Is running retraining effective?

Lower limb injuries are common in the running population. Running retraining (RR) is believed to lower the risk of running related injuries, however currently, there is a lack of evidence on this subject. This study investigated the current evidence on RR. Substantial evidence was found for the immediate biomechanical effects of RR, including evaluation of step rate and strike pattern manipulation, strategies to improve kinematics and to reduce loading. In addition, experts recommend RR and specifically tailored approaches to each injury and individual. 

Running injuries incorporate a wide range of lower limb injuries; the incidence currently ranges from 19% to 78% among studies. It is believed that alterations to running techniques may reduce load in certain muscle groups and joints. However there is a current lack of evidence to guide clinicians and researchers in the practical implementation of RR. Thus, this study investigated the clinical and biomechanical evidence on RR and explored the reasoning related to the use of RR by experts.

A systematic review was carried out. Furthermore, interviews were carried out with 16 international experts. These experts were actively involved in RR research, and had at least 5 years clinical experience, and prescribed RR regularly to treat patients with running injuries.

Limited evidence indicates that visual (video) and verbal feedback to transition from rearfoot strike (RFS) to midfoot strike (MFS) or forefoot strike (FFS) and an increased step rate reduce pain and compartmental pressures in patients with running-related anterior exertional lower leg pain. This approach was strongly supported by the expert opinion.

Experts agreed that the presence of overstriding was considered as one of the most beneficial RR strategies, however, evidence to support the importance of overstriding is lacking.

Strategies to reduce impact noise may be a focus of RR interventions if clinicians seek to reduce impact loading variables.

According to experts tailoring approaches to each injury and individual is likely required to optimise outcomes. However, experts highlighted that running retraining is only part of the solution for the treatment of running injuries and muscle flexibility, strength, etc. should be concurrently applied.

> From: Barton et al., Br J Sports Med 50 (2016) 513–526. All rights reserved to BMJ. Click here for the Pubmed summary.