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Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion

updated

Tags: treatment, injury, running, IT band pain, patellar pain, shin pain, plantar fasciitis, pain problems, exercise, self-treatment, knee, leg, limbs, overuse injury, tendinosis, arthritis, aging, foot

One article on PainSci cites Barton 2016: Shin Splints Treatment, The Complete Guide

PainSci notes on Barton 2016:

A review of the opinions of experts — and the very limited hard evidence — about what kind of changes in running technique might help with running injuries. Although the paper undoubtedly represents the best in expert thinking on this topic, I’m not sure how valuable that is, given the long history of “experts” being wrong about this stuff. What we really need is more evidence and less speculation.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

IMPORTANCE: Running-related injuries are highly prevalent.

OBJECTIVE: Synthesise published evidence with international expert opinion on the use of running retraining when treating lower limb injuries.

DESIGN: Mixed methods.

METHODS: A systematic review of clinical and biomechanical findings related to running retraining interventions were synthesised and combined with semistructured interviews with 16 international experts covering clinical reasoning related to the implementation of running retraining.

RESULTS: Limited evidence supports the effectiveness of transition from rearfoot to forefoot or midfoot strike and increase step rate or altering proximal mechanics in individuals with anterior exertional lower leg pain; and visual and verbal feedback to reduce hip adduction in females with patellofemoral pain. Despite the paucity of clinical evidence, experts recommended running retraining «So what are they basing those recommends on? Speculation and pet theories, guaranteed!» for: iliotibial band syndrome; plantar fasciopathy (fasciitis); Achilles, patellar, proximal hamstring and gluteal tendinopathy; calf pain; and medial tibial stress syndrome. Tailoring approaches to each injury and individual was recommended to optimise outcomes. Substantial evidence exists for the immediate biomechanical effects of running retraining interventions (46 studies), including evaluation of step rate and strike pattern manipulation, strategies to alter proximal kinematics and cues to reduce impact loading variables.

SUMMARY AND RELEVANCE: Our synthesis of published evidence related to clinical outcomes and biomechanical effects with expert opinion indicates running retraining warrants consideration in the treatment of lower limb injuries in clinical practice.

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