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Reducing Impact Loading in Runners

A One-Year Follow-up


Medicine & Science in Sports & Exercise: December 2018 - Volume 50 - Issue 12 - p 2500–2506
doi: 10.1249/MSS.0000000000001710

Increased vertical impact loading during running has been associated with a variety of running related injuries including stress fractures, patellofemoral pain, and plantar fasciitis.

Purpose The purpose of this study was to examine the acute and long-term effect of a gait retraining program aimed at teaching runners with high impact loading to run softer.

Methods Nineteen runners with high tibial shock (TS) first underwent a control period of eight sessions of treadmill running over 2 wk, progressing from 15 to 30 min. This was followed by eight sessions of gait retraining over 2 wk using the identical treadmill protocol. Real-time feedback of TS was provided as the participant ran. Feedback was gradually removed during the last four sessions. Variables of interest included peak TS, vertical impact peak and vertical average loading rate, and vertical instantaneous loading rate. These variables were assessed at intervals following the retraining and at a 1-yr follow-up.

Results All variables of interest were significantly reduced post-retraining (P < 0.001). TS was reduced by 32%, vertical impact peak by 21%, vertical instantaneous loading rate by 27%, and vertical average loading rate by 25%. All variables continued to be significantly reduced at a 1-yr follow-up.

Conclusions Impact loading can be reduced through gait retraining and the results persist at least 1 yr. As impact loading is associated with injury, this simple intervention may provide a powerful method of reducing musculoskeletal injury risk in runners.

1Department of Health and Nutritional Sciences, South Dakota State Universitey, Brookings, SD;

2University of Delaware, Biomechanics and Movement Science Program, Newark, DE;

3Therapy and Rehabilitation Sciences Department, Drexel University, Philadelphia, PA;

4Department of Exercise Science, University of Puget Sound, Tacoma, WA; and

5Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA

Address for correspondence: Bradley J Bowser, Ph.D., Department of Health and Nutritional Sciences, South Dakota State University, Box 2275A, SWG 441, Brookings, SD 57007; E-mail:

Submitted for publication January 2018.

Accepted for publication June 2018.

© 2018 American College of Sports Medicine