Running Medicine: A Clinician's Overview



Published Jan 30, 2016
Nicholas Shannon


Background: Running is a popular activity which is associated with unchanged injury levels since the development of the modern running shoe in the 1970s. Method: This paper provides an evidence based overview of the more common running injuries encountered in practice, the mechanical and technique deficiencies associated with running injuries and describes the different types of foot striking patterns. Conclusion: It is important for primary care physicians to be aware of the injuries a runner presents with, why these injuries occur and the role foot striking plays in the injury process.
Abstract 209 | Running Medicine Downloads 162



Running, Clinical Practice, Injury

1. van der Worp, Maarten P, ten haaf, Dominic SM, et al. Injuries in runners: A systematic review on risk factors and sex differences. Sports Med 2015; 45(7):1017-26.
2. Fields Karl B. Running injuries: changing trends and demographics. Current Sports Med Rep 2011; 299-303.
3. Running USA. Running USA’s Annual Marathon Report [Internet]. 2011. Accessed Aug 2015. Available from:
4. van Gent RN, Siem D, van Middelkoop M, et al. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med 2007;41:469Y80.
5. Richards CE, Magin PJ, Callister R. Is your prescription of distance running shoes evidence-based? Br J Sports Med 2009;43(3):159–62.
6. van Mechelen W. Running injuries. A review of the epidemiological literature. Sports Med 1992;14(5):320–35.
7. Epperly T, Fields KB. Running epidemiology. In: Wilder, RP and O’Connor, FG editors. Textbook of Running Medicine. New York: McGraw Hill. 2001:3-9.
8. Boven AMP, Janssen GME, Vermeer HGW, et al. Occurrence of running injuries in adults following a supervised training program. Int J. Sports Med 1989;10 (Suppl. 3):S186Y90.
9. Bramble DM, Lieberman DE. Endurance running and the evolution of Homo. Nature 2004; 432:345Y52.
10. Milner CE, Ferber R, Pollard CD, Hamill J, Davis IS. Biomechanical factors associated with tibial stress fracture in female runners. Med Sci Sports Exercise 2006;38(2):323–8.
11. Zadpoor AA, Nikooyan AA. The relationship between lower extremity stress fractures and the ground reaction force: a systematic review. Clinical Biomechanics 2011;26(1):23–8.
12. Walther M, Reuter I, et al. Verletzungers und uberlastungsreaktionen im laufsport. Othopade 2005;34:3999.
13. Taunton JE, Ryan MB, Clement DB, et al. A prospective study of running injuries: the Vancouver Sun Run “In Training” clinics. Br J Sports Med 2003;37:239–44.
14. Hoeberigs JH. Factors related to the incidence of running injuries. A review. Sports Med 1992;13:408–422.
15. Macera CA. Lower extremity injuries in runners. advances in prediction. Sports Med 1992; 13:50–57.
16. Noehren B, Hamill J, Davis I. Prospective evidence for a hip etiology in patellofemoral pain. Med Sci Sport Exercise 2013;45(6):1120-1124.
17. Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys Ther 2009;39(1):12-19.
18. Ryan MB, MacLean CL, Taunton JE. A review of anthropometric, biomechanical, neuromuscular and training related factors associated with injury in runners. Int J Sports Med 2006;7:120–37.
19. Taunton JE, Ryan MB, Clement DB, McKenzie D.C., Lloyd-Smith D.R., and Zumbo B.D.: A retrospective case-control analysis of 2002 running injuries. Br J Sports Med 2002;36:95-101.
20. Escullier JF, Roy JS, Bouyer LJ. Lower limb control and strength in runners with and without patellofemoral pain syndrome. Gait Posture 2015;(41)3: 813-819.
21. Napier C, Cochran CK, et al. Gait modification to change lower extremity gait biomechanics in runners: a systematic review. Br J Sports Med 2015;(0):1-8.
22. Ross JA. Examination of the foot and ankle and when to return to play. American College of Sports Medicine, Annual General Meeting, San Diego, May15-17, 2015
23. Davis I. Reducing injury risk with soft, well aligned landings. American College of Sports Medicine, Annual General Meeting, San Diego, May15-17, 2015.
24. Franz JR, Pavlo KW, et al. Changes in the coordination of hip and pelvis kinematics with mode of locomotion. Gait Posture 2009;29(3):494-9.
25. Kumar D, McDermott K, et al. Effects of form focused training on running biomechanics: a pilot randomised trial in untrained individuals, Phys Med Rehabil 2015 (epub ahead of print).
26. Kulmala JP, Avela J, et al. Forefoot strikers exhibit lower running induced knee loading than rearfoot strikers. Med Sci Sport Exercise 2013;2306-2313.
27. Heiderscheit B. Another step to improve running injury management. American College of Sports Medicine, Annual General Meeting, San Diego, May15-17, 2015
28. Altman A and Davis IS. Barefoot running: biomechanics and implications for running injuries. 2012. Current Sports Med Rep; 244-250.
29. Bowser BJ, Davis IS. A prospective study of loading variables in female runners who develop plantar fasciitis. In: Proceedings of the American Society of Biomechanics, Providence (RI), 2010.
30. Pohl MB, Hamill J, Davis IS. Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners. Clin J Sport Med 2009;9:372Y6.
31. Kirby RL, McDermott AG. Anterior tibial compartment pressures during running with rearfoot and forefoot landing styles. Archives Phys Med Rehabil 1983;64:296Y9.
32. Arendse RE, Noakes TD, Azevedo LB, Romanov N, Schwellnus MP, Fletcher G. Reduced eccentric loading of the knee with the pose running method. Med Sci Sports Exercise 2004; 36(2):272–7.
33. Perl DP, Daoud AI, Lieberman DE. Effects of footwear and strike type on running economy. Med Sci Sports Exercise 2012; 44(7):1335–43.
34. Williams D, McClay I, Manal K. Lower extremity mechanics in runners with a converted forefoot strike pattern. J Applied Biomechanics 2000; 16:210–8.