BACKGROUND & OBJECTIVE
A growing number of biomechanical studies have shown that running gait retraining may reduce load on various structures during running. However, the majority of these studies are on healthy individuals and there are relatively few papers on those with pain.Within this biomechanical research a number of approaches have been identified that may reduce patellofemoral joint load including changing foot strike, increasing step rate and adopting a greater forward trunk lean. This study examined these three methods in a group of runners with patellofemoral pain (PFP) to assess their effectiveness for altering running gait and improving symptoms.
18 runners with PFP were recruited and randomized into 1 of 3 groups:
- Forefoot running (cue “strike with the forefoot”)
- Increased step rate by 10% (using a digital audio metronome set at 10% above their self-selected step rate)
- Increased forward trunk lean (cue “run with an increase in flexed trunk posture”)
8 sessions of treadmill-based gait retraining were provided in a 2 week period with gradually reducing feedback during the sessions. This approach is thought to facilitate learning and has been used in a number of gait retraining studies.
Running gait kinematics (movement patterns) and muscle activity were measured at baseline and post gait retraining. Pain and functional limitations associated with PFP were measured at baseline, post gait retraining and at 6 month follow-up using the Anterior Knee Pain Scale (AKPS) and Lower Extremity Functional Scale (LEFS).
Switching to a forefoot strike and increasing forward trunk lean both led to significant improvements in AKPS post training and at 6 month follow up. Increasing step rate improved AKPS from baseline to the 6 month follow up. Regardless of