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Effects of Fatigue on Running Mechanics Associated with Tibial Stress Fracture Risk


Medicine & Science in Sports & Exercise: October 2012 - Volume 44 - Issue 10 - p 1917–1923
doi: 10.1249/MSS.0b013e318259480d
Applied Sciences

Purpose The purpose of this study was to investigate the acute effects of progressive fatigue on the parameters of running mechanics previously associated with tibial stress fracture risk.

Methods Twenty-one trained male distance runners performed three sets (Pre, Mid, and Post) of six overground running trials at 4.5 m·s−1 (±5%). Kinematic and kinetic data were collected during each trial using a 12-camera motion capture system, force platform, and head and leg accelerometers. Between tests, each runner ran on a treadmill for 20 min at their corresponding lactate threshold (LT) speed. Perceived exertion levels (RPE) were recorded at the third and last minute of each treadmill run.

Results RPE scores increased from 11.8 ± 1.3 to 14.4 ± 1.5 at the end of the first LT run and then further to 17.4 ± 1.6 by the end of the second LT run. Peak rearfoot eversion, peak axial head acceleration, peak free moment and vertical force loading rates were shown to increase (P < 0.05) with moderate–large effect sizes during the progression from Pre to Post tests, although vertical impact peak and peak axial tibial acceleration were not significantly affected by the high-intensity running bouts.

Conclusion Previously identified risk factors for impact-related injuries (such as tibial stress fracture) are modified with fatigue. Because fatigue is associated with a reduced tolerance for impact, these findings lend support to the importance of those measures to identify individuals at risk of injury from lower limb impact loading during running.

1Sport and Exercise Sciences Research Institute, University of Ulster, Newtownabbey, Co Antrim, Northern Ireland, UNITED KINGDOM; and 2Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, England, UNITED KINGDOM

Address for Correspondence: Adam C. Clansey, M.Sc., Sport and Exercise Sciences Research Institute, University of Ulster, Jordanstown, Shore Rd, Co Antrim BT37 0QB, Northern Ireland, United Kingdom; E-mail:

Submitted for publication October 2011.

Accepted for publication April 2012.

©2012The American College of Sports Medicine