Which Mechanical Factors Are Associated with Running Injuries?
Who is Most Likely to Have a Running Injury? And Why?
Why do some runners get injured?... And other runners don’t? This prospective study was designed to better understand which mechanical factors associated with running injuries.
Researchers followed 274 recreational runners for 1 year, and tracked their incidence of injury during that year. The researchers took baseline measurements which included clinical measures such as strength, range of motion, foot position, injury/training history, impact loading, and running technique.
Here’s what they found out about running-related injuries:
1. Navicular drop < 10mm increased odds of injury by 2 times
Interestingly, outside of extreme navicular drop measurements, it was shown that runners with LESS navicular drop were more likely to experience a running injury.
This warrants a discussion on correcting overpronation as there does not appear to be an association between rearfoot eversion and the occurrence of a running injury.
2. Less range of motion does NOT appear to be related to a higher rate of running injuries
This is likely true because the ranges of motion necessary to perform running exercise are much less than the motion that was exhibited on the clinical tests in the study. It is more likely that being able to control the limited range of motion that is necessary during running is more relevant to injury prevention
3. Less peak pelvic contralateral (opposite) rotation during stance was associated with increased odds of running injuries
For example, if your right leg is your stance leg, the left leg is the trailing leg. If your left pelvic can’t rotate backwards enough, you could be at increased risk of injury. These are small measurements, based on joint markers, so you would have a difficult time seeing this with the naked eye.
It is clear that less contralateral pelvic rotation is reflective of higher vertical movements at the foot, which has been linked to lower limb torsional stress. So, what types of injuries might this lead to over time? The running injuries that can occur are tibial stress fractures and patellofemoral pain syndrome (PFPS).
4. Less knee valgus, and greater knee valgus-varus excursion were found be be associated with running injuries
I know! Shocking, right? Well… not really. The knee valgus the researchers are referencing is in relation to valgus at the initial contact phase of the running/gait cycle. When we consider the entire stance phase of running, researchers found that injured runners did have greater frontal excursion at the knee. That means the knee moved through a greater side to side range of motion.
It is plausible that greater frontal plane motion at the knee signifies a lack of neuromuscular control at the knee, which loads the knee joint more. Greater knee excursion during stance, despite the similar stance time between injured and uninjured runners, may also indicate that the rate of loading on knee structures during stance was greater among injured runners.
5. No association existed between foot strike and injury rates.
That means that rearfoot, midfoot, and forefoot strikers were all equally as likely to get injured during their training. However, it is important to note that foot strike selection is found to be consistent with the type of running-related injury that occurs. For example, forefoot strikers may be more subject to foot and ankle pain / pathology (especially Achilles tendon pain) while rearfoot strikers may be more subject to injuries at the knee (ITB pain syndrome, Runner’s Knee, etc.)
If you are experiencing pain while running, please consult us to schedule an appointment.
Disclaimer: This is not intended to be formal medical advice. Your individual needs should be met by the appropriate health care practitioners. Please consult with a trusted provider.
Dr. Paul Nasri, PT, DPT, OCS, COMT
Doctor of Physical Therapy
The Game Plan Physical Therapy
