Biomechanical running gait assessments across prevalent adolescent musculoskeletal injuries

While there is substantial information available regarding expected biomechanical adaptations associated with adult running-related injuries, less is known about adolescent gait profiles that may influence injury development.

Which biomechanical profiles are associated with prevalent musculoskeletal lower extremity injuries among adolescent runners, and how do these profiles compare across injury types and body regions?

We conducted a cross-sectional study of 149 injured adolescents (110 F; 39 M) seen at a hospital-affiliated injured runner's clinic between the years 2016-2021. Biomechanical data were obtained from 2-dimensional video analyses and an instrumented treadmill system. Multivariate analyses of variance covarying for gender and body mass index were used to compare continuous biomechanical measures, and Chi-square analyses were used to compare categorical biomechanical variables across injury types and body regions. Spearman's rho correlation analyses were conducted to assess the relationship of significant outcomes.

Patients with bony injuries had significantly higher maximum vertical ground reaction forces (bony: 1.87 body weight [BW] vs. soft tissue: 1.79BW, p = 0.05), and a higher proportion of runners with contralateral pelvic drop at midstance (χ² =5.3, p = 0.02). Maximum vertical ground reaction forces and pelvic drop were significantly yet weakly correlated (ρ = 0.20, p = 0.01). Foot strike patterns differed across injured body regions, with a higher proportion of hip and knee injury patients presenting with forefoot strike patterns (χ² =22.0, p = 0.01).

These biomechanical factors may represent risk factors for injuries sustained by young runners. Clinicians may consider assessing these gait adaptations when treating injured adolescent patients.