methods and analysis The INSPIRE trial is a randomised-controlled trial with a 3-month follow-up. Both novice and more experienced runners, aged 18 years and older, who register for a running event (distances 5 km up to 42.195 km) will be asked to participate in this study. After completing the baseline questionnaire, participants will be randomised into either the intervention group or control group. Participants in the intervention group will get access to the online injury prevention programme. This prevention programme consists of information on evidence-based risk factors and advices to reduce the injury risk. The primary outcome measure is the number of self-reported RRIs in the time frame between registration for a running event and 1 month after the running event. Secondary outcome measures include the running days missed due to injuries, absence of work or school due to injuries, and the injury location. Ethics and dissemination An exemption for a comprehensive application is obtained by the Medical Ethical Committee of the Erasmus University Medical Centre Rotterdam, Netherlands. The results of the study will be published in peer-reviewed journals and presented on international congresses. Trial registration number NTR5998. Pre-results
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Affiliation(s)
- Tryntsje Fokkema
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Robert-Jan de Vos
- Department of Orthopaedics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - John M van Ochten
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jan An Verhaar
- Department of Orthopaedics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Irene S Davis
- Spaulding National Running Centre, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Patrick Je Bindels
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sita Ma Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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