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      Shoe Cushioning Influences the Running Injury Risk According to Body Mass: A Randomized Controlled Trial Involving 848 Recreational Runners

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          Abstract

          Background:

          Shoe cushioning is expected to protect runners against repetitive loading of the musculoskeletal system and therefore running-related injuries. Also, it is a common belief that heavier runners should use footwear with increased shock absorption properties to prevent injuries.

          Purpose:

          The aim of this study was to determine if shoe cushioning influences the injury risk in recreational runners and whether the association depends on the runner’s body mass.

          Study Design:

          Randomized controlled trial; Level of evidence, 1.

          Methods:

          Healthy runners (n = 848) randomly received 1 of 2 shoe prototypes that only differed in their cushioning properties. Global stiffness was 61.3 ± 2.7 and 94.9 ± 5.9 N/mm in the soft and hard versions, respectively. Participants were classified as light or heavy according to their body mass using the median as a cut-off (78.2 and 62.8 kg in male and female runners, respectively). They were followed over 6 months regarding running activity and injury (any physical complaint reducing/interrupting running activity for at least 7 days). Data were analyzed through time-to-event models with the subhazard rate ratio (SHR) and their 95% confidence interval (CI) as measures of association. A stratified analysis was conducted to investigate the effect of shoe cushioning on the injury risk in lighter and heavier runners.

          Results:

          The runners who had received the hard shoes had a higher injury risk (SHR, 1.52 [95% CI, 1.07-2.16]), while body mass was not associated with the injury risk (SHR, 1.00 [95% CI, 0.99-1.01]). However, after stratification according to body mass, results showed that lighter runners had a higher injury risk in hard shoes (SHR, 1.80 [95% CI, 1.09-2.98]) while heavier runners did not (SHR, 1.23 [95% CI, 0.75-2.03]).

          Conclusion:

          The injury risk was higher in participants running in the hard shoes compared with those using the soft shoes. However, the relative protective effect of greater shoe cushioning was found only in lighter runners.

          Registration:

          NCT03115437 (ClinicalTrials.gov identifier)

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          Most cited references20

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          A framework for the etiology of running-related injuries.

          C F Finch, E T Parner, R Nielsen … (2017)
          The etiology of running-related injury is important to consider as the effectiveness of a given running-related injury prevention intervention is dependent on whether etiologic factors are readily modifiable and consistent with a biologically plausible causal mechanism. Therefore, the purpose of the present article was to present an evidence-informed conceptual framework outlining the multifactorial nature of running-related injury etiology. In the framework, four mutually exclusive parts are presented: (a) Structure-specific capacity when entering a running session; (b) structure-specific cumulative load per running session; (c) reduction in the structure-specific capacity during a running session; and (d) exceeding the structure-specific capacity. The framework can then be used to inform the design of future running-related injury prevention studies, including the formation of research questions and hypotheses, as well as the monitoring of participation-related and non-participation-related exposures. In addition, future research applications should focus on addressing how changes in one or more exposures influence the risk of running-related injury. This necessitates the investigation of how different factors affect the structure-specific load and/or the load capacity, and the dose-response relationship between running participation and injury risk. Ultimately, this direction allows researchers to move beyond traditional risk factor identification to produce research findings that are not only reliably reported in terms of the observed cause-effect association, but also translatable in practice.
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            Meta-Analyses of the Effects of Habitual Running on Indices of Health in Physically Inactive Adults

            Luiz Carlos Hespanhol Junior, Julian Pillay, Willem van Mechelen … (2015)
            Background In order to implement running to promote physical activity, it is essential to quantify the extent to which running improves health. Objective The aim was to summarise the literature on the effects of endurance running on biomedical indices of health in physically inactive adults. Data Sources Electronic searches were conducted in October 2014 on PubMed, Embase, CINAHL, SPORTDiscus, PEDro, the Cochrane Library and LILACS, with no limits of date and language of publication. Study Selection Randomised controlled trials (with a minimum of 8 weeks of running training) that included physically inactive but healthy adults (18–65 years) were selected. The studies needed to compare intervention (i.e. endurance running) and control (i.e. no intervention) groups. Study Appraisal and Synthesis Methods Two authors evaluated study eligibility, extracted data, and assessed risk of bias; a third author resolved any uncertainties. Random-effects meta-analyses were performed to summarise the estimates for length of training and sex. A dose-response analysis was performed with random-effects meta-regression in order to investigate the relationship between running characteristics and effect sizes. Results After screening 22,380 records, 49 articles were included, of which 35 were used to combine data on ten biomedical indices of health. On average the running programs were composed of 3.7 ± 0.9 sessions/week, 2.3 ± 1.0 h/week, 14.4 ± 5.4 km/week, at 60–90 % of the maximum heart rate, and lasted 21.5 ± 16.8 weeks. After 1 year of training, running was effective in reducing body mass by 3.3 kg [95 % confidence interval (CI) 4.1–2.5], body fat by 2.7 % (95 % CI 5.1–0.2), resting heart rate by 6.7 min−1 (95 % CI 10.3–3.0) and triglycerides by 16.9 mg dl−1 (95 % CI 28.1–5.6). Also, running significantly increased maximal oxygen uptake (VO2max) by 7.1 ml min−1 kg−1 (95 % CI 5.0–9.1) and high-density lipoprotein (HDL) cholesterol by 3.3 mg dl−1 (95 % CI 1.2–5.4). No significant effect was found for lean body mass, body mass index, total cholesterol and low-density lipoprotein cholesterol after 1 year of training. In the dose-response analysis, larger effect sizes were found for longer length of training. Limitations It was only possible to combine the data of ten out the 161 outcome measures identified. Lack of information on training characteristics precluded a multivariate model in the dose-response analysis. Conclusions Endurance running was effective in providing substantial beneficial effects on body mass, body fat, resting heart rate, VO2max, triglycerides and HDL cholesterol in physically inactive adults. The longer the length of training, the larger the achieved health benefits. Clinicians and health authorities can use this information to advise individuals to run, and to support policies towards investing in running programs. Electronic supplementary material The online version of this article (doi:10.1007/s40279-015-0359-y) contains supplementary material, which is available to authorized users.
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              Greater vertical impact loading in female runners with medically diagnosed injuries: a prospective investigation.

              Irene Davis, Bradley Bowser, David R Mullineaux (2016)
              Running has been critical to human survival. Therefore, the high rate of injuries experienced by modern day runners is puzzling. Landing on the heel, as most modern day shod runners do, results in a distinct vertical impact force that has been shown to be associated with running-related injuries. However, these injury studies were retrospective in nature and do not establish cause and effect.
              Article 0 comments Cited 83 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: The American Journal of Sports Medicine
                Abbreviated Title: Am J Sports Med
                Publisher: SAGE Publications
                ISSN (Print): 0363-5465
                ISSN (Electronic): 1552-3365
                Publication date Created: February 2020
                Publication date (Electronic): December 26 2019
                Publication date (Print): February 2020
                Volume: 48
                Issue: 2
                Pages: 473-480
                Affiliations
                [1 ]Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg
                [2 ]Movement Sciences Department, Decathlon SportsLab, Villeneuve d’Ascq, France
                [3 ]Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Grand Duchy of Luxembourg
                [4 ]ALAN–Maladies Rares Luxembourg, Bascharage, Grand Duchy of Luxembourg
                Article
                DOI: 10.1177/0363546519892578
                PubMed ID: 31877062
                SO-VID: fc6d4072-b254-4c81-bf04-0b4112ffa6ff
                Copyright © © 2020
                License:

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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