Reducing Impact Loading in Runners: A One-Year Follow-up

Med Sci Sports Exerc. 2018 Dec;50(12):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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Athletic Injuries / prevention & control*
  • Feedback
  • Female
  • Follow-Up Studies
  • Fractures, Stress / prevention & control*
  • Gait*
  • Humans
  • Male
  • Physical Conditioning, Human / methods*
  • Running*
  • Tibia
  • Young Adult