Running Shoes Research Articles

Effects of barefoot and shod running on lower extremity joint loading, a musculoskeletal simulation study

The aim of the current investigation was to utilize a musculoskeletal simulation-based approach, to examine the effects of barefoot and shod running on lower extremity joint loading during the stance phase. Twelve male runners, ran over an embedded force plate at 4.0 m/s, in both barefoot and shod conditions. Kinematics of the lower extremities were collected using an eight-camera motion capture system. Lower extremity joint loading was also explored using a musculoskeletal simulation and mathematical modelling approach, and differences between footwear conditions were examined using paired samples t tests. Peak Achilles tendon force was significantly larger (P = 0.039) when running barefoot (6.85 BW) compared to shod (6.07 BW). In addition, both medial (P = 0.013) and lateral (P = 0.007) tibiofemoral instantaneous load rates were significantly larger in the barefoot (medial 289.17 BW/s and lateral 179.59 BW/s) in relation to the shod (medial 167.57 BW/s and lateral 116.40 BW/s) condition. Finally, the barefoot condition (9.70 BW) was associated with a significantly larger (P = 0.037) peak hip force compared to running shod (8.51 BW). The current investigation indicates that running barefoot may place runners at increased risk from the biomechanical factors linked to the etiology of chronic lower extremity pathologies. However, future analyses using habitual barefoot runners, are required before more definitive affirmations regarding injury predisposition can be made.

Dynamic Varus and the Development of Iliotibial Band Syndrome.

Although the risk of osteoarthritis development after acute knee injury has been widely studied, the long-term consequences of knee overuse injury are not well understood. To identify the relationship between gait-related risk factors associated with osteoarthritis and the development of iliotibial band syndrome (ITBS) in members of a single University Army Reserve Officers' Training Corps unit. Prospective cohort study. Biomechanics laboratory. Sixty-eight cadets undergoing standardized physical fitness training. Three-dimensional lower extremity kinematics (240 Hz) and kinetics (960 Hz) were collected for 3 bilateral trials during shod running at 4.0 m/s ± 10%. Injury tracking was conducted for 7 months of training. Biomechanical variables, including varus thrust and knee-adduction moment, were compared between the injured and control groups. Twenty-six cadets with no history of overuse injury served as the control group, whereas 6 cadets (7 limbs) who developed ITBS that required them to modify their training program or seek medical care (or both) served as the injured group. Maximum varus velocity was higher ( P = .006) and occurred sooner during stance ( P = .04) in the injured group than in the control group, indicating greater varus thrust. Maximum knee-varus angle and maximum knee-adduction moment were higher ( P = .02 and P = .002, respectively) and vertical stiffness was lower ( P = .03) in the injured group. Measures of dynamic varus stability appeared to be altered in individuals who developed ITBS. Biomechanical knee variables previously identified as increasing the risk for knee osteoarthritis were also associated with the development of ITBS in healthy adults.

The Variation of Plantar Temperature and Plantar Pressure during Shod Running with Socks or not

Foot temperature can be affected by friction and contact pressure, in this study, we explored the specific changes of foot temperature under different friction conditions, running with socks versus no socks. The relationship between vertical loading force and foot temperature will also be investigated at the same time. Ten male recreational runners wore the same shoes and socks and were tested running 8km/h on a treadmill. The plantar temperature during running was recorded every 3 minutes for a total of 45 minutes. Post-run temperature change was recorded every 3 minutes for 12 minutes. The plantar pressure was recorded before running and at the first 15 minutes during running. The subjects with socks and no socks were tested on separate occasions. There were no significant differences found between the socks and no socks conditions. However, central metatarsal head, lateral metatarsal head, medial rearfoot and lateral rearfoot regions exist differences were reflected at the first 6minutes-12minutes of running. The foot temperature became more stable after 15minutes of running. Also, plantar pressure increased significantly in the hallux, other toes, first metatarsal head and central metatarsal regions. It also could conclude that lower initial temperature had a greater increase trend during the running start stage. When the ankle in plantarflexion stage, toe and forefoot regions showed a higher rise in temperature and also presented higher plantar pressure correspondingly.

Independent factors associated with wearing different types of outdoor footwear in a representative inpatient population: a cross-sectional study

BackgroundFootwear can have both a positive and negative impact on lower limb health and mobility across the lifespan, influencing the risk of foot pain, ulceration, and falls in those at risk. Choice of footwear can be influenced by disease as well as sociocultural factors, yet few studies have investigated the types of footwear people wear and the profiles of those who wear them. The aim of this study was to investigate the prevalence and factors associated with outdoor footwear type worn most often in a representative inpatient population.MethodsThis study was a secondary data analysis of a cohort of 733 inpatients that is highly representative of developed nations’ hospitalised populations; 62 ± 19 years, 55.8% male, and 23.5% diabetes. Socio-demographic, medical history, peripheral arterial disease, peripheral neuropathy, foot deformity, foot ulcer history, amputation history and past foot treatment variables were collected. Participants selected the footwear type they mostly wore outside the house in the previous year from 16 types of footwear. Multivariate logistic regression identified independent factors associated with outdoor footwear types selected.ResultsThe most common outdoor footwear types were: running shoes (20%), thongs/flip flops (14%), walking shoes (14%), sandals (13%) and boots (11%). Several socio-demographic, medical history and foot-related factors were independently associated (Odds Ratio; 95% Confidence Interval)) with different types of footwear. Running shoes were associated with male sex (2.7; 1.8–4.1); thongs with younger age (0.95 for each year; 0.94–0.97), being female (2.0; 1.2–3.1) and socio-economic status (3.1; 1.2–7.6); walking shoes with arthritis (1.9; 1.2–3.0); sandals with female sex (3.8; 2.3–6.2); boots with male sex (9.7; 4.3–21.6) and inner regional (2.6; 1.3–5.1) and remote (3.4; 1.2–9.5) residence (all, p < 0.05).ConclusionsWe profiled the types of outdoor footwear worn most in a large diverse inpatient population and the factors associated with wearing them. Sex was the most consistent factor associated with outdoor footwear type. Females were more likely to wear thongs and sandals and males boots and running shoes. Overall, this data gives insights into the socio-demographic, medical and other health factors that are related to footwear choice in a large diverse population primarily of older age.

Running Economy While Running in Shoes Categorized as Maximal Cushioning

Running Economy While Running in Shoes Categorized as Maximal Cushioning

Effects of barefoot and minimally shod footwear on effective mass – implications for transient musculoskeletal loading

The purpose of this investigation was to explore the effects of barefoot and minimally shod footwear on effective mass, and determine the implications that this has for transient loading during running. Fifteen male runners ran at 4.0 m/s in five different footwear conditions (barefoot, running trainer, Nike-free, Inov-8 and Vibram five-fingers). Kinematics were collected using an 8 camera motion capture system and ground reaction forces via an embedded force platform. Effective mass was examined using impulse-momentum modelling and differences between footwear were examined using one-way repeated measures ANOVA. The findings showed that effective mass was significantly larger in the barefoot (11.47 %BW), Nike-free (9.81 %BW), Inov-8 (12.10 %BW) and Vibram five-fingers (8.84 %BW) compared to the running trainer (6.86 %BW). Furthermore, instantaneous loading rate was significantly larger in the barefoot (347.55 BW/s), Nike-free (178.76 BW/s), Inov-8 (369.93 BW/s) and Vibram five-fingers (339.37 BW/s) compared to the running trainer (133.18 BW/s). It was also revealed that there were significant positive associations between effective mass and the instantaneous rate of loading for each footwear. The findings from the current investigation indicate that effective mass has key implications for the generation of transient forces and also that running barefoot and in minimally shod footwear may place runners at increased risk from impact related injuries compared to the traditional running shoes

How accurate is visual determination of foot strike pattern and pronation assessment

Nowadays, choosing adequate running shoes is very difficult, due to the high number of different designs. Nevertheless, shoes have two main characteristics to fit runners’ technique and morphology: drop and arch support. Retailers’ advices are usually based on the visual assessment of the customer’s running technique. Such method is subjective and requires an experimented examiner while objective methods require expensive material, such as 3D motion system and pressure insoles. Therefore, the aim of this study was to determine the accuracy of foot strike pattern and pronation assessment using video cameras, compared to a gold standard motion tracking system and pressure insoles. 34 subjects had to run at 8, 12 and 16 Km/h shod and 12 Km/h barefoot during 30 s trials on a treadmill. Agreement between foot strike pattern assessment methods was between 88% and 92%. For pronation, agreement on assessment methods was between 42% and 56%. The results obtained indicate a good accuracy on foot strike pattern assessment, and a high difficulty to determine pronation with enough accuracy. There is therefore a need to develop new tools for the assessment of runner’s pronation.

Footwear effects on free moment application in running

The free moment is considered an important variable during running in lower extremity transverse plane loading of the support leg. The effect of current footwear technology on free moment application has not been widely studied despite evidence that greater free moment amplitudes may be related to common lower extremity overuse injuries. Therefore, the purpose of this study was to determine the effect of current running shoe types on the free moment application in running and to identify which design features specifically influence free moment waveforms. The free moments and lower extremity kinematics of 103 recreational runners were collected when running at 3.5 m/s using force plates embedded in the ground. Six conditions were analysed, ranging from minimalistic to motion-control footwear. Runners were classified into three groups of different free moment pattern using functional principal component and cluster analysis techniques. The results revealed that the free moment application can be affected by footwear technologies used in modern running shoes. Nonetheless, the free moment application was influenced to a greater extent by the overall running technique highlighted by the greater effect sizes for pattern membership compared to footwear effects. Footwear may affect the free moment application as a function of its torsional flexibility and to a lesser extent by means of motion-control features. Future studies should address the effect of footwear design features (such as shoe-mass and traction) on free moment application in greater detail to improve the running style with respect to injury prevention and performance enhancement.

The morphology of foot soft tissues is associated with running shoe type in healthy recreational runners

ObjectivesTo determine the differences in the morphology of foot soft tissues between runners using different types of running shoes. DesignCross-sectional study. MethodsThirty-eight recreational runners were divided into four groups based on running shoe type, namely, neutral shoes, motion control shoes, minimalistic shoes and neutral shoes with custom-made insoles. An arch height index and a relative arch deformation index were calculated for each participant. An ultrasound device was used to measure the cross-sectional area and/or the thickness of selected intrinsic foot muscles (abductor hallucis, flexor hallucis brevis and flexor digitorum brevis) and extrinsic foot muscles (flexor digitorum longus, tibialis anterior and the peroneus muscles), and the thickness of the plantar fascia, Achilles tendon and heel pad. ResultsRecreational runners using minimalistic shoes demonstrated stiffer foot arches than those using neutral shoes. Among the selected foot muscles, only abductor hallucis showed a significant morphological difference between shoe groups. Runners using minimalistic shoes had the thickest abductor hallucis. The minimalistic shoe runners also showed a thinner proximal plantar fascia and a thicker Achilles tendon than other runners. Insole runners had a thinner heel pad than neutral shoe runners. ConclusionsThis study suggests that the morphology of foot soft tissues is associated with running shoe type in recreational runners. A sudden change in running shoe type without adjusting training volume should be undertaken with caution, since it may take time for foot soft tissues to adapt to a new shoe condition.

A Comparison of the Energetic Cost of Running in Marathon Racing Shoes

BackgroundReducing the energetic cost of running seems the most feasible path to a sub-2-hour marathon. Footwear mass, cushioning, and bending stiffness each affect the energetic cost of running. Recently, prototype running shoes were developed that combine a new highly compliant and resilient midsole material with a stiff embedded plate.ObjectiveThe aim of this study was to determine if, and to what extent, these newly developed running shoes reduce the energetic cost of running compared with established marathon racing shoes.Methods18 high-caliber athletes ran six 5-min trials (three shoes × two replicates) in prototype shoes (NP), and two established marathon shoes (NS and AB) during three separate sessions: 14, 16, and 18 km/h. We measured submaximal oxygen uptake and carbon dioxide production during minutes 3–5 and averaged energetic cost (W/kg) for the two trials in each shoe model.ResultsCompared with the established racing shoes, the new shoes reduced the energetic cost of running in all 18 subjects tested. Averaged across all three velocities, the energetic cost for running in the NP shoes (16.45 ± 0.89 W/kg; mean ± SD) was 4.16 and 4.01% lower than in the NS and AB shoes, when shoe mass was matched (17.16 ± 0.92 and 17.14 ± 0.97 W/kg, respectively, both p < 0.001). The observed percent changes were independent of running velocity (14–18 km/h).ConclusionThe prototype shoes lowered the energetic cost of running by 4% on average. We predict that with these shoes, top athletes could run substantially faster and achieve the first sub-2-hour marathon.

The effect of eliminating leg length difference on plantar foot pressure distribution in patients wearing forefoot offloading shoe

Background and purposeElevated heel construction offloads the forefoot after surgery. However, side-to-side height difference alters limb kinetics, whereas leg-length equalizing-sole at non-operated side may have beneficial effects on foot loading. The purpose of this study was to characterize leg-length equalizing sole effect on bilateral plantar pressures when using heel-lift forefoot-offloading shoe. Materials and methodsTwenty men were tested walking. Plantar peak pressures (PP) and pressure-time integrals (PTI) in the forefoot-offloading shoe and in contralateral running shoe were compared between two conditions: one with- and the other without leg-length equalizing sole elevation at the running shoe. ResultsAdding leg-length equalizing sole to the running shoe resulted in the following changes in the forefoot-offloading shoe: increased lateral midfoot PP (8.7%, p=0.03), increased lateral midfoot (11.3%, p=0.05) and lateral metatarsals PTI (10.3%, p=0.04), and decreased medial and lateral heel PTI (>5%, p=0.02). These changes were non-significant when applying a Bonferroni correction. Changes in the running shoe were: increased medial midfoot (20.5%, p=0.03) and decreased 2nd and lateral metatarsals PP (23%, p<0.01). PTI increased in medial and lateral heel (>25%, p<0.01), medial midfoot (63.2%, p<0.01) and lateral midfoot (9.2%, p=0.04) and decreased in 2nd and lateral metatarsals (>24.5%, p<0.01). ConclusionLeg-length equalizing sole at contralateral running shoe in subjects wearing forefoot-offloading shoe results in lateral load shift alongside heel pressure attenuation within the forefoot-offloading shoe, which is beneficial during first month after medial forefoot surgery. Reciprocal medial load-shift in the elevated running shoe itself should yet be considered when bilateral medial forefoot pathology is present.

Gait retraining as part of the treatment programme for soldiers with exercise-related leg pain: preliminary clinical experiences and retention

Background: Gait retraining as part of a treatment programme for exercise-related leg pain (ERLP) was introduced in the sports medicine department of the Royal Netherlands Army in 2013.Objectives: To describe clinical experiences and retention of gait retraining in a military setting.Methods: Sixty-one cases from the year 2015 were available for analysis of gait and gait retraining. In 2016, 32 of these patients were available for a follow-up survey, 28 of them also for the follow-up measurement of running biomechanics in running shoes.Results: Soldiers received an outpatient treatment programme that lasted on average 129 days (SD 76). On average they received 2.4 gait retraining sessions, leading to significant and lasting changes in running biomechanics; in particular, reduction in maximal force (N) and maximal pressure (N/cm2) on the heels at 317 days follow-up (average, SD 108). Most soldiers were satisfied with gait retraining. At follow-up, 27 soldiers (84%) contributed some, the majority or all reduction of symptoms to it. Seventy percent reported that they had mastered the new running technique within two months. The Single Assessment Numeric Evaluation score increased from 55% to 78% for males and from 44% to 75% for females.Discussion: This is the first study to report on gait retraining for Medial Tibial Stress Syndrome. In future, prospective studies in the military running in shoes and running in boots respectively should be investigated.Conclusion: Soldiers with exercise-related leg pain (ERLP), among them patients with Medial Tibial Stress Syndrome, respond well to a treatment programme that included gait retraining. Ten months post-gait retraining, their running biomechanics still showed these positive changes from their time of intake.

Gait retraining as part of the treatment programme for soldiers with exercise-related leg pain: preliminary clinical experiences and retention

Background: Gait retraining as part of a treatment programme for exercise-related leg pain (ERLP) was introduced in the sports medicine department of the Royal Netherlands Army in 2013.Objectives: To describe clinical experiences and retention of gait retraining in a military setting.Methods: Sixty-one cases from the year 2015 were available for analysis of gait and gait retraining. In 2016, 32 of these patients were available for a follow-up survey, 28 of them also for the follow-up measurement of running biomechanics in running shoes.Results: Soldiers received an outpatient treatment programme that lasted on average 129 days (SD 76). On average they received 2.4 gait retraining sessions, leading to significant and lasting changes in running biomechanics; in particular, reduction in maximal force (N) and maximal pressure (N/cm2) on the heels at 317 days follow-up (average, SD 108). Most soldiers were satisfied with gait retraining. At follow-up, 27 soldiers (84%) contributed some, the majority or all reduction of symptoms to it. Seventy percent reported that they had mastered the new running technique within two months. The Single Assessment Numeric Evaluation score increased from 55% to 78% for males and from 44% to 75% for females.Discussion: This is the first study to report on gait retraining for Medial Tibial Stress Syndrome. In future, prospective studies in the military running in shoes and running in boots respectively should be investigated.Conclusion: Soldiers with exercise-related leg pain (ERLP), among them patients with Medial Tibial Stress Syndrome, respond well to a treatment programme that included gait retraining. Ten months post-gait retraining, their running biomechanics still showed these positive changes from their time of intake.

Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial

Background: The increasing popularity of distance running has been accompanied by an increase in running-related injuries, such that up to 85% of novice runners incur an injury in a given year. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with many running ailments. However, softer footfalls may not necessarily prevent running injury. Purpose: To examine vertical loading rates before and after a gait retraining program and assess the effectiveness of the program in reducing the occurrence of running-related injury across a 12-month observation period. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 320 novice runners from the local running club completed this study. All the participants underwent a baseline running biomechanics evaluation on an instrumented treadmill with their usual running shoes at 8 and 12 km/h. Participants were then randomly assigned to either the gait retraining group or the control group. In the gait retraining group (n = 166), participants received 2 weeks of gait retraining with real-time visual feedback. In the control group (n = 154), participants received treadmill running exercise but without visual feedback on their performance. The training time was identical between the 2 groups. Participants’ running mechanics were reassessed after the training, and their 12-month posttraining injury profiles were tracked by use of an online surveillance platform. Results: A significant reduction was found in the vertical loading rates at both testing speeds in the gait retraining group (P < .001, Cohen’s d > 0.99), whereas the loading rates were either similar or slightly increased in the control group after training (P = .001 to 0.461, Cohen’s d = 0.03 to −0.14). At 12-month follow-up, the occurrence of running-related musculoskeletal injury was 16% and 38% in the gait retraining and control groups, respectively. The hazard ratio between gait retraining and control groups was 0.38 (95% CI, 0.25-0.59), indicating a 62% lower injury risk in gait-retrained runners compared with controls. Conclusion: A 2-week gait retraining program is effective in lowering impact loading in novice runners. More important, the occurrence of injury is 62% lower after 2 weeks of running gait modification. Registration: HKUCTR-1996 (University of Hong Kong Clinical Trials Registry).

The longer-term effects of minimalist running shoes on lower limb structure and function, running performance, and injury risk

The effects of transitioning to minimalist running shoes are a topic of interest for runners and scientists. However, relatively few studies have investigated longer-term effects of running in minimalist shoes. This paper will report preliminary findings from a planned 20-week follow-up of runners who participated in a 6-week randomised controlled trial of minimalist shoes and had successfully transitioned to using minimalist or control shoes for 35% of weekly training. Runners continued to transition to their allocated shoes throughout the planned 20-week follow-up by increasing minimalist or control shoe use by 5% each week. The allocated shoes were used for 100% of weekly running during the final 6 weeks of the follow-up. Training volume, shoe use, running-related pain and injury were monitored weekly. Time trial performance, running economy, stride rate, stride length, shoe comfort, ankle plantar flexor muscle strength, and bone mineral density in the tibia, calcaneus, and metatarsals were assessed at the end of the 20-week follow-up. Early published findings from this trial demonstrate that risk of sustaining a running-related injury increased for heavier runners using minimalist shoes compared to control shoes. Additionally, greater weekly calf, ankle, and shin pain severity were experienced by runners completing high weekly running distance using minimalist shoes compared to control shoes. This paper will expand on these published findings by (1) discussing the longer-term effects of transitioning to minimalist shoes on time trial performance, running economy, muscle strength and bone mineral density, and (2) use a series of example cases from the study to explore potential moderating factors (shoe comfort, running biomechanics, and training volume) that might influence the effects of minimalist shoes on running performance, muscle strength, bone mineral density, pain and injury. The clinical and research implications of the findings from this planned follow-up study and case series investigation will be discussed.

Lower limb symposium

This symposium will feature extended presentations from leading clinician researchers working in the field of lower limb biomechanics. Dr Kade Patterson from The University of Melbourne will talk about athletic footwear and knee health, with some very interesting (and important) insights arising from recent clinical trials performed at the Centre for Health and Exercise Medicine. Dr Joel Fuller from Macquarie University will present the longer term effects of minimalist running shoes on lower limb structure, function, running performance and injury. Jayishni Maharaj from The University of Queensland will present the findings from her PhD studies of the mechanical function of the subtalar joint and tibialis posterior muscle and tendon during gait. Dr Chris Bishop from the University of South Australia will discuss the findings from his recent research exploring the management of plantar heel pain and specifically, how the key is in the diagnosis

The influence of cadence and shoes on patellofemoral joint kinetics in runners with patellofemoral pain

ObjectivesTo determine the effect of a combination of a minimalist shoe and increased cadence on measures of patellofemoral joint loading during running in individuals with patellofemoral pain. DesignWithin-participant repeated measures with four conditions presented in random order: (1) control shoe at preferred cadence; (2) control shoe with +10% cadence; (3) minimalist shoe at preferred cadence; (4) minimalist shoe with +10% cadence. MethodsFifteen recreational runners with patellofemoral pain ran on an instrumented treadmill while three-dimensional motion capture data were acquired. Peak patellofemoral joint stress, joint reaction force, knee extensor moment and knee joint angle during the stance phase of running were calculated. One-way repeated measures ANOVA was used to compare the control condition (1) to the three experimental conditions (2–4). ResultsRunning in a minimalist shoe at an increased cadence reduced patellofemoral stress and joint reaction force on average by approximately 29% (p<0.001) compared to the control condition. Running in a minimalist shoe at preferred cadence reduced patellofemoral joint stress by 15% and joint reaction force by 17% (p<0.001), compared to the control condition. Running in control shoes at an increased cadence reduced patellofemoral joint stress and joint reaction force by 16% and 19% (p<0.001), respectively, compared to the control condition. ConclusionsIn individuals with patellofemoral pain, running in a minimalist shoe at an increased cadence had the greatest reduction in patellofemoral joint loading compared to a control shoe at preferred cadence. This may be an effective intervention to modulate biomechanical factors related to patellofemoral pain.

Effects of Running Shoes with Abrasion Resistant Rubber Sole on the Exercise Capacity of the Human Body

Effects of Running Shoes with Abrasion Resistant Rubber Sole on the Exercise Capacity of the Human Body

Comparison of Biomechanical Characteristics on Barefoot Running and Shod Running

Background Compared with the rearfoot strike pattern of shod running, barefoot running with a forefoot strike pattern will change the kinematics and kinetic parameters. This paper analyses the biomechanical differences between barefoot running and shod running and aims to provide a reference for barefoot training and the prevention of sports injury. Methods Three-dimensional force plate test and three-dimensional video analysis. Results Kinetic characteristics: The F-t curve by the force plate test shows that barefoot running has a smooth curve with a single peak while the F-t curve of shod running has a double peak on the vertical direction curve. The maximum ground reaction force in the vertical direction of barefoot running is significantly less than shod running. Kinematics characteristics: Compared with shod running, barefoot running has a faster step frequency, a shorter stride length, a shorter foot-to-ground contact time. The smaller stride length means barefoot running has a bigger ankle plantar flexion, which shows barefoot running can reduce sports injuries.

EFFECT OF HEEL LIFTS ON PATELLOFEMORAL JOINT STRESS DURING RUNNING

Patellofemoral pain is a debilitating injury for many recreational runners. Excessive patellofemoral joint stress may be the underlying source of pain and interventions often focus on ways to reduce patellofemoral joint stress. Heel lifts have been used as an intervention within Achilles tendon rehabilitation programs and to address leg length discrepancies. The purpose of this study was to examine the effect of running with heel lifts on patellofemoral joint stress, patellofemoral stress impulse, quadriceps force, step length, cadence, and other related kinematic and spatiotemporal variables. A repeated-measures research design. Sixteen healthy female runners completed five running trials in a controlled laboratory setting with and without 11mm heel lifts inserted in a standard running shoe. Kinetic and kinematic data were used in combination with a static optimization technique to estimate individual muscle forces. These data were inserted into a patellofemoral joint model which was used to estimate patellofemoral joint stress and other variables during running. When running with heel lifts, peak patellofemoral joint stress and patellofemoral stress impulse were reduced by a 4.2% (p=0.049) and 9.3% (p=0.002). Initial center of pressure was shifted anteriorly 9.1% when running with heel lifts (p<0.001) despite all runners utilizing a heel strike pattern. Dorsiflexion at initial contact was reduced 28% (p=0.016) when heel lifts were donned. No differences in step length and cadence (p>0.05) were shown between conditions. Heel lift use resulted in decreased patellofemoral joint stress and impulse without associated changes in step length or frequency, or other variables shown to influence patellofemoral joint stress. The center of pressure at initial contact was also more anterior using heel lifts. The use of heel lifts may have therapeutic benefits for runners with patellofemoral pain if the primary goal is to reduce patellofemoral joint stress. 3b.