Foot strike pattern, step rate, and trunk posture combined gait modifications to reduce impact loading during running

Abstract

Elevated impact loading can be detrimental to runners as it has been linked to the increased risk of tibial stress fracture and plantar fasciitis. The objective of this study was to investigate the combined effects of foot strike pattern, step rate, and anterior trunk lean gait modifications on impact loading in runners. Nineteen healthy runners performed 12 separate gait modification trials involving: three foot strike patterns (rearfoot, midfoot, and forefoot strike), two step rates (natural and 10% increased), and two anterior trunk lean postures (natural and 10-degree increased flexion). Overall, forefoot strike combined with increased step rate led to the lowest impact loading rates, and rearfoot strike combined with anterior trunk lean led to the highest impact loading rates. In addition, there were interaction effects between foot strike pattern and step rate on awkwardness and effort, such that it was both more natural and easier to transition to a combined gait modification involving forefoot strike and increased step rate than to an isolated gait modification involving either forefoot strike or increased step rate. These findings could help to inform gait modifications for runners to reduce impact loading and associated injury risks.

Wearable Technology May Assist in Retraining Foot Strike Patterns in Previously Injured Military Service Members: A Prospective Case Series

“…This subset of individuals also demonstrated the greatest increase in cadence and greatest reduction in AVLR on both limbs (31%) at the post-intervention data collection (T2). Our observation is in agreement with Huang et al, who demonstrated that healthy individuals transitioning to a NRFS combined with increased cadence achieved greater reductions in AVLR than FSP manipulation alone (Huang et al, 2019). Overall, we achieved favorable reductions in AVLR in those with knee complaints with a NRFS transition using an instrumented sock.…”

“…In further support of our hypotheses, cadence increased 2.8% from initial (T1) to post-intervention (T2), but this increase was not maintained at follow-up (T3) ( Table 3, Supplementary Material 4). A cadence increase of 5-10% has been shown to reduce energy absorption of the lower-extremities (Heiderscheit et al, 2011) and reduce ground reaction forces during running (Schubert et al, 2014;Huang et al, 2019;Futrell et al, 2020). Furthermore, it has been reported to be more natural and easier to transition FSP using a combined gait modification involving a NRFS and increased cadence than to transition using an isolated gait modification of NRFS alone (Huang et al, 2019).…”

“…A cadence increase of 5-10% has been shown to reduce energy absorption of the lower-extremities (Heiderscheit et al, 2011) and reduce ground reaction forces during running (Schubert et al, 2014;Huang et al, 2019;Futrell et al, 2020). Furthermore, it has been reported to be more natural and easier to transition FSP using a combined gait modification involving a NRFS and increased cadence than to transition using an isolated gait modification of NRFS alone (Huang et al, 2019). Although the primary intervention for the current study was not cadence manipulation, during running the participants devices provided auditory feedback whenever cadence dropped below 180 steps per minute.…”

“…Altering FSP from RFS to NRFS is a gait retraining technique commonly employed by clinicians to prevent and manage injuries (Barton et al, 2016;Roper et al, 2016;Miller et al, 2020). Reductions in AVLR, peak vertical ground reaction force (vGRF) (greatest magnitude of force during one step), and stance time have been achieved in healthy (Huang et al, 2019) and previously injured runners (Diebal et al, 2012;Roper et al, 2016;Miller et al, 2020) after transitioning from a RFS to a NRFS running pattern. Reductions in pain and improvements in function have also been reported following NRFS gait retraining (Roper et al, 2016;Miller et al, 2020).…”

Real-time feedback by wearables in running: Current approaches, challenges and suggestions for improvements

“…In running, almost all variables are modifiable, but some variables are likely easier and more directly to modify. It is, for example, easier to transfer to a forefoot strike pattern when the step rate can be increased at the same time rather than trying to adopt a forefoot strike while keeping the step rate at the baseline level (Huang et al, 2019).…”