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Running gait modifications and knee pain



Patello-femoral joint pain is a common injury amongst runners, mainly due to the high levels of compression forces exerted on the knee during running.


Evidence suggests that running gait modifications effectively modulate patello-femoral joint forces in healthy runners displaying rearfoot strike pattern. Increasing preferred step rate by 10% can reduce peak patello-femoral joint force by up to 14%, while decreasing step rate tends to increased forces. A fixed step rate of 180 steps/min has been found to be optimal in reducing lower limb forces.


So, is there an immediate response to gait modifications on lower limb kinematics and pain of runners with patello-femoral joint pain? The effects look favourable for those who currently have a rearfoot strike, and go on to adopt a forefoot strike pattern as well as increasing their step rate by 10%. For those that already have a forefoot strike pattern, increasing their step rate by 10% may be a good option in reducing peak patello-femoral joint forces.


It must be highlighted that a transition from a rearfoot strike to a forefoot strike places increased load through the Achilles tendon, so as to avoid injury, transition must be gradual to allow the Achilles tendon to adapt to increased forces.


To conclude, those with patello-femoral joint pain can reduce symptoms by transitioning to forefoot running, as well as increasing their step rate but 10%, aiming for around 180 steps per minute.


Esculier, J.F. et al. (2022). Running gait modifications can lead to immediate reductions in patellofemoral pain. Front. Sports Act. Living. 1048655.

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