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Biomechanics of
Running and Injury
Daniel E. Lieberman
Human Evolutionary Biology
Funding disclosure:
Currently: None
In past: Vibram USA
Today
1. The problem of injury
2. Basic biomechanics of running & injury
3. Treating symptoms (palliative care)
vs preventing causes
Later Lectures
1. Barefoot running (pros, cons, unknowns)
2. The evolution of running
"Ironman360.com"
Repetitive
"911bicycleinjurylaw.com"
Abnormal
Normal
Normal
We can do better!
1. The problem
2. Basic biomechanics of running & injury
3. Treating symptoms (palliative care)
vs preventing causes
to begin:
BIOMECHANICAL DIFFERENCES
BETWEEN RUNNING & WALKING
BASIC TERMINOLOGY
Stride = full cycle from heel strike (HS) to heel strike
STANCE PHASE
1. heel strike
2. foot flat
3. heel off
4. toe off
SWING PHASE
HS
FF.
HO
TO
SWING
WALKING
STANCE PHASE
8%
HS
FF
SWING PHASE
43%
HO
62%
100%
TO
Potential Kinetic
Energy Energy
Energy'
PotenKal"
energy"
KineKc"energy"
Ground'Reac,on'Force''
(%"body"mass)"
0""""""10"""""20"""""30"""""40""""""50"""""60"""""70""""""80"""""90""""100"
%"stride"cycle"
150"
Double""
support"
Single"support"
Double""
support"
100"
50"
0"
HS"
TO"
0""""""10"""""20"""""30"""""40""""""50"""""60"""""70""""""80"""""90""""100"
%"stride"cycle"
Biomechanical challenge:
move Center of Gravity (COG) forward
economically and with stability
5 cm
4.5 cm
Determinants of gait
#1
#4 #2,3
#2
#1
#5
#3
#4-5
Control of vertical
fluctuations of COG
Sprint
300
Endurance run
250
200
150
walk
100
50
Speed (m/s)
Running is a
gait
PE
KE
INVERTED PENDULUM
MASS-SPRING
mass-spring model
x
PE
KE
INVERTED PENDULUM
MASS-SPRING
Kinetic
energy
Potential
energy HS
MS
TO
HS
MS
TO
Elastic
energy
Midstance
250
200
(% body mass)
walk
run
150
150
100
100
50
50
HS
TO
20
40
60
% stride cycle
80
0
100
HS
TO
HS
% stride cycle
TO
Midstance
(maximum elastic
energy storage)
Footstrike
(collision)
Toe off
(recoil)
1.
2.
3.
4.
Force magnitudes
Force rates
Force cycle number
Stabilization (falling)
}"}
energy
energy"
1.Traumatic injury:
sudden tissue damage, usually from high, rapid force
-Collisions
-Falls
-Concussions
-Sprained ankles
-Lacerations
-Broken bones
-Etc
-Muscle injury
-Tears, knots, spasms
-Tendon/ligament injury
-Tears
-Evulsions
-Etc..
and STUPIDITY!
Material properties
Force = mass acceleration (Newtons)
=Stress (F/A)*
f
y
tic
plas
f = fracture
y = yield
y
x
= Strain (L/L)
*unit = Pascals (N/m2)
very stiff
Stress (F/A)
intermediate
very flexible
Strain (L/L)
Stress, , force/area
ion
yield point
Strain, , L/L
fracture!
=Stress (F/A)
f
y
f
y
Weaker
Stiffer
Stronger
Less stiff
Strain (L/L)
f
y
Stiffer isn t
necessarily stronger!
KEY VARIABLES:
1.# of cycles to failure
2. strain rate
3. rate of loading
Microfracture!
Example: bone remodeling
80
70
60
50
40
30
20
10
0
1980
1985
1990
1995
2000
2005
2010
Year of publication
van Gent et al.. Br."J."Sports"Med."41:469"(2007)
MUCH HARDER TO
UNDERSTAND, PREVENT, & TREAT!
f "
=Stress"(F/A)*"
y"
tic
plas
y
x
y"
"="Strain""(L/L)"
f"
=Stress"(F/A)*"
Microcrack!"
f "
y"
tic
plas
Hysteresis
y"
f"
"="Strain""(L/L)"
InammaKon"
1. External Forces
Muscle/tendon
strains
FGRF"
Ground
Reaction
Forces
Fcalf"
rcalf"
Torques
rGRF"
BW
4
3
2
1
0
3.00
2.25
1.50
0.75
0.00
Vertical head
acceleration
SHOCK WAVE
7 milliseconds from ground to head
Ground
reaction force
Must be damped!
X
F
Runners knee
Pohl et al 2009 Clin J Sports Med
IT band syndrome
Achilles tendonitis
Back pain
Davis et al., 2010 ASB
Time
Irene Davis
0Impact peak
Rapid exchange of
momentum between body
and ground
Saw-toothed force profile
Ankle Torques
(external
&
internal)
FGRFrGRF = Fcalfrcalf
FGRF
Fcalf
rcalf
rGRF"
Which require
higher muscle
forces!
TORQUES/INTERNAL FORCES
are affected by
Shoes
Running form
(e.g. strike type)
Fv"
Fv"
Fcalf"
FGRF"
F l"
Kerrigan'et'al'(2009)'Phys'
Med'Rehab'1,'1058'
F l"
rcalf"
rGRF"
Lieberman,'White'and'Daoud,'
unpublished'data'
Dierent'strike'types:'tradeKo'between'ankle'&'knee'
Dorsiexor"
moment"
0.1
0.10
0.05
0.05
0.00
-0.05
-0.05
-0.1
-0.10
-0.15
-0.15
-0.2
-0.20
-0.25
-0.25
-0.3
-0.30
-0.35
-0.35
-0.4
P<0.05"
-0.40
0
20
Plantarexor"
moment"
Extensorm
oment"
40
60
80
100
0.40
0.35
0.35
P<0.05"
0.30
0.25
0.20
0.20
0.15
0.15
0.10
0.10
0.05
0.05
0.00
-0.10
Flexor"
moment"
20
30
40
60
80
100
0.30
0.25
10
40
0.40
-0.05 0
20
50
60
0.00
-0.05 0
10
20
30
40
50
60
-0.10
Lieberman,'White'and'Daoud,'unpublished'data'
Finally
1. The problem
2. Basic biomechanics of running & injury
3. Treating symptoms
vs
Preventing causes
How often do
athletes seek advice
to prevent injuries
BEFORE they get
injured?
How many health care providers have
the opportunity to practice preventative
medicine?
- preventative podiatry?
- preventative orthopedics?
- preventative physical therapy?
Do we know how
runners should run?
(what is good form?)
How many runners
learn good form?
How many health care providers consider
a runners form when treating injuries?
Injury Prevention
1. Adapt structures to bear loads
Every structure in the body has its own
safety factor: = Maximum strength/
Most bones =
maximum load
1.4 4.1
SF = 6
SF = 11
Biewener"A"(1993)"Calc"Tiss"Int"53:"S68"
No pain, no gain is an
adaptation
BMD
young
old
immobilization
activity
loading/day
bone
Little
Slow
tendon/
ligament
muscle
Lots
Fast
Injury Prevention
2. Improve sensory feedback to
prevent falls/collisions
More"tomorrow"
Injury Prevention
3. Avoid repetitive impacts, and rapid torques
Barefoot heelstrike
On hard
surface =
Ouch!
Shod heelstrike
20 miles/week: 1.5
million impacts/year!
Forefoot strike
Less of a
problem!
0-
Impact peak
Runners knee
X
F
IT Band Syndrome
Pohl et al 2009 Clin J Sports Med
Time
Back pain
Davis et al., 2010 ASB
Irene Davis
More expensive/cushioned
running shoes correlate with
higher injury rates
Marti et al, 1988 AmJ Sports Med 16: 285
Hypothesis:
Impact peak free style of running
(forefoot striking) should lead to
lower injury rate than rearfoot
striking
Lower impacts
More gradual
torques
2.3x!"
>"
7.8 .48
Forefoot strikers
N=8
16.4 .64
Rearfoot strikers
N=20
Daoud,'et'al'(2012)'MSSE'
In short
All injuries have a biomechanical basis
Some runners may be more prone to injury from
-weakness/insufficient adaptation
-training errors
-poor form
Considering the biomechanical bases for injury
may help us prevent injuries before they happen
Running form is a far more important factor for
preventing injuries than has been previously
recognized.
BUT
WHAT IS GOOD
FORM?
Next lecture!