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Br J Sports Med. 2016 May;50(9):513-26. doi: 10.1136/bjsports-2015-095278. Epub 2016 Feb 16.

Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion.

Author information

1
Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia Complete Sports Care, Melbourne, Victoria, Australia Pure Sports Medicine, London, UK Centre for Sport and Exercise Medicine, Queen Mary University of London, London, UK.
2
Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
3
Complete Sports Care, Melbourne, Victoria, Australia Back on Track Physiotherapy, Albury, New South Wales, Australia.
4
Pure Sports Medicine, London, UK Centre for Sport and Exercise Medicine, Queen Mary University of London, London, UK.
5
Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia Complete Sports Care, Melbourne, Victoria, Australia Centre for Sport and Exercise Medicine, Queen Mary University of London, London, UK.
6
Sports Surgery Clinic Research Unit, Santry Demesne, Dublin, Republic of Ireland Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Victoria, Australia.

Abstract

IMPORTANCE:

Running-related injuries are highly prevalent.

OBJECTIVE:

Synthesise published evidence with international expert opinion on the use of running retraining when treating lower limb injuries.

DESIGN:

Mixed methods.

METHODS:

A systematic review of clinical and biomechanical findings related to running retraining interventions were synthesised and combined with semistructured interviews with 16 international experts covering clinical reasoning related to the implementation of running retraining.

RESULTS:

Limited evidence supports the effectiveness of transition from rearfoot to forefoot or midfoot strike and increase step rate or altering proximal mechanics in individuals with anterior exertional lower leg pain; and visual and verbal feedback to reduce hip adduction in females with patellofemoral pain. Despite the paucity of clinical evidence, experts recommended running retraining for: iliotibial band syndrome; plantar fasciopathy (fasciitis); Achilles, patellar, proximal hamstring and gluteal tendinopathy; calf pain; and medial tibial stress syndrome. Tailoring approaches to each injury and individual was recommended to optimise outcomes. Substantial evidence exists for the immediate biomechanical effects of running retraining interventions (46 studies), including evaluation of step rate and strike pattern manipulation, strategies to alter proximal kinematics and cues to reduce impact loading variables.

SUMMARY AND RELEVANCE:

Our synthesis of published evidence related to clinical outcomes and biomechanical effects with expert opinion indicates running retraining warrants consideration in the treatment of lower limb injuries in clinical practice.

KEYWORDS:

Injury; Lower limb; Rehabilitation; Running

PMID:
26884223
DOI:
10.1136/bjsports-2015-095278
[Indexed for MEDLINE]

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