2) Running Trends and Injuries 1 Flashcards
1
Q
Running trends
A
- Barefoot running
- Minimalist running
- Forefoot running (pose method)
- Maximalist shoes
2
Q
Running shoe styles
A
- Standard training shoes
- “Lyte” training
- Racing flats
- Minimalist shoes
- Newton shoe (Pose running method)
- Most recently: Maximalist shoes
3
Q
Hoka shoes
A
- Marketed as a “recovery shoe”
- Very stable (wide)
- VERY cushioned and “easy on the feet”
- Rocker technology
- No medical conclusions as of ye
4
Q
Barefoot fallacies
A
- Injury rates have not decreased over the last 40 years so running shoes must be the problem (the running population is different now than in the 1970’s)
- Anecdotal testimonials (injuries cured when shoes discarded)
5
Q
Consequences of cushioned running shoes
A
- De-stabilizes gait
- Do not significantly reduce impact forces
- Inhibits proprioception
6
Q
Negative effects of shoes
A
- Promote heel strike
- Reduce sensory feedback
- Increased joint torsional forces
- Decreased efficiency
- Shoes allow runners to adopt a gait style that increases stride length and decreases cadence, thus increasing impact forces and joint torques
7
Q
Positive effects of shoes
A
- Protection from hard man-made surfaces
- Comfort
- Enable a greater variety of people to run
8
Q
Shoe design: injury prevention
A
- Most running injury research implicates excessive pronation and/or excessive impact forces as major causes
- In recent years this has been challenged
- Newer theories: “muscle tuning”, neuromuscular responses, muscle atrophy, “unnatural gait” and altered limb stiffness caused by footwear
9
Q
Proposed injury mechanisms influenced by shoes
A
- Altered muscle activation
- Asynchronous joint coupling
- Altered joint alignment
- Increased impact forces
- Inhibited proprioception
- Improper or excessively worn footwear
10
Q
Gait in shoes
A
- Higher impact forces
- Longer stride length
- Lower stride frequency
- Decreased net efficiency
- Energy return of shoes is exaggerated
- Decreased proprioceptive feedback
11
Q
Barefoot gait
A
- Lower impact forces
- Shorter stride length
- Higher stride frequency
- Higher net efficiency
- More efficient energy return of foot
- Optimal proprioception
12
Q
Barefoot vs. shoes research
A
- Inncreased joint torques at hip, knee, ankle in shoes vs. barefoot
- Increased rearfoot movement, total and rate of pronation in shoes vs. barefoot
- Decreased awareness of impact and foot position awareness in shoes vs. barefoot
- Decreased running efficiency in shoes vs. barefoot
13
Q
Barefoot running is more economical
A
- VO 2 testing has shown increased economy and lower oxygen consumption over short (30 min) distances
- Shoes produce a “mass effect” and material compression results in energy loss
14
Q
Minimalist shoes
A
- Less cushioning
- Less stability
- Less weight
15
Q
Racing flats
A
- The original “minimalist” shoe
16
Q
Minimalist running benefits
A
- Minimal cushioning allows for optimal plantar stimuli which elicit impact moderating strategies
- Long-term benefits not known
- Injury prevention ?
- Improved performance ?
17
Q
Newton shoe
A
- Natural (toe-strike) running
- Forefoot striker only
18
Q
Etiology of running injuries
A
- Studies show that the average runner will sustain an average of one injury per year
- Training errors (overuse, etc) are responsible for at least 50 % of all injuries
19
Q
Running injuries (% each)
A
- Knee = 42.1 %
- Foot / Ankle = 36.9 %
- Lower leg = 12.8 %
- Hip/Pelvis = 10.9 %
- Calf/Achilles = 6.4 %
- Upper leg = 5.2 %
- Lower back = 3.4 %
20
Q
Modern footwear and injury vulnerability
A
- Running-related injuries are less common in barefoot populations
- Evidence of diminished impact moderating behavior with modern footwear compared with barefoot running
21
Q
Risks of running barefoot
A
- Skin injuries
- Punctures
- Abrasions
- Blisters
- Thermal injuries
- Vasospasticdisorders
- Musculoskeletal injuries
- Achilles, calf
- Metatarsals, fascia
22
Q
Achilles / calf strain
A
- Pre-activation of the gastrocsoleus complex occurs earlier in barefoot running than with shoes
- Increased eccentric loading
23
Q
Achilles tendonopathy
A
- Eccentric exercise
- Stretching
- PRP ? Very little evidence to support usage
- ESWT
24
Q
Metatarsalgia
A
- Increased forefoot loading during contact phase of gait (toe-strike)
- Stress fracture also possible
25
Q
Plantar fasciitis
A
- Due to increased flexibility of shank
- Decreased midfoot stability
26
Q
Barefoot / minimalist running recommendations
A
- Experienced runner
- Best as part of a training program (5 – 10 % of total weekly mileage)
- Grass is best. Avoid concrete and asphalt
- Introduce slowly and keep mileage low
- Some initial discomfort may be expected
- Begin minimalist and progress to barefoot (if desired)