Effect of Strength Training Programs in Middle- and Long-Distance Runners' Economy at Different Running Speeds: A Systematic Review with Meta-analysis

BACKGROUND

Running economy is defined as the energy demand at submaximal running speed, a key determinant of overall running performance. Strength training can improve running economy, although the magnitude of its effect may depend on factors such as the strength training method and the speed at which running economy is assessed.

AIM

To compare the effect of different strength training methods (e.g., high loads, plyometric, combined methods) on the running economy in middle- and long-distance runners, over different running speeds, through a systematic review with meta-analysis.

METHODS

A systematic search was conducted across several electronic databases including Web of Science, PubMed, SPORTDiscus, and SCOPUS. Using different keywords and Boolean operators for the search, all articles indexed up to November 2022 were considered for inclusion. In addition, the PICOS criteria were applied: Population: middle- and long-distance runners, without restriction on sex or training/competitive level; Intervention: application of a strength training method for ≥ 3 weeks (i.e., high loads (≥ 80% of one repetition maximum); submaximal loads [40-79% of one repetition maximum); plyometric; isometric; combined methods (i.e., two or more methods); Comparator: control group that performed endurance running training but did not receive strength training or received it with low loads (< 40% of one repetition maximum); Outcome: running economy, measured before and after a strength training intervention programme; Study design: randomized and non-randomized controlled studies. Certainty of evidence was assessed with the GRADE approach. A three-level random-effects meta-analysis and moderator analysis were performed using R software (version 4.2.1).

RESULTS

The certainty of the evidence was found to be moderate for high load training, submaximal load training, plyometric training and isometric training methods and low for combined methods. The studies included 195 moderately trained, 272 well trained, and 185 highly trained athletes. The strength training programmes were between 6 and 24 weeks' duration, with one to four sessions executed per week. The high load and combined methods induced small (ES = - 0.266, p = 0.039) and moderate (ES = - 0.426, p = 0.018) improvements in running economy at speeds from 8.64 to 17.85 km/h and 10.00 to 14.45 km/h, respectively. Plyometric training improved running economy at speeds ≤ 12.00 km/h (small effect, ES = - 0.307, p = 0.028, β1 = 0.470, p = 0.017). Compared to control groups, no improvement in running economy (assessed speed: 10.00 to 15.28 and 9.75 to 16.00 km/h, respectively) was noted after either submaximal or isometric strength training (all, p > 0.131). The moderator analyses showed that running speed (β1 = - 0.117, p = 0.027) and VO2max (β1 = - 0.040, p = 0.020) modulated the effect of high load strength training on running economy (i.e., greater improvements at higher speeds and higher VO2max).

CONCLUSIONS

Compared to a control condition, strength training with high loads, plyometric training, and a combination of strength training methods may improve running economy in middle- and long-distance runners. Other methods such as submaximal load training and isometric strength training seem less effective to improve running economy in this population. Of note, the data derived from this systematic review suggest that although both high load training and plyometric training may improve running economy, plyometric training might be effective at lower speeds (i.e., ≤ 12.00 km/h) and high load strength training might be particularly effective in improving running economy (i) in athletes with a high VO2max, and (ii) at high running speeds.

PROTOCOL REGISTRATION

The original protocol was registered ( https://osf.io/gyeku ) at the Open Science Framework.

More than energy cost: multiple benefits of the long Achilles tendon in human walking and running

Elastic strain energy that is stored and released from long, distal tendons such as the Achilles during locomotion allows for muscle power amplification as well as for reduction of the locomotor energy cost: as distal tendons perform mechanical work during recoil, plantar flexor muscle fibres can work over smaller length ranges, at slower shortening speeds, and at lower activation levels. Scant evidence exists that long distal tendons evolved in humans (or were retained from our more distant Hominoidea ancestors) primarily to allow high muscle-tendon power outputs, and indeed we remain relatively powerless compared to many other species. Instead, the majority of evidence suggests that such tendons evolved to reduce total locomotor energy cost. However, numerous additional, often unrecognised, advantages of long tendons may speculatively be of greater evolutionary advantage, including the reduced limb inertia afforded by shorter and lighter muscles (reducing proximal muscle force requirement), reduced energy dissipation during the foot-ground collisions, capacity to store and reuse the muscle work done to dampen the vibrations triggered by foot-ground collisions, reduced muscle heat production (and thus core temperature), and attenuation of work-induced muscle damage. Cumulatively, these effects should reduce both neuromotor fatigue and sense of locomotor effort, allowing humans to choose to move at faster speeds for longer. As these benefits are greater at faster locomotor speeds, they are consistent with the hypothesis that running gaits used by our ancestors may have exerted substantial evolutionary pressure on Achilles tendon length. The long Achilles tendon may therefore be a singular adaptation that provided numerous physiological, biomechanical, and psychological benefits and thus influenced behaviour across multiple tasks, both including and additional to locomotion. While energy cost may be a variable of interest in locomotor studies, future research should consider the broader range of factors influencing our movement capacity, including our decision to move over given distances at specific speeds, in order to understand more fully the effects of Achilles tendon function as well as changes in this function in response to physical activity, inactivity, disuse and disease, on movement performance.

Speed-specific optimal contractile conditions of the human soleus muscle from slow to maximum running speed

The soleus is the main muscle for propulsion during human running but its operating behavior across the spectrum of physiological running speeds is currently unknown. This study experimentally investigated the soleus muscle activation patterns and contractile conditions for force generation, power production and efficient work production (i.e. force-length potential, force-velocity potential, power-velocity potential and enthalpy efficiency) at seven running speeds (3.0 m s-1 to individual maximum). During submaximal running (3.0-6.0 m s-1), the soleus fascicles shortened close to optimal length and at a velocity close to the efficiency maximum, two contractile conditions for economical work production. At higher running speeds (7.0 m s-1 to maximum), the soleus muscle fascicles still operated near optimum length, yet the fascicle shortening velocity increased and shifted towards the optimum for mechanical power production with a simultaneous increase in muscle activation, providing evidence for three cumulative mechanisms to enhance mechanical power production. Using the experimentally determined force-length-velocity potentials and muscle activation as inputs in a Hill-type muscle model, a reduction in maximum soleus muscle force at speeds ≥7.0 m s-1 and a continuous increase in maximum mechanical power with speed were predicted. The reduction in soleus maximum force was associated with a reduced force-velocity potential. The increase in maximum power was explained by an enhancement of muscle activation and contractile conditions until 7.0 m s-1, but mainly by increased muscle activation at high to maximal running speed.

Simulating Muscle-Level Energetic Cost Savings When Humans Run with a Passive Assistive Device

Connecting the legs with a spring attached to the shoelaces, called an exotendon, can reduce the energetic cost of running, but how the exotendon reduces the energetic burden of individual muscles remains unknown. We generated muscle-driven simulations of seven individuals running with and without the exotendon to discern whether savings occurred during the stance phase or the swing phase, and to identify which muscles contributed to energy savings. We computed differences in muscle-level energy consumption, muscle activations, and changes in muscle-fiber velocity and force between running with and without the exotendon. The seven of nine participants who reduced energy cost when running with the exotendon reduced their measured energy expenditure rate by 0.9 W/kg (8.3%). Simulations predicted a 1.4 W/kg (12.0%) reduction in the average rate of energy expenditure and correctly identified that the exotendon reduced rates of energy expenditure for all seven individuals. Simulations showed most of the savings occurred during stance (1.5 W/kg), though the rate of energy expenditure was also reduced during swing (0.3 W/kg). The energetic savings were distributed across the quadriceps, hip flexor, hip abductor, hamstring, hip adductor, and hip extensor muscle groups, whereas no changes were observed in the plantarflexor or dorsiflexor muscles. Energetic savings were facilitated by reductions in the rate of mechanical work performed by muscles and their estimated rate of heat production. By modeling muscle-level energetics, this simulation framework accurately captured measured changes in whole-body energetics when using an assistive device. This is a useful first step towards using simulation to accelerate device design by predicting how humans will interact with assistive devices that have yet to be built.

Impairments in muscle shape changes affect metabolic demands during in-vivo contractions

The uncoupling behaviour between muscle belly and fascicle shortening velocity (i.e. belly gearing), affects mechanical output by allowing the muscle to circumvent the limits imposed by the fascicles' force-velocity relationship. However, little is known about the 'metabolic effect' of a decrease/increase in belly gearing. In this study, we manipulated the plantar flexor muscles' capacity to change in shape (and hence belly gearing) by using compressive multidirectional loads. Metabolic, kinetic, electromyography activity and ultrasound data (in soleus and gastrocnemius medialis) were recorded during cyclic fixed-end contractions of the plantar flexor muscles in three different conditions: no load, +5 kg and +10 kg of compression. No differences were observed in mechanical power and electrophysiological variables as a function of compression intensity, whereas metabolic power increased as a function of it. At each compression intensity, differences in efficiency were observed when calculated based on fascicle or muscle behaviour and significant positive correlations (R2 range: 0.7-0.8 and p > 0.001) were observed between delta efficiency (ΔEff: Effmus-Efffas) and belly gearing (Vmus/Vfas) or ΔV (Vmus-Vfas). Thus, changes in the muscles' capacity to change in shape (e.g. in muscle stiffness or owing to compressive garments) affect the metabolic demands and the efficiency of muscle contraction.

Biarticular mechanisms of the gastrocnemii muscles enhance ankle mechanical power and work during running

The objective of the study was to explore how biarticular mechanisms of the gastrocnemii muscles may provide an important energy source for power and work at the ankle joint with increasing running speed. Achilles tendon force was quantified as a proxy of the triceps surae muscle force and the contribution of the monoarticular soleus and the biarticular gastrocnemii to the mechanical power and work performed at the ankle joint was investigated in three running speeds (transition 2.0 m s-1, slow 2.5 m s-1, fast 3.5 m s-1). Although the contribution of the soleus was higher, biarticular mechanisms of the gastrocnemii accounted for a relevant part of the performed mechanical power and work at the ankle joint. There was an ankle-to-knee joint energy transfer in the first part of the stance phase and a knee-to-ankle joint energy transfer during push-off via the gastrocnemii muscles, which made up 16% of the total positive ankle joint work. The rate of knee-to-ankle joint energy transfer increased with speed, indicating a speed-related participation of biarticular mechanisms in running. This energy transfer via the gastrocnemii seems to occur with negligible energy absorption/production from the quadriceps vasti contractile elements and is rather an energy exchange between elastic structures.

Fatigue does not increase limb asymmetry or induce proximal joint power shift in habitual, multi-speed runners

During prolonged jogging, joint moment and work tend to decrease in the distal (ankle) joint but increase at proximal (hip/knee) joints as performance fatigue manifests, and such adaptations might be expected to occur in sprinting. Fatigue is also thought to increase inter-limb asymmetries, which is speculated to influence injury risk. However, the effects of fatigue on sprint running gait have been incompletely studied, so these hypotheses remain untested. Using statistical parametric mapping, we compared 3-D kinematics and ground reaction force production between the dominant (DL) and non-dominant (NDL) legs of 13 soccer players during both non-fatigued and fatigued sprint running. Contrary to the tested hypotheses, relative between-leg differences were greater in non-fatigued than fatigued sprinting. DL generated higher propulsive impulse due to increased ankle work, while NDL exhibited greater vertical impulse, potentially due to greater hip flexion prior to downward foot acceleration. Whilst few changes were detected in DL once fatigued, NDL shifted towards greater horizontal force production, largely resulting from an increase in plantar flexion (distal-joint) moments and power. After fatiguing running, inter-limb asymmetry was reduced and no distal-to-proximal shift in joint work was detected. These adaptations may attenuate decreases in running speed whilst minimising injury risk.

How Connecting the Legs with a Spring Improves Human Running Economy

Connecting the legs with a spring attached to the shoelaces reduces the energy cost of running, but how the spring reduces the energy burden of individual muscles remains unknown. We generated muscle-driven simulations of seven individuals running with and without the spring to discern whether savings occurred during the stance phase or the swing phase, and to identify which muscles contributed to energy savings. We computed differences in muscle-level energy consumption, muscle activations, and changes in muscle-fiber velocity and force between running with and without the spring. Across participants, running with the spring reduced the measured rate of energy expenditure by 0.9 W/kg (8.3%). Simulations predicted a 1.4 W/kg (12.0%) reduction in the average rate of energy expenditure and correctly identified that the spring reduced rates of energy expenditure for all participants. Simulations showed most of the savings occurred during stance (1.5 W/kg), though the rate of energy expenditure was also reduced during swing (0.3 W/kg). The energetic savings were distributed across the quadriceps, hip flexor, hip abductor, hamstring, hip adductor, and hip extensor muscle groups, whereas no changes in the rate of energy expenditure were observed in the plantarflexor or dorsiflexor muscles. Energetic savings were facilitated by reductions in the rate of mechanical work performed by muscles and their estimated rate of heat production. The simulations provide insight into muscle-level changes that occur when utilizing an assistive device and the mechanisms by which a spring connecting the legs improves running economy.

Progressive daily hopping exercise improves running economy in amateur runners: a randomized and controlled trial

This study investigated the effects of a daily plyometric hopping intervention on running economy (RE) in amateur runners. In a randomized, controlled trial, thirty-four amateur runners (29 ± 7 years, 27 males) were allocated to a control or a hopping exercise group. During the six-week study, the exercise group performed 5 min of double-legged hopping exercise daily. To progressively increase loading, the number of hopping bouts (10 s each) was steadily increased while break duration between sets was decreased. Pre- and post-intervention, RE, peak oxygen uptake (VO_2peak), and respiratory exchange ratio (RER) were measured during 4-min stages at three running speeds (10, 12, and 14 km/h). ANCOVAs with baseline values and potential cofounders as cofactors were performed to identify differences between groups. ANCOVA revealed an effect of hopping on RE at 12 km/h (df = 1; F = 4.35; p < 0.05; η² = 0.072) and 14 km/h (df = 1; F = 6.72; p < 0.05; η² = 0.098), but not at 10 km/h (p > 0.05). Exercise did not affect VO_2peak (p > 0.05), but increased RER at 12 km/h (df = 1; F = 4.26; p < 0.05; η² = 0.059) and 14 km/h (df = 1; F = 36.73; p < 0.001; η² = 0.520). No difference in RER was observed at 10 km/h (p > 0.05). Daily hopping exercise is effective in improving RE at high running speeds in amateurs and thus can be considered a feasible complementary training program.Clinical trial registration German Register of Clinical Trials (DRKS00017373).

The interplay between gastrocnemius medialis force-length and force-velocity potentials, cumulative EMG activity and energy cost at speeds above and below the walk to run transition speed

NEW FINDINGS

What is the central question of the study? Are the changes in force potentials (at the muscle level) related with metabolic changes at speeds above and below the walk-to-run transition? What is the main finding and its importance? The force-length and force-velocity potentials of gastrocnemius medialis during human walking decrease as a function of speed; this decrease is associated with an increase in cumulative EMG activity and in the energy cost of locomotion. Switching from fast walking to running is associated to an increase in the force potentials, supporting the idea that the 'metabolic trigger' that determines the transition from walking to running is ultimately driven by a reduction of the muscle's contractile capacity.

ABSTRACT

The aim of this study was to investigate the interplay between the force-length (F-L) and force-velocity (F-V) potentials of gastrocnemius medialis (GM) muscle fascicles, the cumulative muscle activity per distance travelled (CMAPD) of the lower limb muscles (GM, vastus lateralis, biceps femori, tibialis anterior) and net energy cost (Cnet ) during walking and running at speeds above and below the walk-to-run transition speed (walking: 2-8 km h-1 ; running: 6-10 km h-1 ). A strong association was observed between Cnet and CMAPD: both changed significantly with walking speed but were unaffected by speed in running. The F-L and F-V potentials decreased with speed in both gaits and, at 6-8 km h-1 , were significantly larger in running. At low to moderate walking speeds (2-6 km h-1 ), the changes in GM force potentials were not associated with substantial changes in CMAPD (and Cnet ), whereas at walking speeds of 7-8 km h-1 , even small changes in force potentials were associated with steep increases in CMAPD (and Cnet ). These data suggest that: (i) the walk to run transition could be explained by an abrupt increase in Cnet driven by an upregulation of the EMG activity (e.g., in CMAPD) at sustained walking speeds (>7 km h-1 ) and (ii) the reduction in the muscle's ability to produce force (e.g., in the F-L and F-V potentials) contributes to the increase in CMAPD (and Cnet ). Switching to running allows regaining of high force potentials, thus limiting the increase in CMAPD (and Cnet ) that would otherwise occur to sustain the increase in locomotion speed.

The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians

Background

Despite calf muscle strain injuries (CMSI) being problematic in many sports, there is a dearth of research to guide clinicians dealing with these injuries. The aim of this study was to evaluate the current practices and perspectives of a select group of international experts regarding the assessment, management and prevention of CMSI using in-depth semi-structured interviews.

Results

Twenty expert clinicians working in elite sport and/or clinician-researchers specialising in the field completed interviews. A number of key points emerged from the interviews. Characteristics of CMSI were considered unique compared to other muscle strains. Rigor in the clinical approach clarifies the diagnosis, whereas ongoing monitoring of calf capacity and responses to loading exposure provides the most accurate estimate of prognosis. Athlete intrinsic characteristics, injury factors and sport demands shaped rehabilitation across six management phases, which were guided by key principles to optimise performance at return to play (RTP) while avoiding subsequent injury or recurrence. To prevent CMSI, periodic monitoring is common, but practices vary and data are collected to inform load-management and exercise selection rather than predict future CMSI. A universal injury prevention program for CMSI may not exist. Instead, individualised strategies should reflect athlete intrinsic characteristics and sport demands.

Conclusions

Information provided by experts enabled a recommended approach to clinically evaluate CMSI to be outlined, highlighting the injury characteristics considered most important for diagnosis and prognosis. Principles for optimal management after CMSI were also identified, which involved a systematic approach to rehabilitation and the RTP decision. Although CMSI were reportedly difficult to prevent, on- and off-field strategies were implemented by experts to mitigate risk, particularly in susceptible athletes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-021-00364-0.

Neuromechanical adaptations of foot function when hopping on a damped surface

To preserve motion, humans must adopt actuator-like dynamics to replace energy that is dissipated during contact with damped surfaces. Our ankle plantar flexors are credited as the primary source of work generation. Our feet and their intrinsic foot muscles also appear to be an important source of generative work, but their contributions to restoring energy to the body remain unclear. Here, we test the hypothesis that our feet help to replace work dissipated by a damped surface through controlled activation of the intrinsic foot muscles. We used custom-built platforms to provide both elastic and damped surfaces and asked participants to perform a bilateral hopping protocol on each. We recorded foot motion and ground reaction forces, alongside muscle activation, using intramuscular electromyography from flexor digitorum brevis, abductor hallucis, soleus, and tibialis anterior. Hopping in the Damped condition resulted in significantly greater positive work and contact-phase muscle activation compared with the Elastic condition. The foot contributed 25% of the positive work performed about the ankle, highlighting the importance of the foot when humans adapt to different surfaces.NEW & NOTEWORTHY Adaptable foot mechanics play an important role in how we adjust to elastic surfaces. However, natural substrates are rarely perfectly elastic and dissipate energy. Here, we highlight the important role of the foot and intrinsic foot muscles in contributing to replacing dissipated work on damped surfaces and uncover an important energy-saving mechanism that may be exploited by the designers of footwear and other wearable devices.

Running economy and lower extremity stiffness in endurance runners: A systematic review and meta-analysis

Background: Lower extremity stiffness simulates the response of the lower extremity to landing in running. However, its relationship with running economy (RE) remains unclear. This study aims to explore the relationship between lower extremity stiffness and RE. Methods: This study utilized articles from the Web of Science, PubMed, and Scopus discussing the relationships between RE and indicators of lower extremity stiffness, namely vertical stiffness, leg stiffness, and joint stiffness. Methodological quality was assessed using the Joanna Australian Centre for Evidence-Based Care (JBI). Pearson correlation coefficients were utilized to summarize effect sizes, and meta-regression analysis was used to assess the extent of this association between speed and participant level. Result: In total, thirteen studies involving 272 runners met the inclusion criteria and were included in this review. The quality of the thirteen studies ranged from moderate to high. The meta-analysis results showed a negative correlation between vertical stiffness (r = -0.520, 95% CI, -0.635 to -0.384, p < 0.001) and leg stiffness (r = -0.568, 95% CI, -0.723 to -0.357, p < 0.001) and RE. Additional, there was a small negative correlation between knee stiffness and RE (r = -0.290, 95% CI, -0.508 to -0.037, p = 0.025). Meta-regression results showed that the extent to which leg stiffness was negatively correlated with RE was influenced by speed (coefficient = -0.409, p = 0.020, r 2 = 0.79) and participant maximal oxygen uptake (coefficient = -0.068, p = 0.010, r 2 = 0.92). Conclusion: The results of this study suggest that vertical, leg and knee stiffness were negatively correlated with RE. In addition, maximum oxygen uptake and speed will determine whether the runner can take full advantage of leg stiffness to minimize energy expenditure.

Modifications to the net knee moments lead to the greatest improvements in accelerative sprinting performance: a predictive simulation study

The current body of sprinting biomechanics literature together with the front-side mechanics coaching framework provide various technique recommendations for improving performance. However, few studies have attempted to systematically explore technique modifications from a performance enhancement perspective. The aims of this investigation were therefore to explore how hypothetical technique modifications affect accelerative sprinting performance and assess whether the hypothetical modifications support the front-side mechanics coaching framework. A three-dimensional musculoskeletal model scaled to an international male sprinter was used in combination with direct collocation optimal control to perform (data-tracking and predictive) simulations of the preliminary steps of accelerative sprinting. The predictive simulations differed in the net joint moments that were left 'free' to change. It was found that the 'knee-free' and 'knee-hip-free' simulations resulted in the greatest performance improvements (13.8% and 21.9%, respectively), due to a greater knee flexor moment around touchdown (e.g., 141.2 vs. 70.5 Nm) and a delayed and greater knee extensor moment during stance (e.g., 188.5 vs. 137.5 Nm). Lastly, the predictive simulations which led to the greatest improvements were also found to not exhibit clear and noticeable front-side mechanics technique, thus the underpinning principles of the coaching framework may not be the only key aspect governing accelerative sprinting.

Not Lower-Limb Joint Strength and Stiffness but Vertical Stiffness and Isometric Force-Time Characteristics Correlate With Running Economy in Recreational Male Runners

Neuromuscular characteristics, such as lower-limb joint strength, the ability to reuse elastic energy, and to generate force are essential factors influencing running performance. However, their relationship with running economy (RE) remains unclear. The aim of this study was to evaluate the correlations between isokinetic lower-limb joint peak torque (PT), lower-limb stiffness, isometric force-time characteristics and RE among recreational-trained male runners. Thirty male collegiate runners (aged 20–22 years, VO2max: 54.02 ± 4.67 ml·kg−1·min−1) participated in test sessions on four separate days. In the first session, the body composition and RE at 10 km·h−1 were determined. In the second session, leg and vertical stiffness (Kleg and Kvert), knee and ankle stiffness (Kknee and Kankle) were evaluated. In the third session, isokinetic knee and ankle joint PT at velocity of 60°s−1 were tested. The force-time characteristics of isometric mid-thigh pull (IMTP) were evaluated in the final session. The Pearson’s product-moment correlations analysis shows that there were no significant relationships between knee and ankle joint concentric and eccentric PT, Kknee and Kankle, Kleg, and RE at 10 km·h−1. However, Kvert (r = −0.449, p &lt; 0.05) and time-specific rate of force development (RFD) for IMTP from 0 to 50 to 0–300 ms (r = −0.434 to −0.534, p &lt; 0.05) were significantly associated with RE. Therefore, superior RE in recreational runners may not be related to knee and ankle joint strength and stiffness. It seems to be associated with vertical stiffness and the capacity to rapidly produce force within 50–300 ms throughout the lower limb.

Achilles Tendon Mechanical Behavior and Ankle Joint Function at the Walk-to-Run Transition

Walking at speeds higher than transition speed is associated with a decrease in the plantar-flexor muscle fibres’ ability to produce force and, potentially, to an impaired behaviour of the muscle−tendon unit (MTU) elastic components. This study aimed to investigate the ankle joint functional indexes and the Achilles tendon mechanical behaviour (changes in AT force and power) to better elucidate the mechanical determinants of the walk-to-run transition. Kinematics, kinetic and ultrasound data of the gastrocnemius medialis (GM) were investigated during overground walking and running at speeds ranging from 5−9 km·h−1. AT and GM MTU force and power were calculated during the propulsive phase; the ankle joint function indexes (damper, strut, spring and motor) were obtained using a combination of kinetic and kinematic data. AT force was larger in running at speeds > 6.5 km/h. The contribution of AT to the total power provided by the GM MTU was significantly larger in running at speeds > 7.5 km/h. The spring and strut indexes of the ankle were significantly larger in running at speeds > 7.5 km/h. These data suggest that the walk-to-run transition could (at least partially) be explained by the need to preserve AT mechanical behaviour and the ankle spring function.

Hammerstein-Wiener Multimodel Approach for Fast and Efficient Muscle Force Estimation from EMG Signals

This paper develops a novel approach to characterise muscle force from electromyography (EMG) signals, which are the electric activities generated by muscles. Based on the nonlinear Hammerstein-Wiener model, the first part of this study outlines the estimation of different sub-models to mimic diverse force profiles. The second part fixes the appropriate sub-models of a multimodel library and computes the contribution of sub-models to estimate the desired force. Based on a pre-existing dataset, the obtained results show the effectiveness of the proposed approach to estimate muscle force from EMG signals with reasonable accuracy. The coefficient of determination ranges from 0.6568 to 0.9754 using the proposed method compared with a range of 0.5060 to 0.9329 using an artificial neural network (ANN), generating significantly different accuracy (p < 0.03). Results imply that the use of multimodel approach can improve the accuracy in proportional control of prostheses.

The Iliotibial Band: A Complex Structure with Versatile Functions

The development of a pronounced iliotibial band (ITB) is an anatomically distinct evolution of humans. The mechanical behaviour of this “new” structure is still poorly understood and hotly debated in current literature. Iliotibial band syndrome (ITBS) is one of the leading causes of lateral knee pain injuries in runners. We currently lack a comprehensive understanding of the healthy behaviour of the ITB, and this is necessary prior to further investigating the aetiology of pathologies like ITBS. Therefore, the purpose of this narrative review was to collate the anatomical, biomechanical and clinical literature to understand how the mechanical function of the ITB is influenced by anatomical variation, posture and muscle activation. The complexity of understanding the mechanical function of the ITB is due, in part, to the presence of its two in-series muscles: gluteus maximus (GMAX) and tensor fascia latae (TFL). At present, we lack a fundamental understanding of how GMAX and TFL transmit force through the ITB and what mechanical role the ITB plays for movements like walking or running. While there is a range of proposed ITBS treatment strategies, robust evidence for effective treatments is still lacking. Interventions that directly target the running biomechanics suspected to increase either ITB strain or compression of lateral knee structures may have promise, but clinical randomised controlled trials are still required.

Triceps Surae Muscle-Tendon Properties as Determinants of the Metabolic Cost in Trained Long-Distance Runners

Purpose: This study aimed to determine whether triceps surae's muscle architecture and Achilles tendon parameters are related to running metabolic cost (C) in trained long-distance runners. Methods: Seventeen trained male recreational long-distance runners (mean age = 34 years) participated in this study. C was measured during submaximal steady-state running (5 min) at 12 and 16 km h-1 on a treadmill. Ultrasound was used to determine the gastrocnemius medialis (GM), gastrocnemius lateralis (GL), and soleus (SO) muscle architecture, including fascicle length (FL) and pennation angle (PA), and the Achilles tendon cross-sectional area (CSA), resting length and elongation as a function of plantar flexion torque during maximal voluntary plantar flexion. Achilles tendon mechanical (force, elongation, and stiffness) and material (stress, strain, and Young's modulus) properties were determined. Stepwise multiple linear regressions were used to determine the relationship between independent variables (tendon resting length, CSA, force, elongation, stiffness, stress, strain, Young's modulus, and FL and PA of triceps surae muscles) and C (J kg-1m-1) at 12 and 16 km h-1. Results: SO PA and Achilles tendon CSA were negatively associated with C (r 2 = 0.69; p < 0.001) at 12 km h-1, whereas SO PA was negatively and Achilles tendon stress was positively associated with C (r 2 = 0.63; p = 0.001) at 16 km h-1, respectively. Our results presented a small power, and the multiple linear regression's cause-effect relation was limited due to the low sample size. Conclusion: For a given muscle length, greater SO PA, probably related to short muscle fibers and to a large physiological cross-sectional area, may be beneficial to C. Larger Achilles tendon CSA may determine a better force distribution per tendon area, thereby reducing tendon stress and C at submaximal speeds (12 and 16 km h-1). Furthermore, Achilles tendon morphological and mechanical properties (CSA, stress, and Young's modulus) and triceps surae muscle architecture (GM PA, GM FL, SO PA, and SO FL) presented large correlations with C.

Muscle-specific economy of force generation and efficiency of work production during human running

Human running features a spring-like interaction of body and ground, enabled by elastic tendons that store mechanical energy and facilitate muscle operating conditions to minimize the metabolic cost. By experimentally assessing the operating conditions of two important muscles for running, the soleus and vastus lateralis, we investigated physiological mechanisms of muscle work production and muscle force generation. We found that the soleus continuously shortened throughout the stance phase, operating as work generator under conditions that are considered optimal for work production: high force-length potential and high enthalpy efficiency. The vastus lateralis promoted tendon energy storage and contracted nearly isometrically close to optimal length, resulting in a high force-length-velocity potential beneficial for economical force generation. The favorable operating conditions of both muscles were a result of an effective length and velocity-decoupling of fascicles and muscle-tendon unit, mostly due to tendon compliance and, in the soleus, marginally by fascicle rotation.

Mechanics, energetics and implementation of grounded running technique: a narrative review

Grounded running predominantly differs from traditional aerial running by having alternating single and double stance with no flight phase. Approximately, 16% of runners in an open marathon and 33% of recreational runners in a 5 km running event adopted a grounded running technique. Grounded running typically occurs at a speed range of 2–3 m·s⁻¹, is characterised by a larger duty factor, reduced vertical leg stiffness, lower vertical oscillation of the centre of mass (COM) and greater impact attenuation than aerial running. Grounded running typically induces an acute increase in metabolic cost, likely due to the larger duty factor. The increased duty factor may translate to a more stable locomotion. The reduced vertical oscillation of COM, attenuated impact shock, and potential for improved postural stability may make grounded running a preferred form of physical exercise in people new to running or with low loading capacities (eg, novice overweight/obese, elderly runners, rehabilitating athletes). Grounded running as a less impactful, but metabolically more challenging form, could benefit these runners to optimise their cardio-metabolic health, while at the same time minimise running-related injury risk. This review discusses the mechanical demands and energetics of grounded running along with recommendations and suggestions to implement this technique in practice.

The influence of in vivo mechanical behaviour of the Achilles tendon on the mechanics, energetics and apparent efficiency of bouncing gaits

In this study, we used kinematic, kinetic, metabolic and ultrasound analysis to investigate the role of elastic energy utilization on the mechanical and physiological demands of a movement task (hopping) that primarily involves the plantar-flexor muscles to determine the contribution of tendon work to total mechanical work and its relationship with apparent efficiency (AE) in bouncing gaits. Metabolic power (PMET) and (positive) mechanical power at the whole-body level (PMEC) were measured during hopping at different frequencies (2, 2.5, 3 and 3.5 Hz). The (positive) mechanical power produced during the Achilles tendon recoil phase (PTEN) was obtained by integrating ultrasound data with an inverse dynamic approach. As a function of hopping frequency, PMEC decreased steadily and PMET exhibited a U-shape behaviour, with a minimum at about 3 Hz. AE (PMEC/PMET) showed an opposite trend and was maximal (about 0.50) at the same frequency when PTEN was also highest. Positive correlations were observed: (i) between PTEN and AE (AE=0.22+0.15PTEN, R2=0.67, P<0.001) and the intercept of this relationship indicates the value of AE that should be expected when tendon work is nil; (ii) between AE and tendon gearing (Gt=Δmuscle-tendon unit length/Δmuscle belly length; R2=0.50, P<0.001), where a high Gt indicates that the muscle is contracting more isometrically, thus allowing the movement to be more economical (and efficient); (iii) between Gt and PTEN (R2=0.73, P<0.001), which indicates that Gt could play an important role in the tendon's capability to store and release mechanical power.

The effects of footwear midsole longitudinal bending stiffness on running economy and ground contact biomechanics: A systematic review and meta-analysis

This study aimed to address the effects of increased longitudinal bending stiffness (LBS) on running economy (RE) and running biomechanics. A systematic search on four electronic databases (Pubmed, WOS, Medline and Scopus) was conducted on 26 May 2021. Twelve studies met the inclusion criteria and were included. Standardised mean difference with 95% confidence intervals (CI) between footwear with increased LBS vs. non-increased LBS conditions and effect sizes were calculated. To assess the potential effects of moderator variables (type and length plate, increased LBS, shoe mass and running speed) on the main outcome variable (i.e. RE), subgroup analyses were performed. Increased LBS improved RE (SMD = -0.43 [95% CI -0.58, -0.28], Z = 5.60, p < 0.001) compared to non-increased LBS. Significant increases of stride length (SMD = 0.29 [95% CI 0.10, 0.49], Z = 2.93, p = 0.003) and contact time (SMD = 0.17 [95% CI 0.03, 0.31], Z = 2.32, p = 0.02) were found when LBS was increased. RE improved to a greater degree at higher running speeds with footwear with increased LBS. RE improved 3.45% with curve plate compared to no-plate condition without improvements with flat plate shoes. When shoe mass was matched between footwear with increased LBS vs. non-increased LBS conditions, RE improved (3.15%). However, when shoe mass was not controlled (experimental condition with ∼35 grams extra), a significant small improvement was found. These RE improvements appear along with an increase of stride length and contact time. Shoe mass, type of plate (flat or curve) and running speed should be taken into consideration when designing a shoe aimed at improving long-distance running performance.

The Theory of Effort Minimization in Physical Activity

Although the automatic attraction to effort minimization has been evidenced in multiple fields, its potential role in explaining the pandemic of physical inactivity has been overlooked. The theory of effort minimization in physical activity (TEMPA) fills this gap. TEMPA seeks to obtain a more accurate understanding of the neuropsychological determinants of movement-based behaviors.

The effect of speed on Achilles tendon forces and patellofemoral joint stresses in high-performing endurance runners

Achilles tendinopathy and patellofemoral pain are common running injuries associated with increased Achilles tendon (AT) forces and patellofemoral joint (PFJ) stresses. This study examined AT forces and PFJ stresses at different running speeds in high-performing endurance runners. Twenty runners ran overground at four running speeds (3.3, 3.9, 4.8, and 5.6 m/s). AT forces and PFJ stresses were estimated from kinematic and kinetic data. Repeated measures ANOVA with partial eta squared effect sizes was conducted to assess differences between running speeds. Increased peak AT forces (19.5%; p < 0.001) and loading rates (57.3%; p < 0.001) from 3.3 m/s to 5.6 m/s were observed. Cumulative AT loading was greater in the faster speeds compared to the slower speeds. Faster running speeds resulted in increased peak plantar flexor moments, increased peak plantar flexion angles, and a more flexed knee and an anterior center of pressure position at touchdown. Peak PFJ stress was lower in the slowest speed (3.3 m/s) compared to the faster running speeds (3.9-5.6 m/s; p = 0.005). PFJ stress loading rate significantly increased (43.6%; p < 0.001). Greater AT loading observed could be associated with strategies such as increased plantar flexor moments and altered lower body position at touchdown which are commonly employed to generate greater ground contact forces. Greater AT and PFJ loading rates were likely due to shorter ground contact times and therefore less time available to reach the peak. Running at faster speeds could increase the risk of developing Achilles tendinopathy and patellofemoral pain or limit recovery from these injuries without sufficient recovery.

Medial gastrocnemius muscle fascicles shorten throughout stance during sprint acceleration

The compliant nature of distal limb muscle-tendon units is traditionally considered suboptimal in explosive movements when positive joint work is required. However, during accelerative running, ankle joint net mechanical work is positive. Therefore, this study aims to investigate how plantar flexor muscle-tendon behavior is modulated during fast accelerations. Eleven female sprinters performed maximum sprint accelerations from starting blocks, while gastrocnemius muscle fascicle lengths were estimated using ultrasonography. We combined motion analysis and ground reaction force measurements to assess lower limb joint kinematics and kinetics, and to estimate gastrocnemius muscle-tendon unit length during the first two acceleration steps. Outcome variables were resampled to the stance phase and averaged across three to five trials. Relevant scalars were extracted and analyzed using one-sample and two-sample t-tests, and vector trajectories were compared using statistical parametric mapping. We found that an uncoupling of muscle fascicle behavior from muscle-tendon unit behavior is effectively used to produce net positive mechanical work at the joint during maximum sprint acceleration. Muscle fascicles shortened throughout the first and second steps, while shortening occurred earlier during the first step, where negative joint work was lower compared with the second step. Elastic strain energy may be stored during dorsiflexion after touchdown since fascicles did not lengthen at the same time to dissipate energy. Thus, net positive work generation is accommodated by the reuse of elastic strain energy along with positive gastrocnemius fascicle work. Our results show a mechanism of how muscles with high in-series compliance can contribute to net positive joint work.

Quantifying mechanical loading and elastic strain energy of the human Achilles tendon during walking and running

The purpose of the current study was to assess in vivo Achilles tendon (AT) mechanical loading and strain energy during locomotion. We measured AT length considering its curve-path shape. Eleven participants walked at 1.4 m/s and ran at 2.5 m/s and 3.5 m/s on a treadmill. The AT length was defined as the distance between its origin at the gastrocnemius medialis myotendinous junction (MTJ) and the calcaneal insertion. The MTJ was tracked using ultrasonography and projected to the reconstructed skin surface to account for its misalignment. Skin-to-bone displacements were assessed during a passive rotation (5°/s) of the ankle joint. Force and strain energy of the AT during locomotion were calculated by fitting a quadratic function to the experimentally measured tendon force-length curve obtained from maximum voluntary isometric contractions. The maximum AT strain and force were affected by speed (p < 0.05, ranging from 4.0 to 4.9% strain and 1.989 to 2.556 kN), yet insufficient in magnitude to be considered as an effective stimulus for tendon adaptation. Besides the important tendon energy recoil during the propulsion phase (7.8 to 11.3 J), we found a recoil of elastic strain energy at the beginning of the stance phase of running (70-77 ms after touch down) between 1.7 ± 0.6 and 1.9 ± 1.1 J, which might be functionally relevant for running efficiency.

Is there a relationship between muscle-tendon properties and a variety of functional tasks in children with spastic cerebral palsy?

BACKGROUND

Cerebral palsy (CP) is the most common motor and movement disability in childhood. The mechano-morphological alterations of the spastic muscle itself as well as the functional limitations in CP are well documented. However, the relationship between muscle tendon properties and functional tests in CP remains unknown.

RESEARCH QUESTION

The aim of this study was to explore the relationship between spastic muscle mechano-morphological properties and functional performance in children with CP.

METHODS

This study included retrospective data from 22 children with spastic cerebral palsy with a mean age of 12.8 years (19 GMFCS I/3 GMFC II, 15 male/7 female, 8 unilateral involved/14 bilateral). Mechano-morphological properties of gastrocnemius (GM) and Achilles tendon (AT) were correlated with a variety of functional measures, maximal isometric strength, the Muscle Power Sprint test (MPST), 6-minute walk test (6MWT) and 3D-gait analysis using the Pearson Coefficient.

RESULTS

Muscle-tendon properties were normalized to remove anthropometric dimensions because of strong associations with anthropometric data. Higher isometric muscle strength was related to longer normalized GM fascicle lengths (r = 0.67, p < 0.01). The distance reached in the 6MWT positively correlated with normalized GM fascicle lengths (r = 0.61, p < 0.01). Higher AT stiffness was associated with faster performance in the MPST (r = 0.77, p < 0.01). Finally, there was an association between ankle power and both longer normalized AT length and shorter muscle belly (r = 0.60 and r = 0.54, p < 0.01).

SIGNIFICANCE

The findings of this study give more insight into the function specific adaptations of a spastic muscle-tendon unit. While walking, assessed through the 6MWT, was related to normalized gastrocnemius fascicle length, sprint performance was associated with an increased AT stiffness. These results provide a better understanding of the relationship between functional tasks and spastic muscle-tendon properties, which offers potential for improved and targeted interventions in CP.

Lower-limb muscle function is influenced by changing mechanical demands in cycling

Although cycling is a seemingly simple, reciprocal task, muscles must adapt their function to satisfy changes in mechanical demands induced by higher crank torques and faster pedalling cadences. We examined whether muscle function was sensitive to these changes in mechanical demands across a wide range of pedalling conditions. We collected experimental data of cycling where crank torque and pedalling cadence were independently varied from 13 to 44 N m and 60 to 140 rpm. These data were used in conjunction with musculoskeletal simulations and a recently developed functional index-based approach to characterise the role of human lower-limb muscles. We found that in muscles that generate most of the mechanical power and work during cycling, greater crank torque induced shifts towards greater muscle activation, greater positive muscle-tendon unit (MTU) work and a more motor-like function, particularly in the limb extensors. Conversely, with faster pedalling cadence, the same muscles exhibited a phase advance in muscle activity prior to crank top dead centre, which led to greater negative MTU power and work and shifted the muscles to contract with more spring-like behaviour. Our results illustrate the capacity for muscles to adapt their function to satisfy the mechanical demands of the task, even during highly constrained reciprocal tasks such as cycling. Understanding how muscles shift their contractile performance under varied mechanical and environmental demands may inform decisions on how to optimise pedalling performance and to design targeted cycling rehabilitation therapies for muscle-specific injuries or deficits.

Reduced joint reaction and muscle forces with barefoot running

Barefoot running has been associated with lowered joint loading, but it remains unclear whether the biomechanical benefits are evident after mid-distance running. A musculoskeletal model was adopted for estimating lower limb joint loading for barefoot (n = 10) versus shod (n = 10) 5 km running. The barefoot group reduced peak joint reaction force at the hip and knee, and presented muscle force reductions compared to shod controls with significant group effects and interaction effects (p < .05). These changes were primarily group effects as time point effects were not significant. These findings should be considered when designing barefoot running shoes, running programmes, and injury prevention programmes.

Increasing the midsole bending stiffness of shoes alters gastrocnemius medialis muscle function during running

In recent years, increasing the midsole bending stiffness (MBS) of running shoes by embedding carbon fibre plates in the midsole resulted in many world records set during long-distance running competitions. Although several theories were introduced to unravel the mechanisms behind these performance benefits, no definitive explanation was provided so far. This study aimed to investigate how the function of the gastrocnemius medialis (GM) muscle and Achilles tendon is altered when running in shoes with increased MBS. Here, we provide the first direct evidence that the amount and velocity of GM muscle fascicle shortening is reduced when running with increased MBS. Compared to control, running in the stiffest condition at 90% of speed at lactate threshold resulted in less muscle fascicle shortening (p = 0.006, d = 0.87), slower average shortening velocity (p = 0.002, d = 0.93) and greater estimated Achilles tendon energy return (p ≤ 0.001, d = 0.96), without a significant change in GM fascicle work (p = 0.335, d = 0.40) or GM energy cost (p = 0.569, d = 0.30). The findings of this study suggest that running in stiff shoes allows the ankle plantarflexor muscle-tendon unit to continue to operate on a more favourable position of the muscle's force-length-velocity relationship by lowering muscle shortening velocity and increasing tendon energy return.

Lower leg muscle-tendon unit characteristics are related to marathon running performance

The human ankle joint and plantar flexor muscle–tendon unit play an important role in endurance running. It has been assumed that muscle and tendon interactions and their biomechanical behaviours depend on their morphological and architectural characteristics. We aimed to study how plantar flexor muscle characteristics influence marathon running performance and to determine whether there is any difference in the role of the soleus and gastrocnemii. The right lower leg of ten male distance runners was scanned with magnetic resonance imagining. The cross-sectional areas of the Achilles tendon, soleus, and lateral and medial gastrocnemius were measured, and the muscle volumes were calculated. Additional ultrasound scanning was used to estimate the fascicle length of each muscle to calculate the physiological cross-sectional area. Correlations were found between marathon running performance and soleus volume (r = 0.55, p = 0.048), soleus cross-sectional area (r = 0.57, p = 0.04), soleus physiological cross-sectional area (PCSA-IAAF r = 0.77, p < 0.01, CI± 0.28 to 0.94), Achilles tendon thickness (r = 0.65, p < 0.01), and soleus muscle-to-tendon ratio (r = 0.68, p = 0.03). None of the gastrocnemius characteristics were associated with marathon performance. We concluded that a larger soleus muscle with a thicker Achilles tendon is associated with better marathon performance. Based on these results, it can be concluded the morphological characteristics of the lower leg muscle–tendon unit correlate with running performance.

A generic musculoskeletal model of the juvenile lower limb for biomechanical analyses of gait

The aim of this study was to develop a generic musculoskeletal model of a healthy 10-year-old child and examine the effects of geometric scaling on the calculated values of lower-limb muscle forces during gait. Subject-specific musculoskeletal models of five healthy children were developed from in vivo MRI data, and these models were subsequently used to create a generic juvenile (GJ) model. Calculations of lower-limb muscle forces for normal walking obtained from two scaled-generic versions of the juvenile model (SGJ1 and SGJ2) were evaluated against corresponding results derived from an MRI-based model of one subject (SSJ1). The SGJ1 and SGJ2 models were created by scaling the GJ model using gait marker positions and joint centre locations derived from MRI imaging, respectively. Differences in the calculated values of peak isometric muscle forces and muscle moment arms between the scaled-generic models and MRI-based model were relatively small. Peak isometric muscle forces calculated for SGJ1 and SGJ2 were respectively 2.2% and 3.5% lower than those obtained for SSJ1. Model-predicted muscle forces for SGJ2 agreed more closely with calculations obtained from SSJ1 than corresponding results derived from SGJ1. These results suggest that accurate estimates of muscle forces during gait may be obtained by scaling generic juvenile models based on joint centre locations. The generic juvenile model developed in this study may be used as a template for creating subject-specific musculoskeletal models of normally-developing children in studies aimed at describing lower-limb muscle function during gait.

The influence of Achilles tendon mechanical behaviour on "apparent" efficiency during running at different speeds

Purpose

We investigated the role of elastic strain energy on the “apparent” efficiency of locomotion (AE), a parameter that is known to increase as a function of running speed (up to 0.5–0.7) well above the values of “pure” muscle efficiency (about 0.25–0.30).

Methods

In vivo ultrasound measurements of the gastrocnemius medialis (GM) muscle–tendon unit (MTU) were combined with kinematic, kinetic and metabolic measurements to investigate the possible influence of the Achilles tendon mechanical behaviour on the mechanics (total mechanical work, W_TOT) and energetics (net energy cost, C_net) of running at different speeds (10, 13 and 16 km h⁻¹); AE was calculated as W_TOT/C_net.

Results

GM fascicles shortened during the entire stance phase, the more so the higher the speed, but the majority of the MTU displacement was accommodated by the Achilles tendon. Tendon strain and recoil increased as a function of running speed (P < 0.01 and P < 0.001, respectively). The contribution of elastic energy to the positive work generated by the MTU also increased with speed (from 0.09 to 0.16 J kg⁻¹ m⁻¹). Significant negative correlations (P < 0.01) were observed between tendon work and metabolic energy at each running speed (the higher the tendon work the lower the metabolic demand) and significant positive correlations were observed between tendon work and AE (P < 0.001) at each running speed (the higher the tendon work the higher the efficiency).

Conclusion

These results support the notion that the dynamic function of tendons is integral in reducing energy expenditure and increasing the “apparent” efficiency of running.

Effect of Strength Training on Biomechanical and Neuromuscular Variables in Distance Runners: A Systematic Review and Meta-Analysis

BACKGROUND

Concurrent strength and endurance (CSE) training improves distance running performance more than endurance training alone, but the mechanisms underpinning this phenomenon are unclear. It has been hypothesised that biomechanical or neuromuscular adaptations are responsible for improvements in running performance; however, evidence on this topic has not been synthesised in a review.

OBJECTIVE

To evaluate the effect of CSE training on biomechanical and neuromuscular variables in distance runners.

METHODS

Seven electronic databases were searched from inception to November 2018 using key terms related to running and strength training. Studies were included if the following criteria were met: (1) population: 'distance' or 'endurance' runners of any training status; (2) intervention: CSE training; (3) comparator: running-only control group; (4) outcomes: at least one biomechanical or neuromuscular variable; and, (5) study design: randomised and non-randomised comparative training studies. Biomechanical and neuromuscular variables of interest included: (1) kinematic, kinetic or electromyography outcome measures captured during running; (2) lower body muscle force, strength or power outcome measures; and (3) lower body muscle-tendon stiffness outcome measures. Methodological quality and risk of bias for each study were assessed using the PEDro scale. The level of evidence for each variable was categorised according to the quantity and PEDro rating of the included studies. Between-group standardised mean differences (SMD) with 95% confidence intervals (95% CI) were calculated for studies and meta-analyses were performed to identify the pooled effect of CSE training on biomechanical and neuromuscular variables.

RESULTS

The search resulted in 1578 potentially relevant articles, of which 25 met the inclusion criteria and were included. There was strong evidence that CSE training significantly increased knee flexion (SMD 0.89 [95% CI 0.48, 1.30], p < 0.001), ankle plantarflexion (SMD 0.74 [95% CI 0.21-1.26], p = 0.006) and squat (SMD 0.63 [95% CI 0.13, 1.12], p = 0.010) strength, but not jump height, more than endurance training alone. Moderate evidence also showed that CSE training significantly increased knee extension strength (SMD 0.69 [95% CI 0.29, 1.09], p < 0.001) more than endurance training alone. There was very limited evidence reporting changes in stride parameters and no studies examined changes in biomechanical and neuromuscular variables during running.

CONCLUSIONS

Concurrent strength and endurance training improves the force-generating capacity of the ankle plantarflexors, quadriceps, hamstrings and gluteal muscles. These muscles support and propel the centre of mass and accelerate the leg during running, but there is no evidence to suggest these adaptations transfer from strength exercises to running. There is a need for research that investigates changes in biomechanical and neuromuscular variables during running to elucidate the effect of CSE training on run performance in distance runners.

Individualized Muscle-Tendon Assessment and Training

The interaction of muscle and tendon is of major importance for movement performance and a balanced development of muscle strength and tendon stiffness could protect athletes from overuse injury. However, muscle and tendon do not necessarily adapt in a uniform manner during a training process. The development of a diagnostic routine to assess both the strength capacity of muscle and the mechanical properties of tendons would enable the detection of muscle-tendon imbalances, indicate if the training should target muscle strength or tendon stiffness development and allow for the precise prescription of training loads to optimize tendon adaptation. This perspective article discusses a framework of individualized muscle-tendon assessment and training and outlines a methodological approach for the patellar tendon.

Foot strike pattern during running alters muscle-tendon dynamics of the gastrocnemius and the soleus

Running is thought to be an efficient gait due, in part, to the behavior of the plantar flexor muscles and elastic energy storage in the Achilles tendon. Although plantar flexor muscle mechanics and Achilles tendon energy storage have been explored during rearfoot striking, they have not been fully characterized during forefoot striking. This study examined how plantar flexor muscle-tendon mechanics during running differs between rearfoot and forefoot striking. We used musculoskeletal simulations, driven by joint angles and electromyography recorded from runners using both rearfoot and forefoot striking running patterns, to characterize plantar flexor muscle-tendon mechanics. The simulations revealed that foot strike pattern affected the soleus and gastrocnemius differently. For the soleus, forefoot striking decreased tendon energy storage and fiber work done while the muscle fibers were shortening compared to rearfoot striking. For the gastrocnemius, forefoot striking increased muscle activation and fiber work done while the muscle fibers were lengthening compared to rearfoot striking. These changes in gastrocnemius mechanics suggest that runners planning to convert to forefoot striking might benefit from a progressive eccentric gastrocnemius strengthening program to avoid injury.

Eccentric hamstring strength in elite track and field athletes on the British Athletics world class performance program

OBJECTIVES

This novel study aims to provide unique data on eccentric hamstring strength in elite track and field athletes.

DESIGN

Clinical measurement, cross-sectional study.

SETTING

Across two British Athletics performance centres.

PARTICIPANTS

44 elite British track and field athletes.

MAIN OUTCOME MEASURES

Eccentric hamstring force and torque were evaluated using the Nordbord device. Injury history and demographic data was collected to assess whether differences between gender, event group, limb symmetry and previous injury history were present.

RESULTS

Average peak force for males and females was 418.38N and 318.54N. Relative to body weight there were no gender differences (Male 5.21N.kg^-1, Female 4.99N.kg^-1) (p = 0.62). The right limb was significantly stronger in long sprint (400m athletes) (p = 0.00018) (d = 0.56). No differences in relative force or torque were observed between previously injured and non-injured limbs.

CONCLUSIONS

This study provides unique data in elite track and field athletes. Relative force per kilogram should be used when comparing male and female athletes. Unlike other studies, we found no difference in eccentric strength between previously injured and non-injured limbs. The novel finding of increased eccentric strength demonstrated in the right limb in 400m sprinters may be due to the asymmetric demands of bend running and may be considered normal.

Plantar load characteristics among runners with different strike patterns during preferred speed

Objectives

This study aimed to compare the plantar loads between habitual rearfoot strike (RFS) and non-RFS (NRFS) during running under the participant’s preferred speed.

Methods

A total of 66 (36 RFS, 30 NRFS) healthy amateur male runners were included in our study. In-shoe pressure sensors were utilised to the test plantar loads when participants were running using their preferred foot strike pattern and running speed (RFS: 3.2 ± 0.3 m/s; NRFS: 3.4 ± 0.4 m/s).

Results

Results indicated that running speed has a significant effect on the total contact area [F (1, 64) = 7.061, P = 0.01, η² = 0.101], which also affects midfoot and forefoot regions. No significant difference was found on the total maximum force, force-time-integral, peak pressure (PP) and pressure-time-integral (PTI), but the total contact area of RFS was higher than that of NRFS runners [F (1, 64) = 77.406, P < 0.001, η² = 0.551]. Plantar loads were mainly focused on the heel and midfoot for RFS runners in all variables, and NRFS runners experienced increased PP and PTI in medial forefoot regions.

Conclusion

Habitual runners tend to adjust their contact area according to the running speed through midfoot and forefoot regions. RFS runners remain susceptible to high impact force on the heel and midfoot, and NRFS runners experience high impact force in the first metatarsal regions. Therefore, runners should note this situation to avoid running-related injuries.

Calf muscle strain injuries in elite Australian Football players: A descriptive epidemiological evaluation

BACKGROUND

Calf muscle strain injuries (CMSI) show consistent rates of prevalence and re-injury in elite Australian Football players. An epidemiological evaluation is warranted to better understand the clinical presentation and recovery of CMSI.

PURPOSE

First, to describe the epidemiology of CMSI in elite Australian Football players. Second, to determine if recovery following injury is different according to: (a) injury type (index vs re-injury); (b) muscle injured (soleus vs gastrocnemius); and (c) mechanism of injury (running-related activity vs non running-related activity).

STUDY DESIGN

Descriptive epidemiological.

METHODS

Data retrieved from the Soft Tissue injury Registry of the Australian Football League were analyzed. Sixteen clubs submitted data on CMSI from 2014 to 2017. Data included: player characteristics, training and match history at the time of injury, MRI, and the time to reach recovery milestones.

RESULTS

One hundred and eighty-four CMSI were included (149 index injuries; 35 re-injuries). Soleus injuries were most prevalent (84.6%). Soleus injuries took 25.4 ± 16.2 days to return to play, whereas gastrocnemius injuries took 19.1 ± 14.1 days (P = .097). CMSI sustained during running-related activities took approximately 12 days longer to recover than injuries sustained during non running-related activities (P = .001). Compared to index injuries, re-injuries involved older players (P = .03) and significantly more time was taken to run at >90% of maximum speed, return to full training, and return to play (P ≤ .001). Almost all of the observed re-injuries involved soleus (91.4%).

CONCLUSION

Soleus injuries are more prevalent than gastrocnemius injuries in elite Australian Football players. Prognosis appears to be influenced by clinical factors, with CMSI sustained during running-related activities and re-injuries needing more time to recover.

Use of Loaded Conditioning Activities to Potentiate Middle- and Long-Distance Performance: A Narrative Review and Practical Applications

Blagrove, RC, Howatson, G, and Hayes, PR. Use of loaded conditioning activities to potentiate middle- and long-distance performance: a narrative review and practical applications. J Strength Cond Res 33(8): 2288-2297, 2019-The warm-up is an integral component of a middle- and long-distance athlete's preperformance routine. The use of a loaded conditioning activity (LCA), which elicits a postactivation potentiation (PAP) response to acutely enhance explosive power performance, is well researched. A similar approach incorporated into the warm-up of a middle- or long-distance athlete potentially provides a novel strategy to augment performance. Mechanisms that underpin a PAP response, relating to acute adjustments within the neuromuscular system, should theoretically improve middle- and long-distance performance through improvements in submaximal force-generating ability. Attempts to enhance middle- and long-distance-related outcomes using an LCA have been used in several recent studies. Results suggest that benefits to performance may exist in well-trained middle- and long-distance athletes by including high-intensity resistance training (1-5 repetition maximum) or adding load to the sport skill itself during the latter part of warm-ups. Early stages of performance seem to benefit most, and it is likely that recovery (5-10 minutes) also plays an important role after an LCA. Future research should consider how priming activity, designed to enhance the VO2 kinetic response, and an LCA may interact to affect performance, and how different LCAs might benefit various modes and durations of middle- and long-distance exercises.

Ultrasound-Based Optimal Parameter Estimation Improves Assessment of Calf Muscle-Tendon Interaction During Walking

We present and evaluate a new approach to estimate calf muscle-tendon parameters and calculate calf muscle-tendon function during walking. We used motion analysis, ultrasound, and EMG data of the calf muscles collected in six young and six older adults during treadmill walking as inputs to a new optimal estimation algorithm. We used estimated parameters or scaled generic parameters in an existing approach to calculate muscle fiber lengths and activations. We calculated the fit with experimental data in terms of root mean squared differences (RMSD) and coefficients of determination (R²). We also calculated the calf muscle metabolic energy cost. RMSD between measured and calculated fiber lengths and activations decreased and R² increased when estimating parameters compared to using scaled generic parameters. Moreover, R² between measured and calculated gastrocnemius medialis fiber length and soleus activations increased by 19 and 70%, and calf muscle metabolic energy decreased by 25% when using estimated parameters compared to using scaled generic parameters at speeds not used for estimation. This new approach estimates calf muscle-tendon parameters in good accordance with values reported in literature. The approach improves calculations of calf muscle-tendon interaction during walking and highlights the importance of individualizing calf muscle-tendon parameters.

Mechanical work in shuttle running as a function of speed and distance: Implications for power and efficiency

Biomechanics (and energetics) of human locomotion are generally studied at constant, linear, speed whereas less is known about running mechanics when velocity changes (because of accelerations, decelerations or changes of direction). The aim of this study was to calculate mechanical work and power and to estimate mechanical efficiency in shuttle runs (as an example of non-steady locomotion) executed at different speeds and over different distances. A motion capture system was utilised to record the movements of the body segments while 20 athletes performed shuttle runs (with a 180° change of direction) at three paces (slow, moderate and maximal) and over four distances (5, 10, 15 and 20 m). Based on these data the internal, external and total work of shuttle running were calculated as well as mechanical power; mechanical efficiency was then estimated based on values of energy cost reported in the literature. Total mechanical work was larger the faster the velocity and the shorter the distance covered (range: 2.3-3.7 J m^-1 kg^-1) whereas mechanical efficiency showed an opposite trend (range: 0.20-0.50). At maximal speed, over all distances, braking/negative power (about 21 W kg^-1) was twice the positive power. Present results highlight that running humans can exert a larger negative than positive power, in agreement with the fundamental proprieties of skeletal muscles in vivo. A greater relative importance of the constant speed phase, associated to a better exploitation of the elastic energy saving mechanism, is likely responsible of the higher efficiency at the longer shuttle distances.

Distinct muscle-tendon interaction during running at different speeds and in different loading conditions

The interaction between the Achilles tendon and the triceps surae muscles seems to be modulated differently with various task configurations. Here we tested the hypothesis that the increased forces and ankle joint work during running under contrasting conditions (altered speed or load) would be met by different, time-dependent adjustments at the muscle-tendon level. Ultrasonography, electromyography, kinematics, and ground reaction force measurements were used to examine Achilles tendon, gastrocnemius, and soleus muscle mechanics in 16 runners in four different running conditions, consisting of a combination of two different speeds (preferred and +20% of preferred speed) and two loading conditions (unloaded and +20% of body mass). Positive ankle joint work increased similarly (+13%) with speed and load. Gastrocnemius and soleus muscle fascicle length and peak velocity were not altered by either condition, suggesting that contractile conditions are mostly preserved despite the constraints imposed in this experimental design. However, at higher running speed, tendon length changes were unaltered but mean muscle electromyographic activity increased in gastrocnemius (+10%, P < 0.01) and soleus (+14%, P < 0.01). Conversely, when loading was increased, mean muscle activity remained similar to unloaded conditions but the mean velocity of gastrocnemius fascicles was reduced and tendon recoil increased (+29%, P < 0.01). Collectively, these results suggest that the neuromuscular system meets increased mechanical demands by favoring economical force production when enough time is available. NEW & NOTEWORTHY We demonstrate that muscle-tendon mechanics are adjusted differently when running under constraints imposed by speed or load, despite comparable increases in work. The neuromuscular system likely modulates the way force is produced as a function of availability of time and potential energy.

Ultrasonography Features of the Plantar Fascia Complex in Patients with Chronic Non-Insertional Achilles Tendinopathy: A Case-Control Study

Purpose: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). Methods: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. Results: the CFP and PF at the calcaneus thickness showed statistically significant differences (P < 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P > 0.05) were observed between groups. Conclusion: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.

Propulsion strategy in running in children and adolescents with cerebral palsy

BACKGROUND

Running is a fundamental movement skill important for participation in physical activity. Children with cerebral palsy (CP) who are classified at Gross Motor Function Classification Scale (GMFCS) level I and II are able to run but may be limited by neuromuscular impairments.

RESEARCH QUESTION

To describe the propulsion strategy (PS) during running of children and adolescents with CP.

METHODS

This cross-sectional study used kinematic and kinetic data collected during running from 40 children and adolescents with unilateral or bilateral CP and 21 typically developing (TD) children. Maximum speed, peak ankle power generation (A2), peak hip flexor power generation in swing (H3) and PS (PS = A2/(A2 + H3)) were calculated. Linear mixed models were developed to analyze differences between groups.

RESULTS

Maximum speed, A2 and PS were significantly less in children with CP GMFCS level I than in TD children and significantly less in children in GMFCS level II than level I. For children with CP, A2 and PS were significantly smaller in affected legs than non-affected legs. In affected legs, H3 was significantly larger in children in GMFCS level II than GMFCS level I but not different between TD children and children in GFMCS level II.

SIGNIFICANCE

The contribution of ankle plantarflexor power to forward propulsion in running is reduced in young people with CP and is related to GMFCS level. This deficit appears to be compensated in part by increased hip flexor power generation but limits maximum sprinting speed.

Sprint running: from fundamental mechanics to practice-a review

In this review, we examine the literature in light of the mechanical principles that govern linear accelerated running. While the scientific literature concerning sprint mechanics is comprehensive, these principles of fundamental mechanics present some pitfalls which can (and does) lead to misinterpretations of findings. Various models of sprint mechanics, most of which build on the spring-mass paradigm, are discussed with reference to both the insight they provide and their limitations. Although much research confirms that sprinters to some extent behave like a spring-mass system with regard to gross kinematics (step length, step rate, ground contact time, and lower limb deformation), the laws of motion, supported by empirical evidence, show that applying the spring-mass model for accelerated running has flaws. It is essential to appreciate that models are pre-set interpretations of reality; finding that a model describes the motor behaviour well is not proof of the mechanism behind the model. Recent efforts to relate sprinting mechanics to metabolic demands are promising, but have the same limitation of being model based. Furthermore, a large proportion of recent literature focuses on the interaction between total and horizontal (end-goal) force. We argue that this approach has limitations concerning fundamental sprinting mechanics. Moreover, power analysis based on isolated end-goal force is flawed. In closing, some prominent practical concepts and didactics in sprint running are discussed in light of the mechanical principles presented. Ultimately, whereas the basic principles of sprinting are relatively simple, the way an athlete manages the mechanical constraints and opportunities is far more complex.