Effects of Running in Minimal, Maximal and Conventional Footwear on Tibial Stress Fracture Probability: An Examination Using Finite Element and Probabilistic Analyses

Abstract

This study examined the effects of minimal, maximal and conventional running footwear on tibial strains and stress fracture probability using finite element and probabilistic analyses. The current investigation examined fifteen males running in three footwear conditions (minimal, maximal and conventional). Kinematic data were collected during overground running at 4.0 m/s using an eight-camera motion-capture system and ground reaction forces using a force plate. Tibial strains were quantified using finite element modelling and stress fracture probability calculated via probabilistic modelling over 100 days of running. Ninetieth percentile tibial strains were significantly greater in minimal (4681.13 με) (p < 0.001) and conventional (4498.84 με) (p = 0.007) footwear compared to maximal (4069.65 με). Furthermore, tibial stress fracture probability was significantly greater in minimal footwear (0.22) (p = 0.047) compared to maximal (0.15). The observations from this investigation show that compared to minimal footwear, maximal running shoes appear to be effective in attenuating runners’ likelihood of developing a tibial stress fracture.

Effects of a 10-week footstrike transition programme on tibial stress fracture probability; a randomized controlled intervention using finite element and probabilistic modelling

“…Each model had boundary conditions imposed, involving complete constraints applied at the tibial plateau [59,60] (Figure 2a). Net three-dimensional ankle joint contact forces, derived from the musculoskeletal simulation analyses, were then applied to the distal aspect of the tibia [59,60] (Figure 2b).…”

“…Each model had boundary conditions imposed, involving complete constraints applied at the tibial plateau [59,60] (Figure 2a). Net three-dimensional ankle joint contact forces, derived from the musculoskeletal simulation analyses, were then applied to the distal aspect of the tibia [59,60] (Figure 2b). Additionally, anatomically directed net muscle forces were applied at every muscle attachment point on the tibia, utilizing the forces obtained from static optimization (Figure 2c).…”

“…Additionally, anatomically directed net muscle forces were applied at every muscle attachment point on the tibia, utilizing the forces obtained from static optimization (Figure 2c). Given that certain bi-articulating muscles, such as the gastrocnemius, generate substantial forces during running without direct insertion points onto the tibia itself [59,60], their contribution to tibial strain was accounted for by calculating a residual ankle joint moment following the approach outlined by Haider et al [59]. This residual moment was applied to the distal tibia (Figure 2d).…”

“…We determined the probability of stress fracture for each participant in each footwear condition firstly by accounting for the daily running distance which was included into the model as runners completed 5.0 km/day for 100 consecutive days [30,37,60,62]. The num-ber of loading cycles/footfalls per day in each footwear condition was quantified by dividing the modelled daily running distance i.e.…”

“…The probability of tibial stress fracture was assessed through a probabilistic model considering bone damage, repair, and adaptation, aligning with methodologies from prior analyses [30,37,60,62]. The fatigue life of the tibial bone was modelled based on the standard fatigue equation [63]:…”