Treating Running injuries: Form vs Footwear
JANUARY 01, 2013
January 2013 issue of Podiatry Management. It was written on behalf of the American Academy of Podiatric Sports Medicine
AUTHORS: Nicholas A. Campitelli, DPM, FACFAS Podiatrist, Foot and Ankle Surgeon
In conclusion, it seems that most practitioners are straying from the path of helping a runner by focusing on shoes as opposed to form. The term “appropriate shoe” is a misnomer when viewed by the old paradigm of selecting a shoe according to arch type, and many are still advocating shoes this way. A running shoe should allow the foot to function as it was designed to – naturally without inhibiting motion. Adding cushioned heels and motion control mechanisms can inhibit this. By viewing shoes as the first line of treatment for most conditions, we must make sure this does not interfere with the foot’s natural function.
Relationships among self-reported shoe type, footstrike pattern, and injury incidence
OCTOBER 01, 2012
US Army Med Dep J., 2012 Oct-Dec:25-30.
AUTHORS: Goss DL, Gross MT. US Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, Texas, USA.
Context: Some runners are experimenting with barefoot or minimalist shoe running to reduce lower extremity overuse injuries. However, there has been little research to examine injury trends associated with barefoot or minimalist shoe running.
Objective: To assess the association of self-reported shoe selection with reported foot strike patterns, compare overall injury incidence associated with different shoe conditions, and identify differences in injury location between different shoe conditions. Results: Shoe selection was significantly associated with reported footstrike (χ² (4df) =143.4, P<.001). Barefoot and minimalist runners reported a more anterior footstrike than traditionally shod runners. Traditionally shod runners were 3.41 times more likely to report injuries than experienced minimalist shoe wearers (46.7% shod vs 13.7% minimalist, χ² (1df) =77.4, P<.001, n=888). Minimalist shoe wearers also reported fewer injuries at the hip, knee, lower leg, ankle, and foot than traditionally shod runners.
Conclusion: Barefoot and minimalist shoe wearers reported a more anterior footstrike than traditionally shod runners. Traditionally shod runners were more likely to report injuries of the lower extremities than runners who wear minimalist shoes. Additional longitudinal prospective research is required to examine injury incidence among various footstrike patterns and shoe preferences.
Foot strike and Injury Rates in Endurance Runners: A Retrospective Study
JULY 01, 2012
Medicine and Science in Sport and Exercise, July - 44(7):1325-34
AUTHORS: Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE
Purpose: This retrospective study tests if runners who habitually forefoot strike have different rates of injury than runners who habitually rearfoot strike. Conclusion: Competitive cross-country runners on a college team incur high injury rates, but runners who habitually rearfoot strike have significantly higher rates of repetitive stress injury than those who mostly forefoot strike. This study does not test the causal bases for this general difference. One hypothesis, which requires further research, is that the absence of a marked impact peak in the ground reaction force during a forefoot strike compared with a rearfoot strike may contribute to lower rates of injuries in habitual forefoot strikers.
Forefoot Running Improves Pain and Disability Associated With Chronic Exertional Compartment Syndrome
MARCH 16, 2012
The American Journal of Sports Medicine, March 2011
AUTHORS: Angela R. Diebal, PT, DSc (firstname.lastname@example.org), Robert Gregory, PhD, Curtis Alitz, MD and J. Parry Gerber, PT, PhD
Background: Anterior compartment pressures of the leg as well as kinematic and kinetic measures are significantly influenced by running technique. It is unknown whether adopting a forefoot strike technique will decrease the pain and disability associated with chronic exertional compartment syndrome (CECS) in hindfoot strike runners.
Hypothesis: For people who have CECS, adopting a forefoot strike running technique will lead to decreased pain and disability associated with this condition.
Conclusion: In 10 consecutive patients with CECS, a 6-week forefoot strike running intervention led to decreased postrunning lower leg intracompartmental pressures. Pain and disability typically associated with CECS were greatly reduced for up to 1 year after intervention. Surgical intervention was avoided for all patients.
Effects of step rate manipulation on joint mechanics during running
FEBRUARY 01, 2011
Medicine and Science in Sport and Exercise
Feb - 43(2):296-302
AUTHORS: Heiderscheit BS, Chumanov ES, Michalski MP, Wille CM, Ryan MB
The objective of this study was to characterize the biomechanical effects of step rate modification during running on the hip, knee, and ankle joints so as to evaluate a potential strategy to reduce lower extremity loading and risk for injury. Results: Less mechanical energy was absorbed at the knee during the +5% and +10% step rate conditions, whereas the hip absorbed less energy during the +10% condition only. All joints displayed substantially more energy absorption when preferred step rate was reduced by 10%. Step length, center of mass vertical excursion, braking impulse, and peak knee flexion angle were observed to decrease with increasing step rate. When step rate was increased 10% above preferred, peak hip adduction angle and peak hip adduction and internal rotation moments were found to decrease. We conclude that subtle increases in step rate can substantially reduce the loading to the hip and knee joints during running and may prove beneficial in the prevention and treatment of common running-related injuries.
Barefoot running strikes back
JANUARY 28, 2010
Nature – International Weekly Journal of Science,
Nature 463, 433-434 (28 January 2010)
AUTHORS: William L. Jungers
Detailed analyses of foot kinematics and kinetics in barefoot and shod runners offer a refined understanding of bipedalism in human evolution. Conclusion: Foorfoot/Midfoot runners can take fuller advantage of of elastic energy storage in both the Achilles tendon and the longitudinal arch of the foot. FF/MF runners therefore require more calf- and footmuscle strength, but avoid uncomfortable and potentially injurious impact transients.
The Effect of Running Shoes on Lower Extremity Joint Torques
DECEMBER 01, 2009
The American Academy of Physical Medicine and Rehabilitation
, Volume 1, Issue 12, Pages 1058-1063, December 2009
AUTHORS: D Cassey Kerrigan, Jason R. Franz, Geoffrey S. Keenan, Jay Dicharry, Ugo Della Croce, Robert P. Wilder
Results: Increased joint torques at the hip, knee, and ankle were observed with running shoes compared with running barefoot. Disproportionately large increases were observed in the hip internal rotation torque and in the knee flexion and knee varus torques. An average 54% increase in the hip internal rotation torque, a 36% increase in knee flexion torque, and a 38% increase in knee varus torque were measured when running in running shoes compared with barefoot.
Conclusion: The findings at the knee suggest relatively greater pressures at anatomical sites that are typically more prone to knee osteoarthritis, the medial and patellofemoral compartments.