18Background: Previous research has demonstrated clear associations between specific

Background: Aberrant frontal-plane hip and pelvis kinematics have been frequently observed in runners with patellofemoral pain (PFP). Gait retaining interventions have been shown to improve running kinematics and may therefore be beneficial in runners with PFP. Purpose: To investigate whether a 10% increase in the running step rate influences frontal-plane kinematics of the hip and pelvis as well as clinical outcomes in runners with PFP. Study Design: Case series; Level of evidence, 4. Methods: Runners with PFP underwent a 3-dimensional gait analysis to confirm the presence of aberrant frontal-plane hip and/or pelvis kinematics at baseline. A total of 12 participants with frontal-plane hip and/or pelvis kinematics 1 standard deviation above a reference database were invited to undergo the gait retraining intervention. Running kinematics along with clinical outcomes of pain and functional outcomes were recorded at baseline, 4 weeks after retraining, and 3 months. Gait retraining consisted of a single session where step rate was increased by 10% using an audible metronome. Participants were asked to continue their normal running while self-monitoring their step rate using a global positioning system smartwatch and audible metronome. Results: After gait retraining, significant improvements in running kinematics and clinical outcomes were observed at 4-week and 3-month follow-up. Repeated-measures analysis of variance with post hoc Bonferroni correction ( P < .016) showed significant reductions in peak contralateral pelvic drop (mean difference [MD], 3.12° [95% CI, 1.88°-4.37°]), hip adduction (MD, 3.99° [95% CI, 2.01°-5.96°]), and knee flexion (MD, 4.09° [95% CI, 0.04°-8.15°]) as well as significant increases in self-reported weekly running volume (MD, 13.78 km [95% CI, 4.62-22.93 km]) and longest run pain-free (MD, 6.84 km [95% CI, 3.05-10.62 km]). Friedman test with a post hoc Wilcoxon signed-rank test showed significant improvements on a numerical rating scale for worst pain in the past week and the Lower Extremity Functional Scale. Conclusion: A single session of gait retraining using a 10% increase in step rate resulted in significant improvements in running kinematics, pain, and function in runners with PFP. These improvements were maintained at 3-month follow-up. It is important to assess for aberrant running kinematics at baseline to ensure that gait interventions are targeted appropriately. Registration: NCT03067545 (ClinicalTrials.gov identifier)

Load carriage and marching ‘in-step’ are routine military activities associated with lower limb injury risk in service personnel. The fixed pace and stride length of marching typically vary from the preferred walking gait and may result in overstriding. Overstriding increases ground reaction forces and muscle forces. Women are more likely to overstride than men due to their shorter stature. These biomechanical responses to overstriding may be most pronounced when marching close to the preferred walk-to-run transition speed. Load carriage also affects walking gait and increases ground reaction forces, joint moments and the demands on the muscles. Few studies have examined the effects of sex and stature on the biomechanics of marching and load carriage; this evidence is required to inform injury prevention strategies, particularly with the full integration of women in some defence forces. This narrative review explores the effects of sex and stature on the biomechanics of unloaded and loaded marching at a fixed pace and evaluates the implications for injury risk. The knowledge gaps in the literature, and distinct lack of studies on women, are highlighted, and areas that need more research to support evidence-based injury prevention measures, especially for women in arduous military roles, are identified.

No abstract

Background: The spring-mass model is commonly used to investigate the mechanical characteristics of human running. Underlying this model is the assumption of a linear force-length relationship, during the stance phase of running, and the idea that stiffness can be characterised using a single spring constant. However, it remains unclear whether the assumption of linearity is valid across different running styles.Research question: How does the linearity of the force-length curve vary across a sample of runners and is there an association between force-length linearity and foot-strike index/speed? Methods: Kinematic and kinetic data were collected from twenty-eight participants who ran overground at four speeds. The square of the Pearson's correlation coefficient, R 2 , was used to quantify linearity; with a threshold of R 2 ≥ 0.95 selected to define linear behaviour. A linear mixed model was used to investigate the association between linearity and foot-strike index and speed.Results: Only 36-46 % of participants demonstrated linear force-length behaviour across the four speeds during the loading phase. Importantly, the linear model showed a significant effect of both foot-strike index and speed on linearity during the loading phase (p = 0.003 and p < 0.001, respectively).Significance: This study showed that the assumption of a linear force-length relationship is not appropriate for all runners. These findings suggest that the use of the spring-mass model, and a constant value of stiffness, may not be appropriate for characterising and comparing different running styles. Given these findings, it may be better to restrict the use of the spring-mass model to individuals who exhibit linear force-length dependence. It would also be appropriate for future studies, characterising stiffness using the spring-mass model, to report data on force-length linearity across the cohort under study.