Running is a widely practiced physical activity with well-established health benefits. However, it is frequently associated with overuse musculoskeletal injuries. Among the modifiable biomechanical variables, increasing cadence, defined as the number of steps per minute, has emerged as a promising target for reducing injury risk by altering impact forces and load distribution. The aim of this review was to systematically evaluate and critically appraise the scientific evidence on the effects of running cadence modification on biomechanics and injury prevention in adult runners. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic search was conducted in PubMed, Scopus, and Web of Science (2009-2025). Eighteen studies were included, encompassing randomized controlled trials, quasi-experimental studies, cross-sectional analyses, and systematic reviews. Cadence was the main variable examined in relation to biomechanical or clinical outcomes. Data were extracted by three independent reviewers, and a narrative synthesis was performed due to methodological heterogeneity. A moderate increase in cadence (typically 5-10%) led to consistent biomechanical improvements, including reduced vertical ground reaction forces, lower loading rates, shorter stride length, and improved lower limb alignment. These adaptations were associated with reduced stress on the tibia, knee, and hip joints. Importantly, cadence modification did not negatively affect metabolic cost and, in some cases, enhanced running economy. Auditory cueing strategies facilitated adherence, and evidence suggested a preventive effect on injuries such as patellofemoral pain and tibial stress fractures. Cadence retraining appears to be a low-cost, accessible, and effective strategy to optimize running biomechanics and potentially reduce the incidence of overuse injuries. Further high-quality prospective studies are needed to confirm its long-term clinical and performance-related benefits.
Keywords: biomechanics; cadence; gait retraining; overuse injury; running.
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