Increasing Running Step Rate Reduces Patellofemoral Joint Forces

Abstract

Increasing step rate has been shown to elicit changes in joint kinematics and kinetics during running, and it has been suggested as a possible rehabilitation strategy for runners with patellofemoral pain. The purpose of this study was to determine how altering step rate affects internal muscle forces and patellofemoral joint loads, and then to determine what kinematic and kinetic factors best predict changes in joint loading. We recorded whole body kinematics of 30 healthy adults running on an instrumented treadmill at three step rate conditions (90%, 100%, and 110% of preferred step rate). We then used a 3-D lower extremity musculoskeletal model to estimate muscle, patellar tendon, and patellofemoral joint forces throughout the running gait cycles. In addition, linear regression analysis allowed us to ascertain the relative influence of limb posture and external loads on patellofemoral joint force. Increasing step rate to 110% of the preferred reduced peak patellofemoral joint force by 14%. Peak muscle forces were also altered as a result of the increased step rate with hip, knee, and ankle extensor forces, and hip abductor forces all reduced in midstance. Compared with the 90% step rate condition, there was a concomitant increase in peak rectus femoris and hamstring loads during early and late swing, respectively, at higher step rates. Peak stance phase knee flexion decreased with increasing step rate and was found to be the most important predictor of the reduction in patellofemoral joint loading. Increasing step rate is an effective strategy to reduce patellofemoral joint forces and could be effective in modulating biomechanical factors that can contribute to patellofemoral pain.