Abstract
IntroductionRunning-related injuries (RRIs) occur from a combination of training load errors and aberrant biomechanics. Impact loading, measured by peak acceleration, is an important measure of running biomechanics that is related to RRI. Foot strike patterns may moderate the magnitude of impact load in runners. The effect of foot strike pattern on peak acceleration has been measured using tibia-mounted inertial measurement units (IMUs), but not commercially available insole-embedded IMUs. The aim of this study was to compare the peak acceleration signal associated with rearfoot (RFS), midfoot (MFS), and forefoot (FFS) strike patterns when measured with an insole-embedded IMU.Materials and MethodsHealthy runners ran on a treadmill for 1 min at three different speeds with their habitual foot strike pattern. An insole-embedded IMU was placed inside standardized neutral cushioned shoes to measure the peak resultant, vertical, and anteroposterior accelerations at impact. The Foot strike pattern was determined by two experienced observers and evaluated using high-speed video. Linear effect mixed-effect models were used to quantify the relationship between foot strike pattern and peak resultant, vertical, and anteroposterior acceleration.ResultsA total of 81% of the 187 participants exhibited an RFS pattern. An RFS pattern was associated with a higher peak resultant (0.29 SDs; p = 0.029) and vertical (1.19 SD; p < 0.001) acceleration when compared with an FFS running pattern, when controlling for speed and limb, respectively. However, an MFS was associated with the highest peak accelerations in the resultant direction (0.91 SD vs. FFS; p = 0.002 and 0.17 SD vs. RFS; p = 0.091). An FFS pattern was associated with the lowest peak accelerations in both the resultant and vertical directions. An RFS was also associated with a significantly greater peak acceleration in the anteroposterior direction (0.28 SD; p = 0.033) than an FFS pattern, while there was no difference between MFS and FFS patterns.ConclusionOur findings indicate that runners should be grouped by RFS, MFS, and FFS when comparing peak acceleration, rather than the common practice of grouping MFS and FFS together as non-RFS runners. Future studies should aim to determine the risk of RRI associated with peak accelerations from an insole-embedded IMU to understand whether the small observed differences in this study are clinically meaningful.
Highlights
Running-related injuries (RRIs) occur from a combination of training load errors and aberrant biomechanics
The two observers agreed on 89.7% of all the foot strike patterns and 93.6% of foot strike patterns when mixed foot strike (e.g., rearfoot strike (RFS)/midfoot strike (MFS) or MFS/forefoot strike (FFS)) patterns were removed
In support of our hypotheses, an RFS pattern was associated with a higher peak resultant and vertical acceleration when compared with an FFS running pattern
Summary
Running-related injuries (RRIs) occur from a combination of training load errors and aberrant biomechanics. Impact loading, measured by peak acceleration, is an important measure of running biomechanics that is related to RRI. Whether measured via ground reaction force (GRF) or by peak acceleration, is an important measure of running biomechanics that may be related to RRI (van der Worp et al, 2016; Ceyssens et al, 2019). Foot strike pattern may contribute to the magnitude of impact load in runners, as well as the distribution of this load through anatomical structures (Glauberman and Cavanagh, 2014; Almeida et al, 2015). Glauberman and Cavanagh (2014) reported no difference in peak vertical tibial acceleration between RFS and non-RFS runners but found peak resultant and anteroposterior accelerations to be greater among non-RFS runners. Ruder et al (2019) reported that an MFS pattern more closely resembled an RFS pattern and that both of these patterns exhibited higher peak vertical tibial accelerations than runners who exhibited an FFS pattern
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