Sports Medicine Research: In the Lab & In the Field: Possible Keys For Running Away From Injury (Sports Med Res)
Wednesday, March 29, 2017

Possible Keys For Running Away From Injury

A Prospective Comparison of Lower Extremity Kinematics and Kinetics Between Injured and Non-Injured Collegiate Cross Country Runners

Dudley RI, Pamukoff DN, Lynn SK, Kersey RD, & Noffal GJ. Human Movement Science. 2017; 52:197-202. doi: 10.1016/j.humov.2017.0.007

Take Home Message: Cross country runners who developed a running-related injury during a season had greater knee valgus and ankle eversion velocity before the season started compared with runners who remained injury free. 

Running is generally considered to have many positive benefits; however, runners are at greater risk for injury due to the repetitive loads associated with running.  It remains unclear if a runner’s biomechanics may predispose them to a running-related injury. Hence, the researchers in this specific prospective study followed collegiate cross country runners with a goal to identify factors related to a new running-related injury.  The researchers followed 32 cross county athletes on the same team, who would have similar training practices and loads, over a 14-week cross country season.  At the start of the season, all athletes had no running-related injuries within the previous 6 months.  The researchers assessed each athlete’s navicular drop and then their running gait with a motion analysis system. A certified athletic trainer documented any running-related injuries that caused an athlete to miss at least one full practice session.  Twelve (39%) athletes suffered an injury over the course of the season.  The researchers reported that runners who suffered an injury had greater knee adduction moment and ankle eversion velocity than runners who remained injury free. 

The findings of this study are interesting because they potentially identify 2 variables that contribute to running-related injury risk.  This is one of the first studies to prospectively follow runners with similar training patterns. This allowed the authors to control for many factors that could cause false findings.  These findings are interesting and support other previous research that shows that knee adduction moment or knee valgus is linked with injury risk.  Rehabilitation and preventative programs could specifically target hip abduction musculature to try to limit the amount of adduction that occurs during running to try to mitigate injury risk.  It would have been interesting if these authors re-assessed running gaits during various time points in the season.  Many athletes start to develop soreness and pain, but might not report an injury to their athletic trainer.  Compensatory patterns may start to develop and could serve as an early identifier of impending injury, and an opportunity for earlier intervention.  Also – as fatigue sets in, there are variables that change.  Ultimately, there are were couple of biomechanical attributes that were linked with increased running-related injury risk.  While most clinicians cannot perform a complex gait analysis, we can utilize this information to try to look at eccentric hip and ankle muscular control and prescribe appropriate preventative strengthening exercises.

Questions for Discussion:  What do you use for injury risk assessments in runners?  Are there any other clinical evaluations that you commonly use for injury risk in athletes?    

Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

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Dudley RI, Pamukoff DN, Lynn SK, Kersey RD, & Noffal GJ (2017). A prospective comparison of lower extremity kinematics and kinetics between injured and non-injured collegiate cross country runners. Human Movement Science, 52, 197-202 PMID: 28237655

2 comments:

Ryan Duffy said...

I find the results of the study to be significant because it is yet another study that highlights the consequences of having a greater amount of knee valgus/KAM in athletes. An interesting question to asked based on the findings of this article is: does one cause the other? Does an increased ankle dorsiflexion moment cause the increased KAM, or vice versa?

Based on the plentiful amount of evidence supporting the relationship between KAM/decreased eccentric control and injury, injury prevention programs that address this issues really should be considered for most athletes at all levels.

Nicole Cattano said...

Thanks for your comment Ryan. I agree, it would be interesting to see if one prospectively caused the other. I think you bring up a great point about looking at the entire lower kinetic chain with the ankle dorsiflexion moments.

But I absolutely agree with you that we have ample evidence to address in our injury prevention programming.

What injury prevention programming do you currently use or plan to use?

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