Effect of downhill running grade on lower extremity loading in female distance runners

Hill running is often used as a foundational training mechanism to build strength and speed. Distance runners in particular are at an increased likelihood of encountering steep hills during training runs. There is limited research regarding downhill running, and there is no research available on the biomechanics of females specifically during downhill running. The purpose of this study was to quantify the differences in loading when running downhill at different grades compared to a level surface in female distance runners to determine the potential risk for injury. Fifteen female distance runners (age: 23.5 ± 4.9 y), who ran 56.3 ± 20.9 km a week participated in this study. Participants ran on a force-instrumented treadmill at 4.0 m/s for 2 min at 0%, -5%, -10%, -15%, and -20% grades, with 5 min of rest between conditions. Study findings showed increased impact forces (p < 0.001), and increased loading rates (p < 0.001) with increasing downhill grades compared to level. These results indicate a significantly greater risk of overuse injury to the lower extremity with steeper downhill grades. Individuals need to be aware of these risks to plan and implement training programmes that will increase performance while minimising injury risk.