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Estimating Tibial Stress throughout the Duration of a Treadmill Run


Medicine & Science in Sports & Exercise: November 2019 - Volume 51 - Issue 11 - p 2257–2264
doi: 10.1249/MSS.0000000000002039

Introduction Stress fractures of the tibia are a problematic injury among runners of all levels. Quantifying tibial stress using a modeling approach provides an alternative to invasive assessments that may be used to detect changes in tibial stress during running. This study aimed to assess the repeatability of a tibial stress model and to use this model to quantify changes in tibial stress that occur throughout the course of a 40-min prolonged treadmill run.

Methods Synchronized force and kinematic data were collected during prolonged treadmill running from 14 recreational male rearfoot runners on two separate occasions. During each session, participants ran at their preferred speed for two consecutive 20-min runs, separated by a 2-min pause. The tibia was modeled as a hollow ellipse and bending moments and stresses at the distal third of the tibia were estimated using beam theory combined with inverse dynamics and musculoskeletal modeling.

Results Intraclass correlation coefficients indicated good-to-excellent repeatability for peak stress values between sessions. Peak anterior and posterior stresses increased after 20 min of prolonged treadmill running and were 15% and 12% greater, respectively, after 40 min of running compared with the start of the run.

Conclusion The hollow elliptical tibial model presented is a repeatable tool that can be utilized to assess within-participant changes in peak tibial stress during running. The increased stresses observed during a prolonged treadmill run may have implications for the development of tibial stress fracture.

1Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM

2Biomechanics Laboratory, University of Massachusetts, Amherst, MA

3Human Performance Laboratory, Brooks Running Company, Seattle, WA

4Department of Physical Therapy, East Carolina University, NC

5Department of Kinesiology, Iowa State University, IA

Address for correspondence: Hannah Rice, Ph.D., Sport and Health Sciences, Richards Building, St Luke’s Campus, Heavitree Rd, Exeter, EX1 2LU, United Kingdom. E-mail:

Submitted for publication February 2019.

Accepted for publication May 2019.

Online date: May 16, 2019

© 2019 American College of Sports Medicine