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Journal Article

Citation

Johnson CD, Tenforde AS, Outerleys J, Reilly J, Davis IS. Am. J. Sports Med. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, American Orthopaedic Society for Sports Medicine, Publisher SAGE Publishing)

DOI

10.1177/0363546520950731

PMID

32915664

Abstract

BACKGROUND: Inconsistent associations have been reported for impact-related ground reaction force variables and running injuries when grouping all injuries together. However, previous work has shown more consistent associations when focusing on specific injuries.

PURPOSE: To compare ground reaction force variables between healthy and injured runners as a group and within specific common injuries.

STUDY DESIGN: Controlled laboratory study.

METHODS: A total of 125 runners presenting with patellofemoral pain, tibial bone stress injury, plantar fasciitis, Achilles tendinopathy, or iliotibial band syndrome and 65 healthy controls completed an instrumented treadmill assessment at a self-selected speed. Impact-related ground reaction force variables included vertical average (VALR) and instantaneous (VILR) load rates, posterior and medial/lateral instantaneous load rates, and vertical stiffness at initial loading (VSIL). Mean comparisons were made between the general and specific injury and control groups (α =.05). Cutoff thresholds were established and evaluated using several criteria.

RESULTS: VALR (+17.5%; P <.01), VILR (+15.8%; P <.01), and VSIL (+19.7%; P <.01) were significantly higher in the overall injured versus control groups. For individual injuries, VALR, VILR, and VSIL were significantly higher for patellofemoral pain (+23.4%-26.4%; P <.01) and plantar fasciitis (+17.5%-29.0%; P <.01), as well as VSIL for Achilles tendinopathy (+29.4%; P <.01). Cutoff thresholds showed better diagnostic criteria for individual versus grouped injuries.

CONCLUSION: Impact variables (VALR, VILR, and VSIL) were significantly higher when assessing the injured group as a whole. However, these findings were driven by specific injury groups, highlighting the importance of taking an injury-specific approach to biomechanical risk factors for running injury.

CLINICAL RELEVANCE: These results suggest that practitioners may want to address impact loading in their treatment of injured runners, especially in those with patellofemoral pain and plantar fasciitis.


Language: en

Keywords

biomechanics; gait mechanics; kinetics; load rate

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