Reduced vertical impact loading in female runners with medically diagnosed injuries

NewsBot · Dec 8, 2015

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Reduced vertical impact loading in female runners with medically diagnosed injuries: a prospective investigation
Irene S Davis, Bradley J Bowser, David R Mullineauz
Br J Sports Med doi:10.1136/bjsports-2015-094579

Background Running has been critical to human survival. Therefore, the high rate of injuries experienced by modern day runners is puzzling. Landing on the heel, as most modern day shod runners do, results in a distinct vertical impact force that has been shown to be associated with running-related injuries. However, these injury studies were retrospective in nature and do not establish cause and effect.

Objective To determine whether runners with high impacts are at greater risk for developing medically diagnosed injuries.

Methods 249 female runners underwent a gait analysis to measure vertical instantaneous loading rate, vertical average loading rate (VALR), vertical impact peak (VIP) and peak vertical force. Participants then recorded their mileage and any running-related injuries monthly in a web-based, database programme. Variables were first compared between the entire injured (INJ; n=144) and uninjured (n=105) groups. However, the focus of this study was on those injured runners seeking medical attention (n=103) and those who had never injured (n=21).

Results There were no differences between the entire group of injured and uninjured groups. However, all impact-related variables were higher in those with medically diagnosed injuries compared with those who had never been injured. (effect size (ES) 0.4?0.59). When VALR was >66.0 body weight (BW)/s, the odds of being DX_INJ were 2.72 (95% CI 1.0 to 7.4). Impact loading was associated with bony and soft-tissue injuries.

Conclusions We found a VALR in female runners classified as ?never injured? compared with those who had been injured and sought medical attention.
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Craig Payne · Dec 8, 2015

Odd.
Title says one thing and results say another thing.
Conclusions makes no sense.

I pinged the editor for clairfication

Craig Payne · Dec 8, 2015

Here is title from paper

Reduced vertical impact loading in female runners with medically diagnosed injuries: a prospective investigation
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here is the first paragraph from discussion:

The purpose of this prospective observational study was to examine whether high-impact loading was associated with running-related injuries. The central hypothesis was that the impact transient associated with rearfoot striking is related to injury. When assessing the entire injured versus uninjured groups, no differences were found. However, when comparing those who sought medical treatment for their injuries to the
group of runners who had never sustained an injury, all impact-related variables (besides the peak vertical ground reaction force) were higher in the injured groups studied.
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Am I stupidly missing something or is the title saying the opposite of what the results say?

Craig Payne · Dec 8, 2015

I not stupid after all. The authors are trying to get the title corrected.

Ian Drakard · Dec 8, 2015

I have a problem as soon as you get to the background section. "Running has been critical to human survival. Therefore, the high rate of injuries experienced by modern day runners is puzzling."

The implication being that the inury rate of modern humans is higher than our ancestors. If anyone can tell me what the injury rate was for our ancestors was I'd like to know. You know those recreational road running ancestors. I'm not even sure that the injury rates in runners is universally acknowleged as 'high' relative to what by nature is an activity of repetitive stress.

mike weber · Dec 8, 2015

Ian Drakard said: ↑

I have a problem as soon as you get to the background section. "Running has been critical to human survival. Therefore, the high rate of injuries experienced by modern day runners is puzzling."

The implication being that the inury rate of modern humans is higher than our ancestors. If anyone can tell me what the injury rate was for our ancestors was I'd like to know. You know those recreational road running ancestors. I'm not even sure that the injury rates in runners is universally acknowleged as 'high' relative to what by nature is an activity of repetitive stress.
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added to that the 1000?s years where only the sports stars and kids ran, people walked or road horses and carts etc etc

The running revolution was late 70s early 80s not very long ago

NewsBot · Jan 5, 2016

Do runners who suffer injuries have higher vertical ground reaction forces than those who remain injury-free? A systematic review and meta-analysis
Henk van der Worp, Jelte W Vrielink, Steef W Bredeweg
Br J Sports Med doi:10.1136/bjsports-2015-094924

Background Vertical ground reaction force (VGRF) parameters have been implicated as a cause of several running-related injuries. However, no systematic review has examined this relationship.

Aim We systematically reviewed evidence for a relation between VGRF parameters and specific running-related injuries.

Methods MEDLINE, Web of Science and EMBASE databases were searched. Two independent assessors screened the articles and rated the methodological quality. The 3 key VGRF parameters we measured were vertical loading rate, impact/passive peak (Fz1) and propulsive/active peak (Fz2). Standardised mean differences of these parameters were calculated using a random-effects model. Meta-regression was performed using injury type, study type and methodological quality as factors.

Results The search yielded 2016 citations and 18 met the inclusion criteria for the systematic review. The loading rate was higher in studies that included patients with a history of stress fractures and patients with all injury types, both compared with controls. Only studies that included patients with a history of symptoms at the time of kinetic data collection showed higher loading rates overall in cases than in controls. There were no differences between injured subjects and controls for the active and passive peaks of the VGRF.

Summary The loading rate is higher in respondents with a history of stress fractures than in respondents without running injuries. Owing to the absence of prospective studies on other injury types, it is not possible to draw definite conclusions regarding their relation with loading rate.
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