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Landing Pattern Modification to Improve Patellofemoral Pain in Runners

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Nov 29, 2011.

  1. NewsBot

    NewsBot The Admin that posts the news.


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    Landing Pattern Modification to Improve Patellofemoral Pain in Runners: A Case Series
    Roy T.H. Cheung, Irene S. Davis
    J Orthop Sports Phys Ther 2011;41(12):914-919
  2. Craig Payne

    Craig Payne Moderator

    There was a comment on this in another thread: Irene Davis Lecture on Barefoot Running

    Yes, it was only a case series of 3 subjects.
    I would have thought that just an improvement at 3 months was not a very good outcome. I would have thought after 3 months there should be better than improvement
    We know from Cavanagh's work from the 70's that changing gait requires energy, so not surprised with that result.

    There is some dodgy research that appears to show that barefoot/minimalist/forefoot striking does lower the adduction moment at the knee. Stefanyshyn showed a few yrs ago that there was a correlation between a high adduction moment at the knee and patellofemoral pain .... so yes I can see how those with a history of patellofemoral pain could perhaps benefit from this, but as what was commented on in another thread (Perceptions of Barefoot Running) you can not reduce one moment without increasing another ... something that the dodgy research did not report on and something not often reported.

    If you have a history of PFPS and transition to a forefoot strike pattern to assumable reduce that adduction moment, you are going to increase the abduction moment and theoretically increase the risk for other problems. This is not going to be a problem is the adduction moment is really high and the abduction moment is really low ---> the transition will maybe decrease the high moments and increase the low abduction moments closer to normal, so its not necessarily going to be a problem.

    As i said in the thread on Perceptions of Barefoot Running its not a matter of following the rhetoric and propaganda of barefoot/minimalist/Pose/Chi/Forefoot/Heel/Midfoot/Whatever ... its a matter of working out what moments are high and are contributing to the problem and transitioning (or not) to the form/technique/gait/paradigm/whatever that lowers the moments in the tissues that are prone to injury.
  3. If rearfoot strike pattern was associated with patellofemoral syndrome, as this study claims, then 80-90% of runners should have patellofemoral syndrome since 80-90% of runners are rearfoot strikers. The study abstract just doesn't make sense to me...I have run for 40 years with a rearfoot strike pattern and never once had patellofemoral syndrome. Certainly if there was even a loose association between rearfoot strike pattern and patellofemoral syndrome, then we would see more patients with this injury due to the sheer numbers of rearfoot strikers. My clinical guess after a quarter century of treating runners with this pathology is that rearfoot striking and the passive peak of GRF in running seen in rearfoot strikers has very little to do with patellofemoral syndrome and these injuries are more related to abnormal transverse plane rotational forces acting on the lower extremity during running, on patello-femoral anatomy and on quadriceps strength...not on rearfoot striking vs midfoot striking vs forefoot striking running.

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