Timing of lower extremity joint actions during treadmill running.

It has been suggested that a disruption in timing between the subtalar and knee joints may be a possible mechanism for knee injury. It has also been documented that shoe construction can alter rearfoot motion. The purpose of the study was to describe the relationship between the subtalar and knee joint actions during the support phase of treadmill running while wearing different shoes. Twelve healthy subjects ran in each of three running shoes with unique midsole durometers (C1, 70; C2, 55; C3, 45). High-speed video (200 Hz) of the rear and sagittal views of each subject/condition were taken during the last minute of a 5-min run. Retro-reflective markers were processed to determine the rearfoot angle and the sagittal view knee angle. The shoes were also subjected to a midsole material impact test. The impact test results indicated a linear trend in peak g and time to peak g across midsoles with the firmer midsole having a greater peak g and a shorter time to peak g. The results of the kinematic analysis indicated that there were no significant differences among the shoe conditions for the knee flexion parameters. However, there were significant differences in both the magnitude and the time to maximum pronation between the two firmer midsole conditions (C1 and C2) and the softer midsole condition (C3), indicating a nonlinear trend for these parameters. The softer midsole exhibited greater pronation values and a shorter time to maximum pronation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Differences in running biomechanics between a maximal,traditional, and minimal running shoe

ObjectivesPrevious studies comparing shoes based on the amount of midsole cushioning have generally used shoes from multiple manufacturers, where factors outside of stack height may contribute to observed biomechanical differences in running mechanics between shoes. Therefore, the purpose of this study was to compare ground reaction forces and ankle kinematics during running between three shoes (maximal, traditional, and minimal) from the same manufacturer that only varied in stack height.DesignWithin-participant repeated measuresMethodsTwenty recreational runners ran overground in the laboratory in three shoe conditions (maximal, traditional, minimal) while three-dimensional kinematic and kinetic data were collected using a 3D motion capture system and two embedded force plates. Repeated measures ANOVAs (α = .05) compared biomechanical data between shoes.ResultsWhile the loading rate was significantly greater in the minimal shoe compared to the maximal shoe, no other differences were seen for the ground reaction force variables. Peak eversion was greater in the maximal and minimal shoe compared to the traditional shoe, while eversion duration and eversion at toe-off were greater in the maximal shoe.ConclusionsPreviously cited differences in ground reaction force parameters between maximal and traditional footwear may be due to factors outside of midsole stack height. The eversion mechanics in the maximal shoes from this study may place runners at a greater risk of injury. Disagreement between previous studies indicates that more research on maximal running shoes is needed.     

Is midsole thickness a key parameter for the running pattern?

Many studies have highlighted differences in foot strike pattern comparing habitually shod runners who ran barefoot and with running shoes. Barefoot running results in a flatter foot landing and in a decreased vertical ground reaction force compared to shod running. The aim of this study was to investigate one possible parameter influencing running pattern: the midsole thickness. Fifteen participants ran overground at 3.3 m s⁻¹ barefoot and with five shoes of different midsole thickness (0 mm, 2 mm, 4 mm, 8 mm, 16 mm) with no difference of height between rearfoot and forefoot. Impact magnitude was evaluated using transient peak of vertical ground reaction force, loading rate, tibial acceleration peak and rate. Hip, knee and ankle flexion angles were computed at touch-down and during stance phase (range of motion and maximum values). External net joint moments and stiffness for hip, knee and ankle joints were also observed as well as global leg stiffness. No significant effect of midsole thickness was observed on ground reaction force and tibial acceleration. However, the contact time increased with midsole thickness. Barefoot running compared to shod running induced ankle in plantar flexion at touch-down, higher ankle dorsiflexion and lower knee flexion during stance phase. These adjustments are suspected to explain the absence of difference on ground reaction force and tibial acceleration. This study showed that the presence of very thin footwear upper and sole was sufficient to significantly influence the running pattern.     

The effect of different running shoes on treadmill running mechanics and muscle activity assessed using statistical parametric mapping (SPM)

BackgroundDifferences in joint mechanics between running shoes are commonly assessed using discrete parameters, yet statistically significant differences in these parameters between shoes are often scarce with small effect sizes. Statistical parametric mapping (SPM) has been suggested as suitable method for analyzing one-dimensional data such as kinematic, kinetic or muscle intensity time series.Research questionThe purpose of this study was to determine differences in treadmill running mechanics between novel running shoes using SPM.MethodsJoint kinematics, muscle activity and ground reaction force were assessed in 19 rearfoot runners in their own shoes and in two test shoes during treadmill running (test shoe 1: 13 distinct rubber elements in the outer sole, springboard within EVA midsole with posterior elements shifted anteriorly by approximately 1.5 cm; test shoe 2: 17 distinct EVA elements with conventional heel geometry). Joint kinematics were measured using an inertial sensor system, and ground reaction force was measured using an instrumented treadmill.ResultsSPM analysis with repeated measures ANOVA revealed significant reductions in the ankle angle and in tibialis anterior, peroneus longus, vastus medialis and lateralis muscle activity during weight acceptance and in peroneus longus muscle activity during early and late swing and in semitendinosus muscle activity during late swing for the test shoes. Significant differences in muscle activity were observed in the interval of the main activity of the respective muscle. SPM on individual data revealed statistically significant and relevant within-subject differences between conditions in kinematic, muscle activity and ground reaction force patterns.SignificanceInertial sensor systems and SPM may provide an efficient way of detecting changes in joint mechanics between running shoes within runners. Detecting within-subject differences in running mechanics between conditions not only requires statistical criteria but also criteria on the relevance of the magnitude of differences.     

Impact attenuation during weight bearing activities in barefoot vs. shod conditions: A systematic review

Although it could be perceived that there is extensive research on the impact attenuation characteristics of shoes, the approach and findings of researchers in this area are varied. This review aimed to clarify the effect of shoes on impact attenuation to the foot and lower leg and was limited to those studies that compared the shoe condition(s) with barefoot. A systematic search of the literature yielded 26 studies that investigated vertical ground reaction force, axial tibial acceleration, loading rate and local plantar pressures. Meta-analyses of the effect of shoes on each variable during walking and running were performed using the inverse variance technique. Variables were collected at their peak or at the impact transient, but when grouped together as previous comparisons have done, shoes reduced local plantar pressure and tibial acceleration, but did not affect vertical force or loading rate for walking. During running, shoes reduced tibial acceleration but did not affect loading rate or vertical force. Further meta-analyses were performed, isolating shoe type and when the measurements were collected. Athletic shoes reduced peak vertical force during walking, but increased vertical force at the impact transient and no change occurred for the other variables. During running, athletic shoes reduced loading rate but did not affect vertical force. The range of variables examined and variety of measurements used appears to be a reason for the discrepancies across the literature. The impact attenuating effect of shoes has potentially both adverse and beneficial effects depending on the variable and activity under investigation.     

Influence of shoe midsole hardness on plantar pressure distribution in four basketball-related movements

This study examined how shoe midsole hardness influenced plantar pressure in basketball-related movements. Twenty male university basketball players wore customized shoes with hard and soft midsoles (60 and 50 Shore C) to perform four movements: running, maximal forward sprinting, maximal 45° cutting and lay-up. Plantar loading was recorded using an in-shoe pressure measuring system, with peak pressure (PP) and pressure time integral (PTI) extracted from 10 plantar regions. Compared with hard shoes, subjects exhibited lower PP in one or more plantar regions when wearing the soft shoes across all tested movements (Ps < 0.05). Lower PTI was also observed in the hallux for 45° cutting, and the toes and forefoot regions during the first step of lay-up in the soft shoe condition (Ps < 0.05). In conclusion, using a softer midsole in the forefoot region may be a plausible remedy to reduce the high plantar loading experienced by basketball players.     

Footwear affects the behavior of low back muscles when jogging.

Use of modified shoes and insole materials has been widely advocated to treat low back symptoms from running impacts, although considerable uncertainty remains regarding the effects of these devices on the rate of shock transmission to the spine. This study investigated the effects of shoes and insole materials on a) the rate of shock transmission to the spine, b) the temporal response of spinal musculature to impact loading, and c) the time interval between peak lumbar acceleration and peak lumbar muscle response. It was hypothesised that shoes and inserts a) decrease the rate of shock transmission, b) decrease the low back muscle response time, and c) shorten the time interval between peak lumbar acceleration and peak lumbar muscle response. Twelve healthy subjects were tested while jogging barefoot (unshod) or wearing identical athletic shoes (shod). Either no material, semi-rigid (34 Shore A), or soft (9.5 Shore A) insole material covered the force plate in the barefoot conditions and was placed as insole when running shod. Ground reaction forces, acceleration at the third lumbar level, and erector spinae myoelectric activity were recorded simultaneously. The rate of shock transmission to the spine was greater (p < 0.0003) unshod (acceleration rate: Means +/- SD 127.35 +/- 87.23 g/s) than shod (49.84 +/- 33.98 g/s). The temporal response of spinal musculature following heel strike was significantly shorter (p < 0.023) unshod (0.038 +/- 0.021 s) than shod (0.047 +/- 0.036 s). The latency between acceleration peak (maximal external force) and muscle response peak (maximal internal force) was significantly (p < 0.021) longer unshod (0.0137 +/- 0.022s) than shod (0.004 +/- 0.040 s). These results suggest that one of the benefits of running shoes and insoles is improved temporal synchronization between potentially destabilizing external forces and stabilizing internal forces around the lumbar spine.     

Interaction of arch type and footwear on running mechanics

BACKGROUND: Running shoes are designed to accommodate various arch types to reduce the risk of lower extremity injuries sustained during running. Yet little is known about the biomechanical changes of running in the recommended footwear that may allow for a reduction in injuries. PURPOSE: To evaluate the effects of motion control and cushion trainer shoes on running mechanics in low- and high-arched runners. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty high-arched and 20 low-arched recreational runners (>10 miles per week) were recruited for the study. Three-dimensional kinematic and kinetics were collected as subjects ran at 3.5 ms(-1) +/- 5% along a 25-m runway. The motion control shoe evaluated was the New Balance 1122, and the cushioning shoe evaluated was the New Balance 1022. Repeated-measures analyses of variance were used to determine if low- and high-arched runners responded differently to motion control and cushion trainer shoes. RESULTS: A significant interaction was observed in the instantaneous loading rate such that the low-arched runners had a lower instantaneous loading rate in the motion control condition, and the high-arched runners had a lower instantaneous loading rate in the cushion trainer condition. Significant main effects for shoe were observed for peak positive tibial acceleration, peak-to-peak tibial acceleration, mean loading rate, peak eversion, and eversion excursion. CONCLUSION: These results suggest that motion control shoes control rearfoot motion better than do cushion trainer shoes. In addition, cushion trainer shoes attenuate shock better than motion control shoes do. However, with the exception of instantaneous loading rate, these benefits do not differ between arch type. CLINICAL RELEVANCE: Running footwear recommendations should be based on an individual's running mechanics. If a mechanical analysis is not available, footwear recommendations can be based empirically on the individual's arch type.     

Effects of shoes and foot orthotics on VO2 and selected frontal plane knee kinematics

The objective of this study was to investigate the effects of shoes and foot orthotics on running economy and selected frontal plane knee kinematics during the support phase of running. Twenty-one male runners who had been fitted with orthotics served as subjects. Subjects participated in three submaximal runs on a treadmill under the following conditions: barefoot, shoes, and shoes plus orthotics. A run consisted of 1 min at 161 m . min-1, 2 min at 180 m . min-1, and 4 min at 201 m . min-1. VO2 was calculated for the last 3 min of each test. Frontal plane motion was filmed during the sixth min of each submaximal run, and linear and angular displacement of the knee were then calculated from film data. Results from the mechanical aspect of this study indicate that there were no significant differences among the means for linear displacement of the knee. Angular displacement of the knee during barefoot running was significantly (P less than 0.05) less than shoe and shoe-plus-orthotic conditions. There was no difference, however, between shoes and shoes plus orthotics. The economy results revealed that the aerobic cost of running increased as the amount of mass added to the foot increased. In absolute terms (1 . min-1), running in shoes plus orthotics was significantly (P less than 0.05) more costly than running barefoot. It appears that if orthotics do, in fact, improve running economy by improving running mechanics, the amount of improvement is negated by the additional cost of running associated with the mass of the orthotics.     

The effects of shoes on the torsion and rearfoot motion in running.

Excessive pronation is accepted as a good indicator for various running injuries. The least amount of pronation takes place when running barefoot. The latest investigations show that this is connected to a large torsional movement between forefoot and rearfoot which can be influenced by the shoe sole construction. The shoes which are in use among runners in track and field are basically of two types, running shoes (in general torsionally stiff) and spikes (torsionally flexible). The possibly varying effect of these shoes on the shoe/foot motion in running is not known. The purpose of this investigation was therefore to show whether the pronation angle and the torsion angle differ when running barefoot, with spikes, and with running shoes (forefoot touchdown, N = 9 left and right). A film analysis provided the angular movements of the lower leg, rearfoot, and forefoot as well as pronation and torsion in the frontal plane. The results show that at touchdown the torsional movements with both shoe types are quite different from those of running barefoot. With shoes, the torsion angle is reduced back to zero--with running shoes more than with spikes--and the pronation angle is increased beyond the barefoot values (P less than 0.01). In order to reduce the risk of injury, both shoe types should be improved--the running shoes with respect to torsion and the spikes with respect to pronation.     

Acute effect of engineered thermoplastic polyurethane elastomer knockoff running footwear on foot loading and comfort during heel-to-toe running

BackgroundBetter midsole materials and comfort have been incorporated into more expensive shoes and are popular with runners. Consequently, knockoff running shoes are currently widely distributed in the Chinese market and and cost only 30%–50% of the total price of genuine branded products.Research questionUncertainty exists concerning the beneficial effects of advanced shoe material application in decreasing foot loading or impact force during running. Additionally, using comfort as a criterion to identify genuine branded running shoes may exclude brand factor.MethodsFifteen healthy male volunteers were asked to perform two different tests, including running and a comfort evaluation. Each participant was asked to identify which footwear was the Adidas brand shoe based on their perception of comfort.ResultsTime to the first peak of the vertical ground reaction force occurred significantly later when subjects wore the genuine branded shoe compared to knockoff shoe 1 (p = 0.003) and knockoff shoe 2 (p = 0.015) footwea. The genuine branded shoe (p = 0.005) and knockoff shoe 1 (p = 0.029) were significantly more comfortable compared to the knockoff shoe 2. Only four subjects selected the genuine branded shoe, whereas six subjects selected both the genuine branded shoe and knockoff shoe 1.SignificanceKnockoff running footwear significantly increases impact loading compared to the genuine branded product, thereby posing greater risk of running injury.     

Midsole material-related force control during heel-toe running

The impact maximum and rearfoot eversion have been used as indicators of load on internal structures in running. The midsole hardness of a typical running shoe was varied systematically to determine the relationship between external ground reaction force (GRF), in-shoe force, and kinematic variables. Eight subjects were tested during overground running at 4 m/s. Rearfoot movement as well as in-shoe forces and external GRF varied nonsystematically with midsole hardness. Kinematic parameters such as knee flexion and foot velocity at touchdown (TD), also varied nonsystematically with altered midsole hardness. Results demonstrate that considerable variations of in-shoe loading occur that were not depicted by external GRF measurements alone. Individuals apparently use different strategies of mechanical and neuromuscular adaptation in response to footwear modifications. In conclusion, shoe design effects on impact forces or other factors relating to injuries depend on the individual and therefore cannot be generalized.     

Sagittal subtalar and talocrural joint assessment between barefoot and shod walking: A fluoroscopic study

BackgroundWhile wearing shoes is common in daily activities, most foot kinematic models report results on barefoot conditions. It is difficult to describe foot position inside shoes. This study used fluoroscopic images to determine talocrural and subtalar motion.Research QuestionWhat are the differences in sagittal talocrual and subtalar kinematics between walking barefoot and while wearing athletic walking shoes?MethodsThirteen male subjects (mean age 22.9 ± 2.9 years, mean weight 77.2 ± 6.9 kg, mean height 178.2 ± 3.7 cm) screened for normal gait were tested. A fluoroscopy unit was used to collect images during stance. Sagittal motion of the talocrural and subtalar joints of the right foot were analyzed barefoot and in an athletic walking shoe.ResultsShod talocrural position at heel strike was 6.0° of dorsiflexion and shod peak talocrural plantarflexion was 4.2°. Barefoot talocrural plantarflexion at heel strike was 4.2° and barefoot peak talocrural plantarflexion was 10.9°. Shod subtalar position at heel strike was 2.6° of plantarflexion and peak subtalar dorsiflexion was 1.5°. The barefoot subtalar joint at heel strike was in 0.4° dorsiflexion and barefoot peak subtalar dorsiflexion was 3.5°. As the result of wearing shoes, average walking speed and stride length increased and average cadence decreased. Comparing barefoot to shod walking there was a statistical significance in talocrural dorsiflexion and at heel strike and peak talocrural dorsiflexion, subtalar plantarflexion at heel strike and peak subtalar dorsiflexion, walking speed, stride length, and cadence.SignificanceThis work demonstrates the ability to directly measure talocrural and subtalar kinematics of shod walking using fluoroscopy. Future work using this methodology can be used to increase understanding of hindfoot kinematics during a variety of non-barefoot activities.     

A comparison of the spatiotemporal parameters, kinematics, and biomechanics between shod, unshod, and minimally supported running as compared to walking

Recreational running has many proven benefits which include increased cardiovascular, physical and mental health. It is no surprise that Running USA reported over 10 million individuals completed running road races in 2009 not to mention recreational joggers who do not wish to compete in organized events. Unfortunately there are numerous risks associated with running, the most common being musculoskeletal injuries attributed to incorrect shoe choice, training errors and excessive shoe wear or other biomechanical factors associated with ground reaction forces. Approximately 65% of chronic injuries in distance runners are related to routine high mileage, rapid increases in mileage, increased intensity, hills or irregular surface running, and surface firmness. Humans have been running barefooted or wearing minimally supportive footwear such as moccasins or sandals since the beginning of time while modernized running shoes were not invented until the 1970s. However, the current trend is that many runners are moving back to barefoot running or running in “minimal” shoes. The goal of this masterclass article is to examine the similarities and differences between shod and unshod (barefoot or minimally supportive running shoes) runners by examining spatiotemporal parameters, energetics, and biomechanics. These running parameters will be compared and contrasted with walking. The most obvious difference between the walking and running gait cycle is the elimination of the double limb support phase of walking gait in exchange for a float (no limb support) phase. The biggest difference between barefoot and shod runners is at the initial contact phase of gait where the barefoot and minimally supported runner initiates contact with their forefoot or midfoot instead of the rearfoot. As movement science experts, physical therapists are often called upon to assess the gait of a running athlete, their choice of footwear, and training regime. With a clearer understanding of running and its complexities, the physical therapist will be able to better identify faults and create informed treatment plans while rehabilitating patients who are experiencing musculoskeletal injuries due to running.     

Effects of shoe type on cardiorespiratory responses and rearfoot motion during treadmill running

Running kinematics and physiological responses to high intensity submaximal treadmill running in training shoes and racing flats were evaluated. Eight women (mean age = 21.9 yr) completed a peak VO2 test on the treadmill (mean peak VO2 = 49.2 ml.kg-1.min-1). In two subsequent testing sessions, subjects completed 15-min runs at a speed corresponding to 90% of peak VO2 (range = 9.9-13.4 km.hr-1) while wearing training shoes and racing flats (balanced order assignment). No significant time effect or time by shoe condition interaction was observed for the rearfoot motion variables. Maximum rearfoot angle and total rearfoot motion averaged 42% and 13.9% higher, respectively, for the racing flat (P less than 0.05). There were significant increases over time for VO2, VE, HR, and RPE, indicating an increase in cardiorespiratory response and the perception of effort over the course of the 15-min run. Thus, metabolic and perceptual indications of fatigue at the end of the run emerged but were not accompanied by rearfoot motion changes in either running shoe. These results indicate that rearfoot motion is a function of shoe design and did not change during 15 min of high intensity running.     

Gait characteristics as a function of age and gender

Sixty male and fifty-eight female subjects ranging in age from 20 to 79 years performed walking at a controlled pace barefoot, wearing standard shoes, and wearing their personal shoes. Additionally these subjects performed walking in the standard shoe at a freely selected speed. Selected kinematic variables for the knee and ankle joint complexes and ground reaction forces were measured in three dimensions to determine differences with respect to age and gender. Additionally a comparison of the path of motion during ground contact and the active range of motion measured in a range of motion fixture were made. A multivariate analysis revealed a number of the kinematic and kinetic variables which were significantly different although the absolute differences were generally small. The comparison of path of motion and range of motion revealed a high correlation for abduction and adduction and plantarflexion and dorsiflexion. It is speculated that changes in gait pattern with increasing age are associated with decreasing muscle strength and a need for increased stability during locomotion with increasing age. The high correlation between path of motion and range of motion is associated with the decrease in muscle strength with increasing age, which is assumed to influence both path of motion and range of motion.     

Shoe midsole longitudinal bending stiffness and running economy, joint energy, and EMG

PURPOSE: It has been shown that mechanical energy is dissipated at the metatarsophalangeal (MTP) joint during running and jumping. Furthermore, increasing the longitudinal bending stiffness of the midsole significantly reduced the energy dissipated at the MTP joint and increased jump performance. It was hypothesized that increasing midsole longitudinal bending stiffness would also lead to improvements in running economy. This study investigated the influence of midsole longitudinal bending stiffness on running economy (performance variable) and evaluated the local effects on joint energetics and muscular activity. METHODS: Carbon fiber plates were inserted into running shoe midsoles and running economy, joint energy, and electromyographic (EMG) data were collected on 13 subjects. RESULTS: Approximately a 1% metabolic energy savings was observed when subjects ran in a stiff midsole relative to the control midsole. Subjects with a greater body mass had a greater decrease in oxygen consumption rates in the stiff midsole relative to the control midsole condition. The stiffer midsoles showed no significant differences in energy absorption at the MTP joint compared with the control shoe. Finally, no significant changes were observed in muscular activation. CONCLUSION: Increasing midsole longitudinal bending stiffness led to improvements in running economy, yet the underlying mechanisms that can be attributed to this improvement are still not fully understood.     

Effect of viscoelastic shoe insoles on vertical impact forces in heel-toe running

The purposes of this study were: 1) to compare the impact forces in running using running shoes with conventional insoles to the impact forces using running shoes with four different viscoelastic insoles, 2) to discuss possible effects of the viscoelastic insoles on lower leg kinematics, and 3) to explain the force and kinematic results using a mechanical model. Kinetic and kinematic data were collected for 14 subjects running heel-toe at an average speed of 4 m/s. The results showed that the four tested viscoelastic insoles did not differ in variables describing the vertical impact forces (vertical force peak, time of occurrence of vertical force peak, maximum vertical loading rate) compared to the conventional insoles furnished in running shoes. Furthermore, the viscoelastic insoles did not influence kinematic variables of the lower extremities in a systematic way.     

Altering muscle activity in the lower extremities by running with different shoes

PURPOSE: To provide evidence that lower-extremity muscle activity during running is tuned in response to the loading rate of the impact forces at heel-strike. METHODS: Six runners ran two 30-min trials per week for 4 wk. The trials tested two shoes which differed only in the material hardness of the midsole. The shoes were tested in a randomized sequence. Bipolar surface EMG was recorded from the muscles of the rectus femoris, biceps femoris, medial gastrocnemius, and tibialis anterior. EMG was resolved into time-frequency space using wavelet techniques. EMG was analyzed for the 150 ms time window immediately before heel-strike. RESULTS: The intensity of the EMG and the ratio of the EMG intensity between high and low frequency components both showed significant changes between shoes, subjects, and muscles. Additionally, the intensity ratio showed a significant change over the course of each 30-min run. CONCLUSIONS: Lower-extremity muscle activity used to tune the muscles for the impact task can be altered by changing the material hardness of the shoe. The changes in the EMG frequency ratio suggest that muscle fiber-type recruitment patterns can also be altered by the choice of midsole material.