How impact loading affects treatment for different injuries needs to be addressed, according to new research.
An Injury-Specific Approach Is Important for Running Injuries
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Secondary#runninginjury#patellofemoralpain#tibialbonestressinjury
This is especially true when it comes to patients with patellofemoral pain and plantar fasciitis.
In the study, “Impact-Related Ground Reaction Forces Are More Strongly Associated With Some Running Injuries Than Others,” published in The American Journal of Sports Medicine, the researchers wanted to compare ground reaction force variables between healthy and injured runners as a group and within specific common injuries.
They wrote, “Inconsistent associations have been reported for impact-related ground reaction force variables and running injuries when grouping all injuries together. However, previous work has shown more consistent associations when focusing on specific injuries.”
A total of 125 runners with patellofemoral pain, tibial bone stress injury, plantar fasciitis, Achilles tendinopathy, or iliotibial band syndrome and 65 healthy controls were assessed.
They were all asked to complete an instrumental treadmill assessment at a self-selected speed, impact-related ground reaction force variables included vertical average (VALR) and instantaneous (VILR) load rates, posterior and medial/lateral instantaneous load rates, and vertical stiffness at initial loading (VSIL).
According to the data collected, VALR (+17.5%, p < .01), VILR (+15/8%, p < .01), and VSIL (+19.7%, p < .01) were higher in the overall injured versus control group.
For individual injuries, VALR, VILR, and VSIL were significantly higher for patellofemoral pain (+23.4%-26.4%, p < .01) and plantar fasciitis (+17.5%-29.0%, p < .01), as well as VSIL for Achilles tendinopathy (+29.4%, p < .01).
The researchers wrote, “Impact variables (VALR, VILR, and VSIL) were significantly higher when assessing the injured group as a whole. However, these findings were driven by specific injury groups, highlighting the importance of taking an injury-specific approach to biomechanical risk factors for running injury.”
“These results suggest that practitioners may want to address impact loading in their treatment of injured runners, especially in those with patellofemoral pain and plantar fasciitis,” they added.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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