Effects of a 10 week footstrike transition in habitual rearfoot runners with patellofemoral pain

Abstract

Patellofemoral pain is the most common pathology in runners. Mid/fore foot runners experience lower patellofemoral loading compared to those who use a rearfoot strike. The aim of this study was to examine the efficacy of a 10-week intervention allowing runners with patellofemoral pain to transition from a rearfoot strike pattern. Nine male runners with patellofemoral pain were given a graduated 10-week program which allowed them to convert their habitual rearfoot strike pattern. Lower extremity kinematics, tibial accelerations, loading rates, patellofemoral kinetics and Achilles tendon kinetics were collected. Self-reported knee and Achilles tendon pain were examined using the Knee injury and Osteoarthritis Outcome Score and numeric pain rating scale. Data were collected before and after the 10-week transition. Reductions were found in peak patellofemoral force/pressure (pre-transition = 4.76 body weight (BW) and 13.10 MPa and post-transition = 4.27 BW and 11.48 MPa). Improvements were shown for Knee injury and Osteoarthritis Outcome Score subscales pain (pre-transition = 62.04 and post-transition = 78.41), sport (pre-transition = 53.61 and post-transition = 72.67), function and daily living (pre-transition = 67.68 and post-transition = 80.08). Increases were however found for peak Achilles tendon force (pre-transition = 5.07 BW and post-transition = 5.58 BW) and Achilles tendon pain (pre-transition = 1.06 and post-transition = 2.67). Transitioning from a rearfoot strike pattern reduces patellofemoral loading and pain symptoms. The key implication is that rearfoot strike runners with patellofemoral pain can reduce their pain symptoms by altering their footstrike pattern; although this may be at the expense of increased pain at the Achilles tendon.