Medicine & Science in Sports & Exercise

MSSE’s July issue features three interesting articles that may be relevant for understanding runner’s injuries. Of late, the potential benefits of running barefoot or while wearing “minimalist” running shoes have stimulated scientific study and public interest. However, concern remains that running barefoot or in minimalist shoes could also increase stress on the feet, particularly during the runner’s transition from traditional to minimalist footwear, and that could increase risk of injuries including stress fractures. Ridge et al. investigated bone and soft tissue changes exhibited by experienced runners after a 10-week progressive transition from using traditional to the minimalist style of running shoes. Their findings indicated that the prevalence of bone marrow edema, potentially a marker of early stress injury in bone, was higher in feet of runners who had transitioned to minimalist shoes than those who continued using traditional shoes for the same period. The authors concluded that a longer transition period might be necessary to minimize the risk of foot injury in runners who wanted to shift to the minimalist shoes or barefoot.

Anterior cruciate ligament (ACL) tears are a common sports-related injury, especially among female athletes. Despite good clinical outcomes following surgical repair and rehabilitation, quadriceps strength deficits often persist after recovery, which could theoretically promote gait alterations that could increase risk of chronic joint degeneration. In July’s MSSE, Noehren et al. report a study providing evidence that impact forces and gait during running and walking were different when female athletes who had undergone surgical repair of unilateral torn ACL, fully recovered, and had returned to play were compared to healthy female athletes who had not undergone ACL repair surgery. Although this was a cross-sectional study, the findings do suggest that alternations in gait and associated impact forces during walking and running persist following recovery from surgical ACL repair, and those alternations may promote re-injury or joint degeneration over time in these patients. Indeed, that conclusion would be consistent with descriptive observations of injured runners reported in a heavily cited paper from our archives by Messier et al. [Etiologic Factors Associated with Patellofemoral Pain in Runners.  Med Sci Sports Exerc. 1991; 23(9): 1008–15]. We are featuring that classic article this month also.

Also featured in this month’s MSSE, Williams reports an epidemiological study comparing the prevalence of osteoarthritis and hip replacement in 74,752 recreational runners and 14,625 walkers. The author reports that there was no evidence that running increased the risk of either osteoarthritis or hip replacement, and in fact running appeared to reduce those risks compared to effects of other exercise, probably due to the association between lower BMI and running.