Effects of Fatigue on Running Mechanics Associated with Tibial Stress Fracture Risk

Adam C. Clansey, Michael Hanlon, Eric S. Wallace, Mark J. Lake

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to investigate the acute effects of progressive fatigue on the parameters of runningmechanics previously associated with tibial stress fracture risk.Methods: Twenty-one trained male distance runners performed three sets (Pre, Mid, and Post) of six overground running trials at 4.5 mIsj1 (T5%). Kinematic and kinetic data were collected during each trial using a 12-camera motion capture system, force platform,and head and leg accelerometers. Between tests, each runner ran on a treadmill for 20 min at their corresponding lactate threshold (LT) speed. Perceived exertion levels (RPE) were recorded at the third and last minute of each treadmill run. Results: RPE scores increased from 11.8 T 1.3 to 14.4 T 1.5 at the end of the first LT run and then further to 17.4 T 1.6 by the end of the second LT run. Peak rearfoot eversion, peak axial head acceleration, peak free moment and vertical force loading rates were shown to increase (P G 0.05) with moderate–large effect sizes during the progression from Pre to Post tests, although vertical impact peak and peak axial tibial acceleration were not significantly affected by the high-intensity running bouts. Conclusion: Previously identified risk factors for impact-related injuries (such as tibial stress fracture) are modified with fatigue. Because fatigue is associated with a reduced tolerance for impact, these findings lend support to the importance of those measures to identify individuals at risk of injury from lower limb impact loading during running.
LanguageEnglish
Pages1917-1923
JournalMedicine & Science in Sports & Exercise
Volume44
Issue number10
DOIs
Publication statusPublished - Oct 2012

Fingerprint

Stress Fractures
Tibial Fractures
Mechanics
Fatigue
Lactic Acid
Head
Wounds and Injuries
Biomechanical Phenomena
Lower Extremity
Leg

Keywords

  • High Intensity
  • Kinematics
  • Kinetics
  • Overuse Injury Potential
  • Runners

Cite this

Clansey, Adam C. ; Hanlon, Michael ; Wallace, Eric S. ; Lake, Mark J. / Effects of Fatigue on Running Mechanics Associated with Tibial Stress Fracture Risk. In: Medicine & Science in Sports & Exercise. 2012 ; Vol. 44, No. 10. pp. 1917-1923.
@article{807a201ddb67430a8fca52b24b790455,
title = "Effects of Fatigue on Running Mechanics Associated with Tibial Stress Fracture Risk",
abstract = "Purpose: The purpose of this study was to investigate the acute effects of progressive fatigue on the parameters of runningmechanics previously associated with tibial stress fracture risk.Methods: Twenty-one trained male distance runners performed three sets (Pre, Mid, and Post) of six overground running trials at 4.5 mIsj1 (T5{\%}). Kinematic and kinetic data were collected during each trial using a 12-camera motion capture system, force platform,and head and leg accelerometers. Between tests, each runner ran on a treadmill for 20 min at their corresponding lactate threshold (LT) speed. Perceived exertion levels (RPE) were recorded at the third and last minute of each treadmill run. Results: RPE scores increased from 11.8 T 1.3 to 14.4 T 1.5 at the end of the first LT run and then further to 17.4 T 1.6 by the end of the second LT run. Peak rearfoot eversion, peak axial head acceleration, peak free moment and vertical force loading rates were shown to increase (P G 0.05) with moderate–large effect sizes during the progression from Pre to Post tests, although vertical impact peak and peak axial tibial acceleration were not significantly affected by the high-intensity running bouts. Conclusion: Previously identified risk factors for impact-related injuries (such as tibial stress fracture) are modified with fatigue. Because fatigue is associated with a reduced tolerance for impact, these findings lend support to the importance of those measures to identify individuals at risk of injury from lower limb impact loading during running.",
keywords = "High Intensity, Kinematics, Kinetics, Overuse Injury Potential, Runners",
author = "Clansey, {Adam C.} and Michael Hanlon and Wallace, {Eric S.} and Lake, {Mark J.}",
note = "Reference text: 1. Abt JP, Sell TC, Chu Y, Lovalekar M, Burdett RG, Lephart SM. Running kinematics and shock absorption do not change after brief exhaustive running. J Strength Cond Res. 2011;25(6):1479–85. 2. Begon M, Monnet T, Lacouture P. Effects of movement for estimating the hip joint centre. Gait Posture. 2007;25(3):353–9. 3. Bennell KL, Crossley K, Jayarajan J, et al. Ground reaction forces and bone parameters in females with tibial stress fracture. Med Sci Sports Exerc. 2004;36(3):397–404. 4. Bennell KL, Malcolm SA, Thomas SA, Wark JD, Brukner PD. The incidence and distribution of stress fractures in competitive track and field athletes: a twelve-month prospective study. Am J Sports Med. 1996;24(2):211–7. 5. Christina KA, White SC, Gilchrist LA. Effect of localized muscle fatigue on vertical ground reaction forces and ankle joint motion during running. Hum Mov Sci. 2001;20(3):257–76. 6. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, New Jersey: Lawrence Erlbaum; 1988. pp. 8–14. 7. Collins TD, Ghoussayni SN, Ewins DJ, Kent JA. A six degreesof- freedom marker set for gait analysis: repeatability and comparison with a modified Helen Hayes set. Gait Posture. 2009; 30(2):173–80. 8. Coventry E, O’Connor KM, Hart BA, Earl JE, Ebersole KT. The effect of lower extremity fatigue on shock attenuation during single-leg landing. Clin Biomech. 2006;21(10):1090–7. 9. Crossley K, Bennell KL, Wrigley T, Oakes BW. Ground reaction forces, bone characteristics, and tibial stress fracture in male runners. Med Sci Sports Exerc. 1999;31(8):1088–93. 10. Davis I, Bowser B, Mullineaux D. Do impacts cause running injuries? A prospective investigation. In: Conference proceedings of the 34th ASB. 2010. p. 248–9. 11. Davis I, Milner CE, Hamill J, Davis IS. Does increased loading during running lead to tibial stress fractures? A prospective study. Med Sci Sports Exerc. 2004;36(5):S58. 12. Dempster WT. Space requirements of the seated operator. WADC Tech Rep. 1955:55–159. 13. Denadai BS, Greco CC, Tufik S, De Mello MT. Effects of high intensity running to fatigue on isokinetic muscular strength in endurance athletes. Isokinet Exerc Sci. 2007;15(4):281–5. 14. Derrick TR. The effects of knee contact angle on impact forces and accelerations. Med Sci Sports Exerc. 2004;36(5):832–7. 15. Derrick TR, Dereu D, McLean SP. Impacts and kinematic adjustments during an exhaustive run. Med Sci Sports Exerc. 2002;34 (6):998–1002. 16. Dierks TA, Davis IS, Hamill J. The effects of running in an exerted state on lower extremity kinematics and joint timing. J Biomech. 2010;43(15):2993–8. 17. Dierks TA, Manal KT, Hamill J, Davis I. Lower extremity kinematics in runners with patellofemoral pain during a prolonged run. Med Sci Sports Exerc. 2011;43(4):693–700. 18. Farley CT, Gonza´lez O. Leg stiffness and stride frequency in human running. J Biomech. 1996;29(2):181–6. 19. Gerlach KE, White SC, Burton HW, Dorn JM, Leddy JJ, Horvath PJ. Kinetic changes with fatigue and relationship to injury in female runners. Med Sci Sports Exerc. 2005;37(4):657–63. 20. Gerritsen KGM, van den Bogert AJ, Nigg BM. Direct dynamics simulation of the impact phase in heel-toe running. J Biomech. 1995;28(6):661–8. 21. Grimston S, Engsberg J, Kloiber R, Hanley D. Bone mass, external loads, and stress fractures in female runners. Int J Sport Biomech. 1991;7:293–302. 22. Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. 1983;105:136–44. 23. Harrast MA, Colonno D. Stress fractures in runners. Clin Sports Med. 2010;29(3):399–416. 24. Holden JP, Cavanagh PR. The free moment of ground reaction in distance running and its changes with pronation. J Biomech. 1991; 24(10):887–97. 25. Hreljac A. Etiology, prevention, and early intervention of overuse injuries in runners: a biomechanical perspective. Phys Med Rehabil Clin N Am. 2005;16(3):651–67. 26. Hreljac A, Ferber R. A biomechanical perspective of predicting injury risk in running. Int Sportsmed J. 2006;7(2):98–108. 27. Johnson AW, Weiss CB, Wheeler DL. Stress fractures of the femoral shaft in athletes—more common than expected. A new clinical test. Am J Sports Med. 1994;22(2):248–56. 28. Keller T, Weisberger A, Ray J, Hasan S, Shiavi R, Spengler D. Relationship between vertical ground reaction force and speed during walking, slow jogging, and running. Clin Biomech. 1996; 11(5):253–9. 29. Komi PV. Stretch-shortening cycle: a powerful model to study normal and fatigued muscle. J Biomech. 2000;33(10):1197–206. 30. Lafortune MA, Lake MJ, Hennig EM. Transfer function between tibial acceleration and ground reaction force. J Biomech. 1995; 28(1):113–7. 31. Leetun D, Ireland M, Willson J, Ballantyne B, Davis I. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004;36(6):926–34. 32. Mercer J, Bates BT, Dufek J, Hreljac A. Characteristics of shock attenuation during fatigued running. J Sports Sci. 2003;21 (11):911–9. 33. Miller RH, Lowry JL, Meardon SA, Gillette JC. Lower extremity mechanics of iliotibial band syndrome during an exhaustive run. Gait Posture. 2007;26(3):407–13. 34. Milner CE, Ferber R, Pollard CD, Hamill J, Davis IS. Biomechanical factors associated with tibial stress fracture in female runners. Med Sci Sports Exerc. 2006;38(2):323–8. 35. Milner CE, Hamill J, Davis I. Are knee mechanics during early stance related to tibial stress fracture in runners? Clin Biomech. 2007;22(6):697–703. 36. Mizrahi J, Verbitsky O, Isakov E, Daily D. Effect of fatigue on leg kinematics and impact acceleration in long distance running. Hum Mov Sci. 2000;19(2):139–51. 37. Nicol C, Komi PV, Marconnet P. Fatigue effects of marathon running on neuromuscular performance. Scand J Med Sci Sports. 1991; 1(1):10–7. 38. Pohl MB, Mullineaux DR, Milner CE, Hamill J, Davis IS. Biomechanical predictors of retrospective tibial stress fractures in runners. J Biomech. 2008;41(6):1160–5. 39. Radin EL. Role of muscles in protecting athletes from injury. Acta Med Scand. 1986;220(S711):143–7. 40. Saldanha A, Nordlund Ekblom MM, Thorstensson A. Central fatigue affects plantar flexor strength after prolonged running. Scand J Med Sci Sports. 2008;18(3):383–8. 41. Skof B, Strojnik V. Neuromuscular fatigue and recovery dynamics following prolonged continuous run at anaerobic threshold. Br J Sports Med. 2006;40(3):219–22. 42. Steed J, Gaesser GA, Weltman A. Rating of perceived exertion and blood lactate concentration during submaximal running. Med Sci Sports Exerc. 1994;26(6):797–803. 43. Verbitsky O, Mizrahi J, Voloshin A, Treiger J, Isakov E. Shock transmission and fatigue in human running. J Appl Biomech. 1998;14:300–11. 44. Voloshin AS, Mizrahi J, Verbitsky O, Isakov E. Dynamic loading on the human musculoskeletal system—effect of fatigue. Clin Biomech. 1998;13(7):515–20. 45. Winter DA. Biomechanics and Motor Control of Human Movement. 4th ed. Hoboken, New Jersey: John Wiley and Sons Inc.; 2009. pp. 70–3. 46. Winter EM. Sport and Exercise Physiology Testing Guidelines: The British Association of Sport and Exercise Sciences Guide. London: Routledge; 2006. pp 112–20.",
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doi = "10.1249/MSS.0b013e318259480d",
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}

Effects of Fatigue on Running Mechanics Associated with Tibial Stress Fracture Risk. / Clansey, Adam C.; Hanlon, Michael; Wallace, Eric S.; Lake, Mark J.

In: Medicine & Science in Sports & Exercise, Vol. 44, No. 10, 10.2012, p. 1917-1923.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of Fatigue on Running Mechanics Associated with Tibial Stress Fracture Risk

AU - Clansey, Adam C.

AU - Hanlon, Michael

AU - Wallace, Eric S.

AU - Lake, Mark J.

N1 - Reference text: 1. Abt JP, Sell TC, Chu Y, Lovalekar M, Burdett RG, Lephart SM. Running kinematics and shock absorption do not change after brief exhaustive running. J Strength Cond Res. 2011;25(6):1479–85. 2. Begon M, Monnet T, Lacouture P. Effects of movement for estimating the hip joint centre. Gait Posture. 2007;25(3):353–9. 3. Bennell KL, Crossley K, Jayarajan J, et al. Ground reaction forces and bone parameters in females with tibial stress fracture. Med Sci Sports Exerc. 2004;36(3):397–404. 4. Bennell KL, Malcolm SA, Thomas SA, Wark JD, Brukner PD. The incidence and distribution of stress fractures in competitive track and field athletes: a twelve-month prospective study. Am J Sports Med. 1996;24(2):211–7. 5. Christina KA, White SC, Gilchrist LA. Effect of localized muscle fatigue on vertical ground reaction forces and ankle joint motion during running. Hum Mov Sci. 2001;20(3):257–76. 6. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, New Jersey: Lawrence Erlbaum; 1988. pp. 8–14. 7. Collins TD, Ghoussayni SN, Ewins DJ, Kent JA. A six degreesof- freedom marker set for gait analysis: repeatability and comparison with a modified Helen Hayes set. Gait Posture. 2009; 30(2):173–80. 8. Coventry E, O’Connor KM, Hart BA, Earl JE, Ebersole KT. The effect of lower extremity fatigue on shock attenuation during single-leg landing. Clin Biomech. 2006;21(10):1090–7. 9. Crossley K, Bennell KL, Wrigley T, Oakes BW. Ground reaction forces, bone characteristics, and tibial stress fracture in male runners. Med Sci Sports Exerc. 1999;31(8):1088–93. 10. Davis I, Bowser B, Mullineaux D. Do impacts cause running injuries? A prospective investigation. In: Conference proceedings of the 34th ASB. 2010. p. 248–9. 11. Davis I, Milner CE, Hamill J, Davis IS. Does increased loading during running lead to tibial stress fractures? A prospective study. Med Sci Sports Exerc. 2004;36(5):S58. 12. Dempster WT. Space requirements of the seated operator. WADC Tech Rep. 1955:55–159. 13. Denadai BS, Greco CC, Tufik S, De Mello MT. Effects of high intensity running to fatigue on isokinetic muscular strength in endurance athletes. Isokinet Exerc Sci. 2007;15(4):281–5. 14. Derrick TR. The effects of knee contact angle on impact forces and accelerations. Med Sci Sports Exerc. 2004;36(5):832–7. 15. Derrick TR, Dereu D, McLean SP. Impacts and kinematic adjustments during an exhaustive run. Med Sci Sports Exerc. 2002;34 (6):998–1002. 16. Dierks TA, Davis IS, Hamill J. The effects of running in an exerted state on lower extremity kinematics and joint timing. J Biomech. 2010;43(15):2993–8. 17. Dierks TA, Manal KT, Hamill J, Davis I. Lower extremity kinematics in runners with patellofemoral pain during a prolonged run. Med Sci Sports Exerc. 2011;43(4):693–700. 18. Farley CT, Gonza´lez O. Leg stiffness and stride frequency in human running. J Biomech. 1996;29(2):181–6. 19. Gerlach KE, White SC, Burton HW, Dorn JM, Leddy JJ, Horvath PJ. Kinetic changes with fatigue and relationship to injury in female runners. Med Sci Sports Exerc. 2005;37(4):657–63. 20. Gerritsen KGM, van den Bogert AJ, Nigg BM. Direct dynamics simulation of the impact phase in heel-toe running. J Biomech. 1995;28(6):661–8. 21. Grimston S, Engsberg J, Kloiber R, Hanley D. Bone mass, external loads, and stress fractures in female runners. Int J Sport Biomech. 1991;7:293–302. 22. Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. 1983;105:136–44. 23. Harrast MA, Colonno D. Stress fractures in runners. Clin Sports Med. 2010;29(3):399–416. 24. Holden JP, Cavanagh PR. The free moment of ground reaction in distance running and its changes with pronation. J Biomech. 1991; 24(10):887–97. 25. Hreljac A. Etiology, prevention, and early intervention of overuse injuries in runners: a biomechanical perspective. Phys Med Rehabil Clin N Am. 2005;16(3):651–67. 26. Hreljac A, Ferber R. A biomechanical perspective of predicting injury risk in running. Int Sportsmed J. 2006;7(2):98–108. 27. Johnson AW, Weiss CB, Wheeler DL. Stress fractures of the femoral shaft in athletes—more common than expected. A new clinical test. Am J Sports Med. 1994;22(2):248–56. 28. Keller T, Weisberger A, Ray J, Hasan S, Shiavi R, Spengler D. Relationship between vertical ground reaction force and speed during walking, slow jogging, and running. Clin Biomech. 1996; 11(5):253–9. 29. Komi PV. Stretch-shortening cycle: a powerful model to study normal and fatigued muscle. J Biomech. 2000;33(10):1197–206. 30. Lafortune MA, Lake MJ, Hennig EM. Transfer function between tibial acceleration and ground reaction force. J Biomech. 1995; 28(1):113–7. 31. Leetun D, Ireland M, Willson J, Ballantyne B, Davis I. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004;36(6):926–34. 32. Mercer J, Bates BT, Dufek J, Hreljac A. Characteristics of shock attenuation during fatigued running. J Sports Sci. 2003;21 (11):911–9. 33. Miller RH, Lowry JL, Meardon SA, Gillette JC. Lower extremity mechanics of iliotibial band syndrome during an exhaustive run. Gait Posture. 2007;26(3):407–13. 34. Milner CE, Ferber R, Pollard CD, Hamill J, Davis IS. Biomechanical factors associated with tibial stress fracture in female runners. Med Sci Sports Exerc. 2006;38(2):323–8. 35. Milner CE, Hamill J, Davis I. Are knee mechanics during early stance related to tibial stress fracture in runners? Clin Biomech. 2007;22(6):697–703. 36. Mizrahi J, Verbitsky O, Isakov E, Daily D. Effect of fatigue on leg kinematics and impact acceleration in long distance running. Hum Mov Sci. 2000;19(2):139–51. 37. Nicol C, Komi PV, Marconnet P. Fatigue effects of marathon running on neuromuscular performance. Scand J Med Sci Sports. 1991; 1(1):10–7. 38. Pohl MB, Mullineaux DR, Milner CE, Hamill J, Davis IS. Biomechanical predictors of retrospective tibial stress fractures in runners. J Biomech. 2008;41(6):1160–5. 39. Radin EL. Role of muscles in protecting athletes from injury. Acta Med Scand. 1986;220(S711):143–7. 40. Saldanha A, Nordlund Ekblom MM, Thorstensson A. Central fatigue affects plantar flexor strength after prolonged running. Scand J Med Sci Sports. 2008;18(3):383–8. 41. Skof B, Strojnik V. Neuromuscular fatigue and recovery dynamics following prolonged continuous run at anaerobic threshold. Br J Sports Med. 2006;40(3):219–22. 42. Steed J, Gaesser GA, Weltman A. Rating of perceived exertion and blood lactate concentration during submaximal running. Med Sci Sports Exerc. 1994;26(6):797–803. 43. Verbitsky O, Mizrahi J, Voloshin A, Treiger J, Isakov E. Shock transmission and fatigue in human running. J Appl Biomech. 1998;14:300–11. 44. Voloshin AS, Mizrahi J, Verbitsky O, Isakov E. Dynamic loading on the human musculoskeletal system—effect of fatigue. Clin Biomech. 1998;13(7):515–20. 45. Winter DA. Biomechanics and Motor Control of Human Movement. 4th ed. Hoboken, New Jersey: John Wiley and Sons Inc.; 2009. pp. 70–3. 46. Winter EM. Sport and Exercise Physiology Testing Guidelines: The British Association of Sport and Exercise Sciences Guide. London: Routledge; 2006. pp 112–20.

PY - 2012/10

Y1 - 2012/10

N2 - Purpose: The purpose of this study was to investigate the acute effects of progressive fatigue on the parameters of runningmechanics previously associated with tibial stress fracture risk.Methods: Twenty-one trained male distance runners performed three sets (Pre, Mid, and Post) of six overground running trials at 4.5 mIsj1 (T5%). Kinematic and kinetic data were collected during each trial using a 12-camera motion capture system, force platform,and head and leg accelerometers. Between tests, each runner ran on a treadmill for 20 min at their corresponding lactate threshold (LT) speed. Perceived exertion levels (RPE) were recorded at the third and last minute of each treadmill run. Results: RPE scores increased from 11.8 T 1.3 to 14.4 T 1.5 at the end of the first LT run and then further to 17.4 T 1.6 by the end of the second LT run. Peak rearfoot eversion, peak axial head acceleration, peak free moment and vertical force loading rates were shown to increase (P G 0.05) with moderate–large effect sizes during the progression from Pre to Post tests, although vertical impact peak and peak axial tibial acceleration were not significantly affected by the high-intensity running bouts. Conclusion: Previously identified risk factors for impact-related injuries (such as tibial stress fracture) are modified with fatigue. Because fatigue is associated with a reduced tolerance for impact, these findings lend support to the importance of those measures to identify individuals at risk of injury from lower limb impact loading during running.

AB - Purpose: The purpose of this study was to investigate the acute effects of progressive fatigue on the parameters of runningmechanics previously associated with tibial stress fracture risk.Methods: Twenty-one trained male distance runners performed three sets (Pre, Mid, and Post) of six overground running trials at 4.5 mIsj1 (T5%). Kinematic and kinetic data were collected during each trial using a 12-camera motion capture system, force platform,and head and leg accelerometers. Between tests, each runner ran on a treadmill for 20 min at their corresponding lactate threshold (LT) speed. Perceived exertion levels (RPE) were recorded at the third and last minute of each treadmill run. Results: RPE scores increased from 11.8 T 1.3 to 14.4 T 1.5 at the end of the first LT run and then further to 17.4 T 1.6 by the end of the second LT run. Peak rearfoot eversion, peak axial head acceleration, peak free moment and vertical force loading rates were shown to increase (P G 0.05) with moderate–large effect sizes during the progression from Pre to Post tests, although vertical impact peak and peak axial tibial acceleration were not significantly affected by the high-intensity running bouts. Conclusion: Previously identified risk factors for impact-related injuries (such as tibial stress fracture) are modified with fatigue. Because fatigue is associated with a reduced tolerance for impact, these findings lend support to the importance of those measures to identify individuals at risk of injury from lower limb impact loading during running.

KW - High Intensity

KW - Kinematics

KW - Kinetics

KW - Overuse Injury Potential

KW - Runners

U2 - 10.1249/MSS.0b013e318259480d

DO - 10.1249/MSS.0b013e318259480d

M3 - Article

VL - 44

SP - 1917

EP - 1923

JO - Medicine and Science in Sports and Exercise

T2 - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

SN - 0195-9131

IS - 10

ER -