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Foot Strike Run Retraining for Patients With Patellofemoral Chondral Defects: A Case Series
Marisa Pontillo1,2, Brittney Mazzone Gunterstockman3, Adam Bunn1,2
1Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, VA 22042, USA.
Military Medicine
|November 6, 2023
Summary
Military service members with patellofemoral chondral defects (PFCDs) can improve running ability and reduce pain. Foot strike retraining helps modify running mechanics, decreasing impact forces and potentially slowing osteoarthritis progression.
Area of Science:
- Orthopedics
- Sports Medicine
- Biomechanics
Background:
- Military service members (SMs) have high rates of patellofemoral chondral defects (PFCDs).
- Untreated PFCDs can lead to osteoarthritis.
- Running is crucial for SMs, but evidence on maintaining running ability with cartilage defects is limited.
Purpose of the Study:
- To assess the clinical application of foot strike run retraining in patients with PFCDs.
- To evaluate the impact of retraining on running mechanics and patient outcomes.
Main Methods:
- A case series involving two active duty U.S. Marine Corps SMs with PFCD diagnosed via MRI.
- Both patients underwent eight foot strike run retraining sessions.
- Running mechanics and patient-reported outcomes were measured pre-training, post-training, and at 1-month follow-up.
Main Results:
- Both patients converted from rearfoot to non-rearfoot strike patterns and maintained this change.
- Increased running tolerance, improved pain scores (Numeric Pain Rating Scale), and enhanced function (Lower Extremity Functional Scale) were observed.
- A 63% to 70% reduction in average and peak vertical ground reaction force loading rates was noted post-treatment.
Conclusions:
- Modifying foot strike pattern can reduce impact loading in individuals with PFCDs.
- Foot strike run retraining appears to be a feasible strategy for SMs with PFCDs.
- This retraining may help reduce pain, improve function, and potentially limit disease progression.
