Lower Extremity Biomechanics and Self-Reported Foot-Strike Patterns Among Runners in Traditional and Minimalist Shoes

Abstract

Context:The injury incidence rate among runners is approximately 50%. Some individuals have advocated using an anterior-foot-strike pattern to reduce ground reaction forces and injury rates that they attribute to a rear-foot-strike pattern. The proportion of minimalist shoe wearers who adopt an anterior-foot-strike pattern remains unclear.Objective: To evaluate the accuracy of self-reported footstrike patterns, compare negative ankle-and knee-joint angular work among runners using different foot-strike patterns and wearing traditional or minimalist shoes, and describe average vertical-loading rates.Design: Descriptive laboratory study. Setting: Research laboratory. Patients or Other Participants: A total of 60 healthy volunteers (37 men, 23 women; age ¼ 34.9 6 8.9 years, height ¼ 1.74 6 0.08 m, mass ¼ 70.9 6 13.4 kg) with more than 6 months of experience wearing traditional or minimalist shoes were instructed to classify their foot-strike patterns.Intervention(s): Participants ran in their preferred shoes on an instrumented treadmill with 3-dimensional motion capture.Main Outcome Measure(s): Self-reported foot-strike patterns were compared with 2-dimensional video assessments.Runners were classified into 3 groups based on video assessment: traditional-shoe rear-foot strikers (TSR; n ¼ 22), minimalist-shoe anterior-foot strikers (MSA; n ¼ 21), and minimalist-shoe rear-foot strikers (MSR; n ¼ 17). Ankle and knee negative angular work and average vertical-loading rates during stance phase were compared among groups.Results: Only 41 (68.3%) runners reported foot-strike patterns that agreed with the video assessment (j ¼ 0.42, P , .001). The TSR runners demonstrated greater ankle-dorsiflexion and knee-extension negative work than MSA and MSR runners (P , .05). The MSA (P , .001) and MSR (P ¼ .01) runners demonstrated greater ankle plantar-flexion negative work than TSR runners. The MSR runners demonstrated a greater average vertical-loading rate than MSA and TSR runners (P , .001).Conclusions: Runners often cannot report their foot-strike patterns accurately and may not automatically adopt an anterior-foot-strike pattern after transitioning to minimalist running shoes.Key Words: barefoot running, ground reaction forces, negative work, loading rate Key PointsAccuracy of self-reported foot-strike patterns for runners wearing minimalist running shoes was poor. A cohort of runners who wore minimalist shoes for at least 6 months demonstrated a rear-foot-strike pattern and potentially injurious ground reaction force rates of loading. Runners using a rear-foot-strike pattern and wearing traditional shoes demonstrated more overall knee excursion, greater knee-extension negative work, and greater ankle-dorsiflexion negative work than runners wearing minimalist shoes, regardless of foot-strike pattern.

Using real‐time biofeedback to alter running biomechanics: A randomized controlled trial

“…These findings are expected based on loading patterns of the lower extremity while utilizing a NRFS pattern . Goss et al observed that there is increased negative work of the plantar flexors in NRFS runners compared to RFS runners . This may explain the large percentage of self‐reported ankle and leg injuries in this group.…”

“…The most common location for injuries in the NRFS runners was the foot (n = 12), ankle (n = 8), and leg (n = 12), accounting for 75% of the injuries in this group. These findings are expected based on loading patterns of the lower extremity while utilizing a NRFS pattern . Goss et al observed that there is increased negative work of the plantar flexors in NRFS runners compared to RFS runners .…”

“…The most common injuries in the RFS runners were the knee (n = 11) and ankle (n = 6), accounting for 60% of the injuries. Previous studies have demonstrated that RFS runners exhibit increased patellofemoral contact force, increased frontal plane motion, and increased negative work of the knee extensors compared to NRFS runners . This may explain the increase in self‐reported knee injuries in the RFS runners compared to the NRFS runners.…”

Adaptation of running pattern to the drop of standard cushioned shoes: A randomised controlled trial with a 6-month follow-up

“…Over the last decades, many running shoe features such as motion control, enhanced cushioning or elevated heel have been developed to improve comfort and protect against runninginduced repetitive overload. [1][2][3] Indeed, some of these shoe technologies were recently associated with the risk of sustaining a running-related injury in retrospective 4 as well as in prospective cohort studies. [5][6][7] Therefore, identifying biomechanical adaptations associated with these technologies is essential to understand the mechanism of any protective effects.…”

A Reliability Comparison of Different Methods for Detecting Step Rate and Foot Strike Pattern in Runners Using Two-dimensional Video

“…[4][5][6][7][8][9] Alterations in SR have consistently demonstrated the ability to reduce lower extremity loads associated with injury development to include; average vertical loading rate (AVLR), 10 shock attenuation, 11 and energy absorbed at the hip, knee, and ankle joints during running. 6 Individuals recovering from anterior exertional compartment syndrome, 12,13 tibial stress fracture, 14 anterior shin pain, 15 and patellofemoral pain 16,17 have reported reductions in running pain after gait retraining to increase their SR. By increasing one's preferred SR by 10% or greater (assuming a constant speed), reduced impact load on the body can be achieved. 6,10 A runner's FSP and the resulting loading properties may also be a principal factor in lower extremity injury.…”