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Kinetic risk factors of running-related injuries in female recreational runners

PainSci » bibliography » Napier et al 2018
Tags: etiology, injury, running, patellar pain, IT band pain, plantar fasciitis, shin pain, pro, pain problems, exercise, self-treatment, treatment, arthritis, aging, knee, leg, limbs, overuse injury, tendinosis, foot

One article on PainSci cites Napier 2018: Shin Splints Treatment, The Complete Guide

PainSci commentary on Napier 2018: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This trial (done in my backyard, in Vancouver) measured a half dozen running gait metrics in sixty-five healthy female recreational runners and then tracked them through a half-marathon training program. About a third of them got hurt, and shin splints was the most common injury (followed by ITBS), but there was no statistical correlation between injury and most of the things they measured, most surprisingly the prime suspect, “average vertical loading rate.”

Instead, “peak braking force” was prominent in the injured: a measure of how hard your feet push backward horizontally on impact. In fact, people with the highest PBF scores were eight times more likely to get hurt.

The authors reasonably concluded that braking force might be a good thing to try to reduce.

This is an interesting result, but also a bit of an outlier in the literature, reporting a novel risk factor for the first time, based on data from a smallish study of women only, and measuring gait only on a treadmill. As of 2022, this result still needs replication.

~ Paul Ingraham

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.

Our objective was to prospectively investigate the association of kinetic variables with running-related injury (RRI) risk. Seventy-four healthy female recreational runners ran on an instrumented treadmill while 3D kinetic and kinematic data were collected. Kinetic outcomes were vertical impact transient, average vertical loading rate, instantaneous vertical loading rate, active peak, vertical impulse, and peak braking force (PBF). Participants followed a 15-week half-marathon training program. Exposure time (hours of running) was calculated from start of program until onset of injury, loss to follow-up, or end of program. After converting kinetic variables from continuous to ordinal variables based on tertiles, Cox proportional hazard models with competing risks were fit for each variable independently, before analysis in a forward stepwise multivariable model. Sixty-five participants were included in the final analysis, with a 33.8% injury rate. PBF was the only kinetic variable that was a significant predictor of RRI. Runners in the highest tertile (PBF < -0.27 BW) were injured at 5.08 times the rate of those in the middle tertile and 7.98 times the rate of those in the lowest tertile. When analyzed in the multivariable model, no kinetic variables made a significant contribution to predicting injury beyond what had already been accounted for by PBF alone. Findings from this study suggest PBF is associated with a significantly higher injury hazard ratio in female recreational runners and should be considered as a target for gait retraining interventions.

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