1
|
Shiotani H, Mizokuchi T, Yamashita R, Naito M, Kawakami Y. Influence of Body Mass on Running-Induced Changes in Mechanical Properties of Plantar Fascia. J Strength Cond Res 2023; 37:e588-e592. [PMID: 37099441 PMCID: PMC10599803 DOI: 10.1519/jsc.0000000000004536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
ABSTRACT Shiotani, H, Mizokuchi, T, Yamashita, R, Naito, M, and Kawakami, Y. Influence of body mass on running-induced changes in mechanical properties of plantar fascia. J Strength Cond Res 37(11): e588-e592, 2023-Body mass is a major risk factor for plantar fasciopathy; however, evidence explaining the process between risk factors and injury development is limited. Long-distance running induces transient and site-specific reduction in plantar fascia (PF) stiffness, reflecting mechanical fatigue and microscopic damage within the tissue. As greater mechanical loads can induce greater reduction in tissue stiffness, we hypothesized that the degree of running-induced change in PF stiffness is associated with body mass. Ten long-distance male runners (age: 21 - 23 years, body mass: 55.5 ± 4.2 kg; mean ± SD ) and 10 untrained men (age: 20 - 24 years, body mass: 58.4 ± 5.6 kg) ran for 10 km. Before and immediately after running, the shear wave velocity (SWV) of PF at the proximal site, which is an index of tissue stiffness, was measured using ultrasound shear wave elastography. Although the PF SWV significantly decreased after running in runners (-4.0%, p = 0.010) and untrained men (-21.9%, p < 0.001), runners exhibited smaller changes ( p < 0.001). The relative changes in SWV significantly correlated with body mass in both runners ( r = -0.691, p = 0.027) and untrained individuals ( r = -0.723, p = 0.018). These results indicate that a larger body mass is associated with a greater reduction in PF stiffness. Our findings provide in vivo evidence of the biomechanical basis for body mass as a risk factor for plantar fasciopathy. Furthermore, group differences suggest possible factors that reduce the fatigue responses, such as adaptation enhancing the resilience of PF and running mechanics.
Collapse
Affiliation(s)
- Hiroto Shiotani
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Human Performance Laboratory, Comprehensive Research Organization, Waseda University, Tokyo, Japan
| | | | - Ryo Yamashita
- School of Sport Sciences, Waseda University, Saitama, Japan; and
| | - Munekazu Naito
- Human Performance Laboratory, Comprehensive Research Organization, Waseda University, Tokyo, Japan
- Department of Anatomy, Aichi Medical University, Aichi, Japan
| | - Yasuo Kawakami
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Human Performance Laboratory, Comprehensive Research Organization, Waseda University, Tokyo, Japan
| |
Collapse
|
2
|
Hegedus EJ, Ickes L, Jakobs F, Ford KR, Smoliga JM. Comprehensive Return to Competitive Distance Running: A Clinical Commentary. Sports Med 2021; 51:2507-2523. [PMID: 34478108 DOI: 10.1007/s40279-021-01547-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 01/02/2023]
Abstract
Running injuries are very common, and there are well-established protocols for clinicians to manage specific musculoskeletal conditions in runners. However, competitive and elite runners may experience different injuries than the average recreational runner, due to differences in training load, biomechanics, and running experience. Additionally, injury-specific rehabilitation protocols do not consider the broader goal of return to competitive running, including the unique psychosocial and cardiorespiratory fitness needs of elite athletes. This review aims to suggest a guideline for running-specific progression as part of a comprehensive rehabilitation program for injured competitive runners. Tools to evaluate an athlete's psychosocial preparedness to return to competition are presented. Recommendations are also provided for monitoring cardiorespiratory fitness of injured runners, including the nuances of interpreting these data. Finally, a six-phase training paradigm is proposed to guide clinicians as they help competitive runners transition from the early stages of injury through a full return to competition.
Collapse
Affiliation(s)
- Eric J Hegedus
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA. .,Physical Therapy Program, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA.
| | - Lindsey Ickes
- Department of Exercise Science, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - Franziska Jakobs
- Department of Exercise Science, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - Kevin R Ford
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - James M Smoliga
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA
| |
Collapse
|
3
|
Raghunandan A, Charnoff JN, Matsuwaka ST. The Epidemiology, Risk Factors, and Nonsurgical Treatment of Injuries Related to Endurance Running. Curr Sports Med Rep 2021; 20:306-311. [PMID: 34099608 DOI: 10.1249/jsr.0000000000000852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Running is a popular form of exercise that is easily accessible to various populations; endurance running, defined as distances beyond 5 km, continues to grow within the sport. Endurance running-related injuries are common in the lower extremities and are primarily overuse related. A multitude of risk factors for injury exist, including extrinsic factors, such as running distance and frequency, and intrinsic factors, such as biomechanics and nutrition status. Training and rehabilitation techniques vary with a general focus on strengthening and gradual increase in activity, but evidence is mixed, and it is difficult to generalize programs across different running populations. Management of specific running groups, including youth runners, is an area in which additional research is needed. New treatments, such as orthobiologics and wearable technology, have promising potential to optimize performance and recovery and minimize injury. However, they need to be further evaluated with high-quality studies.
Collapse
|
4
|
Derbakova A, Khuu S, Ho K, Lewis C, Ma T, Melo LT, Zabjek KF, Goligher EC, Brochard L, Fregonezi G, Reid WD. Neck and Inspiratory Muscle Recruitment during Inspiratory Loading and Neck Flexion. Med Sci Sports Exerc 2020; 52:1610-1616. [PMID: 31977643 DOI: 10.1249/mss.0000000000002271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE This study aimed to compare muscle activation of the diaphragm (DIA), scalenes (SA), parasternal intercostals (PS), and sternomastoid (SM) during submaximal intermittent neck flexion (INF) versus submaximal inspiratory threshold loading (ITL) until task failure in healthy adults. METHODS Twelve healthy adults performed submaximal ITL or INF tests in random order for 2 d. Surface electromyography was monitored to acquire root mean square (RMS) and median power frequency (MPF) from the SA, PS, SM, and DIA. Maximal inspiratory pressures and maximal voluntary contraction for neck flexion were determined. Next, participants performed the first submaximal test-ITL or INF-targeting 50% ± 5% of the maximal inspiratory pressure or maximal voluntary contraction, respectively, until task failure. After a rest, they performed the other test until task failure. Two days later, they performed ITL and INF but in the opposite order. The Borg scale assessed breathlessness and perceived exertion. RESULTS Endurance times for ITL and INF were 38.1 and 26.3 min, respectively. INF activated three of four inspiratory muscles at higher average RMS (PS, SM, and SA) and at different MPF (PS, SM, and DIA but not SA) compared with ITL. During ITL, RMS did not change in the four inspiratory muscles over time, but MPF decreased in PS, SM, and SA (P < 0.04). In contrast, RMS increased in three of four inspiratory muscles (SM, PS, and SA) during INF, but MPF did not change throughout its duration. Borg rating was 3.9-fold greater than ITL compared with INF. CONCLUSION At a similar percentage of maximal load, INF evokes greater activation of primary muscles of inspiration (PS and SA) and a major accessory muscle of inspiration (SM) compared with ITL during a prolonged submaximal protocol.
Collapse
Affiliation(s)
- Anastasia Derbakova
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, CANADA
| | - Steven Khuu
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, CANADA
| | - Kevin Ho
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, CANADA
| | - Chantelle Lewis
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, CANADA
| | - Timothy Ma
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, CANADA
| | - Luana T Melo
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, CANADA
| | | | | | | | - Guilherme Fregonezi
- Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, BRAZIL
| | | |
Collapse
|
5
|
Eken MM, Withers A, Flanagan K, Burger J, Bosch A, Lamberts RP. Muscular Activation Patterns During Exercise on the Treadmill, Stepper, and Elliptical Trainer. J Strength Cond Res 2020; 36:1847-1852. [PMID: 32881840 DOI: 10.1519/jsc.0000000000003743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Eken, MM, Withers, A, Flanagan, K, Burger, J, Bosch, A, and Lamberts, RP. Muscular activation patterns during exercise on the treadmill, stepper, and elliptical trainer. J Strength Cond Res XX(X): 000-000, 2020-Because of the low-impact, the stepper and elliptical trainer are popular alternatives to running when runners sustain running-related injuries. Muscular effort is expected to be lower during exercise on the stepper and elliptical trainer compared with running. The aim of this study was to quantify this by comparing muscular effort when exercising at similar moderate-to-high exercise intensities on a treadmill, stepper, and elliptical trainer. Seventeen well-trained runners (V[Combining Dot Above]O2max: 53.3 ml·min·kg [male: n = 9], 44.8 ml·min·kg [female: n = 8]; average peak treadmill running speed: 18.7 km·h [male], 16.3 km·h [female]) performed exercise at submaximal levels (60%-70%-80% of peak workload) on the treadmill, stepper, and elliptical trainer. Peak workload was determined during peak exercise tests on separate days. Surface electromyography was recorded from lower extremity muscles. Root-mean-squared (RMS) values were calculated and compared between exercise modalities and submaximal levels. Significance was set at p < 0.05. Root-mean-squared levels of lower extremity muscles were significantly reduced during exercise on the stepper and elliptical trainer compared with treadmill running (p < 0.05, except for quadriceps (p > 0.05). Overall, similar RMS levels were found on stepper and elliptical trainer (p > 0.05), whereas in several cases higher RMS levels were found on the stepper compared with elliptical trainer (p < 0.05). These findings support clinical expectations that exercise on the stepper and elliptical trainer reduces muscular effort up to 60% compared with (treadmill) running, and therefore can be effective training modalities during rehabilitation from running-related injuries by restricting impact on lower extremities.
Collapse
Affiliation(s)
- Maaike M Eken
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Adrian Withers
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kirsten Flanagan
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jana Burger
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Andrew Bosch
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Robert P Lamberts
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.,Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| |
Collapse
|
6
|
Francis P, Thornley I, Jones A, I. Johnson M. Pain and Function in the Runner a Ten (din) uous Link. ACTA ACUST UNITED AC 2020; 56:medicina56010021. [PMID: 31936119 PMCID: PMC7023329 DOI: 10.3390/medicina56010021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/27/2019] [Indexed: 11/30/2022]
Abstract
A male runner (30 years old; 10-km time: 33 min, 46 s) had been running with suspected insertional Achilles tendinopathy (AT) for ~2 years when the pain reached a threshold that prevented running. Diagnostic ultrasound (US), prior to a high-volume stripping injection, confirmed right-sided medial insertional AT. The athlete failed to respond to injection therapy and ceased running for a period of 5 weeks. At the beginning of this period, the runner completed the Victoria institute of sports assessment–Achilles questionnaire (VISA-A), the foot and ankle disability index (FADI), and FADI sport prior to undergoing an assessment of bi-lateral gastrocnemius medialis (GM) muscle architecture (muscle thickness (MT) and pennation angle (PA); US), muscle contractile properties (maximal muscle displacement (Dm) and contraction time (Tc); Tensiomyography (TMG)) and calf endurance (40 raises/min). VISA-A and FADI scores were 59%/100% and 102/136 respectively. Compared to the left leg, the right GM had a lower MT (1.60 cm vs. 1.74 cm), a similar PA (22.0° vs. 21.0°), a lower Dm (1.2 mm vs. 2.0 mm) and Tc (16.5 ms vs. 17.7 ms). Calf endurance was higher in the right leg compared to the left (48 vs. 43 raises). The athlete began a metronome-guided (15 BPM), 12-week progressive eccentric training protocol using a weighted vest (1.5 kg increments per week), while receiving six sessions of shockwave therapy concurrently (within 5 weeks). On returning to running, the athlete kept daily pain (Numeric Rating Scale; NRS) and running scores (miles*rate of perceived exertion (RPE)). Foot and ankle function improved according to scores recorded on the VISA-A (59% vs. 97%) and FADI (102 vs. 127/136). Improvements in MT (1.60 cm vs. 1.76 cm) and PA (22.0° vs. 24.8°) were recorded via US. Improvements in Dm (1.15 mm vs. 1.69 mm) and Tc (16.5 ms vs. 15.4 ms) were recorded via TMG. Calf endurance was lower in both legs and the asymmetry between legs remained (L: 31, R: 34). Pain intensity (mean weekly NRS scores) decreased between week 1 and week 12 (6.6 vs. 2.9), while running scores increased (20 vs. 38) during the same period. The program was maintained up to week 16 at which point mean weekly NRS was 2.2 and running score was 47.
Collapse
Affiliation(s)
- Peter Francis
- Department of Science and Health, Institute of Technology Carlow, Carlow, Ireland
- Musculoskeletal Health Research Group, Leeds Beckett University, Leeds LS13HE, UK; (I.T.); (A.J.); (M.I.J.)
- Correspondence: ; Tel.: +353-59917-5000
| | - Isobel Thornley
- Musculoskeletal Health Research Group, Leeds Beckett University, Leeds LS13HE, UK; (I.T.); (A.J.); (M.I.J.)
| | - Ashley Jones
- Musculoskeletal Health Research Group, Leeds Beckett University, Leeds LS13HE, UK; (I.T.); (A.J.); (M.I.J.)
| | - Mark I. Johnson
- Musculoskeletal Health Research Group, Leeds Beckett University, Leeds LS13HE, UK; (I.T.); (A.J.); (M.I.J.)
- Centre for Pain for Research, Leeds Beckett University, Leeds LS13HE, UK
| |
Collapse
|