Changes in technique, footwear and intervention prevent running-related knee injuries

1. In this study, technique modifications such as softer landings was shown to reduce knee injury risk by two-thirds.

2. Active (e.g. technique retraining and exercise therapy) and passive (foot orthoses, osteopathic manipulation) may reduce patellofemoral pain.

Evidence Rating Level: 1 (Excellent)

Although running is one of the most popular forms of exercise and provides significant health benefits, injury is common with the potential for prolonged periods of recovery. There is currently a need to provide an updated synthesis on prevention and management strategies of running injuries. As a result, the objective of the present systemic review of randomized controlled trials was to synthesize and critically appraise the evidence on the prevention and management of running-related knee injuries.

Of 4057 identified records, 30 trials (18 preventions, 12 management) were included from database inception to May 2022. Studies were included if they compared interventions aimed at prevention or management of running-related injuries with another intervention or control. Participants had to be free from pre-existing injury at baseline. Studies were excluded if they included military participants, primarily sprinters, or sports other than running. The primary outcome of prevention interventions was the incidence of running-related knee injury. The primary outcome for management interventions was self-reported knee pain. Risk of bias was assessed using the Cochrane Risk of Bias tool V.2. Data was analyzed using a random-effects meta-analysis.

Results demonstrated that technique modifications such as softer landings may reduce knee injury risk by two-thirds. Furthermore, active (e.g. technique retraining and exercise therapy) and passive (foot orthoses, osteopathic manipulation) may reduce patellofemoral pain. Despite these findings, the present study was limited not only by the low certainty of the evidence, but by the various definitions of “running-related injury” which may have influenced the effect size of the interventions. Nonetheless, this study provides early insight into strategies that may be adopted to decrease running related injuries.

Click to read the study in British Journal of Sports Medicine 

Image: PD

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