Are changes in running economy associated with changes in performance in runners? A systematic review and meta-analysis

Improvements in running economy (RE) are thought to lead to improvements in running performance (P). Multiple interventions have been designed with the aim of improving RE in middle and long-distance runners. The aim of this study was to assess the effect of interventions of at least 2-weeks’ duration on RE and P and to determine whether there is a relationship between changes in RE (ΔRE) and changes in running performance (ΔP). A database search was carried out in Web of Science, Scopus and SPORTDiscus. In accordance with a PRISMA checklist 10 studies reporting 12 comparisons between interventions and controls were included in the review. There was no correlation between percentage ΔRE and percentage ΔP (r = 0.46, P = 0.936, 12 comparisons). There was a low risk of reporting bias but an unclear risk of bias for other items. Meta-analyses found no statistically significant differences between interventions and controls for RE (SMD (95% CI) = ?0.37 (?1.43, 0.69), 204 participants, p = 0.49) or for P (SMD (95% CI) = ?0.65 (?26.02, 24.72, 204 participants, p = 0.99). There is a need for studies of greater statistical power, methodological quality, duration and homogeneity of intervention and population. Standardised measures of performance and greater control over non-intervention training are also required.     

Effects of a minimalist shoe on running economy and 5-km running performance

The purpose of this study was to determine if minimalist shoes improve time trial performance of trained distance runners and if changes in running economy, shoe mass, stride length, stride rate and footfall pattern were related to any difference in performance. Twenty-six trained runners performed three 6-min sub-maximal treadmill runs at 11, 13 and 15 km·h^?1 in minimalist and conventional shoes while running economy, stride length, stride rate and footfall pattern were assessed. They then performed a 5-km time trial. In the minimalist shoe, runners completed the trial in less time (effect size 0.20 ± 0.12), were more economical during sub-maximal running (effect size 0.33 ± 0.14) and decreased stride length (effect size 0.22 ± 0.10) and increased stride rate (effect size 0.22 ± 0.11). All but one runner ran with a rearfoot footfall in the minimalist shoe. Improvements in time trial performance were associated with improvements in running economy at 15 km·h^?1 (r = 0.58), with 79% of the improved economy accounted for by reduced shoe mass (P < 0.05). The results suggest that running in minimalist shoes improves running economy and 5-km running performance.     

Comparison of foot strike patterns of barefoot and minimally shod runners in a recreational road race

BackgroundPrevious studies of foot strike patterns of distance runners in road races have typically found that the overwhelming majority of shod runners initially contact the ground on the rearfoot. However, none of these studies has attempted to quantify foot strike patterns of barefoot or minimally shod runners. This study classifies foot strike patterns of barefoot and minimally shod runners in a recreational road race.MethodsHigh-speed video footage was obtained of 169 barefoot and 42 minimally shod distance runners at the 2011 New York City Barefoot Run. Foot strike patterns were classified for each runner, and frequencies of forefoot, midfoot, and rearfoot striking were compared between the barefoot and minimally shod groups.ResultsA total of 59.2% of barefoot runners were forefoot strikers, 20.1% were midfoot strikers, and 20.7% were rearfoot strikers. For minimally shod runners, 33.3% were forefoot strikers, 19.1% were midfoot strikers, and 47.6% were rearfoot strikers. Foot strike distributions for barefoot and minimally shod runners were significantly different both from one another and from previously reported foot strike distributions of shod road racers.ConclusionFoot strike patterns differ between barefoot and minimally shod runners, with forefoot striking being more common, and rearfoot striking less common in the barefoot group.     

Foot strike patterns of recreational and sub-elite runners in a long-distance road race

Abstract

Although the biomechanical properties of the various types of running foot strike (rearfoot, midfoot, and forefoot) have been studied extensively in the laboratory, only a few studies have attempted to quantify the frequency of running foot strike variants among runners in competitive road races. We classified the left and right foot strike patterns of 936 distance runners, most of whom would be considered of recreational or sub-elite ability, at the 10 km point of a half-marathon/marathon road race. We classified 88.9% of runners at the 10 km point as rearfoot strikers, 3.4% as midfoot strikers, 1.8% as forefoot strikers, and 5.9% of runners exhibited discrete foot strike asymmetry. Rearfoot striking was more common among our sample of mostly recreational distance runners than has been previously reported for samples of faster runners. We also compared foot strike patterns of 286 individual marathon runners between the 10 km and 32 km race locations and observed increased frequency of rearfoot striking at 32 km. A large percentage of runners switched from midfoot and forefoot foot strikes at 10 km to rearfoot strikes at 32 km. The frequency of discrete foot strike asymmetry declined from the 10 km to the 32 km location. Among marathon runners, we found no significant relationship between foot strike patterns and race times.     

Effects of increased participation on veteran running performance

Contrary to elite performance that is approaching an asymptote, recent analyses suggested a trend for improvement in veterans. This might be attributable to a disproportionate increase in older age-group participation. We extracted 26 years (1987–2012) of men’s results of a running event in Switzerland, “La Course de l’Escalade” (7.25 km). We investigated trends in performance by five-year age-groups, taking the 10, 20, 30, and 50 fastest in each group, and then the 1^st, 5^th, and 10^th percentiles. Taking the 10, 20, 30 or 50 fastest runners there was a trend for improvement ranging from 0.07 to 0.22 min·year^?1 (p < .0001; 95% CI ?0.083 to ?0.049 and p < .0001; 95% CI ?0.250 to ?0.196 respectively) in the elder age-groups. Taking the 1^st, 5^th, and 10^th percentiles there were no trends for improvement, and actual deteriorations up to 0.13 (p < .0001; 95% CI +0.119 to +0.138) min·year^?1. Mixed-effect models with repeated measures for runners, confirmed a global deteriorating trend with an estimate of +0.11 min·year^?1 (p < .0001; 95% CI +0.107 to +0.116). The results suggest that increases in performance in older runners arise from modifications of sampling from a growing population.     

Longer-term effects of minimalist shoes on running performance,strength and bone density: A 20-week follow-up study*

This study investigated whether male runners improve running performance, running economy, ankle plantar flexor strength, and alter running biomechanics and lower limb bone mineral density when gradually transitioning to using minimalist shoes for 100% of weekly running. The study was a planned follow-up of runners (n?=?50) who transitioned to minimalist or conventional shoes for 35% of weekly structured training in a previous 6-week randomised controlled trial. In that trial, running performance and economy improved more with minimalist shoes than conventional shoes. Runners in each group were instructed to continue running in their allocated shoe during their own preferred training programme for a further 20 weeks while increasing allocated shoe use to 100% of weekly training. At the 20-week follow-up, minimalist shoes did not affect performance (effect size: 0.19; p?=?0.218), running economy (effect size: ≤?0.24; p?≥?0.388), stride rate or length (effect size: ≤?0.12; p?≥?0.550), foot strike (effect size: ≤?0.25; p?≥?0.366), or bone mineral density (effect size: ≤?0.40; p?≥?0.319). Minimalist shoes increased plantar flexor strength more than conventional shoes when runners trained with greater mean weekly training distances (shoe*distance interaction: p?=?0.036). After greater improvements with minimalist shoes during the initial six weeks of a structured training programme, increasing minimalist shoe use from 35% to 100% over 20 weeks, when runners use their own preferred training programme, did not further improve performance, running economy or alter running biomechanics and lower limb bone mineral density. Minimalist shoes improved plantar flexor strength more than conventional shoes in runners with greater weekly training distances.     

Joint work is not shifted proximally after a long run in rearfoot strike runners

ABSTRACT

Distal-to-proximal redistribution of joint work occurs following exhaustive running in recreational but not competitive runners but the influence of a submaximal run on joint work is unknown. The purpose of this study was to assess if a long submaximal run produces a distal-to-proximal redistribution of positive joint work in well-trained runners. Thirteen rearfoot striking male runners (weekly distance: 72.6 ± 21.2 km) completed five running trials while three-dimensional kinematic and ground reaction force data were collected before and after a long submaximal treadmill run (19 ± 6 km). Joint kinetics were calculated from these data and percent contributions of joint work relative to total lower limb joint work were computed. Moderate reductions in absolute negative ankle work (p = 0.045, Cohen’s d = 0.31), peak plantarflexor torque (p = 0.004, d = 0.34) and, peak negative ankle power (p = 0.005, d = 0.32) were observed following the long run. Positive ankle, knee and hip joint work were unchanged (p < 0.05) following the long run. These findings suggest no proximal shift in positive joint work in well-trained runners after a prolonged run. Runner population, running pace, distance, and relative intensity should be considered when examining changes in joint work following prolonged running.     

Arch-support foot-orthoses normalize dynamic in-shoe foot pressure distribution in medial tibial stress syndrome

Excessive foot pronation during gait is a risk factor in medial tibial stress syndrome (MTSS). Arch-support foot-orthoses are commonly used to manage overpronation, but it is unknown whether it is effective to manage MTSS. The present study investigated the effects of bilateral foot orthoses during running on dynamic foot-pressure distribution patterns in recreational runners with MTSS. Fifty novice (started within the last 4 months) runners diagnosed with MTSS (20.7?±?2.2 years; 71.1?±?8.6?kg; 1.78?±?0.07?m; mean?±?SD) and 50 anthropometrically-matched healthy novice runners (21.9?±?2.4 years; 71.4?±?8.8?kg; 1.73?±?0.07?m) participated in this study. The dynamic foot-pressure distribution during running with and without bilateral arch-support foot-orthoses was measured using pedobarography. MTSS novice runners have more medially directed pressures during the touchdown phase of the forefoot flat (p?=?0.009) and heel off (p?=?0.009), and a lateral pressure distribution during forefoot push-off phase (p?=?0.007) during running than healthy runners. When using the arch-support foot-orthoses the foot-pressure distribution during all phases was not significantly different from that seen in participants without MTSS. These findings indicate that during running the medial shift of foot pressures during the loading response phase and the lateral shift during the propulsion phase of foot roll-over in MTSS are effectively corrected by using arch-support foot-orthoses. The use of such arch-support orthoses may thus be an effective tool to normalize foot-pressure distribution patterns during running, indicating the potential to treat and prevent MTSS in recreational runners.     

Effect of downhill running grade on lower extremity loading in female distance runners

ABSTRACT

Hill running is often used as a foundational training mechanism to build strength and speed. Distance runners in particular are at an increased likelihood of encountering steep hills during training runs. There is limited research regarding downhill running, and there is no research available on the biomechanics of females specifically during downhill running. The purpose of this study was to quantify the differences in loading when running downhill at different grades compared to a level surface in female distance runners to determine the potential risk for injury. Fifteen female distance runners (age: 23.5 ± 4.9 y), who ran 56.3 ± 20.9 km a week participated in this study. Participants ran on a force-instrumented treadmill at 4.0 m/s for 2 min at 0%, ?5%, ?10%, ?15%, and ?20% grades, with 5 min of rest between conditions. Study findings showed increased impact forces (p < 0.001), and increased loading rates (p < 0.001) with increasing downhill grades compared to level. These results indicate a significantly greater risk of overuse injury to the lower extremity with steeper downhill grades. Individuals need to be aware of these risks to plan and implement training programmes that will increase performance while minimising injury risk.     

The biomechanical difference between running with traditional and 3D printed orthoses

ABSTRACT

Running-related injuries have been associated with excessive foot pronation and high vertical loading rates. Traditional plaster-molded (TPM) foot orthoses are commonly prescribed to minimize these atypical biomechanical patterns. Recently, 3D printed (3DP) orthoses have become popular, yet the functional difference between these two types of orthoses remains unknown. Therefore, this study compared running biomechanics and perceived comfort during treadmill running in three orthotic conditions: 3DP orthoses, TPM orthoses, and a no-orthoses control condition (CON). Thirteen female asymptomatic runners with excessive foot pronation were recruited. Rearfoot eversion angle and velocity (at initial contact and peak) during stance, vertical loading rates, and perceived comfort were compared. Results showed lower peak rearfoot eversion angles during running with TPM (p=0.001, d=0.38) or 3DP orthoses (p=0.002, d=0.24) than CON. No differences were observed in other biomechanical parameters among the three conditions (p>0.05). Running with TPM (p≤0.001, d=1.74–1.82) and 3DP orthoses (p<0.003, d=1.06–1.34) resulted in better perceived comfort in “medial-lateral control” and “heel cushioning” than CON. There were no statistical differences in all parameters between TPM and 3DP orthoses. The present findings indicate improved comfort during running with TPM or 3DP orthoses, which hinted 3DP orthoses could be a viable alternative to TPM orthoses for clinical practice.     

Relationship between Achilles tendon properties and foot strike patterns in long-distance runners

The purpose of this study was to investigate the relationship between Achilles tendon properties and foot strike patterns in long-distance runners. Forty-one highly trained male long-distance runners participated in this study. Elongation of the Achilles tendon and aponeurosis of the medial gastrocnemius muscle were measured using ultrasonography, while the participants performed ramp isometric plantar flexion up to the voluntary maximum. The relationship between the estimated muscle force and tendon elongation during the ascending phase was fit to a linear regression, the slope of which was defined as stiffness. In addition, the cross-sectional area of the Achilles tendon was measured using ultrasonography. Foot strike patterns (forefoot, midfoot and rearfoot) during running were determined at submaximal velocity (18 km · h^?1) on a treadmill. The number of each foot strike runner was 12 for the forefoot (29.3%), 12 for the midfoot (29.3%) and 17 for the rearfoot (41.5%). No significant differences were observed in the variables measured for the Achilles tendon among the three groups. These results suggested that the foot strike pattern during running did not affect the morphological or mechanical properties of the Achilles tendon in long-distance runners.     

Effects of arch-support orthoses on ground reaction forces and lower extremity kinematics related to running at various inclinations

ABSTRACT

While foot orthoses are commonly used in running, little is known regarding biomechanical risk potentials during uphill running. This study investigated the effects of arch-support orthoses on kinetic and kinematic variables when running at different inclinations. Sixteen male participants ran at different inclinations (0°, 3° and 6°) when wearing arch-support and flat orthoses on an instrumented treadmill. Arch-support orthoses induced longer contact time, larger initial ankle dorsiflexion, maximum ankle eversion, and knee sagittal range of motion (RoM) (p < 0.05). As incline slopes increased, vertical impact peak and loading rate, stride length, and ankle coronal RoM decreased, but contact time, stride frequency, initial ankle dorsiflexion and inversion, maximum dorsiflexion, initial knee flexion, and ankle sagittal RoM increased (p < 0.05). Furthermore, knee sagittal RoM was lowest when running at an inclination of 3°. The interaction effect indicated that in arch-support condition, participants running at 6° induced higher maximum ankle eversion than running at 0° (p < 0.05), while no differences were found in flat orthosis condition. These findings suggest that the use of arch-support orthoses would influence running biomechanics that is related to injury risks. Running at higher inclination led to more alterations to biomechanical variables than at lower inclination.     

Effects of footwear midsole thickness on running biomechanics

Shoe manufacturers launch running shoes with increased (e.g., maximalists) or decreased (e.g., minimalists) midsole thickness and claim that they may prevent running injury. Previous studies tested footwear models with different midsole thicknesses on the market but the shoe construct was not strictly comparable. Therefore, in the present study, we examined the effect of midsole thickness, from 1-mm to 29-mm, in a standard test shoe prototype on the vertical loading rates, footstrike angle and temporal spatial parameters in distance runners. Fifteen male habitual rearfoot strikers were recruited from local running clubs. They were asked to run on an instrumented treadmill in shoes with different midsole thicknesses. We found significant interactions between midsole thickness with vertical loading rates (p < 0.001), footstrike angle (p = 0.013), contact time (p < 0.001), cadence (p = 0.003), and stride length (p = 0.004). Specifically, shoes with thinner midsole (1- and 5-mm) significantly increased the vertical loading rates and shortened the contact time, when compared with thicker midsole shoes (25- and 29-mm). However, we did not observe any substantial differences in the footstrike angle, cadence and stride length between other shod conditions. The present study provides biomechanical data regarding the relationship between full spectrum midsole thicknesses and running biomechanics in a group of rearfoot strikers.     

Acute effect of different minimalist shoes on foot strike pattern and kinematics in rearfoot strikers during running

Despite the growing interest in minimalist shoes, no studies have compared the efficacy of different types of minimalist shoe models in reproducing barefoot running patterns and in eliciting biomechanical changes that make them differ from standard cushioned running shoes. The aim of this study was to investigate the acute effects of different footwear models, marketed as “minimalist” by their manufacturer, on running biomechanics. Six running shoes marketed as barefoot/minimalist models, a standard cushioned shoe and the barefoot condition were tested. Foot–/shoe–ground pressure and three-dimensional lower limb kinematics were measured in experienced rearfoot strike runners while they were running at 3.33 m · s^?1 on an instrumented treadmill. Physical and mechanical characteristics of shoes (mass, heel and forefoot sole thickness, shock absorption and flexibility) were measured with laboratory tests. There were significant changes in foot strike pattern (described by the strike index and foot contact angle) and spatio-temporal stride characteristics, whereas only some among the other selected kinematic parameters (i.e. knee angles and hip vertical displacement) changed accordingly. Different types of minimalist footwear models induced different changes. It appears that minimalist footwear with lower heel heights and minimal shock absorption is more effective in replicating barefoot running.     

Textured insoles reduce vertical loading rate and increase subjective plantar sensation in overground running

The effect of textured insoles on kinetics and kinematics of overground running was assessed. 16 male injury-free-recreational runners attended a single visit (age 23?±?5 yrs; stature 1.78?±?0.06 m; mass 72.6?±?9.2?kg). Overground 15-m runs were completed in flat, canvas plimsolls both with and without textured insoles at self-selected velocity on an indoor track in an order that was balanced among participants. Average vertical loading rate and peak vertical force (F_peak) were captured by force platforms. Video footage was digitised for sagittal plane hip, knee and ankle angles at foot strike and mid stance. Velocity, stride rate and length and contact and flight time were determined. Subjectively rated plantar sensation was recorded by visual scale. 95% confidence intervals estimated mean differences. Smallest worthwhile change in loading rate was defined as standardised reduction of 0.54 from a previous comparison of injured versus non-injured runners. Loading rate decreased (?25 to ?9.3?BW?s^?1; 60% likely beneficial reduction) and plantar sensation was increased (46–58?mm) with the insole. F_peak (?0.1 to 0.14?BW) and velocity (?0.02 to 0.06?m?s^?1) were similar. Stride length, flight and contact time were lower (?0.13 to ?0.01 m; ?0.02 to?0.01?s; ?0.016 to ?0.006?s) and stride rate was higher (0.01–0.07 steps?s^?1) with insoles. Textured insoles elicited an acute, meaningful decrease in vertical loading rate in short distance, overground running and were associated with subjectively increased plantar sensation. Reduced vertical loading rate could be explained by altered stride characteristics.     

Dissociation between running economy and running performance in elite Kenyan distance runners

The purpose of this study was to investigate the relationship between running economy (RE) and performance in a homogenous group of competitive Kenyan distance runners. Maximal aerobic capacity (VO_2max) (68.8 ± 3.8 ml?kg^?1?min^?1) was determined on a motorised treadmill in 32 Kenyan (25.3 ± 5.0 years; IAAF performance score: 993 ± 77 p) distance runners. Leg anthropometry was assessed and moment arm of the Achilles tendon determined. While Achilles moment arm was associated with better RE (r² = 0.30, P = 0.003) and upper leg length, total leg length and total leg length to body height ratio were correlated with running performance (r = 0.42, P = 0.025; r = 0.40, P = 0.030 and r = 0.38, P = 0.043, respectively), RE and maximal time on treadmill (t_max) were not associated with running performance (r = ?0.01, P = 0.965; r = 0.27; P = 0.189, respectively) in competitive Kenyan distance runners. The dissociation between RE and running performance in this homogenous group of runners would suggest that RE can be compensated by other factors to maintain high performance levels and is in line with the idea that RE is only one of many factors explaining elite running performance.     

Differences in technique between sprinters and distance runners at equal and maximal speeds

In the finishing kick of a distance race, maximizing speed becomes the focus even if economy may be sacrificed. If distance runners knew how to alter their technique to become more sprint-like, this process could be more successful. In this study, we compared the differences in technique between sprinters and distance runners while running at equal and maximal speeds. Athletes consisted of 10 Division I distance runners, 10 Division I sprinters, and 10 healthy non-runners. They performed two tests, each consisting of a 60-m run on the track: Test 1 at a set pace of 5.81 m/s, while Test 2 was maximal speed. Video was collected at 180 Hz. Significant differences (P < 0.05) between the sprint and distance groups at maximal speeds were found in the following areas: speed, minimum hip angle, knee extension at toe-off, stride length, contact time, and recovery knee at touchdown. In Test 1, sprinters and distance runners displayed many of the same significant differences. The control group was similar to the distance group in both trials. As distance runners attempt to sprint, the desired adjustments do not necessarily occur. Distance runners may benefit from biomechanical interventions to improve running speed near the end of a race.     

Estimating running spatial and temporal parameters using an inertial sensor

An inertial measurement unit (IMU) is widely considered to be an economical alternative to capture human motion in daily activities. Use of an IMU for clinical study, rehabilitation, and in the design of orthoses and prostheses has increased tremendously. However, its use in defining running gait is limited. This study presents a practical method to estimate running spatial and temporal parameters using an inertial sensor by placing it on a shoe. A combination of a zero-crossing method and thresholding is used to identify foot-strike and foot-off based on foot acceleration during running. Stride time, ground contact time and flight time can then be identified. An off-phase segmentation algorithm is applied to estimate stride length and running speed. These two parameters are commonly used to evaluate running efficiency and to differentiate elite runners. This study found that an IMU can estimate foot-strike and foot-off with average absolute time differences of 2.60–6.04 and 2.61–16.28 ms, respectively. Stride time was estimated with error between ? 4.04 and 0.33 ms. Stride length and running speed were estimated with maximum average errors of 45.97 mm and 0.41 km/h.     

Relationship between foot strike pattern,running speed,and footwear condition in recreational distance runners

Compared to competitive runners, recreational runners appear to be more prone to injuries, which have been associated with foot strike patterns. Surprisingly, only few studies had examined the foot strike patterns outside laboratories. Therefore, this study compared the foot strike patterns in recreational runners at outdoor tracks with previously reported data. We also investigated the relationship between foot strike pattern, speed, and footwear in this cohort. Among 434 recreational runners analysed, 89.6% of them landed with rearfoot strike (RFS). Only 6.9 and 3.5% landed with midfoot and forefoot, respectively. A significant shift towards non-RFS was observed in our cohort, when compared with previously reported data. When speed increased by 1 m/s, the odds of having forefoot strike and midfoot strike relative to RFS increased by 2.3 times and 2.6 times, respectively. Runners were 9.2 times more likely to run with a forefoot strike in minimalists compared to regular running shoes, although 70% of runners in minimalists continued to use a RFS. These findings suggest that foot strike pattern may differ across running conditions and runners should consider these factors in order to mitigate potential injury.