Prediction of running-induced Achilles tendinopathy with pain sensitivity - a 1-year prospective study

The Impact of Excessive Body Weight and Foot Pronation on Running Kinetics: A Cross-Sectional Study

BACKGROUND

Running exercise is an effective means to enhance cardiorespiratory fitness and body composition. Besides these health benefits, running is also associated with musculoskeletal injuries that can be more prevalent in individuals with excessive body weight. Little is known regarding the specific effects of overweight and foot pronation on ground reaction force distribution during running. Therefore, this study aimed to investigate the effects of overweight/obesity and foot pronation on running kinetics.

METHODS

Eighty-four young adults were allocated to four experimental groups: non-excessive body weight/non-pronated feet; non-excessive body weight/pronated feet; overweight or obesity/ non-pronated feet and overweight or obesity/pronated feet. Biomechanical testing included participants to run at ~ 3.2 m/s over an 18-m walkway with an embedded force plate at its midpoint. Three-dimensional ground reaction forces were recorded and normalized to body mass to evaluate running kinetics from 20 running trials. Test-re-test reliability for running speed data demonstrated ICC > 0.94 for each group and in total.

RESULTS

The results indicated significantly lower vertical impact peak forces (p = 0.001, effect size = 0.12), shorter time to reach the vertical impact peak (p = 0.006, effect size = 0.08) and reduced vertical loading rate (p = 0.0007, effect size = 0.13) in individuals with excessive body weight (overweight or obesity/non-pronated feet group and overweight or obesity/pronated feet) compared with individuals non-excessive body weight (non-excessive body weight/non-pronated feet and non-excessive body weight/pronated feet). Moreover, the excessive body weight groups presented lower peak braking (p = 0.01, effect size = 0.06) and propulsion forces (p = 0.003, effect size = 0.09), lower medio-lateral loading rate (p = 0.0009, effect size = 0.12), and greater free moments (p = 0.01, effect size = 0.07) when compared to the non-overweight groups. Moreover, a significant body mass by foot pronation interaction was found for peak medio-lateral loading rate. Non-excessive body weight/pronated feet, excessive body weight/non-pronated feet and excessive body weight/pronation groups presented lower medio-lateral loading rates compared to non-excessive body weight/non-pronated feet (p = 0.0001, effect size = 0.13).

CONCLUSIONS

Our results suggest that excessive body weight has an impact on ground reaction forces during running. We particularly noted an increase in medio-lateral and torsional forces during the stance phase. Individuals with excessive body weight appear to adapt their running patterns in an effort to attenuate early vertical impact loading.

Quantitative Sensory Changes Related to Physical Activity in Adult Populations: A Scoping Review

ABSTRACT

Exercise-induced hypoalgesia related to physical activity produces sensory adaptations, but its mechanism remains unclear. Quantitative sensory testing is an effective measurement tool to identify sensory changes, but the extent of evidence linking quantitative sensory testing and physical activity has not been explored. The purpose of this scoping review is to synthesize the evidence on using quantitative sensory testing to evaluate psychophysical changes related to physical activity in adult populations. The researchers developed a comprehensive search strategy with a Health Sciences Librarian using the Arksey and O'Malley Methodological framework. Four databases (Medline [PubMed], CINAHL, Web of Science, and Embase) were searched for peer-reviewed primary research. After 2790 articles were evaluated, 196 studies were included for final review. More than half of studies used randomized controlled trial design (50.5%), followed by quasi-experimental (24.0%) and observational (25.5%) strategies. Healthy adults (42.9%) and individuals with chronic health conditions (20.9%) were examined most frequently. Aerobic (27.6%) and strength (21.4%) physical activity types were most commonly studied. Static quantitative sensory testing measures of pressure pain threshold (84%) were used most frequently. The findings of this scoping review demonstrate available evidence for quantitative sensory testing as a measurement tool of neuromodulation related to physical activity in adult populations. A systematic review is warranted to examine outcomes and recommendations.

Runners with mid-portion Achilles tendinopathy have greater triceps surae intracortical inhibition than healthy controls

OBJECTIVES

This study aimed to investigate short-interval intracortical inhibition (SICI) and muscle function in the triceps surae of runners with mid-portion Achilles tendinopathy (AT).

METHODS

Runners with (n = 11) and without (n = 13) AT were recruited. Plantar flexor isometric peak torque and rate of torque development (RTD) were measured using an isokinetic dynamometer. Triceps surae endurance was measured as single-leg heel raise (SLHR) to failure test. SICI was assessed using paired-pulse transcranial magnetic stimulation during a sustained contraction at 10% of plantar flexor isometric peak torque.

RESULTS

Triceps surae SICI was 14.3% (95% CI: -2.1 to 26.4) higher in AT than in the control group (57.9%, 95% CI: 36.2 to 79.6; and 43.6% 95% CI: 16.2 to 71.1, p = 0.032) irrespective of the tested muscle. AT performed 16 (95% CI: 7.9 to 23.3, p < 0.001) fewer SLHR repetitions on the symptomatic side compared with controls, and 14 (95% CI: 5.8 to 22.0, p = 0.004), fewer SLHR repetitions on the non-symptomatic compared with controls. We found no between-groups differences in isometric peak torque (p = 0.971) or RTD (p = 0.815).

PERSPECTIVE

Our data suggest greater intracortical inhibition for the triceps surae muscles for the AT group accompanied by reduced SLHR endurance, without deficits in isometric peak torque or RTD. The increased SICI observed in the AT group could be negatively influencing triceps surae endurance; thus, rehabilitation aiming to reduce intracortical inhibition should be considered to improve patient outcomes. Furthermore, SLHR is a useful clinical tool to assess plantar flexor function in AT patients.

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

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

Effects of nail softness and stiffness with distance running shoes on ground reaction forces and vertical loading rates in male elite long-distance runners with pronated feet

BACKGROUND

To improve propulsion during running, athletes often wear spike shoes designed for training and/or competition. Running with spike shoes may cause pain and/or injuries. To address this problem, a modified spike shoe was tested. This study aimed to evaluate the effects of running with dual-versus single-stiffness spike running shoes on running mechanics in long-distance runners with pronated feet.

METHODS

Sixteen male elite (national competitive level) runners (5000 or 10,000 m) aged 28.2 ± 2.5 years with pronated feet volunteered to participate in this study. To be included, participants had to have achieved personal best race times over 5- and/or 10-km races under 17 or 34 min during official running competitions. All participants were heel strikers and had a history of 11.2 ± 4.2 years of training. For the assessment of running kinetics, a force plate was imbedded into a walkway. Running kinematics were recorded using a Vicon-motion-capture system. Nike Zoom Rival shoes (Nike, Nike Zoom Rival, USA) were selected and adapted according to spike softness and stiffness. Participants ran at a constant speed of ~4.0 m/s across the walkway with both shoe conditions in randomized order. Six trials were recorded per condition. The main outcomes included peak ground reaction forces and their time-to-peak, average and instantaneous vertical loading rates, free moments, and peak ankle eversion angles.

RESULTS

Paired t-tests revealed significantly lower lateral (p = 0.021, d = 0.95) and vertical (p = 0.010, d = 1.40) forces at heel contact during running with dual-stiffness spike shoes. Running with dual-stiffness spike shoes resulted in a significantly longer time-to-peak vertical (p = 0.004, d = 1.40) force at heel contact. The analysis revealed significantly lower average (p = 0.005, d = 0.46) and instantaneous (p = 0.021, d = 0.49) loading rates and peak negative free moment amplitudes (p = 0.016, d = 0.81) when running with dual-stiffness spike shoes. Finally, significantly lower peak ankle eversion angles were observed with dual-stiffness spike shoes (p < 0.001, d = 1.29).

CONCLUSIONS

Running in dual- compared with single-stiffness spike distance running shoes resulted in lower loading rates, free moment amplitudes, and peak ankle eversion angles of long-distance runners with pronated feet.