Biofeedback on abnormal mechanics lowers risk for stress fractures, pain under kneecap

s research had found that individuals with tibial stress fractures tend to land harder when each foot hits the ground, and in fact about half of the at-risk runners who have completed the study so far already had experienced microfractures. During their retraining sessions, the runners wore a shock measuring device on their lower legs while they ran on a tread mill. A monitor on the front of the treadmill showed the force of each footstrike measured against a line of what a normal, healthy footstrike should look like. The runners task was to constantly adjust the force with which each of their own feet hit the ground to keep it at or below the line on the screen.

With this feedback, all runners immediately were able to modify the hardness of their footstrike to meet the desired level, but all reported that the softer footstrike level did not "feel normal." By the end of the eighth session, however, even when they were receiving relatively little feedback, all runners had adjusted the force of their footstrike by half. Furthermore, they reported that they found the new gait now felt more normal.

The runners experiencing pain under the kneecap followed the same protocol. Dr. Davis earlier gait mechanics studies had found that individuals with kneecap pain (patellofemoral pain syndrome) demonstrate poor hip stability, hips rotating inward, causing a knock-kneed type running gait. On the laboratory treadmill, these runners watched a monitor that compared their gait, measured by markers on their legs, to a normal angular curve.

By keeping their knees apart, not letting them collapse inward, they soon were able to make the two images merge. Before retraining, the group had classified their kneecap pain from five to seven on a ten point scale, ten being the worst. In every case, after retraining, the runners reported zero pain.

A month after the retraining, during which runners had resumed their regular running schedule, they

Contact: Sylvia Wrobel
Federation of American Societies for Experimental Biology

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