Purpose 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. Methods Three-dimensional kinematics and kinetics were recorded from 45 healthy recreational runners during treadmill running at constant speed under various step rate conditions (preferred, ± 5% and ± 10%). We tested our primary hypothesis that a reduction in energy absorption by the lower extremity joints during the loading response would occur, primarily at the knee, when step rate was increased. Results Less mechanical energy was absorbed at the knee (p<0.01) during the +5% and +10% step rate conditions, while the hip (p<0.01) absorbed less energy during the +10% condition only. All joints displayed substantially (p<0.01) more energy absorption when preferred step rate was reduced by 10. Step length (p<0.01), center of mass vertical excursion (p<0.01), breaking impulse (p<0.01) and peak knee flexion angle (p<0.01) were observed to decrease with increasing step rate. When step rate was increased 10% above preferred, peak hip adduction angle (p<0.01), as well as peak hip adduction (p<0.01) and internal rotation (p<0.01) moments, were found to decrease. Conclusion 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.

The anatomical data regarding the deltoid ligament bands in this study will help to guide anatomical placement of repairs and reconstructions for deltoid ligament injury or instability.

The establishment of a new standard reference point within the acetabulum will enhance the consistency of interpretation of the location of labral pathology and improve arthroscopic orientation and navigation.

Aerobic training at the dose and schedule tested is safe but not feasible for a significant proportion of patients with metastatic breast cancer. The acceptable feasibility and promising benefit for select patients warrant further evaluation in a dose-finding phase 1/2 study. Cancer 2018;124:2552-60. © 2018 American Cancer Society.

Footprint center distances from surgically relevant osseous landmarks identified in this study can be used during reconstructive surgery of the lateral ankle ligaments and may result in more anatomically accurate placement of the reconstructed ligaments.