Arch structure and injury patterns in runners

Williams, D.S. Blaise; McClay, Irene S.; Hamill, Joseph

doi:10.1016/s0268-0033(01)00005-5

Cited by 407 publications

(292 citation statements)

References 25 publications

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“…88, 101 The authors of 1 study did not report standard deviations or standard errors, 10 and the authors of 5 other studies did not report data on the number of lower extremity injuries (outcome) 1,12,56,72 or the number of participants (sample) 3 with each foot type. Of the corresponding authors of these 6 studies with missing data, only 3 12,56,72 provided the required data when contacted; the remaining 3 studies 1,3,10 were excluded from the meta-analysis.…”

Section: Foot-classification Methodsmentioning

confidence: 99%

Association Between Foot Type and Lower Extremity Injuries: Systematic Literature Review With Meta-analysis

Tong

Kong²

2013

Journal of Orthopaedic & Sports Physical Therapy

145

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T he human foot is often classified into 3 structural categories: high, normal, and low arch, based on its anatomical alignment 89 and the height of the medial longitudinal arch. 27 Classification in these 3 categories is typically based on cutoff values determined from the distribution of data (standard deviations 65,93,102 or percentiles 15,16 ) from measurements taken on a large population. The interest in such classification is the belief that nonneutral foot morphology, such as a high or low arch (flatfoot), may lead to less than optimal foot function and be associated with the development of lower extremity and low back injuries. 23,28,29,59 A review of the literature provides conflicting evidence on the potential relationship between foot type and lower extremity injuries. Although a number of published reports have found no relationships between nonneutral foot types and lower extremity injuries, 40,94,96,99 the authors of a recent systematic review concluded that both high-and low-arch foot types were associated with runningrelated injuries. 14 The results of this systematic review, 14 which did not include a meta-analysis and effect-size estimates, contrast those of a few qualitative reviews that failed to demonstrate a relationship between foot type and future lower extremity injuries. 4,8,20,70 This lack of consensus in the literature could be attributed, in part, to the variation in the operational definition of foot type among investigators. 4,70 A large variety of methods have been developed to classify the foot based on structure and alignment. These T T OBJECTIVES:To investigate the association between nonneutral foot types (high arch and flatfoot) and lower extremity and low back injuries, and to identify the most appropriate methods to use for foot classification. T T METHODS:A search of 5 electronic databases (PubMed, Embase, CINAHL, SPORTDiscus, and ProQuest Dissertations and Theses), Google Scholar, and the reference lists of included studies was conducted to identify relevant articles. The review included comparative cross-sectional, casecontrol, and prospective studies that reported qualitative/quantitative associations between foot types and lower extremity and back injuries. Quality of the selected studies was evaluated, and data synthesis for the level of association between foot types and injuries was conducted. A randomeffects model was used to pool odds ratio (OR) and standardized mean difference (SMD) results for meta-analysis. T T RESULTS:Twenty-nine studies were included for meta-analysis. A significant association between nonneutral foot types and lower extremity injuries was determined (OR = 1.23; 95% confidence interval [CI]: 1.11, 1.37; P<.001). Foot posture index (OR = 2.58; 95% CI: 1.33, 5.02; P<.01) and visual/ physical examination (OR = 1.17; 95% CI: 1.06, 1.28; P<.01) were 2 assessment methods using distinct foot-type categories that showed a significant association with lower extremity injuries.

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Section: Foot-classification Methodsmentioning

confidence: 99%

Association Between Foot Type and Lower Extremity Injuries: Systematic Literature Review With Meta-analysis

Tong

Kong²

2013

Journal of Orthopaedic & Sports Physical Therapy

145

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“…Several studies have cited increased rearfoot eversion as a contributing factor to lower extremity injuries. 15,24,28 Recently, Miller et al 16 reported that at the end of an exhaustive run, runners with ITBS demonstrated a greater rearfoot inversion angle at heel strike compared to controls, which they hypothesized contributed to a greater peak knee (tibial) internal rotation velocity and thus torsional strain to the iliotibial band. In contrast, Messier et al 15 reported that runners with a history of ITBS exhibited no difference in rearfoot mechanics while running, compared to healthy individuals.…”

Section: Methodsmentioning

confidence: 99%

“…3,9,14,28 During the first half of the stance phase, the calcaneus everts and the head of the talus internally rotates. 11,13 Consequently, the tibia internally rotates with the talus due to the tight articulation of the ankle joint mortise.…”

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confidence: 99%

Competitive Female Runners With a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics

Ferber¹,

Noehren²,

Hamill³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

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212

169

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Study Design: Cross-sectional experimental laboratory study. Objective: To examine differences in running mechanics between runners who had previously sustained iliotibial band syndrome (ITBS) and runners with no knee-related running injuries. Background: ITBS is the second leading cause of knee pain in runners and the most common cause of lateral knee pain. Despite its prevalence, few biomechanical studies have been conducted to better understand its aetiology. Because the iliotibial band has both femoral and tibial attachments, it is possible that atypical hip and foot mechanics could result in the development of ITBS. Methods: The running mechanics of 35 females who had previously sustained ITBS were compared to 35 healthy age-matched and running distance-matched healthy females. Comparisons of hip, knee, and ankle 3-dimensional kinematics and internal moments during the stance phase of running gait were measured. Results: The ITBS group exhibited significantly greater peak rearfoot invertor moment, peak knee internal rotation angle, and peak hip adduction angle compared to controls. No significant differences in peak rearfoot eversion angle, peak knee flexion angle, peak knee external rotator moment, or peak hip abductor moments were observed between groups. Conclusion: Females with a previous history of ITBS demonstrate a kinematic profile that is suggestive of increased stress on the iliotibial band. These results were generally similar to those reported for a prospective study conducted within the same laboratory environment. J Orthop Sports Phys Ther 2010;40(2):52–58. doi:10.2519/jospt.2010.3028

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“…9 Different arch configurations are an intrinsic risk factor for lower extremity overuse injuries. [10][11][12][13][14][15][16] The first ray is responsible for shock absorption during the loading phase and stability at the end of stance phase. 17 Dysfunction of the first ray affects load transmission to the forefoot, possibly leading to mechanical breakdown of the bony structures and pathological conditions.…”

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confidence: 99%

A clinically applicable six‐segmented foot model

Mits

Segers

Woodburn

et al. 2011

Journal Orthopaedic Research

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We describe a multi-segmented foot model comprising lower leg, rearfoot, midfoot, lateral forefoot, medial forefoot, and hallux for routine use in a clinical setting. The Ghent Foot Model describes the kinematic patterns of functional units of the foot, especially the midfoot, to investigate patient populations where midfoot deformation or dysfunction is an important feature, for example, rheumatoid arthritis patients. Data were obtained from surface markers by a 6 camera motion capture system at 500 Hz. Ten healthy subjects walked barefoot along a 12 m walkway at self-selected speed. Joint angles (rearfoot to shank, midfoot to rearfoot, lateral and medial forefoot to midfoot, and hallux to medial forefoot) in the sagittal, frontal, and transverse plane are reported according to anatomically based reference frames. These angles were calculated and reported during the foot rollover phases in stance, detected by synchronized plantar pressure measurements. Repeated measurements of each subject revealed low intra-subject variability, varying between 0.78 and 2.38 for the minimum values, between 0.58 and 2.18 for the maximum values, and between 0.88 and 5.88 for the ROM. The described movement patterns were repeatable and consistent with biomechanical and clinical knowledge. As such, the Ghent Foot model permits intersegment, in vivo motion measurement of the foot, which is crucial for both clinical and research applications. Keywords: multi-segment foot model; foot and ankle kinematics; gait analysis; Ghent Foot Model Multi-segmented foot models can provide better insight into foot kinematics (and to a less extent segmental foot kinetics) during gait than single segments models. Clinically, they are used to describe and analyze functional characteristics associated with foot impairments. A number of multi-segmented foot models, using either bone pins or surface markers, have been proposed. They vary according to the number of segments and functional unit definition, in the methods of calculating intersegment angles, and in the definition of the neutral foot reference position. 1,2The need exists for a clinically relevant, user-friendly multi-segment foot model that would include the lower leg, hindfoot, midfoot, medial and lateral forefoot, and the hallux, with wide utility to investigate single joint/segment joint dysfunction through to complex foot deformities. Models with <5 segments often can not describe whole foot kinematics. [3][4][5][6][7] In contrast, those with nine segments 8 are not always easily applicable in clinical settings. To our knowledge and based upon a recent review, 2 no such model is currently available.There are two main reasons why a 6 segment model is clinically relevant. First, these segments are examined clinically by physical therapists and podiatrists. The medial arch, formed by the rearfoot (talus), the medial part of the midfoot, and the first ray, plays an important role in foot function during weight bearing activities. 9 Different arch configurations are an intrinsic ris...

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Arch structure and injury patterns in runners

Cited by 407 publications

References 25 publications

Association Between Foot Type and Lower Extremity Injuries: Systematic Literature Review With Meta-analysis

Association Between Foot Type and Lower Extremity Injuries: Systematic Literature Review With Meta-analysis

Competitive Female Runners With a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics

A clinically applicable six‐segmented foot model

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