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Braun L, Mai P, Hipper M, Denis Y, Helwig J, Anedda B, Utku B, Gehring D, Willwacher S. Managing lower extremity loading in distance running by altering sagittal plane trunk leaning. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100985. [PMID: 39251186 DOI: 10.1016/j.jshs.2024.100985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/02/2024] [Accepted: 06/14/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Trunk lean angle is an underrepresented biomechanical variable for modulating and redistributing lower extremity joint loading and potentially reducing the risk of running-related overuse injuries. The purpose of this study was to systematically alter the trunk lean angle in distance running using an auditory real-time feedback approach and to derive dose-response relationships between sagittal plane trunk lean angle and lower extremity (cumulative) joint loading to guide overuse load management in clinical practice. METHODS Thirty recreational runners (15 males and 15 females) ran at a constant speed of 2.5 m/s at 5 systematically varied trunk lean conditions on a force-instrumented treadmill while kinematic and kinetic data were captured. RESULTS A change in trunk lean angle from -2° (extension) to 28° (flexion) resulted in a systematic increase in stance phase angular impulse, cumulative impulse, and peak moment at the hip joint in the sagittal and transversal plane. In contrast, a systematic decrease in these parameters at the knee joint in the sagittal plane and the hip joint in the frontal plane was found (p < 0.001). Linear fitting revealed that with every degree of anterior trunk leaning, the cumulative hip joint extension loading increases by 3.26 Nm·s/kg/1000 m, while simultaneously decreasing knee joint extension loading by 1.08 Nm·s/kg/1000 m. CONCLUSION Trunk leaning can reduce knee joint loading and hip joint abduction loading, at the cost of hip joint loading in the sagittal and transversal planes during distance running. Modulating lower extremity joint loading by altering trunk lean angle is an effective strategy to redistribute joint load between/within the knee and hip joints. When implementing anterior trunk leaning in clinical practice, the increased demands on the hip musculature, dynamic stability, and the potential trade-off with running economy should be considered.
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Affiliation(s)
- Luca Braun
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg 77652, Germany.
| | - Patrick Mai
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo 0863, Norway
| | - Markus Hipper
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg 77652, Germany
| | - Yannick Denis
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg 77652, Germany
| | - Janina Helwig
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg 77652, Germany
| | - Bastian Anedda
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg 77652, Germany
| | - Burkay Utku
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg 77652, Germany
| | - Dominic Gehring
- Department of Sport and Sport Science, University of Freiburg, Freiburg 79102, Germany
| | - Steffen Willwacher
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University, Offenburg 77652, Germany
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Rice H, Starbuck C, Willer J, Allen S, Bramah C, Jones R, Herrington L, Folland J. Does high-intensity running to fatigue influence lower limb injury risk? J Sci Med Sport 2024:S1440-2440(24)00490-0. [PMID: 39242326 DOI: 10.1016/j.jsams.2024.08.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/26/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVES The aim of this study was to quantify changes in peak bending moments at the distal tibia, peak patellofemoral joint contact forces and peak Achilles tendon forces during a high-intensity run to fatigue at middle-distance speed. DESIGN Observational study. METHODS 16 high-level runners (7 female) ran on a treadmill at the final speed achieved during a preceding maximum oxygen uptake test until failure (~3 min). Three-dimensional kinetics and kinematics were used to derive and compare tibial bending moments, patellofemoral joint contact forces and Achilles tendon forces at the start, 33 %, 67 % and the end of the run. RESULTS Average running speed was 5.7 (0.4) m·s-1. There was a decrease in peak tibial bending moments (-6.8 %, p = 0.004) from the start to the end of the run, driven by a decrease in peak bending moments due to muscular forces (-6.5 %, p = 0.001), whilst there was no difference in peak bending moments due to joint reaction forces. There was an increase in peak patellofemoral joint forces (+8.9 %, p = 0.026) from the start to the end of the run, but a decrease in peak Achilles tendon forces (-9.1 %, p < 0.001). CONCLUSIONS Running at a fixed, high-intensity speed to failure led to reduced tibial bending moments and Achilles tendon forces, and increased patellofemoral joint forces. Thus, the altered neuromechanics of high-intensity running to fatigue may increase patellofemoral joint injury risk, but may not be a mechanism for tibial or Achilles tendon overuse injury development.
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Affiliation(s)
- Hannah Rice
- Department of Physical Performance, Norwegian School of Sport Sciences, Norway.
| | - Chelsea Starbuck
- Department of Sport and Exercise Sciences, Swansea University, United Kingdom
| | - Jasmin Willer
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Sam Allen
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | | | - Richard Jones
- School of Health and Society, University of Salford, United Kingdom
| | - Lee Herrington
- School of Health and Society, University of Salford, United Kingdom
| | - Jonathan Folland
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom; Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, Loughborough University, Loughborough, United Kingdom; National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, United Kingdom
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Golubjatnikov M, Walker A. Endurance Sporting Events. Emerg Med Clin North Am 2024; 42:581-596. [PMID: 38925776 DOI: 10.1016/j.emc.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have experienced a surge in popularity, we have a greater need to understand the associated medical risks. This article reviews the history of endurance races, reviews the most critical and common causes of cardiovascular, heat, electrolyte, and musculoskeletal injuries/illnesses, and discusses considerations for medical directors/personnel associated with such events.
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Affiliation(s)
- Matt Golubjatnikov
- St Joseph's Medical Center, 1800 N California Street, Stockton, CA 95204, USA
| | - Anne Walker
- St Joseph's Medical Center, 1800 N California Street, Stockton, CA 95204, USA.
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Reiter AJ, Martin JA, Knurr KA, Adamczyk PG, Thelen DG. Achilles Tendon Loading during Running Estimated Via Shear Wave Tensiometry: A Step Toward Wearable Kinetic Analysis. Med Sci Sports Exerc 2024; 56:1077-1084. [PMID: 38240495 PMCID: PMC11096059 DOI: 10.1249/mss.0000000000003396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
PURPOSE Understanding muscle-tendon forces (e.g., triceps surae and Achilles tendon) during locomotion may aid in the assessment of human performance, injury risk, and rehabilitation progress. Shear wave tensiometry is a noninvasive technique for assessing in vivo tendon forces that has been recently adapted to a wearable technology. However, previous laboratory-based and outdoor tensiometry studies have not evaluated running. This study was undertaken to assess the capacity for shear wave tensiometry to produce valid measures of Achilles tendon loading during running at a range of speeds. METHODS Participants walked (1.34 m·s -1 ) and ran (2.68, 3.35, and 4.47 m·s -1 ) on an instrumented treadmill while shear wave tensiometers recorded Achilles tendon wave speeds simultaneously with whole-body kinematic and ground reaction force data. A simple isometric task allowed for the participant-specific conversion of Achilles tendon wave speeds to forces. Achilles tendon forces were compared with ankle torque measures obtained independently via inverse dynamics analyses. Differences in Achilles tendon wave speed, Achilles tendon force, and ankle torque across walking and running speeds were analyzed with linear mixed-effects models. RESULTS Achilles tendon wave speed, Achilles tendon force, and ankle torque exhibited similar temporal patterns across the stance phase of walking and running. Significant monotonic increases in peak Achilles tendon wave speed (56.0-83.8 m·s -1 ), Achilles tendon force (44.0-98.7 N·kg -1 ), and ankle torque (1.72-3.68 N·m·(kg -1 )) were observed with increasing locomotion speed (1.34-4.47 m·s -1 ). Tensiometry estimates of peak Achilles tendon force during running (8.2-10.1 body weights) were within the range of those estimated previously via indirect methods. CONCLUSIONS These results set the stage for using tensiometry to evaluate Achilles tendon loading during unobstructed athletic movements, such as running, performed in the field.
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Affiliation(s)
- Alex J Reiter
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI
| | | | | | - Peter G Adamczyk
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI
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Van Hooren B, van Rengs L, Meijer K. Per-step and cumulative load at three common running injury locations: The effect of speed, surface gradient, and cadence. Scand J Med Sci Sports 2024; 34:e14570. [PMID: 38389144 DOI: 10.1111/sms.14570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/02/2024] [Accepted: 01/15/2024] [Indexed: 02/24/2024]
Abstract
Understanding how loading and damage on common running injury locations changes across speeds, surface gradients, and step frequencies may inform training programs and help guide progression/rehabilitation after injuries. However, research investigating tissue loading and damage in running is limited and fragmented across different studies, thereby impairing comparison between conditions and injury locations. This study examined per-step peak load and impulse, cumulative impulse, and cumulative weighted impulse (hereafter referred to as cumulative damage) on three common injury locations (patellofemoral joint, tibia, and Achilles tendon) across different speeds, surface gradients, and cadences. We also explored how cumulative damage in the different tissues changed across conditions relative to each other. Nineteen runners ran at five speeds (2.78, 3.0, 3.33, 4.0, 5.0 m s-1 ), and four gradients (-6, -3, +3, +6°), and three cadences (preferred, ±10 steps min-1 ) each at one speed. Patellofemoral, tibial, and Achilles tendon loading and damage were estimated from kinematic and kinetic data and compared between conditions using a linear mixed model. Increases in running speed increased patellofemoral cumulative damage, with nonsignificant increases for the tibia and Achilles tendon. Increases in cadence reduced damage to all tissues. Uphill running increased tibial and Achilles tendon, but decreased patellofemoral damage, while downhill running showed the reverse pattern. Per-step and cumulative loading, and cumulative loading and cumulative damage indices diverged across conditions. Moreover, changes in running speed, surface gradient, and step frequency lead to disproportional changes in relative cumulative damage on different structures. Methodological and practical implications for researchers and practitioners are discussed.
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Affiliation(s)
- Bas Van Hooren
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Lars van Rengs
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Joachim MR, Kliethermes SA, Heiderscheit BC. Preinjury Knee and Ankle Mechanics during Running Are Reduced among Collegiate Runners Who Develop Achilles Tendinopathy. Med Sci Sports Exerc 2024; 56:128-133. [PMID: 37703042 DOI: 10.1249/mss.0000000000003276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Achilles tendinopathies (AT) are common in runners, but prospective data assessing running mechanics associated with developing AT are limited. Asymmetry in running mechanics is also considered a risk factor for injury, although it is unknown if the problematic mechanics occur on the injured limb only or are present bilaterally. PURPOSE This study aimed to prospectively identify differences in preinjury running biomechanics in collegiate runners who did and did not develop AT and determine if between-limb asymmetries were associated with which limb developed AT. METHODS Running gait data were obtained preseason on healthy collegiate cross-country runners, and AT incidence was prospectively recorded each year. Spatiotemporal, ground reaction forces, and joint kinematics and kinetics were analyzed. Linear mixed-effects models assessed differences in biomechanics between those who did and did not develop AT during the subsequent year. Generalized linear mixed-effects models determined if the asymmetry direction was associated with which limb developed an AT, with odds ratios (OR) and 95% confidence intervals (95% CI) reported. RESULTS Data from 106 runners were analyzed and 15 developed AT. Preinjury biomechanics of runners who developed AT showed less peak knee flexion (noninjured: 45.9° (45.2°-46.6°), injured: 43.2° (41.5°-44.9°), P < 0.001), ankle dorsiflexion (noninjured: 28.7° (28.0°-30.2°), injured: 26.0° (23.8°-28.3°), P = 0.01), and knee extensor moment (noninjured: -2.18 (N·m)·kg -1 (-2.24 to -2.12 (N·m)·kg -1 ), injured: -2.00 (N·m)·kg -1 (-2.17 to -1.84 (N·m)·kg -1 ), P = 0.02). The limb demonstrating less peak knee flexion had greater odds of sustaining an AT (OR, 1.29 (1.00-1.65), P = 0.05). CONCLUSIONS Knee and ankle kinematics, in addition to knee kinetics, were associated with developing an AT. Monitoring these mechanics may be useful for prospectively identifying runners at risk of developing AT.
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Pohlman C, Pardee A, Friedman M, Rutherford D, Vannatta CN, Kernozek TW. Effects of Body Weight Support in Running on Achilles Tendon Loading. Int J Sports Med 2023; 44:913-918. [PMID: 37336504 DOI: 10.1055/a-2113-1026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Achilles tendon (AT) tendinopathy is common in runners. Repetitive AT loading may play a role in etiology. Interventions such as body weight support (BWS) may reduce loading on the AT in running. Examine how ground reaction force, AT loading, foot strike, and cadence variables change in running with BWS. Twenty-four healthy female runners free from injury were examined. Participants ran on an instrumented treadmill with and without BWS using a harness-based system at a standardized speed. The system has 4 elastic cords affixed to a harness that is attached to a frame-like structure. Kinematic data and kinetic data were used in a musculoskeletal model (18 segments and 16 degrees of freedom) to determine AT loading variables, foot strike angle, and cadence. Paired t-tests were used to compare each variable between conditions. Ground reaction force was 9.0% lower with BWS (p<.05). Peak AT stress, force, and impulse were 9.4, 11.7%, and 14.8% lower when using BWS in running compared to no support (p<.05). Foot strike angle was similar (p<.05) despite cadence being reduced (p<.05). BWS may reduce AT loading and impulse variables during running. This may be important in rehabilitation efforts.
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Affiliation(s)
- Callie Pohlman
- Health Professions, Physical Therapy Program, University of Wisconsin-La Crosse, La Crosse, United States
- Sports Physical Therapy, Gundersen Health System, La Crosse, United States
| | - Andrew Pardee
- Health Professions, Physical Therapy Program, University of Wisconsin-La Crosse, La Crosse, United States
- Sports Physical Therapy, Gundersen Health System, La Crosse, United States
| | - Mikey Friedman
- Health Professions, Physical Therapy Program, University of Wisconsin-La Crosse, La Crosse, United States
- Sports Physical Therapy, Gundersen Health System, La Crosse, United States
| | - Drew Rutherford
- Health Professions, Physical Therapy Program, University of Wisconsin-La Crosse, La Crosse, United States
- Sports Physical Therapy, Gundersen Health System, La Crosse, United States
| | - Charles Nathan Vannatta
- La Crosse Institute for Movement Science, University of Wisconsin-La Crosse, La Crosse, United States
| | - Thomas W Kernozek
- Health Professions, La Crosse Institute for Movement Science (LIMS), La Crosse, United States
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Evans RJ, Moffit TJ, Mitchell PK, Pamukoff DN. Injury and performance related biomechanical differences between recreational and collegiate runners. Front Sports Act Living 2023; 5:1268292. [PMID: 37780121 PMCID: PMC10536965 DOI: 10.3389/fspor.2023.1268292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Running related injuries (RRI) are common, but factors contributing to running performance and RRIs are not commonly compared between different types of runners. Methods We compared running biomechanics previously linked to RRIs and performance between 27 recreational and 35 collegiate runners. Participants completed 5 overground running trials with their dominant limb striking a force plate, while outfitted with standardised footwear and 3-dimensional motion capture markers. Results Post hoc comparisons revealed recreational runners had a larger vertical loading rate (194.5 vs. 111.5 BW/s, p < 0.001) and shank angle (6.80 vs. 2.09, p < 0.001) compared with the collegiate runners who demonstrated greater vertical impulse (0.349 vs. 0.233 BWs, p < 0.001), negative impulse (-0.022 vs. -0.013 BWs, p < 0.001), positive impulse (0.024 vs. 0.014 BWs, p < 0.001), and propulsive force (0.390 vs. 0.333 BW, p = 0.002). Adjusted for speed, collegiate runners demonstrated greater total support moment (TSM), plantar flexor moment, knee extensor moment, hip extensor moment, and had greater proportional plantar flexor moment contribution and less knee extensor moment contribution to the TSM compared with recreational runners. Unadjusted for speed, collegiate runners compared with recreational had greater TSM and plantar flexor moment but similar joint contributions to the TSM. Discussion Greater ankle joint contribution may be more efficient and allow for greater capacity to increase speed. Improving plantarflexor function during running provides a strategy to improve running speed among recreational runners. Moreover, differences in joint kinetics and ground reaction force characteristics suggests that recreational and collegiate runners may experience different types of RRI.
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Affiliation(s)
- Ryan J. Evans
- School of Kinesiology, Western University, London ON, Canada
| | - Tyler J. Moffit
- Department of Kinesiology, California State University, Bakersfield, CA, United States
| | - Peter K. Mitchell
- Department of Kinesiology, California State University, Fullerton, CA, United States
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Hagen M, Vanmechelen A, Cloet E, Sellicaerts J, VAN Welden K, Verstraete J, Catelli DS, Verschueren S, Vanrenterghem J. Increasing Step Frequency Reduces Patellofemoral Joint Stress and Patellar Tendon Force Impulse More at Low Running Speed. Med Sci Sports Exerc 2023; 55:1555-1563. [PMID: 37093897 DOI: 10.1249/mss.0000000000003194] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
PURPOSE Patellofemoral pain syndrome and patellar tendinopathy are important running-related overuse injuries. This study investigated the interaction of running speed and step frequency alterations on peak and cumulative patellofemoral joint stress (PFJS) and patellar tendon force (PTF) parameters. METHODS Twelve healthy individuals completed an incremental running speed protocol on a treadmill at habitual, increased and decreased step frequency. Peak PFJS and PTF, peak rate of PFJS and PTF development, and PFJS and PTF impulse per kilometer (km) were calculated using musculoskeletal modeling. RESULTS With increasing running speed, peak PFJS ( P < 0.001) and PTF ( P < 0.001) and peak rate of PFJS ( P < 0.001) and PTF ( P < 0.001) development increased, whereas PFJS ( P < 0.001) and PTF ( P < 0.001) impulse per km decreased. While increasing step frequency by 10%, the peak PFJS ( P < 0.001) and PTF ( P < 0.001) and the PFJS ( P < 0.001) and PTF ( P < 0.001) impulse per kilometer decreased. No significant effect of step frequency alteration was found for the peak rate of PFJS ( P = 0.008) and PTF ( P = 0.213) development. A significant interaction effect was found for PFJS ( P < 0.001) and PTF ( P < 0.001) impulse per km, suggesting that step frequency alteration was more effective at low running speed. CONCLUSIONS The effectiveness of step frequency alteration on PFJS and PTF impulse per km is dependent on the running speed. With regard to peak PFJS and PTF, step frequency alteration is equally effective at low and high running speeds. Step frequency alteration was not effective for peak rate of PFJS and PTF development. These findings can assist the optimization of patellofemoral joint and patellar tendon load management strategies.
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Affiliation(s)
- Michiel Hagen
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Anna Vanmechelen
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Emile Cloet
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Jan Sellicaerts
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Kaat VAN Welden
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Jesper Verstraete
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | | | - Sabine Verschueren
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Jos Vanrenterghem
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
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Wang B, Mao Z, Guo J, Yang J, Zhang S. The non-invasive evaluation technique of patellofemoral joint stress: a systematic literature review. Front Bioeng Biotechnol 2023; 11:1197014. [PMID: 37456733 PMCID: PMC10343958 DOI: 10.3389/fbioe.2023.1197014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction: Patellofemoral joint stress (PFJS) is an important parameter for understanding the mechanism of patellofemoral joint pain, preventing patellofemoral joint injury, and evaluating the therapeutic efficacy of PFP rehabilitation programs. The purpose of this systematic review was to identify and categorize the non-invasive technique to evaluate the PFJS. Methods: Literature searches were conducted from January 2000 to October 2022 in electronic databases, namely, PubMed, Web of Science, and EBSCO (Medline, SPORTDiscus). This review includes studies that evaluated the patellofemoral joint reaction force (PJRF) or PFJS, with participants including both healthy individuals and those with patellofemoral joint pain, as well as cadavers with no organic changes. The study design includes cross-sectional studies, case-control studies, and randomized controlled trials. The JBI quality appraisal criteria tool was used to assess the risk of bias in the included studies. Results: In total, 5016 articles were identified in the database research and the citation network, and 69 studies were included in the review. Discussion: Researchers are still working to improve the accuracy of evaluation for PFJS by using a personalized model and optimizing quadriceps muscle strength calculations. In theory, the evaluation method of combining advanced computational and biplane fluoroscopy techniques has high accuracy in evaluating PFJS. The method should be further developed to establish the "gold standard" for PFJS evaluation. In practical applications, selecting appropriate methods and approaches based on theoretical considerations and ecological validity is essential.
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Doyle EW, Doyle TLA, Bonacci J, Beach AJ, Fuller JT. Cumulative patellofemoral force and stress are lower during faster running compared to slower running in recreational runners. Sports Biomech 2023:1-13. [PMID: 37364918 DOI: 10.1080/14763141.2023.2226111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023]
Abstract
Management strategies for patellofemoral pain often involve modifying running distance or speed. However, the optimal modification strategy to manage patellofemoral joint (PFJ) force and stress accumulated during running warrants further investigation. This study investigated the effect of running speed on peak and cumulative PFJ force and stress in recreational runners. Twenty recreational runners ran on an instrumented treadmill at four speeds (2.5-4.2 m/s). A musculoskeletal model derived peak and cumulative (per 1 km of continuous running) PFJ force and stress for each speed. Cumulative PFJ force and stress decreased with faster speeds (9.3-33.6% reduction for 3.1-4.2 m/s vs. 2.5 m/s). Peak PFJ force and stress significantly increased with faster speeds (9.3-35.6% increase for 3.1-4.2 m/s vs. 2.5 m/s). The largest cumulative PFJ kinetics reductions occurred when speeds increased from 2.5 to 3.1 m/s (13.7-14.2%). Running at faster speeds increases the magnitude of peak PFJ kinetics but conversely results in less accumulated force over a set distance. Selecting moderate running speeds (~3.1 m/s) with reduced training duration or an interval-based approach may be more effective for managing cumulative PFJ kinetics compared to running at slow speeds.
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Affiliation(s)
- Eoin W Doyle
- Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Biomechanics, Physical Performance, and Exercise Research Group, Macquarie University, Sydney, New South Wales, Australia
| | - Tim L A Doyle
- Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Biomechanics, Physical Performance, and Exercise Research Group, Macquarie University, Sydney, New South Wales, Australia
| | - Jason Bonacci
- Centre for Sports Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Aaron J Beach
- Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Joel T Fuller
- Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Biomechanics, Physical Performance, and Exercise Research Group, Macquarie University, Sydney, New South Wales, Australia
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Demangeot Y, Whiteley R, Gremeaux V, Degache F. The load borne by the Achilles tendon during exercise: A systematic review of normative values. Scand J Med Sci Sports 2023; 33:110-126. [PMID: 36278501 DOI: 10.1111/sms.14242] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/29/2022] [Accepted: 09/30/2022] [Indexed: 01/11/2023]
Abstract
The Achilles tendon (AT) can be exposed to considerable stress during athletic activities and is often subject to pathologies such as tendinopathies. When designing a prevention or rehabilitation protocol, mechanical loading is a key factor to consider. This implies being able to accurately determine the load applied to the AT when performing exercises that stress this tendon. A systematic review was performed to synthesize the load borne by the AT during exercises/activities. Three databases (Pubmed, Embase and Cochrane) were searched for articles up to May 2021, and only the studies assessing the AT load in newtons relative to body-weight (BW) on humans during activities or exercises were included. Most of the 11 included studies assessed AT load when running or walking (N = 10), and only three tested exercises were usually performed during rehabilitation. The load on the tendon ranged from 2.7 to 3.95 BW when walking, from 4.15 to 7.71 BW when running, and from 0.41 to 7.3 BW according to the strengthening exercise performed. From the collected data, a progression of exercises progressively loading the Achilles tendon, as well as the possible connections with walking and running activities, could be defined. However, the trends highlighted in the relationship between tendon loading and walking or running speeds present some inconsistencies. Further research is still needed to clarify them, but also to complete the data set in healthy and injured people.
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Affiliation(s)
- Yoann Demangeot
- Therapeutic and Performance Sports Institute, MotionLab, Le Mont-sur-Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Rod Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Vincent Gremeaux
- Unit of Sports Medicine, Swiss Olympic Medical Center, Lausanne University Hospital, Lausanne, Switzerland.,Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Francis Degache
- Therapeutic and Performance Sports Institute, MotionLab, Le Mont-sur-Lausanne, Switzerland
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Acute Effects of Dermal Suction on Passive Muscle and Joint Stiffness. Healthcare (Basel) 2021; 9:healthcare9111483. [PMID: 34828529 PMCID: PMC8624662 DOI: 10.3390/healthcare9111483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of the present study was to examine the acute effects of dermal suction on the passive mechanical properties of specific muscles and joints. Dermal suction was applied to the calves of 24 subjects. Passive plantar flexion torque was measured with the right knee fully extended and the right ankle positioned at 20°, 10°, 0°, and −10° angles, where 0° represents the ankle neutral position, and positive values correspond to the plantar flexion angle. The shear wave velocity (SWV) (m/s) of the medial gastrocnemius was measured in the same position using ultrasound shear wave elastography. The relationship between the joint angle and passive torque at each 10° angle was defined as passive joint stiffness (Nm/°). Passive muscle and joint stiffness were measured immediately before and after the dermal suction protocol. When the ankle joint was positioned at 20° (r = 0.53, P = 0.006), 10° (r = 0.43, P = 0.030), and −10° (r = 0.60, P = 0.001), the SWV was significantly higher after dermal suction than that before dermal suction. Regarding joint stiffness, we found no significant difference between the pre- and post-dermal suction values (partial η2 = 0.093, P > 0.05). These findings suggest that dermal suction increases passive muscle stiffness and has a limited impact on passive joint stiffness.
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