Skeletal Lower Extremity Motions During Running

The purpose of this study was to quantify the effects of (i) medial foot orthoses and (ii) shoe sole modifications (lateral heel flares) on skeletal movements during the stance phase of running, to compare (iii) barefoot versus shod running, and to describe (iv) the movement coupling between selected segments of the lower extremity. Marker triads were attached to intracortical bone pins inserted under standard local anesthesia into the calcaneus, tibia and femur of five subjects. The subjects ran barefoot, with a normal shoe, with three shoe soles and with two orthotic modifications. The trials were recorded during the stance phase of running using three high speed cine cameras operating at 200Hz. Tibiocalcaneal and tibiofemoral movements were calculated using three-dimensional marker reconstruction and a joint coordinate system approach.

Medially placed foot orthoses did not substantially change tibiocalcaneal movement patterns during running. Differences between subjects were significantly larger (up to 10°) than between orthotic conditions (1° to 4°; p<.01). Significant orthotic effects across subjects were found only for total internal tibial rotation (p<.05). Lateral heel flare effects on tibiocalaneal movements were small and unsystematic. Total shoe eversion and shoe eversion velocity were found to be approximately twice as large as the respective bone eversion. Tibiocalcaneal movements were similar in barefoot running compared to running with shoes. Only one specific shoe modification (posterior orthosis) showed significant (p<.01) differences to barefoot running, all other test variable comparisons were not significant. Movement coupling was observed between various segments at the lower extremity (shoe-calcaneus, calcaneus-tibia, and tibia-femur) and was found to be subject and shoe dependent. Generally, movement coupling varied in distinct phases between heel strike and take-off. It was suggested that the input to calcaneus-tibia coupling was from distal to proximal, and that to tibia-femur coupling (at least partially) from proximal to distal.

A number of possible factors were identified that may have influenced the results, including the test shoes used, the shoe sole construction, and the application of local anesthesia and its possible influence on proprioceptive feedback.

The results of this in-vivo study suggest that (a) orthotic effects and effects of shoe sole modifications on skeletal movement patterns are small and subject specific and that these effects may be mechanical as well as proprioceptive, (b) calcaneal and tibial movement patterns may not be changed substantially when using shoes compared to running barefoot, but differences may occur when extreme shoe modifications are used (c) movement coupling varies between heel-strike and take-off and takes place in phases between various segments of the lower extremity during the stance phase of running.

Year	Entry
1996	Stergiou P. Biomechanical Factors Associated With Patellofemoral Pain Syndrome in Runners [Master's thesis]. Calgary, AB: University of Calgary; January 1996.
1990	Areblad M, Nigg BM, Ekstrand J, Olsson KO, Ekström H. Three-dimensional measurement of rearfoot motion during running. J Biomech. 1990;23(9):933-940.
1983	Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.
1990	McClay IS. A Comparison of Tibiofemoral and Patellofemoral Joint Motion in Runners With and Without Patellofemoral Pain [PhD thesis]. State College, PA: Pennsylvania State University; December 1990.
1997	McClay I, Manal K. Coupling parameters in runners with normal and excessive pronation. J Appl Biomech. May 1997;13(1):109-124.
1993	Nigg BM, Cole GK, Nachbauer W. Effects of arch height of the foot on angular motion of the lower extremities in running. J Biomech. August 1993;26(8):909-916.
1941	Manter JT. Movements of the subtalar and transverse tarsal joints. Anat Rec. August 1941;80(4):397-410.
1982	Procter P, Paul P J. Ankle joint biomechanics. J Biomech. 1982;15(9):627-634.
1997	Cavanagh PR, Morag E, Boulton AJM, Young MJ, Deffner KT, Pammer SE. The relationship of static foot structure to dynamic foot function. J Biomech. March 1997;30(3):243-250.
1986	Nigg BM, Bahlsen AH, Denoth J, Luethi SM, Stacoff A. Factors influencing kinetic and kinematic variables in running. In: Nigg BM, ed. Biomechanics of Running Shoes. Champaign, IL: Inc., Human Kinetics Publishers; 1986:139-159.
1964	Wright DG, Desai SM, Henderson WH. Action of the subtalar and ankle-joint complex during the stance phase of walking. J Bone Joint Surg. March 1964;46A(2):361-382.
1995	Wu G, Cavanagh PR. ISB recommendations for standardization in the reporting of kinematic data. J Biomech. 1995;28(10):1257-1261.
1948	Levens AS, Inman VT, Blosser JA. Transverse rotation of the segments of the lower extremity in locomotion. J Bone Joint Surg. October 1948;30A(4):859-872.
1986	Denoth J. Load on the locomotor system and modeling. In: Nigg BM, ed. Biomechanics of Running Shoes. Champaign, IL: Inc., Human Kinetics Publishers; 1986:63-116.
1978	James SL, Bates BT, Osternig LR. Injuries to runners. Am J Sports Med. 1978;6(2):40-50.
1990	Winter DA. Biomechanics and Motor Control of Human Movement. 2nd ed. New York, NY: Inc., John Wiley & Sons; 1990.
1988	Bahlsen A. The Etiology of Running Industries: A Longitudinal, Prospective Study [PhD thesis]. Calgary, AB: University of Calgary; December 1988.
1987	Nigg BM, Bahlsen HA, Luethi SM, Stokes S. The influence of running velocity and midsole hardness on external impact forces in heel-toe running. J Biomech. 1987;20(10):951-959.
1994	van den Bogert AJ, Smith GD, Nigg BM. In vivo determination of the anatomical axes of the ankle joint complex: an optimization approach. J Biomech. December 1994;27(12):1477-1488.
1993	Cole GK, Nigg BM, Ronsky JL, Yeadon MR. Application of the joint coordinate system to three-dimensional joint attitude and movement representation: a standardization proposal. J Biomech Eng. November 1993;115(4A):344-349.
1988	Siegler S, Chen J, Schneck CD. The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joints, I: kinematics. J Biomech Eng. November 1988;110(4):364-373.
1976	Inman VT. The Joints of the Ankle. Baltimore, MD: Williams & Wilkins; 1976.
1997	Reinschmidt C, van den Bogert A, Nigg B, Lundberg A, Murphy N. Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech. July 1997;30(7):729-732.
1992	Lafortune MA, Cavanagh PR, Sommer HJ III, Kalenak A. Three-dimensional kinematics of the human knee during walking. J Biomech. April 1992;25(4):347-357.
1996	Cappozzo A, Catani F, Leardini A, Benedetti M, Della Croce U. Position and orientation in space of bones during movement: experimental artefacts. Clin Biomech (Bristol, Avon). March 1996;11(2):90-100.
1980	Cavanagh PR. The Running Shoe Book. Mountain View, CA: Anderson World; 1980.
1993	Söderkvist I, Wedin P-Å. Determining the movements of the skeleton using well-configured markers. J Biomech. December 1993;26(12):1473-1477.
1981	Clement DB, Taunton JE, Smart GW, McNicol KL. A survey of overuse running injuries. Phys Sportsmed. May 1981;9(5):47-58.
1995	Cappozzo A, Catani F, Della Croce U, Leardini A. Position and orientation in space of bones during movement: anatomical frame definition and determination. Clin Biomech (Bristol, Avon). June 1995;10(4):171-178.
1910	Fick R. Handbuch Der Anatomie Und Mechanik Der Gelenke: Unter Berücksichtigung Der Bewegenden Muskeln. Jena: Verlag von Gustav Fischer; 1910.
1996	Reinschmidt C. Three-Dimensional Tibiocalcaneal and Tibiofemoral Kinematics During Human Locomotion: Measured With External and Bone Markers [PhD thesis]. Calgary, AB: University of Calgary; 1996.
1997	Reinschmidt C, van den Bogert AJ, Murphy N, Lundberg A, Nigg BM. Tibiocalcaneal motion during running, measured with external and bone markers. Clin Biomech (Bristol, Avon). January 1997;12(1):8-16.
1987	Nigg BM, Morlock M. The influence of lateral heel flare of running shoes on pronation and impact forces. Med Sci Sports Exer. June 1987;19(3):294-302.
1989	Lundberg A. Kinematics of the ankle and foot: in vivo roentgen stereophotogrammetry. Acta Orthop Scand. 1989;60(suppl 223):1-26.
1983	Winter DA. Moments of force and mechanical power in jogging. J Biomech. 1983;16(1):91-97.
1953	Hicks JH. The mechanics of the foot, I: the joints. J Anat. 1953;87(pt 4):345-357.

Year

Entry

1996

Stergiou P. Biomechanical Factors Associated With Patellofemoral Pain Syndrome in Runners [Master's thesis]. Calgary, AB: University of Calgary; January 1996.

1990

Areblad M, Nigg BM, Ekstrand J, Olsson KO, Ekström H. Three-dimensional measurement of rearfoot motion during running. J Biomech. 1990;23(9):933-940.

1983

Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.

1990

McClay IS. A Comparison of Tibiofemoral and Patellofemoral Joint Motion in Runners With and Without Patellofemoral Pain [PhD thesis]. State College, PA: Pennsylvania State University; December 1990.

1997

McClay I, Manal K. Coupling parameters in runners with normal and excessive pronation. J Appl Biomech. May 1997;13(1):109-124.

1993

Nigg BM, Cole GK, Nachbauer W. Effects of arch height of the foot on angular motion of the lower extremities in running. J Biomech. August 1993;26(8):909-916.

1941

Manter JT. Movements of the subtalar and transverse tarsal joints. Anat Rec. August 1941;80(4):397-410.

1982

Procter P, Paul P J. Ankle joint biomechanics. J Biomech. 1982;15(9):627-634.

1997

Cavanagh PR, Morag E, Boulton AJM, Young MJ, Deffner KT, Pammer SE. The relationship of static foot structure to dynamic foot function. J Biomech. March 1997;30(3):243-250.

1986

Nigg BM, Bahlsen AH, Denoth J, Luethi SM, Stacoff A. Factors influencing kinetic and kinematic variables in running. In: Nigg BM, ed. Biomechanics of Running Shoes. Champaign, IL: Inc., Human Kinetics Publishers; 1986:139-159.

1964

Wright DG, Desai SM, Henderson WH. Action of the subtalar and ankle-joint complex during the stance phase of walking. J Bone Joint Surg. March 1964;46A(2):361-382.

1995

Wu G, Cavanagh PR. ISB recommendations for standardization in the reporting of kinematic data. J Biomech. 1995;28(10):1257-1261.

1948

Levens AS, Inman VT, Blosser JA. Transverse rotation of the segments of the lower extremity in locomotion. J Bone Joint Surg. October 1948;30A(4):859-872.

1986

Denoth J. Load on the locomotor system and modeling. In: Nigg BM, ed. Biomechanics of Running Shoes. Champaign, IL: Inc., Human Kinetics Publishers; 1986:63-116.

1978

James SL, Bates BT, Osternig LR. Injuries to runners. Am J Sports Med. 1978;6(2):40-50.

1990

Winter DA. Biomechanics and Motor Control of Human Movement. 2nd ed. New York, NY: Inc., John Wiley & Sons; 1990.

1988

Bahlsen A. The Etiology of Running Industries: A Longitudinal, Prospective Study [PhD thesis]. Calgary, AB: University of Calgary; December 1988.

1987

Nigg BM, Bahlsen HA, Luethi SM, Stokes S. The influence of running velocity and midsole hardness on external impact forces in heel-toe running. J Biomech. 1987;20(10):951-959.

1994

van den Bogert AJ, Smith GD, Nigg BM. In vivo determination of the anatomical axes of the ankle joint complex: an optimization approach. J Biomech. December 1994;27(12):1477-1488.

1993

Cole GK, Nigg BM, Ronsky JL, Yeadon MR. Application of the joint coordinate system to three-dimensional joint attitude and movement representation: a standardization proposal. J Biomech Eng. November 1993;115(4A):344-349.

1988

Siegler S, Chen J, Schneck CD. The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joints, I: kinematics. J Biomech Eng. November 1988;110(4):364-373.

1976

Inman VT. The Joints of the Ankle. Baltimore, MD: Williams & Wilkins; 1976.

1997

Reinschmidt C, van den Bogert A, Nigg B, Lundberg A, Murphy N. Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech. July 1997;30(7):729-732.

1992

Lafortune MA, Cavanagh PR, Sommer HJ III, Kalenak A. Three-dimensional kinematics of the human knee during walking. J Biomech. April 1992;25(4):347-357.

1996

Cappozzo A, Catani F, Leardini A, Benedetti M, Della Croce U. Position and orientation in space of bones during movement: experimental artefacts. Clin Biomech (Bristol, Avon). March 1996;11(2):90-100.

1980

Cavanagh PR. The Running Shoe Book. Mountain View, CA: Anderson World; 1980.

1993

Söderkvist I, Wedin P-Å. Determining the movements of the skeleton using well-configured markers. J Biomech. December 1993;26(12):1473-1477.

1981

Clement DB, Taunton JE, Smart GW, McNicol KL. A survey of overuse running injuries. Phys Sportsmed. May 1981;9(5):47-58.

1995

Cappozzo A, Catani F, Della Croce U, Leardini A. Position and orientation in space of bones during movement: anatomical frame definition and determination. Clin Biomech (Bristol, Avon). June 1995;10(4):171-178.

1910

Fick R. Handbuch Der Anatomie Und Mechanik Der Gelenke: Unter Berücksichtigung Der Bewegenden Muskeln. Jena: Verlag von Gustav Fischer; 1910.

1996

Reinschmidt C. Three-Dimensional Tibiocalcaneal and Tibiofemoral Kinematics During Human Locomotion: Measured With External and Bone Markers [PhD thesis]. Calgary, AB: University of Calgary; 1996.

1997

Reinschmidt C, van den Bogert AJ, Murphy N, Lundberg A, Nigg BM. Tibiocalcaneal motion during running, measured with external and bone markers. Clin Biomech (Bristol, Avon). January 1997;12(1):8-16.

1987

Nigg BM, Morlock M. The influence of lateral heel flare of running shoes on pronation and impact forces. Med Sci Sports Exer. June 1987;19(3):294-302.

1989

Lundberg A. Kinematics of the ankle and foot: in vivo roentgen stereophotogrammetry. Acta Orthop Scand. 1989;60(suppl 223):1-26.

1983

Winter DA. Moments of force and mechanical power in jogging. J Biomech. 1983;16(1):91-97.

1953

Hicks JH. The mechanics of the foot, I: the joints. J Anat. 1953;87(pt 4):345-357.

Year	Entry
2000	Stacoff A, Nigg BM, Reinschmidt C, van den Bogert AJ, Lundberg A. Tibiocalcaneal kinematics of barefoot versus shod running. J Biomech. 2000;33(11):1387-1395.
1999	Nigg BM, Nurse MA, Stefanyshyn DJ. Shoe inserts and orthotics for sport and physical activities. Med Sci Sports Exer. July 1999;31(suppl 7):S421-S428.

Year

Entry

2000

Stacoff A, Nigg BM, Reinschmidt C, van den Bogert AJ, Lundberg A. Tibiocalcaneal kinematics of barefoot versus shod running. J Biomech. 2000;33(11):1387-1395.

1999

Nigg BM, Nurse MA, Stefanyshyn DJ. Shoe inserts and orthotics for sport and physical activities. Med Sci Sports Exer. July 1999;31(suppl 7):S421-S428.