Outline

The running cycle

Spatial parameters
Runners varus?
Biomechanics

Impact forces
Incidence of overuse
injuries & risk factors for
of Running
runners
Do running shoes cause
injury?
Orthoses and running
Summary
Adam Bird

The running cycle

References
Assorted articles mentioned no double support phase
Nigg BM (1986) Biomechanics of running Human three phases
Kinetics Publishers, Illinois, Chapter 1 stance (40%)
*Cavanagh PR (1989) The biomechanics of running float (30%)
and runnning shoe problems. In: Segesser B,
Pforringer W (eds). The shoe in sport. Yearbook swing (30%)
Medical Publishers, p 3-15 stance consists of
*Novachek TF (1998) The biomechanics of running contact, midstance, propulsion
(review paper) Gait & Posture 7: 77-95
CD-ROM Running & Sprinting: a dynamic analysis float phase
BUND AV 612.76 body airborne, no foot contact
consists of forward swing and foot descent

The running cycle Running gait cycle

the duration of each phase is relative to

the speed of running

jogging: stance > swing

distance: stance = swing

sprinting: stance < swing From: Subotnick SI. Podiatric Sports Medicine. Futura, New York, 1975
 Spatial parameters Spatial parameters

step and stride length much

greater than walking
stride width much narrower
no double support phase
uphill running
shorter stride length
increased stride rate
downhill running
longer stride length
decreased stride rate
WALKING RUNNING

Spatial parameters Running style variations

at any given running speed, each individual 80% distance

has an optimal combination of stride length runners are rearfoot
and rate to minimise energy requirements strikers (Kerr et al, 1983)
increased speed leads to
Elite sprinters have
increased hip flexion
only forefoot contact
increased knee flexion
increased forward trunk lean
increased float phase duration
decreased support phase

Runners varus Impact force

F=MV, therefore running will result
foot must be placed under CoG,
in greater impact force than walking
due to lack of double support
two peaks:
requires adduction of femur in the
heel strike (2 X BW)
acetabulum
midstance (3 X BW)
increased varus position at heel
strike joint compressive forces in the foot
may reach up to 10 X BW
this varus position may favour
high potential for stress fracture
increased STJ pronation,
particularly in females rapid STJ pronation and knee
flexion
 Impact force
Impact force

Passive force
Peak - shock of Theres no
contact with the
ground evidence that
biomechanical
research in load
Due to active
Muscle forces - analysis has
Marks end of contributed to a
Deceleration &
Beginning of
decreased
acceleration frequency of
running injuries
(Nigg, 1990)

Overuse injuries Incidence of running injuries

massive increase in number of joggers in last 25 OTHER 35% KNEE 30%

years

estimated thirty million joggers in the USA (Nigg, 1986)

Between 25-50% of runners will sustain an injury that

is severe enough to cause a change in practice or ACHILLES 10% TIBIA 15%
MLA 10%
performance (Renstrom, 1993)

the knee is most common site of injury From: Nigg BM. (ed.) Biomechanics of running shoes. Human
Kinetics Publishers, Illinois1986.

Incidence of marathon Clinical / Historical Factors

running injuries associated with overuse injuries*
Ultramarathon injuries impact force
Westfield Syd-Melb, 1990 hard surfaces
stress fractures
Knee (31.3%), ankle (28.1%)
downhill running
Most common
shin splints, patellar
Retropatella pain
tendonopathy
Achilles tendonopathy
lack of flexibility
Medial tibial stress syndrome
(Fallon, 1996) esp. achilles and hamstrings
overstriding
Risk factors: 1st time participation, illness less than 2
weeks before, current use of medication, drinking hamstrings, knee pain
alcohol once a month or more Shoes (last, stability, age to replace)
(Satterwaite et al, 1999) running on one side of road
environmental LLD
 Aetiological factors that are Aetiological factors that are unclear
strongly associated with injury as to whether associated with injury
Body height
Previous injury Muscular imbalance
Lack of running experience Restricted range of motion
Running to compete Stability of running pattern
Running on one side of the road
Excessive weekly running distance
Biomechanical malalignment
(van Mechelen, 1992) Warm up/stretching exercises
Shoes/orthoses...
(van Mechelen, 1992)

Aetiological factors that are strongly

Do running shoes cause injury ?
not associated with injury

Age Evidence:
Gender large increase in overuse injuries over the last 20
years
Body mass index
a Boston marathon study found that there was a
Participation in other sports higher incidence of overuse injury in subjects
Time of year/time of day who wore more expensive shoes
very low incidence of injury in barefoot runners
(van Mechelen, 1992)

Do running shoes
cause injury?
Robbins-Gouw hypothesis:
running shoes cause injury due to
creating a perceptual illusion of
lower impact force
excessive cushioning decreases
proprioceptive feedback
body unable to judge severity of
impact
reduced innate impact moderating
behaviour
increased impact
(Robbins & Gouw, 1991)
 Shoe factor associated with
overuse injuries?
A large lateral flare provides ground reaction forces
with a longer lever arm for pronating the STJ. This
will increase the velocity of contact phase pronation
and may predispose to injury (Nigg & Morlock, 1987)
Early 2D studies looking at effects
of orthoses when running
Reduction in
maximum pronation/calc eversion (Clarke,
1984)
Maximum pronation velocity (Novic, 1990)
Time-to-max pronation (Bates, 1979)
Total rearfoot motion (Novick, 1990)
Differences in footwear, orthoses, test surfaces, only
2D analysis?
General principles for running
orthoses
Semi-flexible?
Aware of greater forces being placed
through devices - discomfort/fracture?
Rearfoot posting?
Competitive athletes = weight of
devices?
Use of orthoses with running
injuries
At least 70% of runners who experience
lower extremity symptoms
eg. knee pain, plantar fasciitis, shin pain,
iliotibial band tendinitis
report marked improvement with
orthotic use
(DAmbrosia, 1985, Donatelli et al., 1988,
Gross et al., 1991, James et al., 1990)
Foot orthotics effect on 3D kinematics
of lower limb during running
20 recreational runners
Semi-rigid foot orthoses
Significant change in:
Decreased amount (2) of internal tibial
rotation (in first half of stance)
No change in frontal plane rotations (ie.
calc inv/ev)
(Nawoczenski, Cook & Saltzman, 1995)
Long term sequelae of
running?
Knee Osteoarthritis?
117 former athletes, now 45-68 years old
No
(Factors that do: previous knee injuries,
High BMI at age 20, participation in heavy
work, kneeling/squatting work, previously
played soccer/heavy weightlifting)
(Kujala et al, 1995)
 Summary
Case Study lecture
significantly altered mechanics due to:
Please read (Keenan, 1997) in your
floatation phase
POD21PBM manual
impact forces up to 3 X BW
rapid contact phase pronation Summarises some of the issues Craig
increased varus heel strike spoke about in his lectures so far this year
not necessarily heel to toe pattern Talks about integration of traditional and
increased incidence of injury newer theories of foot function
Know risk factors
different orthotic requirements
Importance of early recognition of
symptoms of overuse & complete rehabilitation