Comparison of lower limb biomechanical responses to running-induced fatigue between rearfoot and non-rearfoot strike male amateur marathon runners

Xu, Yufan; Zhu, Chengyuan; Fang, Yufei; Sun, Dong; Lin, Junxia; Wu, Dijian; Song, Yang; Janićijević, Danica; Cen, Xuanzhen; Gu, Yaodong

doi:10.37190/abb/210577

Abstract

Purpose: The purpose of this study was to investigate the effects of foot strike patterns and running-induced fatigue on the biomechanical responses of the knee and ankle joints in amateur marathon runners by analyzing the combined effects of these two factors on lower limb joint kinematics, kinetics, and muscle activation characteristics under different conditions.

Methods: A total of 26 participants were recruited.13 male amateur marathon runners with habitual non-rearfoot strike and 13 with rearfoot strike patterns underwent mild, moderate and severe running-induced fatigue interventions. Kinematic, ground reaction force and electromyographic data were collected. A two-way analysis of variance was performed in SPSS for statistical analysis.

Results: Fatigue level significantly affected knee joint range of motion ( p = 0.023), peak joint moment ( p = 0.003), and joint stiffness ( p = 0.040). The non-rearfoot strike runners exhibited significantly greater ankle joint range of motion ( p < 0.001) and lower peak joint moments ( p < 0.001) compared to rearfoot strike runners. A significant interaction effect between fatigue and foot strike pattern was observed on the Root Mean Square amplitude of the medial gastrocnemius ( p = 0.017) and biceps femoris ( p = 0.021).

Conclusions: A significant interaction effect between fatigue and foot strike patterns was observed in Root Mean Square. Given the impact of localized muscle fatigue on joint kinematics and kinetics, the nonrearfoot strike runners may demonstrate intense fatigue-related biomechanical alterations to the knee and ankle joints during the latter stages of long-distance running. These results suggest that understanding foot strike biomechanics under fatigue may inform training and injury prevention.

References

Anderson L.M., Bonanno D.R., Hart H.F., Barton C.J., What are the Benefits and Risks Associated with Changing Foot Strike Pattern During Running? A Systematic Review and Meta-analysis of Injury, Running Economy, and Biomechanics, Sports Med., 2020, 50 (5), 885–917, DOI: 10.1007/s40279-019-01238-y.
Search in Google Scholar Back to article
Bates N.A., Hewett T.E., Motion Analysis and the Anterior Cruciate Ligament: Classification of Injury Risk, J. Knee Surg., 2016, 29 (2), 117–125, DOI: 10.1055/s-0035-1558855.
Search in Google Scholar Back to article
Borg G., Ratings of Perceived Exertion and Heart Rates During Short-Term Cycle Exercise and Their Use in a New Cycling Strength Test, Int. J. Sports Med., 1982, 3 (3), 153–158, DOI: 10.1055/s-2008-1026080.
Search in Google Scholar Back to article
Cen X., Song Y., Sun D., Bíró I., Gu Y., Applications of finite element modeling in biomechanical analysis of foot arch deformation: A scoping review, J. Biomech. Eng., 2023, 145, 070801, DOI: 10.1115/1.4062311.
Search in Google Scholar Back to article
Cen X., Song Y., Yu P., Sun D., Simon J., Bíró I., Gu Y., Effects of plantar fascia stiffness on the internal mechanics of idiopathic pes cavus by finite element analysis: Implications for metatarsalgia, Comput. Methods Biomech. Biomed. Eng., 2024, 27, 1961–1969, DOI: 10.1080/10255842.2023.2268231.
Search in Google Scholar Back to article
Chang H., Cen X., Can running technique modification benefit patellofemoral pain improvement in runners? A systematic review and meta-analysis, Int. J. Biomed. Eng. Tec., 2024, 45, 83–101, DOI: https://doi.org/10.1504/IJBET.2024.138706.
Search in Google Scholar Back to article
Challis R.E., Kitney R.I., Biomedical Signal Processing (in Four Parts). Part 1. Time-Domain Methods, Med. Biol. Eng. Comput., 1990, 28 (6), 509–524, DOI: 10.1007/BF02442601.
Search in Google Scholar Back to article
Chen T.L.-W., Wong D.W.-C., Wang Y., Lin J., Zhang M., Foot Arch Deformation and Plantar Fascia Loading during Running with Rearfoot Strike and Forefoot Strike: A Dynamic Finite Element Analysis, J. Biomech., 2019, 83, 260–272, DOI: 10.1016/j.jbiomech.2018.12.007.
Search in Google Scholar Back to article
Chen T.L.-W., Wong D.W.-C., Wang Y., Tan Q., Lam W.-K., Zhang M., Changes in Segment Coordination Variability and the Impacts of the Lower Limb across Running Mileages in Half Marathons: Implications for Running Injuries, J. Sport Health. Sci., 2022, 11 (1), 67–74, DOI: 10.1016/j.jshs.2020.09.006.
Search in Google Scholar Back to article
Clansey A.C., Lake M.J., Wallace E.S., Feehally T., Hanlon M., Can Trained Runners Effectively Attenuate Impact Acceleration During Repeated High-Intensity Running Bouts?, J. Appl. Biomech., 2016, 32 (3), 261–268, DOI: 10.1123/jab.2015-0125.
Search in Google Scholar Back to article
Darch L., Chalmers S., Causby R., Arnold J., Effect of Running-Induced Fatigue on Tibial Acceleration and the Role of Lower Limb Muscle Strength, Power and Endurance, Med. Sci. Sports Exerc., 2023, 55 (3), 581–589, DOI: 10.1249/MSS.0000000000003062.
Search in Google Scholar Back to article
Davies C.T.M., Thompson M.W., Aerobic Performance of Female Marathon and Male Ultramarathon Athletes, Eur. J. Appl. Physiol. Occup. Physiol., 1979, 41 (4), 233–245, DOI: 10.1007/BF00429740.
Search in Google Scholar Back to article
Enoka R.M., Duchateau J., Translating Fatigue to Human Performance, Med. Sci. Sports Exerc., 2016, 48 (11), 2228–2238, DOI: 10.1249/MSS.0000000000000929.
Search in Google Scholar Back to article
Gao S., Song Y., Sun D., Cen X., Wang M., Lu Z., Gu Y., Impact of Becker muscular dystrophy on gait patterns: Insights from biomechanical analysis, Gait Posture, 2025, 121, 160–165, DOI: https://doi.org/10.1016/j.gaitpost.2025.05.008.
Search in Google Scholar Back to article
Günther M., Blickhan R., Joint Stiffness of the Ankle and the Knee in Running, J, Biomech,, 2002, 35 (11, :1459–1474, DOI: 10.1016/S0021-9290(02)00183-5.
Search in Google Scholar Back to article
Hajiloo B., Anbarian M., Esmaeili H., Mirzapour M., The Effects of Fatigue on Synergy of Selected Lower Limb Muscles during Running, J. Biomech., 2020, 103, 109692, DOI: 10.1016/j.jbiomech.2020.109692.
Search in Google Scholar Back to article
Hiemstra L.A., Lo I.K., Fowler P.J., Effect of Fatigue on Knee Proprioception: Implications for Dynamic Stabilization, J. Orthop. Sports Phys. Ther., 2001, 31 (10), 598–605, DOI: 10.2519/jospt.2001.31.10.598.
Search in Google Scholar Back to article
Jiang X., Sárosi J., Bíró I., Characteristics of lower limb running-related injuries in trail runners: a systematic review, Physical Activity and Health, 2024, 8, 137–147, DOI: 10.5334paah.375.
Search in Google Scholar Back to article
Jewell C., Hamill J., von Tscharner V., Boyer K.A., Altered Multi-Muscle Coordination Patterns in Habitual Forefoot Runners during a Prolonged, Exhaustive Run, Eur. J. Sport Sci., 2019, 19 (8), 1062–1071, DOI: 10.1080/17461391.2019.1575912.
Search in Google Scholar Back to article
Johannsen H.V., Lind T., Jakobsen B.W., Krøner K., Exercise-Induced Knee Joint Laxity in Distance Runners, Br. J. Sports Med., 1989, 23 (3), 165–168, DOI: 10.1136/bjsm.23.3.165.
Search in Google Scholar Back to article
Kakouris N., Yener N., Fong D.T.P., A Systematic Review of Running-Related Musculoskeletal Injuries in Runners, J. Sport Health Sci., 2021, 10 (5), 513–522, DOI: 10.1016/j.jshs.2021.04.001.
Search in Google Scholar Back to article
Khassetarash A., Hassannejad R., Ettefagh M.M., Sari-Sarraf V., Fatigue and Soft Tissue Vibration during Prolonged Running, Hum. Mov. Sci., 2015, 44, 157–167, DOI: 10.1016/j.humov.2015.08.024.
Search in Google Scholar Back to article
Kulmala J.-P., Avela J., Pasanen K., Parkkari J., Forefoot Strikers Exhibit Lower Running-Induced Knee Loading than Rearfoot Strikers, Med. Sci. Sports Exerc., 2013, 45 (12), 2306, DOI: 10.1249/MSS.0b013e31829efcf7.
Search in Google Scholar Back to article
Lieberman D.E., What we can learn about running from barefoot running: An evolutionary medical perspective, Exerc. Sport Sci. Rev., 2012, 40 (2), 63–72, DOI: 10.1097/JES. 0b013e31824ab210.
Search in Google Scholar Back to article
Lieberman D.E., Venkadesan M., Werbel W.A., Daoud A.I., D’Andrea S., Davis I.S., Mang’eni R.O., Pitsiladis Y., Foot Strike Patterns and Collision Forces in Habitually Barefoot versus Shod Runners, Nature, 2010, 463 (7280), 531–535, DOI: 10.1038/nature08723.
Search in Google Scholar Back to article
Melcher D.A., Paquette M.R., Schilling B.K., Bloomer R.J., Joint Stiffness and Running Economy during Imposed Forefoot Strike before and after a Long Run in Rearfoot Strike Runners, J. Sports Sci., 2017, 35 (23) 2297–2303, DOI: 10.1080/02640414.2016.1266016.
Search in Google Scholar Back to article
Millet G.Y., Lepers R., Alterations of Neuromuscular Function After Prolonged Running, Cycling and Skiing Exercises, Sports Med., 2004, 34 (2), 105–116, DOI: 10.2165/00007256-200434020-00004.
Search in Google Scholar Back to article
Milner C.E., Ferber R., Pollard C.D., Hamill J., Davis I.S., Biomechanical Factors Associated with Tibial Stress Fracture in Female Runners, Med. Sci. Sports Exerc., 2006, 38 (2), 323–328, DOI: 10.1249/01.mss.0000183477.75808.92.
Search in Google Scholar Back to article
Murray L., Beaven C.M., Hébert-Losier K., The Effects of Running a 12-Km Race on Neuromuscular Performance Measures in Recreationally Competitive Runners, Gait Posture, 2019, 70, 341–346, DOI: 10.1016/j.gaitpost.2019.03.025.
Search in Google Scholar Back to article
Pohl M.B., Hamill J., Davis I.S., Biomechanical and Anatomic Factors Associated with a History of Plantar Fasciitis in Female Runners, Clin. J. Sport Med., 2009, 19 (5), 372–376, DOI: 10.1097/JSM.0b013e3181b8c270.
Search in Google Scholar Back to article
Rice H., Starbuck C., Willer J., Allen S., Bramah C., Jones R., Herrington L., Folland J., Does High-Intensity Running to Fatigue Influence Lower Limb Injury Risk?, J. Sci. Med. Sport, 2025, 28 (1), 33–38, DOI: 10.1016/j.jsams.2024. 08.205.
Search in Google Scholar Back to article
Skypala J., Hamill J., Sebera M., Elavsky S., Monte A., Jandacka D., Running-Related Achilles Tendon Injury: A Prospective Biomechanical Study in Recreational Runners, J. Appl. Biomech., 2023, 39 (4), 237–245, DOI: 10.1123/jab.2022-0221.
Search in Google Scholar Back to article
Skypala J., Monte A., Hamill J., Plesek J., Jandacka D., Achilles Tendon Dimensions, Ankle Stiffness and Footfall Patterns in Recreational Runners, J. Sports Sci., 2023, 41 (8), 812–819, DOI: 10.1080/02640414.2023.2240631.
Search in Google Scholar Back to article
Song Y., Cen X., Sun D., Bálint K., Wang Y., Chen H., Gao S., Bíró I., Zhang M., Gu Y., Curved carbon-plated shoe may further reduce forefoot loads compared to flat plate during running, Sci. Rep., 2024, 14, 13215, DOI: 10.1038/s41598-024-64177-3.
Search in Google Scholar Back to article
Song Y., Cen X., Wang M., Bálint K., Tan Q., Sun D., Zhang M., The influence of simulated worn shoe and foot inversion on heel internal biomechanics during running impact: A subject-specific finite element analysis, J. Biomech., 2025, 180, 112517, DOI: 10.1016/j.jbiomech.2024.112517.
Search in Google Scholar Back to article
Song Y., Cen X., Wang M., Gao Z., Tan Q., Sun D., Gu Y., Wang Y., Zhang M., A Systematic Review of Finite Element Analysis in Running Footwear Biomechanics: Insights for Running-Related Musculoskeletal Injuries, J. Sports Sci. Med., 2025, 24, (2), 370–387, DOI: 10.52082/jssm.2025.370.
Search in Google Scholar Back to article
Tam N., Coetzee D.R., Ahmed S., Lamberts R.P., Albertus-Kajee Y., Tucker R., Acute Fatigue Negatively Affects Risk Factors for Injury in Trained but Not Well-Trained Habitually Shod Runners When Running Barefoot, Eur. J. Sport Sci., 2017, 17 (9), 1220–1229, DOI: 10.1080/17461391. 2017.1358767.
Search in Google Scholar Back to article
The State of Running 2019. RunRepeat – Athletic shoe reviews. https://runrepeat.com/state-of-running (Accessed: April 11, 2025).
Search in Google Scholar Back to article
Urbaczka J., Silvernail J.F., Jandacka D., The Effect of Fatigue on the Ankle and Knee Kinematics and Kinetics in Moderately and Highly Trained Healthy Non-Rearfoot Runners, Sports Biomech, 2022, [Epub.], 1–15, DOI: 10.1080/14763141. 2022.2146909.
Search in Google Scholar Back to article
Xu Y., Yuan P., Wang R., Wang D., Liu J., Zhou H., Effects of Foot Strike Techniques on Running Biomechanics: A Systematic Review and Meta-Analysis, Sports Health, 2021, 13 (1), 71–77, DOI: 10.1177/1941738120934715.
Search in Google Scholar Back to article

Comparison of lower limb biomechanical responses to running-induced fatigue between rearfoot and non-rearfoot strike male amateur marathon runners

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