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Covelli I, De Giorgi S, Di Lorenzo A, Moretti B, Solarino G, Notarnicola A. The Role of Bone Edema in Plantar Fasciitis Treated with Temperature-Controlled High-Energy Adjustable Multi-Mode Emission Laser (THEAL) and Exercise: A Prospective Randomized Clinical Trial. Biomedicines 2024; 12:1729. [PMID: 39200194 PMCID: PMC11351923 DOI: 10.3390/biomedicines12081729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 07/28/2024] [Accepted: 07/30/2024] [Indexed: 09/02/2024] Open
Abstract
Plantar fasciitis is one of the most common causes of foot pain; in 35% of cases, it is also associated with bone edema of the heel. The aim of this study was to investigate the relationship between bone edema and the outcomes of temperature-controlled high-energy adjustable multi-mode emission laser (THEAL) and/or exercises in patients with plantar fasciitis. A prospective randomized clinical trial was designed, in which 48 patients suffering from plantar fasciitis, with or without bone edema, were treated with temperature-controlled high-energy adjustable multi-mode emission laser and exercises (the laser group) or with exercises only (the control group). The patients were evaluated at recruitment (T0) and at 2 (T1) and 6 months (T2), monitoring pain (with the Visual Analogue Scale), functionality (with the Foot Function Index), perception of improvement (with the Roles and Maudsley Score), and fascia thickness (with ultrasound examination). In both groups, there was a significant improvement in pain, functional recovery, perception of remission, and a reduction in plantar fascia thickness at T1 and T2. The laser group presented statistically better values at T2 for the Roles and Maudsley Score (z: 2.21; 0.027). The regression analysis showed that a greater reduction in fascia thickness occurred in the laser group (p-value: 0.047). In conclusion, the two conservative treatments were effective in patients suffering from plantar fasciitis, even in the presence of bone edema, but with lesser results.
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Affiliation(s)
- Ilaria Covelli
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
| | - Silvana De Giorgi
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Biagio Moretti
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
| | - Giuseppe Solarino
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
| | - Angela Notarnicola
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
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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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3
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Tenforde A, Hoenig T, Saxena A, Hollander K. Bone Stress Injuries in Runners Using Carbon Fiber Plate Footwear. Sports Med 2023; 53:1499-1505. [PMID: 36780101 PMCID: PMC10356879 DOI: 10.1007/s40279-023-01818-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/14/2023]
Abstract
The introduction of carbon fiber plate footwear has led to performance benefits in runners. The mechanism for these changes in running economy includes altered biomechanics of the foot and ankle. The association of this footwear with injuries has been a topic of debate clinically, but not described in the literature. In this Current Opinion article, illustrated by a case series of five navicular bone stress injuries in highly competitive running athletes, we discuss the development of running-related injuries in association with the use of carbon fiber plate footwear. While the performance benefits of this footwear are considerable, sports medicine providers should consider injuries possibly related to altered biomechanical demands affecting athletes who use carbon fiber plate footwear. Given the introduction of carbon fiber plate footwear into athletics and other endurance sports, strategies may be required to reduce risk of injury due to altered foot and ankle mechanics. This article is intended (1) to raise awareness on possible health concerns around the use of carbon fiber plate footwear, (2) to suggest a slow gradual transition from habitual to carbon fiber plate footwear, and (3) to foster medical research related to carbon fiber plate technology and injuries.
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Affiliation(s)
- Adam Tenforde
- Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA USA
| | - Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amol Saxena
- Department of Sports Medicine, Sutter-PAMF, Palo Alto, CA USA
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany
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Knopp M, Muñiz-Pardos B, Wackerhage H, Schönfelder M, Guppy F, Pitsiladis Y, Ruiz D. Variability in Running Economy of Kenyan World-Class and European Amateur Male Runners with Advanced Footwear Running Technology: Experimental and Meta-analysis Results. Sports Med 2023; 53:1255-1271. [PMID: 36862339 DOI: 10.1007/s40279-023-01816-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Advanced footwear technology improves average running economy compared with racing flats in sub-elite athletes. However, not all athletes benefit as performance changes vary from a 10% drawback to a 14% improvement. The main beneficiaries from such technologies, world-class athletes, have only been analyzed using race times. OBJECTIVE The aim of this study was to measure running economy on a laboratory treadmill in advanced footwear technology compared to a traditional racing flat in world-class Kenyan (mean half-marathon time: 59:30 min:s) versus European amateur runners. METHODS Seven world-class Kenyan and seven amateur European male runners completed a maximal oxygen uptake assessment and submaximal steady-state running economy trials in three different models of advanced footwear technology and a racing flat. To confirm our results and better understand the overall effect of new technology in running shoes, we conducted a systematic search and meta-analysis. RESULTS Laboratory results revealed large variability in both world-class Kenyan road runners, which ranged from a 11.3% drawback to a 11.4% benefit, and amateur Europeans, which ranged from a 9.7% benefit to a 1.1% drawback in running economy of advanced footwear technology compared to a flat. The post-hoc meta-analysis revealed an overall significant medium benefit of advanced footwear technology on running economy compared with traditional flats. CONCLUSIONS Variability of advanced footwear technology performance appears in both world-class and amateur runners, suggesting further testing should examine such variability to ensure validity of results and explain the cause as a more personalized approach to shoe selection might be necessary for optimal benefit.
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Affiliation(s)
- Melanie Knopp
- adidas Innovation, adidas AG, Herzogenaurach, Germany. .,Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
| | - Borja Muñiz-Pardos
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Saragossa, Spain
| | - Henning Wackerhage
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Martin Schönfelder
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Fergus Guppy
- Institute of Life and Earth Sciences, Heriot Watt University, Edinburgh, UK
| | - Yannis Pitsiladis
- School of Sport and Health Sciences, University of Brighton, Eastbourne, UK
| | - Daniel Ruiz
- adidas Innovation, adidas AG, Herzogenaurach, Germany
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Linares-Martín JÁ, Rico-González M. Influence of Minimalist Footwear in Middle and Long Distance Runners' Physical Fitness, Biomechanics, and Injury Incidence: A Systematic Review. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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6
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Shen B, Zhang S, Cui K, Zhang X, Fu W. Effects of a 12-week gait retraining program combined with foot core exercise on morphology, muscle strength, and kinematics of the arch: A randomized controlled trial. Front Bioeng Biotechnol 2022; 10:1022910. [PMID: 36299287 PMCID: PMC9589891 DOI: 10.3389/fbioe.2022.1022910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022] Open
Abstract
Objective: This study aims to explore the effects of a 12-week gait retraining program combined with foot core exercise on arch morphology, arch muscles strength, and arch kinematics. Methods: A total of 26 male recreational runners with normal arch structure who used rear-foot running strike (RFS) were divided into the intervention group (INT group) and control group (CON group) (n = 13 in each group). The INT group performed a 12-week forefoot strike (FFS) training combined with foot core exercises. The CON group did not change the original exercise habit. Before and after the intervention, the arch morphology, as well as the strength of hallux flexion, lesser toe flexion, and the metatarsophalangeal joint (MPJ) flexors were measured in a static position, and changes in the arch kinematics during RFS and FFS running were explored. Results: After a 12-week intervention, 1) the normalized navicular height increased significantly in the INT group by 5.1% (p = 0.027, Cohen's d = 0.55); 2) the hallux absolute flexion and relative flexion of the INT group increased significantly by 20.5% and 21.7%, respectively (p = 0.001, Cohen's d = 0.59; p = 0.001, Cohen's d = 0.73), the absolute and relative strength of the MPJ flexors of the INT group were significantly improved by 30.7% and 32.5%, respectively (p = 0.006, Cohen's d = 0.94; p = 0.006, Cohen's d = 0.96); 3) and during RFS, the maximum arch angle of the INT group declined significantly by 5.1% (p < 0.001, Cohen's d = 1.49), the arch height at touchdown increased significantly in the INT group by 32.1% (p < 0.001, Cohen's d = 1.98). Conclusion: The 12-week gait retraining program combined with foot core exercise improved the arch in both static and dynamic positions with a moderate to large effect size, demonstrating the superiority of this combined intervention over the standalone interventions. Thus, runners with weak arch muscles are encouraged to use this combined intervention as an approach to enhance the arch.
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Affiliation(s)
- Bin Shen
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Shen Zhang
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
| | - Kedong Cui
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xini Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Weijie Fu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
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7
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Encarnación-Martínez A, Wikstrom E, García-Gallart A, Sanchis-Sanchis R, Pérez-Soriano P. Seven-Weeks Gait-Retraining in Minimalist Footwear Has No Effect on Dynamic Stability Compared With Conventional Footwear. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:640-649. [PMID: 34665996 DOI: 10.1080/02701367.2021.1892021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 02/14/2021] [Indexed: 06/13/2023]
Abstract
Purpose: To investigate the effects of two different running footwear conditions (transition to minimalist footwear and conventional running footwear) on dynamic postural stability before and after 7 weeks of gait retraining program, and to evaluate the effect of fatigue on dynamic stability. Method: This randomized controlled clinical trial was carried out by 42 recreational male runners, who were randomly divided into two groups; Conventional Footwear Group (CFG) (n = 22) and Minimalist Footwear Group (MFG) (n = 20). Dynamic Postural Stability Index (DPSI), in a fatigued and non-fatigued state, were assessed before and after a gait retraining program. The gait retraining program consisted of three guided training sessions per week for 7 weeks. Training program was mainly focused on running technique and submaximal aerobic training with step-frequency exercises. Minimalist footwear was progressively introduced in the MFG. The CFG and MFG performed the same training exercises and a full body conditioning program. Fatigue was induced using a 30-minute running test at individual 85% of the maximal aerobic speed. Results: No differences in dynamic stability variables were found between MFG and CFG in any of the study condition. MFG and CFG showed better dynamic stability after the intervention program (CFG: 13.1% of change, DPSIpre = 0.3221 ± 0.04, DPSIpost = 0.2799 ± 0.04; p < .05; MFG: 6.7% of change, DPSIpre = 0.3117 ± 0.04, DPSIpost = 0.2907 ± 0.05). Finally, dynamic stability was significatively lower in both groups after fatigue protocol (p < .05). Conclusions: Following a 7-week gait retraining program, footwear did not affect the results, being the gait retraining program more relevant on improving dynamic stability.
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8
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Jastifer JR. Contemporary Review: The Foot and Ankle in Long-Distance Running. FOOT & ANKLE ORTHOPAEDICS 2022; 7:24730114221125455. [PMID: 36185350 PMCID: PMC9520164 DOI: 10.1177/24730114221125455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Distance runners represent a unique patient population. The cyclic activity associated with distance running leads to a high incidence of injury. Gait patterns, the extrinsic and intrinsic muscles of the foot and ankle, foot strike pattern, shoe wear considerations, alignment, and orthotics are also all important considerations that must be considered by the treating provider. The purpose of this work is to review relevant functional anatomy, recent studies on gait patterns in running, orthotics, and theory on how the body moves through space during running in order to better equip the clinician to treat long distance runners.
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Affiliation(s)
- James R. Jastifer
- Department Orthopaedic Surgery, Ascension Borgess Orthopedics, Kalamazoo, MI, USA
- Department of Orthopaedic Surgery, Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
- Department of Mechanical and Aerospace Engineering, Western Michigan University, Kalamazoo, MI, USA
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9
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Hébert-Losier K, Finlayson SJ, Lamb PF, Driller MW, Hanzlíková I, Dubois B, Esculier JF, Beaven CM. Kinematics of recreational male runners in "super", minimalist and habitual shoes. J Sports Sci 2022; 40:1426-1435. [PMID: 35699253 DOI: 10.1080/02640414.2022.2081767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We conducted an exploratory analysis to compare running kinematics of 16 male recreational runners wearing Nike Vaporfly 4% (VP4), Saucony Endorphin racing flat (FLAT), and their habitual (OWN) footwear. We also explored potential relationships between kinematic and physiological changes. Runners (age: 33 ± 12 y, V˙ O2peak: 55.2 ± 4.3 ml · kg-1·min-1) attended 3 sessions after completing an V˙ O2peak test in which sagittal plane 3D kinematics at submaximal running speeds (60%, 70% and 80% ʋ V˙ O2peak) were collected alongside economy measures. Kinematics were compared using notched boxplots, and between-shoe kinematic differences were plotted against between-shoe economy differences. Across intensities, VP4 involved longer flight times (6.7 to 10.0 ms) and lower stance hip range of motion (~3°), and greater vertical pelvis displacement than FLAT (~0.4 cm). Peak dorsiflexion angles (~2°), ankle range of motion (1.0° to 3.9°), and plantarflexion velocities (11.3 to 89.0 deg · sec-1) were greatest in FLAT and lowest in VP4. Foot-ground angles were smaller in FLAT (2.5° to 3.6°). Select kinematic variables were moderately related to economy, with higher step frequencies and shorter step lengths in VP4 and FLAT associated with improved economy versus OWN. Footwear changes from OWN altered running kinematics. The most pronounced differences were observed in ankle, spatiotemporal, and foot-ground angle variables.
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Affiliation(s)
- Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand.,Research & Development, The Running Clinic, Lac Beauport, Québec, Canada
| | - Steven J Finlayson
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
| | - Peter F Lamb
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Matthew W Driller
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Ivana Hanzlíková
- Department of Physiotherapy, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Blaise Dubois
- Research & Development, The Running Clinic, Lac Beauport, Québec, Canada
| | - Jean-Francois Esculier
- Research & Development, The Running Clinic, Lac Beauport, Québec, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher Martyn Beaven
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
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10
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Hébert-Losier K, Finlayson SJ, Driller MW, Dubois B, Esculier JF, Beaven CM. Metabolic and performance responses of male runners wearing 3 types of footwear: Nike Vaporfly 4%, Saucony Endorphin racing flats, and their own shoes. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:275-284. [PMID: 33264686 PMCID: PMC9189709 DOI: 10.1016/j.jshs.2020.11.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/02/2020] [Accepted: 10/22/2020] [Indexed: 06/01/2023]
Abstract
PURPOSE We compared running economy (RE) and 3-km time-trial (TT) variables of runners wearing Nike Vaporfly 4% (VP4), Saucony Endorphin lightweight racing flats (FLAT), and their habitual running (OWN) footwear. METHODS Eighteen male recreational runners (age = 33.5 ± 11.9 year (mean ± SD), peak oxygen uptake (VO2peak) = 55.8 ± 4.4 mL/kg·min) attended 4 sessions approximately 7 days apart. The first session consisted of a VO2peak test to inform subsequent RE speeds set at 60%, 70%, and 80% of the speed eliciting VO2peak. In subsequent sessions, treadmill RE and 3-km TTs were assessed in the 3 footwear conditions in a randomized, counterbalanced crossover design. RESULTS Oxygen consumption (mL/kg·min) was less in VP4 (from 4.3% to 4.4%, p ≤ 0.002) and FLAT (from 2.7% to 3.4%, p ≤ 0.092) vs. OWN across intensities, with a non-significant difference between VP4 and FLAT (1.0%-1.7%, p ≥ 0.292). Findings related to energy cost (W/kg) and energetics cost of transport (J/kg·m) were comparable. VP4 3-km TT performance (11:07.6 ± 0:56.6 mm:ss) was enhanced vs. OWN by 16.6 s (2.4%, p = 0.005) and vs. FLAT by 13.0 s (1.8%, p = 0.032). The 3-km times between OWN and FLAT (0.5%, p = 0.747) were similar. Most runners (n = 11, 61%) ran their fastest TT in VP4. CONCLUSION Overall, VP4 improved laboratory-based RE measures in male recreational runners at relative speeds compared to OWN, but the RE improvements in VP4 were not significant vs. FLAT. More runners exhibited better treadmill TT performances in VP4 (61%) vs. FLAT (22%) and OWN (17%). The variability in RE (-10.3% to 13.3%) and TT (-4.7% to 9.3%) improvements suggests that responses to different types of shoes are individualized and warrant further investigation.
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Affiliation(s)
- Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Mount Maunganui, Tauranga 3116, New Zealand.
| | - Steven J Finlayson
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Mount Maunganui, Tauranga 3116, New Zealand
| | - Matthew W Driller
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Mount Maunganui, Tauranga 3116, New Zealand; Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
| | - Blaise Dubois
- Research & Development, the Running Clinic, Lac-Beauport, QC G3B 2J8, Canada
| | | | - Christopher Martyn Beaven
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Mount Maunganui, Tauranga 3116, New Zealand
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11
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Thompson M, Hoffman K, Blythe L, Hasler R, Longtain M. The Coupling of Stride Length and Foot Strike in Running. Front Sports Act Living 2022; 4:768801. [PMID: 35498531 PMCID: PMC9039359 DOI: 10.3389/fspor.2022.768801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
Modifying stride length and/or foot strike in running results in mechanical alterations associated with injury risk. Stride length and foot strike have often been treated as independent factors that affect running mechanics, but there is evidence to suggest that they may be coupled. The purpose of this study was to determine if foot strike and stride length are coupled in running, and if so, can these variables be independently manipulated? Additionally, we sought to determine how independently and simultaneously manipulating stride length and foot strike influenced running kinematics and kinetics. Fifteen individuals ran over ground with stride lengths +/– 10 % of their preferred stride length while adopting both a fore/mid foot strike and rear foot strike pattern, as well as running with their self-selected stride length and foot strike when the opposite variable was controlled. Three-dimensional motion capture and force plate data were captured synchronously during the manipulated stride length x foot strike trials. The results indicate that foot strike and stride length are coupled, with shorter stride lengths being associated with a F/MFS and longer stride lengths being associated with a RFS pattern. Impact peak magnitude was primarily dependent on foot strike, with a F/MFS pattern reducing the magnitude of the impact peak force regardless of stride length. Peak vertical and horizontal ground reaction forces were found to be primarily dependent on stride length, with longer stride lengths resulting in increased vertical and horizontal ground reaction forces, regardless of foot strike. It is difficult, but possible, to independently manipulate stride length and foot strike. Clinicians should be aware of the coupled changes in stride length and foot strike.
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Affiliation(s)
- Missy Thompson
- Department of Health & Human Performance, Fort Lewis College, Durango, CO, United States
- *Correspondence: Missy Thompson
| | - Kristine Hoffman
- Department of Orthopedics, Denver Health Medical Center, Denver, CO, United States
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lindsay Blythe
- Department of Health & Human Performance, Fort Lewis College, Durango, CO, United States
| | - Rachel Hasler
- Department of Health & Human Performance, Fort Lewis College, Durango, CO, United States
| | - Megan Longtain
- Department of Health & Human Performance, Fort Lewis College, Durango, CO, United States
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12
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Effects of Minimalist Footwear and Foot Strike Pattern on Plantar Pressure during a Prolonged Running. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12010506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The use of minimalist shoes (MS) in running involves changes in running mechanics compared to conventional shoes (CS), but there is still little research analysing the effects of this footwear on plantar pressure, which could help to understand some risk injury factors. Moreover, there are no studies examining the effects of a prolonged running and foot strike patterns on baropodometric variables in MS. Therefore, the aim of this study was to analyse the changes produced using MS on plantar pressure during a prolonged running, as well as its interaction with the time and foot strike pattern. Twenty-one experienced minimalist runners (age 38 ± 10 years, MS running experience 2 ± 1 years) ran with MS and CS for 30 min at 80% of their maximal aerobic speed, and mean pressure, peak pressure, contact time, centre of pressure velocity, relative force and contact area were analysed using a pressure platform. Foot strike pattern and time were also considered as factors. The multivariable linear regression mixed models showed that the use of MS induced, at the end of a prolonged running, higher peak pressure (p = 0.008), lower contact time (p = 0.004) and lower contact area (p < 0.001) than using CS. Also, runners with forefoot strike pattern using MS, compared to midfoot and rearfoot patterns, showed higher mean and peak pressure (p < 0.001) and lower contact time and area (p < 0.05). These results should be considered when planning training for runners using MS, as higher peak pressure values when using this type of footwear could be a risk factor for the development of some foot injuries.
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Davis IS, Hollander K, Lieberman DE, Ridge ST, Sacco ICN, Wearing SC. Stepping Back to Minimal Footwear: Applications Across the Lifespan. Exerc Sport Sci Rev 2021; 49:228-243. [PMID: 34091498 DOI: 10.1249/jes.0000000000000263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Minimal footwear has existed for tens of thousands of years and was originally designed to protect the sole of the foot. Over the past 50 yr, most footwear has become increasingly more cushioned and supportive. Here, we review evidence that minimal shoes are a better match to our feet, which may result in a lower risk of musculoskeletal injury.
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Affiliation(s)
- Irene S Davis
- Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
| | | | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge MA
| | - Sarah T Ridge
- Department of Exercise Sciences, Brigham Young University, Salt Lake City, Utah
| | - Isabel C N Sacco
- Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
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Daily activity in minimal footwear increases foot strength. Sci Rep 2021; 11:18648. [PMID: 34545114 PMCID: PMC8452613 DOI: 10.1038/s41598-021-98070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 08/30/2021] [Indexed: 11/24/2022] Open
Abstract
The human foot is uniquely adapted to bipedal locomotion and has a deformable arch of variable stiffness. Intrinsic foot muscles regulate arch deformation, making them important for foot function. In this study we explore the hypothesis that normal daily activity in minimal footwear, which provides little or no support, increases foot muscle strength. Western adults wore minimal footwear for a six-month period (the “intervention” group). Foot strength, i.e., maximum isometric plantarflexion strength at the metatarsophalangeal joints, and foot biometrics were measured before and after the intervention. An additional group was investigated to add further insight on the long-term effects of footwear, consisting of Western adults with an average 2.5 years of experience in minimal footwear (the “experienced” group). This study shows that foot strength increases by, on average, 57.4% (p < 0.001) after six months of daily activity in minimal footwear. The experienced group had similar foot strength as the post intervention group, suggesting that six months of regular minimal footwear use is sufficient to gain full strength, which may aid healthy balance and gait.
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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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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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Troy KL, Davis IS, Tenforde AS. A Narrative Review of Metatarsal Bone Stress Injury in Athletic Populations: Etiology, Biomechanics, and Management. PM R 2020; 13:1281-1290. [PMID: 33155355 DOI: 10.1002/pmrj.12518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 01/13/2023]
Abstract
Metatarsal bone stress injuries (BSIs) are common in athletic populations. BSIs are overuse injuries that result from an accumulation of microdamage that exceeds bone remodeling. Risk for metatarsal BSI is multifactorial and includes factors related to anatomy, biology, and biomechanics. In this article, anatomic factors including foot type, metatarsal length, bone density, bone geometry, and intrinsic muscle strength, which each influence how the foot responds to load, are discussed. Biologic factors such as low energy availability and impaired bone metabolism influence the quality of the bone. Finally, the influence of biomechanical loads to bone such as peak forces, load rates, and loading cycles are reviewed. General management of metatarsal BSI is discussed, including acute care, rehabilitation, treatment of refractory metatarsal BSI, and evaluation of healing/return to sport. Finally, we identify future research priorities and emerging treatments for metatarsal BSI.
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Affiliation(s)
- Karen L Troy
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Irene S Davis
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, USA.,Spaulding National Running Center, Spaulding Hospital, Cambridge, MA, USA
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, USA.,Spaulding National Running Center, Spaulding Hospital, Cambridge, MA, USA
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Abstract
Long-distance running has become increasingly popular during the past decades. Many running patients pose questions to their orthopaedic surgeons regarding risks, benefits, and running techniques. This article identifies 11 running-related questions that patients may ask and provides information to help answer those questions. This review discusses data on the health benefits of running, common running injuries, the relationship between running and osteoarthritis, recommendations regarding running after orthopaedic surgery, running shoes, and other questions that may arise when treating the running athlete.
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Abstract
Loading rates have been linked to running injuries, revealing persistent impact features that change direction among three-dimensional axes in different footwear and footstrike patterns. Extracting peak loads from ground reaction forces, however, can neglect the time-varying loading patterns experienced by the runner in each footfall. Following footwear and footstrike manipulations during laboratory-based overground running, we examined three-dimensional loading rate-time features in each direction (X, Y, Z) using principal component analysis. Twenty participants (9 M, 11 F, age: 25.3 ± 3.6 y) were analysed during 14 running trials in each of two footwear (cushioned and minimalist) and three footstrike conditions (forefoot, midfoot, rearfoot). Two principal components (PC) captured the primary loading rate-time features (PC1: 42.5% and PC2: 22.8% explained variance) and revealed interaction among axes, footwear, and footstrike conditions (PC1: F (2.1, 40.1) = 5.6, p = 0.007, η 2 = 0.23; PC2: F (2.0, 38.4) = 62.3, p < 0.001, η 2 = 0.77). Rearfoot running in cushioned footwear attenuated impact loads in the vertical direction, and forefoot running in minimalist footwear attenuated impact loads in the anterior-posterior and medial-lateral directions relative to forefoot running in cushioned shoes. Loading patterns depend on footwear and footstrike interactions, which require shoes that match the runner's footstrike pattern.
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Affiliation(s)
- Andrew D Nordin
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida , Gainesville, FL, USA
| | - Janet S Dufek
- Department of Kinesiology and Nutrition Sciences, University of Nevada , Las Vegas, NV, USA
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Futrell EE, Gross KD, Reisman D, Mullineaux DR, Davis IS. Transition to forefoot strike reduces load rates more effectively than altered cadence. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:248-257. [PMID: 32444149 PMCID: PMC7242218 DOI: 10.1016/j.jshs.2019.07.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/02/2019] [Accepted: 06/10/2019] [Indexed: 05/13/2023]
Abstract
BACKGROUND Excessive vertical impacts at landing are associated with common running injuries. Two primary gait-retraining interventions aimed at reducing impact forces are transition to forefoot strike and increasing cadence. The objective of this study was to compare the short- and long-term effects of 2 gait-retraining interventions aimed at reducing landing impacts. METHODS A total of 39 healthy recreational runners using a rearfoot strike and a cadence of ≤170 steps/min were randomized into cadence (CAD) or forefoot strike (FFS) groups. All participants performed 4 weeks of strengthening followed by 8 sessions of gait-retraining using auditory feedback. Vertical average load rates (VALR) and vertical instantaneous load rates (VILR) were calculated from the vertical ground reaction force curve. Both cadence and foot strike angle were measured using 3D motion analysis and an instrumented treadmill at baseline and at 1 week, 1 month, and 6 months post retraining. RESULTS ANOVA revealed that the FFS group had significant reductions in VALR (49.7%) and VILR (41.7%), and changes were maintained long term. Foot strike angle in the FFS group changed from 14.2° dorsiflexion at baseline to 3.4° plantarflexion, with changes maintained long term. The CAD group exhibited significant reduction only in VALR (16%) and only at 6 months. Both groups had significant and similar increases in cadence at all follow-ups (CAD, +7.2% to 173 steps/min; and FFS, +6.1% to 172 steps/min). CONCLUSION Forefoot strike gait-retraining resulted in significantly greater reductions in VALR and similar increases in cadence compared to cadence gait-retraining in the short and long term. Cadence gait-retraining resulted in small reductions in VALR at only the 6-month follow-up.
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Affiliation(s)
- Erin E Futrell
- Department of Physical Therapy, Springfield College, Springfield, MA 01109, USA; Spaulding National Running Center, Harvard Medical School, Cambridge, MA 02138, USA.
| | - K Douglas Gross
- Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA 02129, USA
| | - Darcy Reisman
- Department of Physical Therapy, University of Delaware, Newark, DE 19713, USA
| | - David R Mullineaux
- School of Sport and Exercise Science, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, Brayford Pool, LN6 7TS, UK
| | - Irene S Davis
- Spaulding National Running Center, Harvard Medical School, Cambridge, MA 02138, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
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Sánchez-Ramírez C, Alegre LM. Plantar support adaptations in healthy subjects after eight weeks of barefoot running training. PeerJ 2020; 8:e8862. [PMID: 32266122 PMCID: PMC7120041 DOI: 10.7717/peerj.8862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/05/2020] [Indexed: 11/24/2022] Open
Abstract
Background Although the studies of barefoot running have intensified, it is still missing longitudinal work analyzing the effects of barefoot running on the phases of plantar support. The objective of this research was to analyze the modifications undergone by the Total Foot Contact (TFC) phase and its Flat Foot Phase (FFP) in subjects beginning the practice of barefoot running, in its acute and chronic effects. Methods A total of 28 subjects were divided into the Barefoot Group (BFGr) (n = 16) and the Shod Group (SHGr) (n = 12), evaluated before (Baseline) and after running for 20 min at 3.05 m·s−1 (Post 20 min Running), and at the end of a running training protocol with an 8-week long progressive volume (Post-8-week Training). The dynamic plantar support was measured with a baropodoscope. The duration of TFC (ms), the moment at which the FFP occurred, the maximum surface of TFC (MSTFC) (cm2), the FFP surface (SFFP) (cm2), the peak pressure of TFC (PP°TFC) (kg·cm−2), and the peak pressure of FFP (PP°FFP) (kg·cm−2) were recorded. The 3 × 2 ANOVA analysis was made to determine the effects and interactions that the condition produced (Shod/Barefoot), and the time factor (Baseline/Post 20 min Running/Post-8-week Training). Results The condition factor caused more significant effects than the time factor in all the variables. Duration of TFC in BFGr showed significant differences between the Baseline and Post-8-week Training (p = 0.000) and between Post-20-min Running and Post-8-week Training (p = 0.000), with an increasing trend. In the moment at which the FFP occurred a significant increase (p = 0.029) increase was found in Post-20 min Running (48.5%) compared to the Baseline (42.9%). In MSTFC, BFGr showed in Post-8-week Training values significantly higher than the Baseline (p = 0.000) and than Post-20-min Running (p = 0.000). SHGr presented a significant difference between the Baseline and Post-8-week Training (p = 0.040). SFFP in BFGr modified its values with an increasing trend (p = 0.000). PP°TFC in BFGr showed a significant decrease (p = 0.003) in Post-8-week Training (1.9 kg·cm−2) compared to the Baseline (2.4 kg·cm−2). In PP°FFP significant decreases were recorded in BFGr and between Post-8-week Training and Baseline (p = 0.000), and Post-8-week Training and Post 20 min Running (p = 0.035). Conclusions The adaptation took place after the 8-week training. The adaptations to running barefoot were characterized by causing an increase of the foot’s plantar support in TFC and in FFP, as well as a decrease of the plantar pressure peak in both phases. Also, there is an increased duration of the TFC and FFP, which may be related to an acquired strategy to attenuate the impacts of the ground’s reaction forces.
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Affiliation(s)
- Celso Sánchez-Ramírez
- Escuela de Ciencias de la Actividad Física/Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Región Metropolitana, Chile
| | - Luis M Alegre
- Grupo de Investigación GENUD, CIBER de Fragilidad y Envejecimiento Saludable, Universidad de Castilla La Mancha, Toledo, Toledo, Spain
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Latorre-Román PA, García-Pinillos F, Soto-Hermoso VM, Muñoz-Jiménez M. Effects of 12 weeks of barefoot running on foot strike patterns, inversion-eversion and foot rotation in long-distance runners. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:579-584. [PMID: 31720071 PMCID: PMC6835025 DOI: 10.1016/j.jshs.2016.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 08/20/2015] [Accepted: 10/12/2015] [Indexed: 06/10/2023]
Abstract
PURPOSE The purpose of this study was to determine the effects of 12 weeks of barefoot running on foot strike patterns, inversion-eversion and foot rotation in long-distance runners. METHODS Thirty-one endurance runners with no experience in barefoot running were randomized into a control group and an experimental group who received barefoot training. At pre-test and post-test, all subjects ran at low and high self-selected speeds on a treadmill. Data were collected by systematic observation of lateral and back recordings at 240 Hz. RESULTS McNemar's test indicated significant changes (p < 0.05) in the experimental group at both high and low speed running in foot strike patterns, reducing the percentage of high rearfoot strikers and increasing the number of midfoot strikers. A significant increase (p < 0.05) of external rotation of the foot and a decrease of inversion occurred at comfortable speed in the experimental group. CONCLUSION Twelve weeks of barefoot running, applied progressively, causes significant changes in foot strike pattern with a tendency toward midfoot or forefoot strikes, regardless of running speed and significant changes in foot rotation at low speed, while the inversion was reduced in left foot at low speed with a tendency toward centered strike.
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Affiliation(s)
| | | | | | - Marcos Muñoz-Jiménez
- Department of Didactics of Corporal Expression, University of Jaén, Jaén 23071, Spain
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Vincent HK, Mackenzie B, Vincent KR. Counseling Runners on Safely Transitioning to Minimal Shoes. Curr Sports Med Rep 2019; 18:315-316. [PMID: 31503040 DOI: 10.1249/jsr.0000000000000630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Heather K Vincent
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL
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Curtis R, D’Août K. Daily activity in minimal footwear increases foot strength. FOOTWEAR SCIENCE 2019. [DOI: 10.1080/19424280.2019.1606299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rory Curtis
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Kristiaan D’Août
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom of Great Britain and Northern Ireland
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Garofolini A, Zadeh AG, Taylor S, Mclaughlin P, Mickle KJ. Effect of habitual foot strike patterns on muscle and bone properties of the foot. FOOTWEAR SCIENCE 2019. [DOI: 10.1080/19424280.2019.1606293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Ali Ghasem Zadeh
- Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Simon Taylor
- College of Sport and Exercise Science, Victoria University, ISEAL, Melbourne, Australia
| | - Patrick Mclaughlin
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Karen Julie Mickle
- College of Sport and Exercise Science, Victoria University, Melbourne, Australia
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T2 relaxation time measurements in tibiotalar cartilage after barefoot running and its relationship to ankle biomechanics. J Biomech 2019; 90:103-112. [DOI: 10.1016/j.jbiomech.2019.04.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/05/2019] [Accepted: 04/29/2019] [Indexed: 11/17/2022]
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RIDGE SARAHT, OLSEN MARKT, BRUENING DUSTINA, JURGENSMEIER KEVIN, GRIFFIN DAVID, DAVIS IRENES, JOHNSON AWAYNE. Walking in Minimalist Shoes Is Effective for Strengthening Foot Muscles. Med Sci Sports Exerc 2019; 51:104-113. [DOI: 10.1249/mss.0000000000001751] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Fuller JT, Thewlis D, Tsiros MD, Brown NA, Hamill J, Buckley JD. Longer-term effects of minimalist shoes on running performance, strength and bone density: A 20-week follow-up study. Eur J Sport Sci 2018; 19:402-412. [DOI: 10.1080/17461391.2018.1505958] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Joel T. Fuller
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Dominic Thewlis
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
- Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, Australia
| | - Margarita D. Tsiros
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | | | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts, Amherst, MA, USA
| | - Jonathan D. Buckley
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
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Gait retraining versus foot orthoses for patellofemoral pain: a pilot randomised clinical trial. J Sci Med Sport 2018; 21:457-461. [DOI: 10.1016/j.jsams.2017.09.187] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/13/2017] [Accepted: 09/22/2017] [Indexed: 11/18/2022]
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Aibast H, Okutoyi P, Sigei T, Adero W, Chemjor D, Ongaro N, Fuku N, Konstabel K, Clark C, Lieberman DE, Pitsiladis Y. Foot Structure and Function in Habitually Barefoot and Shod Adolescents in Kenya. Curr Sports Med Rep 2018; 16:448-458. [PMID: 29135646 DOI: 10.1249/jsr.0000000000000431] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Habitually barefoot (HB) children from the Kalenjin tribe of Kenya are known for their high physical activity levels. To date, there has been no comprehensive assessment of foot structure and function in these highly active and HB children/adolescents and link with overuse injuries. PURPOSE The aim of this research is to assess foot structure, foot function, injury and physical activity levels in Kenyan children and adolescents who are HB compared with those who were habitually shod (HS). METHODS Foot structure, function, injury prevalence, and physical activity levels were studied using two studies with equal numbers of HS and HB. HS and HB children and adolescents were matched for age, sex, and body mass. Foot arch characteristics, foot strength, and lower-limb injury prevalence were investigated in Study 1 (n = 76). Heel bone stiffness, Achilles tendon moment arm length and physical activity levels in Study 2 (n=62). Foot muscle strength was measured using a strength device TKK 3360 and heel bone stiffness by bone ultrasonometry. The moment arm length of the Achilles tendon was estimated from photographs and physical activity was assessed using questionnaires and accelerometers. RESULTS Foot shortening strength was greater in HB (4.8 ± 1.9 kg vs 3.5 ± 1.8 kg, P < 0.01). Navicular drop was greater in HB (0.53 ± 0.32 cm vs 0.39 ± 0.19 cm, P < 0.05). Calcaneus stiffness index was greater (right 113.5 ± 17.1 vs 100.5 ± 116.8, P < 0.01 left 109.8 ± 15.7 vs 101.7 ± 18.7, P < 0.05) and Achilles tendon moment arm shorter in HB (right, 3.4 ± 0.4 vs 3.6 ± 0.4 cm, P < 0.05; left, 3.4 ± 0.5 vs 3.7 ± 0.4 cm, P < 0.01). Lower-limb injury prevalence was 8% in HB and 61% in HS. HB subjects spent more time engaged in moderate to vigorous physical activity (60 ± 26 min·d vs 31 ± 13 min·d; P < 0.001). CONCLUSIONS Significant differences observed in foot parameters, injury prevalence and general foot health between HB and HS suggest that footwear conditions may impact on foot structure and function and general foot health. HB children and adolescents spent more time engaged in moderate to vigorous physical activity and less time sedentary than HS children and adolescents.
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Affiliation(s)
- Herje Aibast
- 1Institute of Sports Biology and Physiotherapy, Department of Exercise and Sport Sciences, University of Tartu, Tartu, ESTONIA; 2Department of Orthopaedics and Rehabilitation, Moi University, Eldoret, KENYA; 3Department of Statistics and Computer Science, Moi University, Eldoret, KENYA; 4Graduated School of Health and Sport Science, Juntendo University, Chiba, JAPAN; 5Institute of Psychology, University of Tartu, ESTONIA; 6Department of Chronic Diseases, National Institute for Health Development, Tallinn, ESTONIA; 7Department of Human Science and Public Health, Bournemouth University, Bournemouth, UNITED KINGDOM; 8Department of Human Evolutionary Biology, Harvard University, Cambridge, MA; 9Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UNITED KINGDOM; and 10Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, ITALY
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Lee SP, Bailey JP, Smith JA, Barton S, Brown D, Joyce T. Adaptations of lumbar biomechanics after four weeks of running training with minimalist footwear and technique guidance: Implications for running-related lower back pain. Phys Ther Sport 2018; 29:101-107. [DOI: 10.1016/j.ptsp.2016.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 11/17/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
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A Tale of Two Treatments for Patellofemoral Pain. PM R 2017; 9:1283-1289. [PMID: 29274679 DOI: 10.1016/j.pmrj.2017.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/27/2017] [Indexed: 11/22/2022]
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Nordin AD, Dufek JS, Mercer JA. Three-dimensional impact kinetics with foot-strike manipulations during running. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:489-497. [PMID: 30356650 PMCID: PMC6189262 DOI: 10.1016/j.jshs.2015.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/18/2015] [Accepted: 09/02/2015] [Indexed: 06/08/2023]
Abstract
BACKGROUND Lack of an observable vertical impact peak in fore/mid-foot running has been suggested as a means of reducing lower extremity impact forces, although it is unclear if impact characteristics exist in other axes. The purpose of the investigation was to compare three-dimensional (3D) impact kinetics among foot-strike conditions in over-ground running using instantaneous loading rate-time profiles. METHODS Impact characteristics were assessed by identifying peak loading rates in each direction (medial-lateral (ML), anterior-posterior (AP), vertical, and 3D resultant) following foot-strike instructions (fore-foot, mid-foot, subtle heel, and obvious heel strike). Kinematic and kinetic data were analyzed among 9 male participants in each foot-strike condition. RESULTS Loading rate peaks were observed in each direction and foot-strike condition, differing in magnitude by direction (3D resultant and vertical > AP > ML, p ≤ 0.031) and foot-strike: ML (fore-foot and mid-foot strike > obvious heel strike, p ≤ 0.032), AP (fore-foot and mid-foot strikes > subtle-heel and obvious heel strikes, p ≤ 0.023). In each direction, the first loading rate peak occurred later during heel strike running relative to fore-foot (p ≤ 0.019), with vertical and 3D resultant impact durations exceeding shear (ML and AP, p ≤ 0.007) in each condition. CONCLUSION Loading rate-time assessment identified contrasting impact characteristics in each direction and the 3D resultant following foot-strike manipulations, with potential implications for lower extremity structures in running.
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Hollander K, Heidt C, VAN DER Zwaard BC, Braumann KM, Zech A. Long-Term Effects of Habitual Barefoot Running and Walking: A Systematic Review. Med Sci Sports Exerc 2017; 49:752-762. [PMID: 27801744 DOI: 10.1249/mss.0000000000001141] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Barefoot locomotion is widely believed to be beneficial for motor development and biomechanics but are implied to be responsible for foot pathologies and running-related injuries. Although most of available studies focused on acute effects of barefoot running and walking little is known regarding the effects of long-term barefoot versus shod locomotion. The purpose of this study was to systematically review the literature to evaluate current evidence of habitual barefoot (HB) versus habitual shod locomotion on foot anthropometrics, biomechanics, motor performance, and pathologies. METHODS Four electronic databases were searched using terms related to habitually barefoot locomotion. Relevant studies were identified based on title, abstract, and full text, and a forward (citation tracking) and backward (references) search was performed. Risk of bias was assessed, data pooling, and meta-analysis (random effects model) performed and finally levels of evidence determined. RESULTS Fifteen studies with 8399 participants were included. Limited evidence was found for a reduced ankle dorsiflexion at footstrike (pooled effect size, -3.47; 95% confidence interval [CI], -5.18 to -1.76) and a lower pedobarographically measured hallux angle (-1.16; 95% CI, -1.64 to -0.68). HB populations had wider (0.55; 95% CI, 0.06-1.05) but no shorter (-0.22; 95% CI, -0.51 to 0.08) feet compared with habitual shod populations. No differences in relative injury rates were found, with limited evidence for a different body part distribution of musculoskeletal injuries and more foot pathologies and less foot deformities and defects in HB runners. CONCLUSIONS Only limited or very limited evidence is found for long-term effects of HB locomotion regarding biomechanics or health-related outcomes. Moreover, no evidence exists for motor performance. Future research should include prospective study designs.
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Affiliation(s)
- Karsten Hollander
- 1Department of Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, GERMANY; 2Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, SWITZERLAND; 3Department of Sport Science, Stellenbosch University, Stellenbosch, SOUTH AFRICA; and 4Institute of Sport Science, Friedrich Schiller University Jena, GERMANY
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Effects of footwear and stride length on metatarsal strains and failure in running. Clin Biomech (Bristol, Avon) 2017; 49:8-15. [PMID: 28826012 DOI: 10.1016/j.clinbiomech.2017.08.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/13/2017] [Accepted: 08/15/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The metatarsal bones of the foot are particularly susceptible to stress fracture owing to the high strains they experience during the stance phase of running. Shoe cushioning and stride length reduction represent two potential interventions to decrease metatarsal strain and thus stress fracture risk. METHODS Fourteen male recreational runners ran overground at a 5-km pace while motion capture and plantar pressure data were collected during four experimental conditions: traditional shoe at preferred and 90% preferred stride length, and minimalist shoe at preferred and 90% preferred stride length. Combined musculoskeletal - finite element modeling based on motion analysis and computed tomography data were used to quantify metatarsal strains and the probability of failure was determined using stress-life predictions. FINDINGS No significant interactions between footwear and stride length were observed. Running in minimalist shoes increased strains for all metatarsals by 28.7% (SD 6.4%; p<0.001) and probability of failure for metatarsals 2-4 by 17.3% (SD 14.3%; p≤0.005). Running at 90% preferred stride length decreased strains for metatarsal 4 by 4.2% (SD 2.0%; p≤0.007), and no differences in probability of failure were observed. INTERPRETATIONS Significant increases in metatarsal strains and the probability of failure were observed for recreational runners acutely transitioning to minimalist shoes. Running with a 10% reduction in stride length did not appear to be a beneficial technique for reducing the risk of metatarsal stress fracture, however the increased number of loading cycles for a given distance was not detrimental either.
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Warne JP, Gruber AH. Transitioning to Minimal Footwear: a Systematic Review of Methods and Future Clinical Recommendations. SPORTS MEDICINE - OPEN 2017; 3:33. [PMID: 28916956 PMCID: PMC5602809 DOI: 10.1186/s40798-017-0096-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 08/11/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent interest in barefoot running has led to the development of minimalist running shoes that are popular in distance runners. A careful transition to these shoes has been suggested and examined in the literature. However, no guidelines based on systematic evidence have been presented. The purpose of this review is to systematically examine the methods employed in the literature to transition to minimal footwear (MFW), as well as the outcomes to these studies in distance runners. In addition, MFW transition guidelines for future clinical practice will be presented based on observations from this review. METHODS A systematic database search was employed using PubMed online as the primary database. Twenty papers were included in the final review. RESULTS All studies implemented a prospective transition design to MFW with a detail of this transition provided, which increased MFW exposure up to an average of 60% (30-100%) at completion. Only 8/20 studies included injury prevention exercises, and 9/20 included gait retraining. The main outcomes of this transition included limited positive evidence of transitioning into MFW for running economy (n = 4 studies) and muscle development (n = 5). The injury incidence comparing running during the MFW transition (17.9 injuries per 100 participants) to matched participants in conventional running shoes (13.4 injuries per 100) appears equivocal (p = 0.219; effect size phi (φ) = 0.06 [very small]). Finally, several important recommendations for clinical practice and future research have been presented. CONCLUSIONS It is hoped that this paper will present important first steps in unifying the process of transitioning to MFW, both for academic and clinical use.
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Affiliation(s)
- Joe P Warne
- Department of Applied Science, Institute of Technology Tallaght, Blessington Rd, Dublin 24, Ireland.
- Setanta College, Thurles Chamber of Enterprise Centre, Thurles, Tipperary, Ireland.
| | - Allison H Gruber
- Department of Kinesiology, Indiana University, Bloomington, IN, USA
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Rice HM, Jamison ST, Davis IS. Footwear Matters: Influence of Footwear and Foot Strike on Load Rates during Running. Med Sci Sports Exerc 2017; 48:2462-2468. [PMID: 27387292 DOI: 10.1249/mss.0000000000001030] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Running with a forefoot strike (FFS) pattern has been suggested to reduce the risk of overuse running injuries, due to a reduced vertical load rate compared with rearfoot strike (RFS) running. However, resultant load rate has been reported to be similar between foot strikes when running in traditional shoes, leading to questions regarding the value of running with a FFS. The influence of minimal footwear on the resultant load rate has not been considered. This study aimed to compare component and resultant instantaneous loading rate (ILR) between runners with different foot strike patterns in their habitual footwear conditions. METHODS Twenty-nine injury-free participants (22 men, seven women) ran at 3.13 m·s along a 30-m runway, with their habitual foot strike and footwear condition. Ground reaction force data were collected. Peak ILR values were compared between three conditions; those who habitually run with an RFS in standard shoes, with an FFS in standard shoes, and with an FFS in minimal shoes. RESULTS Peak resultant, vertical, lateral, and medial ILR were lower (P < 0.001) when running in minimal shoes with an FFS than in standard shoes with either foot strike. When running with an FFS, peak posterior ILR were lower (P < 0.001) in minimal than standard shoes. CONCLUSIONS When running in a standard shoe, peak resultant and component ILR were similar between footstrike patterns. However, load rates were lower when running in minimal shoes with a FFS, compared with running in standard shoes with either foot strike. Therefore, it appears that footwear alters the load rates during running, even with similar foot strike patterns.
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Affiliation(s)
- Hannah M Rice
- 1Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA; and 2Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke's Campus, University of Exeter, Devon, UNITED KINGDOM
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Barcellona MG, Buckley L, Palmer LJM, Ormond RM, Owen G, Watson DJ, Woledge R, Newham D. The effect of minimalist footwear and instruction on running: an observational study. BMJ Open Sport Exerc Med 2017; 3:e000160. [PMID: 28761694 PMCID: PMC5530131 DOI: 10.1136/bmjsem-2016-000160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 11/28/2022] Open
Abstract
Background It is not known whether the effects on altered running style which are attributed to minimalist footwear can be achieved by verbal instructions in standard running shoes (SRS). Aim To explore the effect of Vibram FiveFingers (VFF) versus SRS plus running instruction on lower extremity spatiotemporal parameters and lower limb joint kinematics. Methods 35 healthy subjects (mean=30 years, 18 females) were assessed on two occasions with 3D motion analysis. At each session subjects ran on a treadmill (3.58 m/s) for 2 min in either VFF or SRS (randomised order); with and without running instruction. Differences between spatiotemporal parameters and lower limb joint kinematics between conditions were assessed using a 2x2 repeated-measures ANOVA. Results Wearing VFF significantly increased cadence (p<0.001) and reduced stride length (p<0.01). Prior to initial contact, both instruction and VFF significantly increased foot (p<0.001 and p=0.02, respectively) and ankle (p<0.001 and p=0.02, respectively) plantarflexion, while wearing VFF significantly increased knee extension (p=0.04). At initial contact, instruction significantly increased knee flexion (p=0.04), and foot (p=0.001) and ankle (p=0.03) plantarflexion. At mid-stance and toe-off, instruction significantly increased knee flexion (p=0.048 and p<0.001, respectively) and foot plantarflexion (p<0.001 and p=0.01, respectively). Instruction had a greater effect on increasing knee flexion (p=0.007) and plantarflexion angle (p<0.001) when subjects wore SRS and VFF, respectively. Conclusion Alterations in spatiotemporal parameters observed when running in VFF are likely to be attributable to the minimalist footwear. However, the kinematic adaptations observed following instruction suggests that changes in joint angles previously attributed to minimalist footwear alone may be similarly achieved with instruction.
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Affiliation(s)
- Massimo Giuseppe Barcellona
- Division of Health & Social Care Research, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Linda Buckley
- Department of Physiotherapy, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Lisa J M Palmer
- Department of Physiotherapy, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Roisin M Ormond
- Department of Physiotherapy, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Gwawr Owen
- Department of Physiotherapy, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Daniel J Watson
- Department of Physiotherapy, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Roger Woledge
- Centre of Human & Aerospace Physiological Sciences, Faculty of Health & Life Sciences, King's College London, London, UK
| | - Di Newham
- Centre of Human & Aerospace Physiological Sciences, Faculty of Health & Life Sciences, King's College London, London, UK
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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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Davis IS, Rice HM, Wearing SC. Why forefoot striking in minimal shoes might positively change the course of running injuries. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:154-161. [PMID: 30356630 PMCID: PMC6189002 DOI: 10.1016/j.jshs.2017.03.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/26/2016] [Accepted: 02/02/2017] [Indexed: 05/26/2023]
Abstract
It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of our body form. As our bodies have adapted to run, it seems unusual that up to 79% of modern day runners are injured annually. The etiology of these injuries is clearly multifactorial. However, 1 aspect of running that has significantly changed over the past 50 years is the footwear we use. Modern running shoes have become increasingly cushioned and supportive, and have changed the way we run. In particular, they have altered our footstrike pattern from a predominantly forefoot strike (FFS) landing to a predominantly rearfoot strike (RFS) landing. This change alters the way in which the body is loaded and may be contributing to the high rate of injuries runners experience while engaged in an activity for which they were adapted. In this paper, we will examine the benefits of barefoot running (typically an FFS pattern), and compare the lower extremity mechanics between FFS and RFS. The implications of these mechanical differences, in terms of injury, will be discussed. We will then provide evidence to support our contention that FFS provides an optimal mechanical environment for specific foot and ankle structures, such as the heel pad, the plantar fascia, and the Achilles tendon. The importance of footwear will then be addressed, highlighting its interaction with strike pattern on mechanics. This analysis will underscore why footwear matters when assessing mechanics. Finally, proper preparation and safe transition to an FFS pattern in minimal shoes will be emphasized. Through the discussion of the current literature, we will develop a justification for returning to running in the way for which we were adapted to reduce running-related injuries.
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Affiliation(s)
- Irene S. Davis
- Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
| | - Hannah M. Rice
- Sport and Health Sciences, University of Exeter, Exeter, EX4 4PY, UK
| | - Scott C. Wearing
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia
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Boyer ER, Derrick TR. Lower extremity joint loads in habitual rearfoot and mid/forefoot strike runners with normal and shortened stride lengths. J Sports Sci 2017; 36:499-505. [PMID: 28481686 DOI: 10.1080/02640414.2017.1321775] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Our purpose was to compare joint loads between habitual rearfoot (hRF) and habitual mid/forefoot strikers (hFF), rearfoot (RFS) and mid/forefoot strike (FFS) patterns, and shorter stride lengths (SLs). Thirty-eight hRF and hFF ran at their normal SL, 5% and 10% shorter, as well as with the opposite foot strike. Three-dimensional ankle, knee, patellofemoral (PF) and hip contact forces were calculated. Nearly all contact forces decreased with a shorter SL (1.2-14.9% relative to preferred SL). In general, hRF had higher PF (hRF-RFS: 10.8 ± 1.4, hFF-FFS: 9.9 ± 2.0 BWs) and hip loads (axial hRF-RFS: -9.9 ± 0.9, hFF-FFS: -9.6 ± 1.0 BWs) than hFF. Many loads were similar between foot strike styles for the two groups, including axial and lateral hip, PF, posterior knee and shear ankle contact forces. Lateral knee and posterior hip contact forces were greater for RFS, and axial ankle and knee contact forces were greater for FFS. The tibia may be under greater loading with a FFS because of these greater axial forces. Summarising, a particular foot strike style does not universally decrease joint contact forces. However, shortening one's SL 10% decreased nearly all lower extremity contact forces, so it may hold potential to decrease overuse injuries associated with excessive joint loads.
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Affiliation(s)
- Elizabeth R Boyer
- a Center for Gait and Motion Analysis , Gillette Children's Specialty Healthcare , St. Paul , MN , USA
| | - Timothy R Derrick
- b Department of Kinesiology , Iowa State University , Ames , IA , USA
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Fuller JT, Thewlis D, Tsiros MD, Brown NAT, Buckley JD. Six-week transition to minimalist shoes improves running economy and time-trial performance. J Sci Med Sport 2017; 20:1117-1122. [PMID: 28483557 DOI: 10.1016/j.jsams.2017.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 04/08/2017] [Accepted: 04/16/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study investigated if gradually introducing runners to minimalist shoes during training improved running economy and time-trial performance compared to training in conventional shoes. Changes in stride rate, stride length, footfall pattern and ankle plantar-flexor strength were also investigated. DESIGN Randomised parallel intervention trial. METHODS 61 trained runners gradually increased the amount of running performed in either minimalist (n=31) or conventional (n=30) shoes during a six-week standardised training program. 5-km time-trial performance, running economy, ankle plantar-flexor strength, footfall pattern, stride rate and length were assessed in the allocated shoes at baseline and after training. Footfall pattern was determined from the time differential between rearfoot and forefoot (TDR-F) pressure sensors. RESULTS The minimalist shoe group improved time-trial performance (effect size (ES): 0.24; 95% confidence interval (CI): 0.01, 0.48; p=0.046) and running economy (ES 0.48; 95%CI: 0.22, 0.74; p<0.001) more than the conventional shoe group. There were no minimalist shoe training effects on ankle plantar-flexor concentric (ES: 0.11; 95%CI: -0.18, 0.41; p=0.45), isometric (ES: 0.23; 95%CI: -0.17, 0.64; p=0.25), or eccentric strength (ES: 0.24; 95%CI: -0.17, 0.65; p=0.24). Minimalist shoes caused large reductions in TDR-F (ES: 1.03; 95%CI: 0.65, 1.40; p<0.001) but only two runners changed to a forefoot footfall. Minimalist shoes had no effect on stride rate (ES: 0.04; 95%CI: -0.08, 0.16; p=0.53) or length (ES: 0.06; 95%CI: -0.06, 0.18; p=0.35). CONCLUSIONS Gradually introducing minimalist shoes over a six-week training block is an effective method for improving running economy and performance in trained runners.
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Affiliation(s)
- Joel T Fuller
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Australia.
| | - Dominic Thewlis
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Australia
| | - Margarita D Tsiros
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Australia
| | | | - Jonathan D Buckley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Australia
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Gerrard JM, Bonanno DR. Increasing preferred step rate during running reduces plantar pressures. Scand J Med Sci Sports 2017; 28:144-151. [PMID: 28345173 DOI: 10.1111/sms.12886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 12/01/2022]
Affiliation(s)
- James M. Gerrard
- Discipline of Podiatry; School of Allied Health; La Trobe University; Melbourne Vic. Australia
| | - Daniel R. Bonanno
- Discipline of Podiatry; School of Allied Health; La Trobe University; Melbourne Vic. Australia
- La Trobe Sport and Exercise Medicine Research Centre; School of Allied Health; La Trobe University; Melbourne Vic. Australia
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Azevedo APDS, Mezêncio B, Amadio AC, Serrão JC. 16 Weeks of Progressive Barefoot Running Training Changes Impact Force and Muscle Activation in Habitual Shod Runners. PLoS One 2016; 11:e0167234. [PMID: 27907069 PMCID: PMC5132300 DOI: 10.1371/journal.pone.0167234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 11/08/2016] [Indexed: 12/03/2022] Open
Abstract
Short-term effects of barefoot and simulated barefoot running have been widely discussed in recent years. Consequences of adopting barefoot running for a long period, including as a training approach, still remain unknown. The present study evaluated the influence of 16 weeks of progressive barefoot running training on impact force and muscle activation in habitual shod runners. Six habitual shod runners (3 men and 3 women, 29.5 ± 7.3 years) were tested barefoot (BF) and shod (SH), before and after 16 weeks of progressive barefoot running training. Tests consisted of running on instrumented treadmill at 9 km/h, for 10 minutes in each experimental condition. Nine data acquisitions (10 s) of vertical ground reaction force (VGRF) and electromyographic (EMG) signal were conducted in each experimental condition for each test. BF training was effective to alter VGRF and EMG parameters of running in habitual shod runners, regardless of footwear condition (SH or BF). The magnitude of first peak of VGRF (Fy1) and the impulse of the first 50 ms decreased after training for BF and SH (p<0.01). The activation reduced from PRE to POST training for four muscles in BF running (p<0.001), whereas only muscle gastrocnemius lateralis decreased significantly its activation (p<0.01) in SH running. A 16-week progressive barefoot running training seems to be an effective training strategy to reduce impact force, improve shock attenuation and to decrease muscle activation intensity, not only in BF running, but also in SH running, although BF condition seems to be more influenced by BF training.
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Affiliation(s)
- Ana Paula da Silva Azevedo
- Laboratory of Biomechanics, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
- * E-mail:
| | - Bruno Mezêncio
- Laboratory of Biomechanics, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Alberto Carlos Amadio
- Laboratory of Biomechanics, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Julio Cerca Serrão
- Laboratory of Biomechanics, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
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45
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Malisoux L, Chambon N, Urhausen A, Theisen D. Influence of the Heel-to-Toe Drop of Standard Cushioned Running Shoes on Injury Risk in Leisure-Time Runners: A Randomized Controlled Trial With 6-Month Follow-up. Am J Sports Med 2016; 44:2933-2940. [PMID: 27501833 DOI: 10.1177/0363546516654690] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Modern running shoes are available in a wide range of heel-to-toe drops (ie, the height difference between the forward and rear parts of the inside of the shoe). While shoe drop has been shown to influence strike pattern, its effect on injury risk has never been investigated. Therefore, the reasons for such variety in this parameter are unclear. PURPOSE The first aim of this study was to determine whether the drop of standard cushioned running shoes influences running injury risk. The secondary aim was to investigate whether recent running regularity modifies the relationship between shoe drop and injury risk. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Leisure-time runners (N = 553) were observed for 6 months after having received a pair of shoes with a heel-to-toe drop of 10 mm (D10), 6 mm (D6), or 0 mm (D0). All participants reported their running activities and injuries (time-loss definition, at least 1 day) in an electronic system. Cox regression analyses were used to compare injury risk between the 3 groups based on hazard rate ratios (HRs) and their 95% CIs. A stratified analysis was conducted to evaluate the effect of shoe drop in occasional runners (<6 months of weekly practice over the previous 12 months) versus regular runners (≥6 months). RESULTS The overall injury risk was not different among the participants who had received the D6 (HR, 1.30; 95% CI, 0.86-1.98) or D0 (HR, 1.17; 95% CI, 0.76-1.80) versions compared with the D10 shoes. After stratification according to running regularity, low-drop shoes (D6 and D0) were found to be associated with a lower injury risk in occasional runners (HR, 0.48; 95% CI, 0.23-0.98), whereas these shoes were associated with a higher injury risk in regular runners (HR, 1.67; 95% CI, 1.07-2.62). CONCLUSION Overall, injury risk was not modified by the drop of standard cushioned running shoes. However, low-drop shoes could be more hazardous for regular runners, while these shoes seem to be preferable for occasional runners to limit injury risk.
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Affiliation(s)
- Laurent Malisoux
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg
| | - Nicolas Chambon
- Movement Sciences Department, Decathlon, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg.,Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg
| | - Daniel Theisen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg
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Salzler MJ, Kirwan HJ, Scarborough DM, Walker JT, Guarino AJ, Berkson EM. Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity. PHYSICIAN SPORTSMED 2016; 44:373-379. [PMID: 27653557 DOI: 10.1080/00913847.2016.1238282] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Minimalist running is increasing in popularity based upon a concept that it can reduce impact forces and decrease injury rates. The purpose of this investigation is to identify the rate and severity of injuries in runners transitioning from traditional to minimalist footwear. The secondary aims were to identify factors correlated with injuries. METHODS Fourteen habitually shod (traditional running shoes) participants were enrolled for this prospective study investigating injury prevalence during transition from traditional running shoes to 5-toed minimalist shoes. Participants were uninjured, aged between 22-41 years, and ran at least twenty kilometers per week in traditional running shoes. Participants were given industry recommended guidelines for transition to minimalist footwear and fit with a 5-toed minimalist running shoe. They completed weekly logs for identification of injury, pain using Visual Analogue Scale (VAS), injury location, and severity. Foot strike pattern and impact forces were collected using 3D motion analysis at baseline, 4 weeks, and 12 weeks. Injuries were scored according to a modified Running Injury Severity Score (RISS). RESULTS Fourteen runners completed weekly training and injury logs over an average of 30 weeks. Twelve of 14 (86%) runners sustained injuries. Average injury onset was 6 weeks (range 1-27 weeks). Average weekly mileage of 23.9 miles/week prior to transition declined to 18.3 miles/week after the transition. The magnitude of the baseline impact transient peak in traditional shoes and in minimalist shoes negatively correlated with RISS scores (r = -0.45, p = 0.055 and r = -0.53, p = 0.026, respectively). CONCLUSION High injury rates occurred during the transition from traditional to minimalist footwear. Non-compliance to transition guidelines and high injury rates suggest the need for improved education. High impact transient forces unexpectedly predicted lower modified RISS scores in this population.
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Affiliation(s)
- Matthew J Salzler
- a Department of Orthopaedics , Tufts Medical Center , Boston , MA , USA
| | - Hollie J Kirwan
- b Department of Orthopaedic Surgery , Massachusetts General Hospital , Boston , MA , USA
| | - Donna M Scarborough
- b Department of Orthopaedic Surgery , Massachusetts General Hospital , Boston , MA , USA
| | - James T Walker
- b Department of Orthopaedic Surgery , Massachusetts General Hospital , Boston , MA , USA
| | - Anthony J Guarino
- c Center for Interprofessional Studies and Innovation , Massachusetts General Hospital , Boston , MA , USA
| | - Eric M Berkson
- b Department of Orthopaedic Surgery , Massachusetts General Hospital , Boston , MA , USA
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Campitelli NA, Spencer SA, Bernhard K, Heard K, Kidon A. Effect of Vibram FiveFingers Minimalist Shoes on the Abductor Hallucis Muscle. J Am Podiatr Med Assoc 2016; 106:344-351. [PMID: 27762613 DOI: 10.7547/14-084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND This study investigated the effect of Vibram FiveFingers Bikila minimalist shoes on intrinsic foot musculature. We hypothesized that a gradual transition into minimalist shoes will increase the thickness of the abductor hallucis muscle. METHODS Forty-one individuals were divided into four groups: control (traditional shod) (n = 9), restricted walking in Vibram FiveFingers (n = 11), running in Vibram FiveFingers (n = 10), and unlimited walking in Vibram FiveFingers (n = 11). At baseline, 12 weeks, and 24 weeks, the thickness of the abductor hallucis muscle was determined using ultrasound. Statistical analysis was performed to determine the significance of differences in muscle thickness at the three different time points. RESULTS The mean thickness of the abductor hallucis muscle at 24 weeks was significantly greater than that at baseline for the restricted walking (P = .005) and running (P < .001) groups. In the unlimited walking group, the mean thickness of the muscle at 12 weeks was significantly greater than that at baseline (P < .05) but not at 24 weeks. There were no significant differences in muscle thickness among the three time points for the control group (P = .432). CONCLUSIONS This study demonstrated that wearing Vibram FiveFinger Bikila footwear over a controlled period of time, an unlimited amount of time, as well as transitioning runners over a 6-month period of time using the 10% philosophy for increasing mileage, significantly increases intrinsic muscle thickness of the abductor hallucis. The abductor hallucis muscle aids in support of the medial longitudinal arch, and an increase in this muscle thickness may help reduce running-related injuries thought to arise from arch weakness.
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Affiliation(s)
- Nicholas A. Campitelli
- Kent State University College of Podiatric Medicine, Independence, OH. Dr. Bernhard is now with Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO. Dr. Heard is now with Millcreek Community Hospital Residency Program, Erie, PA. Dr. Kidon is now with St. John Macomb Oakland Hospital, Warren, MI
| | - Scott A. Spencer
- Kent State University College of Podiatric Medicine, Independence, OH. Dr. Bernhard is now with Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO. Dr. Heard is now with Millcreek Community Hospital Residency Program, Erie, PA. Dr. Kidon is now with St. John Macomb Oakland Hospital, Warren, MI
| | - Kaitlyn Bernhard
- Kent State University College of Podiatric Medicine, Independence, OH. Dr. Bernhard is now with Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO. Dr. Heard is now with Millcreek Community Hospital Residency Program, Erie, PA. Dr. Kidon is now with St. John Macomb Oakland Hospital, Warren, MI
| | - Kristen Heard
- Kent State University College of Podiatric Medicine, Independence, OH. Dr. Bernhard is now with Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO. Dr. Heard is now with Millcreek Community Hospital Residency Program, Erie, PA. Dr. Kidon is now with St. John Macomb Oakland Hospital, Warren, MI
| | - Alan Kidon
- Kent State University College of Podiatric Medicine, Independence, OH. Dr. Bernhard is now with Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO. Dr. Heard is now with Millcreek Community Hospital Residency Program, Erie, PA. Dr. Kidon is now with St. John Macomb Oakland Hospital, Warren, MI
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48
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Warne JP, Smyth BP, Fagan JO, Hone ME, Richter C, Nevill AM, Moran KA, Warrington GD. Kinetic changes during a six-week minimal footwear and gait-retraining intervention in runners. J Sports Sci 2016; 35:1538-1546. [PMID: 27571390 DOI: 10.1080/02640414.2016.1224916] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
An evaluation of a six-week Combined minimal footwear transition and gait-retraining combination vs. gait retraining only on impact characteristics and leg stiffness. Twenty-four trained male runners were randomly assigned to either (1) Minimalist footwear transition Combined with gait-retraining over a six-week period ("Combined" group; n = 12) examined in both footwear, or (2) a gait-retraining group only with no minimalist footwear exposure ("Control"; n = 12). Participants were assessed for loading rate, impact peak, vertical, knee and ankle stiffness, and foot-strike using 3D and kinetic analysis. Loading rate was significantly higher in the Combined group in minimal shoes in pre-tests compared to a Control (P ≤ 0.001), reduced significantly in the Combined group over time (P ≤ 0.001), and was not different to the Control group in post-tests (P = 0.16). The impact peak (P = 0.056) and ankle stiffness reduced in both groups (P = 0.006). Loading rate and vertical stiffness was higher in minimalist footwear than conventional running shoes both pre (P ≤ 0.001) and post (P = 0.046) the intervention. There has a higher tendency to non-rearfoot strike in both interventions, but more acute changes in the minimalist footwear. A Combined intervention can potentially reduce impact variables. However, higher loading rate initially in minimalist footwear may increase the risk of injury in this condition.
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Affiliation(s)
- Joe P Warne
- a School of Health and Human Performance, Applied Sports Performance Research Group , Dublin City University , Dublin , Ireland.,d Department of Applied Science , Institute of Technology Tallaght , Dublin , Ireland
| | - Barry P Smyth
- a School of Health and Human Performance, Applied Sports Performance Research Group , Dublin City University , Dublin , Ireland
| | - John O'C Fagan
- a School of Health and Human Performance, Applied Sports Performance Research Group , Dublin City University , Dublin , Ireland
| | - Michelle E Hone
- a School of Health and Human Performance, Applied Sports Performance Research Group , Dublin City University , Dublin , Ireland
| | - Chris Richter
- a School of Health and Human Performance, Applied Sports Performance Research Group , Dublin City University , Dublin , Ireland.,d Department of Applied Science , Institute of Technology Tallaght , Dublin , Ireland
| | - Alan M Nevill
- b School of Sport, Performing Arts and Leisure , University of Wolverhampton , Walsall , UK
| | - Kieran A Moran
- a School of Health and Human Performance, Applied Sports Performance Research Group , Dublin City University , Dublin , Ireland.,c Department of Sport Medicine , Sports Surgery Clinic , Dublin , Ireland
| | - Giles D Warrington
- a School of Health and Human Performance, Applied Sports Performance Research Group , Dublin City University , Dublin , Ireland
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Ostermann K, Ridpath L, Hanna JB. Self-Reported Minimalist Running Injury Incidence and Severity: A Pilot Study. J Osteopath Med 2016; 116:512-20. [PMID: 27455100 DOI: 10.7556/jaoa.2016.104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Minimalist running entails using shoes with a flexible thin sole and is popular in the United States. Existing literature disagrees over whether minimalist running shoes (MRS) improve perceived severity of injuries associated with running in traditional running shoes (TRS). Additionally, the perceived injury patterns associated with MRS are relatively unknown. OBJECTIVES To examine whether injury incidence and severity (ie, degree of pain) by body region change after switching to MRS, and to determine if transition times affect injury incidences or severity with MRS. METHODS Runners who were either current or previous users of MRS were recruited to complete an Internet-based survey regarding self-reported injury before switching to MRS and whether self-reported pain from that injury decreased after switching. Questions regarding whether new injuries developed in respondents after switching to MRS were also included. Analyses were calculated using t tests, Wilcoxon signed rank tests, and Fischer exact tests. RESULTS Forty-seven runners completed the survey, and 16 respondents reported injuries before switching to MRS. Among these respondents, pain resulting from injuries of the feet (P=.03) and knees (P=.01) decreased. Eighteen respondents (38.3%) indicated they sustained new injuries after switching to MRS, but the severity of these did not differ significantly from no injury. Neither time allowed for transition to MRS nor use or disuse of a stretching routine during this period was correlated with an increase in the incidence or severity of injuries. CONCLUSION After switching to MRS, respondents perceived an improvement in foot and knee injuries. Additionally, respondents using MRS reported an injury rate of 38.3%, compared with the approximately 64% that the literature reports among TRS users. Future studies should be expanded to determine the full extent of the differences in injury patterns between MRS and TRS.
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Chen TLW, Sze LKY, Davis IS, Cheung RTH. Effects of training in minimalist shoes on the intrinsic and extrinsic foot muscle volume. Clin Biomech (Bristol, Avon) 2016; 36:8-13. [PMID: 27195735 DOI: 10.1016/j.clinbiomech.2016.05.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 05/09/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Minimalist shoes have gained popularity recently because it is speculated to strengthen the foot muscles and foot arches, which may help to resist injuries. However, previous studies provided limited evidence supporting the link between changes in muscle size and footwear transition. Therefore, this study sought to examine the effects of minimalist shoes on the intrinsic and extrinsic foot muscle volume in habitual shod runners. The relationship between participants' compliance with the minimalist shoes and changes in muscle õvolume was also evaluated. METHODS Twenty habitual shod runners underwent a 6-month self-monitoring training program designed for minimalist shoe transition. Another 18 characteristics-matched shod runners were also introduced with the same program but they maintained running practice with standard shoes. Runners were monitored using an online surveillance platform during the program. We measured overall intrinsic and extrinsic foot muscle volume before and after the program using MRI scans. FINDINGS Runners in the experimental group exhibited significantly larger leg (P=0.01, Cohen's d=0.62) and foot (P<0.01, Cohen's d=0.54) muscle after transition. Foot muscle growth was mainly contributed by the forefoot (P<0.01, Cohen's d=0.64) but not the rearfoot muscle (P=0.10, Cohen's d=0.30). Leg and foot muscle volume of runners in the control group remained similar after the program (P=0.33-0.95). A significant positive correlation was found between participants' compliance with the minimalist shoes and changes in leg muscle volume (r=0.51; P=0.02). INTERPRETATION Habitual shod runners who transitioned to minimalist shoes demonstrated significant increase in leg and foot muscle volume. Additionally, the increase in leg muscle volume was significantly correlated associated with the compliance of minimalist shoe use.
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Affiliation(s)
- Tony Lin-Wei Chen
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Louis K Y Sze
- Industrial Centre, The Hong Kong Polytechnic University, Hong Kong
| | - Irene S Davis
- Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, The Harvard University, MA, Cambridge, USA
| | - Roy T H Cheung
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
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