Peak Rearfoot Eversion Research Articles

Foot kinematics in people with medial compartment knee osteoarthritis

Objectives. Foot orthoses are commonly used in the management of knee OA, although the relationship between foot function and knee OA is still unclear. The purpose of the study was to examine foot function during walking in people with and without medial compartment knee OA. Methods. Motion of the tibia, rearfoot and forefoot in 32 patients with medial compartment knee OA and 28 age-matched control subjects was investigated. Multivariate analysis was used to compare the groups. Results. The knee OA group contacted the ground with a more everted rearfoot, demonstrated greater peak rearfoot eversion and exhibited reduced rearfoot frontal plane range of motion and reduced rearfoot peak inversion. The tibia was more internally rotated and laterally tilted throughout the gait cycle, with reduced peak external rotation. Conclusion. People with medial compartment knee OA exhibit altered foot kinematics during gait that are indicative of a less mobile, more everted foot type. The presence and degree of tibial malalignment and the available rearfoot range of motion during walking may affect individual responses to load-altering interventions, such as foot orthoses and footwear modifications. Trial registration: Australian New Zealand Clinical Trials Registry, www.anzctr.org.au/, ACTRN

Relationships between the Foot Posture Index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome

BackgroundFoot posture assessment is commonly undertaken in clinical practice for the evaluation of individuals with patellofemoral pain syndrome (PFPS), particularly when considering prescription of foot orthoses. However, the validity of static assessment to provide insight into dynamic function in individuals with PFPS is unclear. This study was designed to evaluate the extent to which a static foot posture measurement tool (the Foot Posture Index - FPI) can provide insight into kinematic variables associated with foot pronation during level walking in individuals with PFPS and asymptomatic controls.MethodsTwenty-six individuals (5 males, 21 females) with PFPS aged 25.1 ± 4.6 years and 20 control participants (4 males, 16 females) aged 23.4 ± 2.3 years were recruited into the study. Each participant underwent clinical evaluation of the FPI and kinematic analysis of the rearfoot and forefoot during walking using a three-dimensional motion analysis system. The association of the FPI score with rearfoot eversion, forefoot dorsiflexion, and forefoot abduction kinematic variables (magnitude, timing of peak and range of motion) were evaluated using partial correlation coefficient statistics with gait velocity entered as a covariate.ResultsA more pronated foot type as measured by the FPI was associated with greater peak forefoot abduction (r = 0.502, p = 0.013) and earlier peak rearfoot eversion relative to the laboratory (r = -0.440, p = 0.031) in the PFPS group, and greater rearfoot eversion range of motion relative to the laboratory (r = 0.614, p = 0.009) in the control group.ConclusionIn both individuals with and without PFPS, there was fair to moderate association between the FPI and some parameters of dynamic foot function. Inconsistent findings between the PFPS and control groups indicate that pathology may play a role in the relationship between static foot posture and dynamic function. The fair association between pronated foot posture as indicated by the FPI and earlier peak rearfoot eversion relative to the laboratory observed exclusively in those with PFPS is consistent with the biomechanical model of PFPS development. However, prospective studies are required to determine whether this relationship is causal.

Walking kinematics in individuals with patellofemoral pain syndrome: A case–control study

Patellofemoral pain syndrome (PFPS) development is considered to be multifactorial with various knee, hip and foot/ankle kinematic factors thought to be involved. A paucity of research evaluating kinematic factors throughout the lower limb kinematic chain simultaneously in individuals with PFPS was identified in a recent systematic review. The objective of this study was to compare kinematics at the knee, hip and foot/ankle in a group of individuals with PFPS to a group of asymptomatic controls. Twenty-six individuals with PFPS and 20 controls aged between 18 and 35 were recruited. Between-group comparisons were made for magnitude and timing of peak angles, and range of motion at the forefoot (dorsiflexion, abduction and supination), rearfoot (dorsiflexion, internal rotation and eversion), knee (flexion, abduction and internal rotation) and hip (adduction and internal rotation) during walking. The PFPS group demonstrated less peak hip internal rotation (7.0° versus 11.8°, p=0.024, p=0.024), earlier peak rearfoot eversion relative to the laboratory (30.4% versus 35.3% of the gait cycle, p=0.010) and tibia (32.7% versus 36.5% of the gait cycle, p=0.030), and greater rearfoot dorsiflexion range of motion relative to the laboratory (72.3° versus 68.2°, p=0.007). Additionally, a trend toward reduced gait velocity (p=0.070) was found in the PFPS group. Reduced peak hip internal rotation and gait velocity in individuals with PFPS may indicate compensation to reduce PFJ load during walking. However, earlier peak rearfoot eversion may be a factor related to the pathomechanical development of the condition.

Greater peak rearfoot eversion predicts foot orthoses efficacy in individuals with patellofemoral pain syndrome

ObjectiveThere is growing evidence for the provision of foot orthoses when treating individuals with patellofemoral pain syndrome (PFPS), and prescription is frequently based on the assessment of foot posture/function. However,...

Temporal couplings between rearfoot–shank complex and hip joint during walking

Background Rearfoot pronation–supination and hip internal–external rotation are commonly assumed to be temporally coupled. Many mechanisms of musculoskeletal injury are proposed based on this assumption. Previous studies suggested that this theoretical coupling does not exist. However, recent experimental studies observed relationships consistent with foot–hip mechanical interdependence. Methods Three-dimensional kinematics of the lower extremity of 18 healthy subjects, wearing flat trekking sandals, was measured during the stance phase of normal walking. Rearfoot–shank complex motion in the transverse plane (shank internal–external rotation) and frontal plane (rearfoot eversion–inversion) and hip motion in the transverse plane were analyzed. Cross-correlation coefficients were calculated to investigate temporal similarities between curves of rearfoot–shank and hip motions. Pearson correlations were used to investigate relationships between the timings of the peaks of these motions. Findings Cross-correlations revealed a strong mean temporal coupling (mean r = 0.77, range 0.56 to 0.92) between shank internal–external rotation and hip internal–external rotation and a moderate mean temporal coupling (mean r = 0.56, range 0.37 to 0.78) between rearfoot eversion–inversion and hip internal–external rotation. Pearson correlations revealed significant ( P ≤ 0.031) moderate relationships of timing of peak shank internal rotation ( r = 0.45) and timing of peak rearfoot eversion ( r = 0.62) with timing of peak hip internal rotation. Interpretation The findings suggest a temporal coupling of rearfoot pronation with hip internal rotation and rearfoot supination with hip external rotation during walking stance. The between-subjects variability of curves' temporal similarities and the moderate relationships between timings of motion peaks indicate that coupling strength should be clinically addressed on an individual basis.

Use of gait sandals for measuring rearfoot and shank motion during running

Gait sandals may be used as an alternative to shoes in gait analysis. However, their similarity to running shoes remains unclear. This study aimed to compare rearfoot and shank kinematics between barefoot, running shoes and gait sandal conditions during running. We hypothesised that gait sandals would more closely replicate the kinematics seen when wearing running shoes than when barefoot. Rearfoot and shank kinematics were measured in 14 male participants as they ran in three footwear conditions (barefoot, gait sandals and running shoes) at 3.5 m/s. Both barefoot and gait sandals resulted in greater peak rearfoot eversion compared to running shoes. Gait sandals were similar to running shoes for all other variables. These findings suggest that gait sandals can be used in place of running shoes during gait analysis to study rearfoot and shank kinematics.

Distinct Hip and Rearfoot Kinematics in Female Runners With a History of Tibial Stress Fracture

Cross-sectional controlled laboratory study. To investigate the kinematics of the hip, knee, and rearfoot in the frontal and transverse planes in female distance runners with a history of tibial stress fracture. Tibial stress fractures are a common overuse injury in runners, accounting for up to half of all stress fractures. Abnormal kinematics of the lower extremity may contribute to abnormal musculoskeletal load distributions, leading to an increased risk of stress fractures. Thirty female runners with a history of tibial stress fracture were compared to 30 age-matched and weekly-running-distance-matched control subjects with no previous lower extremity bony injuries. Kinematic and kinetic data were collected using a motion capture system and a force platform, respectively, as subjects ran in the laboratory. Selected variables of interest were compared between the groups using a multivariate analysis of variance (MANOVA). Peak hip adduction and peak rearfoot eversion angles were greater in the stress fracture group compared to the control group. Peak knee adduction and knee internal rotation angles and all joint angles at impact peak were similar between the groups. Runners with a previous tibial stress fracture exhibited greater peak hip adduction and rearfoot eversion angles during the stance phase of running compared to healthy controls. A consequence of these mechanics may be altered load distribution within the lower extremity, predisposing individuals to stress fracture.

Competitive Female Runners With a History of Iliotibial Band Syndrome Demonstrate Atypical Hip and Knee Kinematics

Cross-sectional experimental laboratory study. To examine differences in running mechanics between runners who had previously sustained iliotibial band syndrome (ITBS) and runners with no knee-related running injuries. ITBS is the second leading cause of knee pain in runners and the most common cause of lateral knee pain. Despite its prevalence, few biomechanical studies have been conducted to better understand its aetiology. Because the iliotibial band has both femoral and tibial attachments, it is possible that atypical hip and foot mechanics could result in the development of ITBS. The running mechanics of 35 females who had previously sustained ITBS were compared to 35 healthy age-matched and running distance-matched healthy females. Comparisons of hip, knee, and ankle 3-dimensional kinematics and internal moments during the stance phase of running gait were measured. The ITBS group exhibited significantly greater peak rearfoot invertor moment, peak knee internal rotation angle, and peak hip adduction angle compared to controls. No significant differences in peak rearfoot eversion angle, peak knee flexion angle, peak knee external rotator moment, or peak hip abductor moments were observed between groups. Females with a previous history of ITBS demonstrate a kinematic profile that is suggestive of increased stress on the iliotibial band. These results were generally similar to those reported for a prospective study conducted within the same laboratory environment.

The role of tibialis posterior fatigue on foot kinematics during walking

BackgroundThe purpose of this study was to investigate the effect of localised tibialis posterior muscle fatigue on foot kinematics during walking. It was hypothesised that following fatigue, subjects would demonstrate greater forefoot and rearfoot motion during walking. It was also postulated that the magnitude of the change in rearfoot motion would be associated with standing anatomical rearfoot posture.MethodsTwenty-nine subjects underwent an exercise fatigue protocol aimed at reducing the force output of tibialis posterior. An eight camera motion analysis system was used to evaluate 3D foot kinematics during treadmill walking both pre- and post-fatigue. The anatomical rearfoot angle was measured during standing prior to the fatigue protocol using a goniometer.ResultsPeak rearfoot eversion remained unchanged following the fatigue protocol. Although increases in rearfoot eversion excursion were observed following fatigue, these changes were of a magnitude of questionable clinical significance (<1.0°). The magnitude of the change in rearfoot eversion due to fatigue was not associated with the anatomical measurement of standing rearfoot angle. No substantial changes in forefoot kinematics were observed following the fatigue protocol.ConclusionsThese data indicate that reduced force output of the tibialis posterior muscle did not alter rearfoot and forefoot motion during gait. The anatomical structure of the rearfoot was not associated with the dependence of muscular activity that an individual requires to maintain normal rearfoot kinematics during gait.

Effect of foot orthoses on magnitude and timing of rearfoot and tibial motions, ground reaction force and knee moment during running

Changes in magnitude and timing of rearfoot eversion and tibial internal rotation by foot orthoses and their contributions to vertical ground reaction force and knee joint moments are not well understood. The objectives of this study were to test if orthoses modify the magnitude and time to peak rearfoot eversion, tibial internal rotation, active ground reaction force and knee adduction moment and determine if rearfoot eversion, tibial internal rotation magnitudes are correlated to peak active ground reaction force and knee adduction moment during the first 60% stance phase of running. Eleven healthy men ran at 170 steps per minute in shod and with foot orthoses conditions. Video and force-plate data were collected simultaneously to calculate foot joint angular displacement, ground reaction forces and knee adduction moments. Results showed that wearing semi-rigid foot orthoses significantly reduced rearfoot eversion 40% (4.1°; p = 0.001) and peak active ground reaction force 6% (0.96 N/kg; p = 0.008). No significant time differences occurred among the peak rearfoot eversion, tibial internal rotation and peak active ground reaction force in both conditions. A positive and significant correlation was observed between peak knee adduction moment and the magnitude of rearfoot eversion during shod ( r = 0.59; p = 0.04) and shod/orthoses running ( r = 0.65; p = 0.02). In conclusion, foot orthoses could reduce rearfoot eversion so that this can be associated with a reduction of knee adduction moment during the first 60% stance phase of running. Finding implies that modifying rearfoot and tibial motions during running could not be related to a reduction of the ground reaction force.

O055 Stride kinematics and running economy during graded exercise

Step width is a spatiotemporal parameter that may influence lower extremity biomechanics at the hip and knee joint. The purpose of this study was to determine the biomechanical response of the lower extremity joints to step width changes during running. Lower extremity data from 30 healthy runners, half of them male, were collected during running in three step width conditions: preferred, wide, and narrow. Dependent variables and step width were analyzed using a mixed model ANOVA and pairwise t-tests for post hoc comparisons. Step width was successfully altered in the wide and narrow conditions. Generally, frontal plane peak values decreased as step width increased from narrow to preferred to wide. Peak hip adduction and rearfoot eversion angles decreased as step width increased from narrow to wide. Peak knee abduction moment and knee abduction impulse also decreased as step width increased from narrow to wide. Although men and women ran differently, gender only influenced the effect of step width on peak rearfoot inversion moment. In conclusion, step width influences lower extremity biomechanics in healthy runners. When step width increased from narrow to wide, peak values of frontal plane variables decreased. In addition to previously reported changes at the rearfoot, the hip and knee joint biomechanics were also influenced by changes in step width.

Biomechanical predictors of retrospective tibial stress fractures in runners

Both kinematics and kinetics of the lower limb have been shown separately to be related with a history of tibial stress fractures (TSFs) in female runners. However, it is likely that these factors interact together to increase the risk of a TSF. This study was conducted to determine which combination of kinematic and kinetic factors are the best predictors of retrospective TSF in female distance runners. Total 30 female runners who had previously sustained a TSF were recruited, along with an age and mileage matched control group ( n=30). Subjects ran overground at 3.7 m/s while kinematic and kinetic data were recorded. Five trials from each subject were used for data analysis and ensemble means were calculated for both groups. The kinematic variables of peak hip adduction (HADD), peak knee internal rotation (KIR) and knee adduction (KADD), peak rearfoot eversion (RFEV) were entered into a binary logistic regression along with the kinetic variables of vertical instantaneous load rate (VILR) and absolute free moment (FM). The variables HADD, FM and RFEV were able to correctly predict a history of TSF in 83% of cases. Increases in HADD, FM and RFEV (odds ratios of 1.29, 1.37 and 1.18) were associated with an elevated risk of having a history of TSF. The addition of VILR, KIR and KADD did not improve the ability to predict previous injury. Based on these results, HADD, FM and RFEV appear to be the most important of the variables of interest in terms of predicting retrospective TSF in female runners.

Consecutive Footstrikes May Not be Necessary to Quantify Gait Symmetry During Running

Quantification of gait symmetry is useful for the detection of pathology, as well as the efficacy of treatment. It is often calculated using non-consecutive footstrikes due to equipment limitations (ie, one forceplate). Yet, studies assessing symmetry in this way may be criticized as gait is continuous in nature and each step is affected by those prior. To date, the effect of non-consecutive steps on gait symmetry calculation is unknown. PURPOSE: To determine whether there is a difference in symmetry values calculated using consecutive versus non-consecutive footstrikes. METHODS: Kinetic and kinematic variables were measured in 52 injury-free runners. Knee stiffness (KSTF), peak ground reaction force along the long axis of the shank (SHfz), peak instantaneous loading rate along the shank (SHlr), peak acceleration along the shank (PPA), peak hip adduction angle (HAD), peak hip internal rotation angle (HIR), peak knee abduction angle (KAD), and peak rearfoot eversion angle (REV) were calculated. Data were collected for five trials of two consecutive footstrikes. Symmetry was quantified using the Symmetry Angle (SA). For each variable, the SA was calculated between the values for each set of consecutive footstrikes and between the average right and left-side values: SAconsec = (SA1, … SA5)avg and SAnon-consec = SA(XRavg, XLavg), respectively. Paired t-tests were used to compare between methods (α = 0.05). No differences were expected between methods. RESULTS: Of the eight variables, only KAD exhibited a significant difference between methods, where the SA calculated from non-consecutive footstrikes was greater (p = 0.02). The remaining variables were less than 7.5% different between methods. CONCLUSIONS: In general, quantification of gait symmetry is unaffected by the use of non-consecutive footstrikes. This suggests that the patterns of movement are sufficiently consistent, such that differences between sides can be reliably detected using either method.

Application of Center-of-Pressure Data to Indicate Rearfoot Inversion-Eversion in Shod Running

Although pressure plates are used to help in the selection of appropriate footwear for runners, evidence relating aspects of pressure data to movement is lacking. A study was conducted to investigate whether center-of-pressure (COP) data obtained for shod running could be used to indicate the amount of rearfoot eversion. It was hypothesized that subjects exhibiting high rearfoot eversion during the initial ground contact phase of running would also show a large lateral-to-medial deviation in the COP. Pressure plate and rearfoot movement data were collected for 33 subjects. The COP was characterized using the lateral-to-medial deviation of the COP during the eversion phase of ground contact. Correlation coefficients were determined for COP deviation versus rearfoot range of motion and versus peak rearfoot eversion (P < .05). In addition, subjects were grouped as high, moderate, or low pronators, and analysis of variance was used to test whether there were significant differences in COP deviation for these three groups (P < .05). The COP deviation was found to have a low correlation with rearfoot range of motion (R = 0.46; P < .05) and with peak rearfoot eversion (R = .54; P < .05). High pronators had significantly higher COP deviation than the medium- and low-pronation groups (P < .05). These findings support the use of COP deviation to detect high pronation. However, caution is advised in using the COP to indicate absolute rearfoot eversion.

Secondary Plane Biomechanics of Iliotibial Band Syndrome in Competitive Female Runners

Iliotibial band syndrome (ITBS) is the second leading cause of knee pain in runners and is the number one cause of lateral knee pain. The mechanisms by which runners develop ITBS are still poorly understood with few investigations looking at the contribution of the frontal and transverse planes of motion. It has been suggested increased motion in these planes would place greater tension on the ITB and result in ITBS over time. PURPOSE: To retrospectively examine the biomechanical differences between a control group with no history of ITBS, and a group who have previously sustained ITBS in the past. It was hypothesized that runners who had previously sustained ITBS would exhibit greater peak rearfoot eversion (RFEV), knee internal rotation (KIR), hip adduction (HADD), and hip internal rotation (HIR) angles. In addition greater knee frontal and transverse moments (KMOMY, KMOMZ) at initial impact peak of vertical ground reaction force were expected. METHODS: 35 female runners, between the ages of 18–45 who have previously sustained ITBS, were recruited for the study. 35 age and mileage match female runners who had never had any hip or knee injuries, served as the controls. Subjects ran along a 25M runway at a speed of 3.7 m/s. Data from 5 trials were averaged for analysis using One tail independent t-test's for group comparisons (p <0.05). RESULTS:TableThe ITBS group exhibited significantly greater KIR and HADD peak angles and greater KMOMY and KMOMZ compared to controls. CONCLUSIONS: These data suggest that repetitive exposure to increased joint motion and loading over time would require greater restraint from the ITB and result in the cascade of events that cause ITBS. Prospective studies are necessary to more fully determine if these running biomechanics are predictive of future injury.

Tibia and rearfoot motion and ground reaction forces in subjects with patellofemoral pain syndrome during walking

Abnormal subtalar joint function and the consequent rotation of the tibia during walking are thought to contribute to patellofemoral pain syndrome (PFPS). The purpose of this study was to measure rearfoot and tibia motion, and the ground reaction force (GRF) during the stance phase of walking in subjects with PFPS and compare them to healthy subjects. A four camera motion analysis system with a single force plate was used to investigate rearfoot motion relative to the tibia in three planes, the tibial transverse plane rotation and the GRF during the stance phase of walking in 13 female subjects diagnosed with PFPS and 14 healthy females. Analysis showed significantly delayed peak rearfoot eversion (p=0.02), and earlier occurrence of peak dorsiflexion (p=0.02) for the PFPS group. Furthermore, significantly lower peak medial GRF (p=0.03), minimum vertical GRF trough (p=0.02) and the second vertical GRF peak (p=0.01) were found in the PFPS group. Tibial transverse rotation was not shown to be different in PFPS subjects. However, there was prolonged rearfoot eversion during the stance phase of walking. The earlier appearance of rearfoot dorsiflexion as well as the lower GRFs indicate altered propulsive function of the foot during supination.

Comparison of static and dynamic biomechanical measures in military recruits with and without a history of third metatarsal stress fracture

For Royal Marine recruits in training, the third metatarsal is the most common site for stress fracture. Previous evidence regarding biomechanical factors contributing to metatarsal stress fracture development is conflicting, possibly due to the lack of differentiation between the metatarsals. The present retrospective study compares static anatomical characteristics and dynamic biomechanical variables for Royal Marine recruits with and without a history of third metatarsal stress fracture. Ten Royal Marine recruits with a history of third metatarsal stress fracture were compared with control subjects with no previous stress fracture occurrence. Selected static anatomical variables were measured to describe the ankle and subtalar joints. Peak ankle dorsi-flexion and rearfoot eversion were measured during running. In addition, peak vertical and horizontal ground reaction force variables were compared for the two study groups. No significant differences in static anatomical variables were identified between study groups. During running, peak rearfoot eversion was found to occur significantly earlier for the stress fracture group than for their matched controls, suggesting an increase in time spent loading the forefoot. The peak applied resultant horizontal force during the braking phase was directed significantly more laterally for the stress fracture group. In addition, the peak magnitude of resultant horizontal force applied during the propulsion phase was significantly lower for the stress fracture subjects. The findings of this study highlight the importance of including dynamic biomechanical data when exploring variables associated with the development of third metatarsal stress fracture and indicate that successful interventions to reduce the incidence of this injury are likely to focus on forefoot function during braking and propulsion.

Orthotic intervention in forefoot and rearfoot strike running patterns

Objective. To compare the differential effect of custom orthoses on the lower extremity mechanics of a forefoot and rearfoot strike pattern. Design. Fifteen subjects ran with both a forefoot and a rearfoot strike pattern with and without orthoses. Lower extremity kinematic and kinetic variables were compared between strike pattern and orthotic conditions. Background. Foot orthoses have been shown to be effective in controlling excessive rearfoot motion in rearfoot strikers. The effect of orthotic intervention on rearfoot motion in forefoot strikers has not been previously reported. Methods. Five trials were collected for each condition. Peak rearfoot eversion, eversion excursion, eversion velocity, peak inversion moment, and inversion work were compared between conditions. Kinematic variables in the sagittal plane of the rearfoot and in the frontal and sagittal plane of the knee were also determined. Results. Increased rearfoot excursions and velocities and decreased peak eversion were noted in the forefoot strike pattern compared to the rearfoot strike pattern. Orthotic intervention, however,did not significantly change rearfoot motion in either strike pattern. Reductions in internal rotation and abduction of the knee were noted with orthotic intervention. Conclusions. Foot orthoses do not differentially effect rearfoot motion of a rearfoot strike and a forefoot strike running pattern. Orthotic intervention has a larger and more systematic effect on rearfoot kinetics compared to rearfoot kinematics. Relevance Due to the similarity in response to orthotic intervention, foot strike pattern should not be a factor when prescribing a foot orthoses for controlling rearfoot motion.

KINEMATICS AND KNEE INJURIES IN RUNNERS WITH LOW ARCHES

Gender differences in injury incidence at the knee have been reported in the literature. Additionally, medial longitudinal arch structure has been suggested to effect injuries at the knee. However, the relationship between gender and arch structure as it relates to injury has not been investigated. PURPOSE: To evaluate injury histories and compare rearfoot and knee kinematics in male and female runners with low arches. METHODS: Twenty runners (10 female and 10 male) with extremely low arches were evaluated. All subjects were screened for inclusion in the low-arched group using an arch ratio method. Retroreflective markers were affixed to the pelvis, thigh, shank and foot unilaterally. A standing calibration trial was collected and subjects then ran along a runway at a fixed speed. Ten trials were collected. Data were sampled at 120 HZ using a six camera motion analysis system. Three-dimensional joint kinematics were calculated during the stance phase of gait. Knee flexion excursion, peak knee flexion, peak knee abduction, rearfoot eversion excursion and peak rearfoot eversion were calculated and compared using a Student's t-test (p ≤ 0.05). Running-related injuries were reported via questionnaire. RESULTS: Females exhibited lower knee flexion excursion when compared to males, although not significantly (p = 0.11). Both groups exhibited a similar peak knee flexion angle (p = 0.34). Low-arched female subjects in the current study showed a trend toward greater knee flexion at heel strike than male runners (p = 0.12). Females demonstrated significantly higher peak knee abduction when compared to males (p = 0.04). No significant difference was observed between the groups in rearfoot eversion excursion (p = 0.39) while the female group exhibited a lower peak rearfoot eversion (p = 0.03). Finally, low-arched females reported more than twice as many knee injuries as their male counterparts (14 vs. 6). CONCLUSION: Low-arched females appear to exhibit more control of peak frontal plane angle (eversion) at the ankle while exhibiting less frontal plane control at the knee (abduction). This may be one factor contributing to the increased number of knee injuries in the low-arched female runner when compared to males. Further investigation should focus on medial longitudinal arch structure in the female athlete and its relationship to running or landing-related injuries. The results of these data suggest that similar structural deviations may have different relationships to running mechanics and injuries between male and female athletes.