Diving Into the Health Problems of Competitive Divers: A Systematic Review of Injuries and Illnesses in Pre-elite and Elite Diving Athletes.

CONTEXT: The Olympic sport of diving involves the competitive disciplines of 3 m springboard and 10 m platform. Although it is generally accepted that lumbar spine injuries are common in diving athletes, the existing literature of health problems in diving athletes remains scarce. OBJECTIVE: To identify the incidence, prevalence, and type of health problems that occur in competitive diving athletes. DATA SOURCES: Medline, EMBASE, SportsDiscus, PsycINFO, and Google Scholar. STUDY SELECTION: Studies written in English investigating elite or pre-elite competitive diving (springboard, platform) injuries and/or illnesses were eligible. Two independent reviewers screened for inclusion by title, abstract, and full text in accordance with the eligibility criteria. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Data extraction was completed by 1 author using a structured form. A second author then independently reviewed and verified the extracted data, any discrepancies were resolved through consensus. RESULTS: The search identified 2554 potential articles, with 28 studies meeting eligibility criteria. The surveillance setting of most studies was restricted to competition-based events, with the reported injury incidence proportion ranging from 2.1% to 22.2%. The reported injury incidence rate ranged from 1.9 to 15.5 per 1000 athlete-exposures. Injuries to the shoulder, lower back/lumbar spine, trunk, and wrist/hand were reported most frequently. The prevalence of low back pain was reported as high as 89% (lifetime), 43.1% (period), and 37.3% (point). The illness incidence proportion ranged from 0.0% to 22.2%, with respiratory and gastrointestinal illness reported most frequently. CONCLUSION: Up to 1 in 5 diving athletes sustain an injury and/or illness during periods of competition. A reporting bias was observed, with most cohort studies limiting surveillance to short competition-based periods only. This limits the current understanding of the health problems experienced by diving athletes to competition periods only and requires expansion to whole-of-year surveillance.

Increased muscle force does not induce greater stretch-induced damage to calf muscles during work-matched heel drop exercise.

PURPOSE: To investigate the effect of muscle force during active stretch on quantitative and qualitative indicators of exercise-induced muscle damage (EIMD) in the medial gastrocnemius (MG) muscle. METHODS: Twelve recreationally active volunteers performed two trials of an eccentric heel drop exercise. Participants performed a single bout of low-load (body weight) and high-load (body weight + 30% body weight) exercises on separate legs. The total mechanical work output for each condition was matched between legs. Before, two hours and 48 h after each bout of eccentric exercise, electrically stimulated triceps surae twitch torque, muscle soreness, MG active fascicle length at maximum twitch torque and muscle passive stiffness were collected. Triceps surae electromyographic (EMG) activity, MG fascicle stretch and MG muscle-tendon unit (MTU) length were measured during the eccentric tasks. RESULTS: The high-load condition increased triceps surae muscle activity by 6-9%, but reduced MG fascicle stretch (p < 0.001). MTU stretch was similar between conditions. The greater muscle force during stretch did not give rise to additional torque loss (5 vs 6%) or intensify muscle soreness. CONCLUSIONS: Adding 30% body weight during eccentric contractions has a modest impact on exercise-induced muscle damage in the medial gastrocnemius muscle. These results suggest that muscle load may not be an important determinant of stretch-induced muscle damage in the human MG muscle. The muscle investigated does exhibit large pennation angles and high series elastic compliance; architectural features that likely buffer muscle fibres against stretch and damage.

Hamstring musculotendon mechanics of prospectively injured elite rugby athletes.

The musculotendon mechanics of the hamstrings during high-speed running are thought to relate to injury but have rarely been examined in the context of prospectively occurring injury. This prospective study describes the hamstring musculotendon mechanics of two elite rugby players who sustained hamstring injuries during on-field running. Athletes undertook biomechanical analyses of high-speed running during a Super Rugby pre-season, prior to sustaining hamstring injuries during the subsequent competition season. The biceps femoris long head muscle experienced the greatest strain of all hamstring muscles during the late swing phase. When expressed relative to force capacity, biceps femoris long head also experienced the greatest musculotendon forces of all hamstring muscles. Musculotendon strain and force may both be key mechanisms for hamstring injury during the late swing phase of running.

Stiffening the human foot with a biomimetic exotendon.

Shoes are generally designed protect the feet against repetitive collisions with the ground, often using thick viscoelastic midsoles to add in-series compliance under the human. Recent footwear design developments have shown that this approach may also produce metabolic energy savings. Here we test an alternative approach to modify the foot-ground interface by adding additional stiffness in parallel to the plantar aponeurosis, targeting the windlass mechanism. Stiffening the windlass mechanism by about 9% led to decreases in peak activation of the ankle plantarflexors soleus (~ 5%, p < 0.001) and medial gastrocnemius (~ 4%, p < 0.001), as well as a ~ 6% decrease in positive ankle work (p < 0.001) during fixed-frequency bilateral hopping (2.33 Hz). These results suggest that stiffening the foot may reduce cost in dynamic tasks primarily by reducing the effort required to plantarflex the ankle, since peak activation of the intrinsic foot muscle abductor hallucis was unchanged (p = 0.31). Because the novel exotendon design does not operate via the compression or bending of a bulky midsole, the device is light (55 g) and its profile is low enough that it can be worn within an existing shoe.

Cyclic eccentric stretching induces more damage and improved subsequent protection than stretched isometric contractions in the lower limb.

PURPOSE: Controversy remains about whether exercise-induced muscle damage (EIMD) and the subsequent repeated bout effect (RBE) are caused by the stretching of an activated muscle, or the production of high force at long, but constant, muscle lengths. The aim of this study was to determine the influence of muscle fascicle stretch elicited during different muscle contraction types on the magnitude of EIMD and the RBE. METHODS: Fourteen participants performed an initial bout of lower limb exercise of the triceps surae. One leg performed sustained static contractions at a constant long muscle length (ISO), whereas the contralateral leg performed a bout of eccentric heel drop exercise (ECC). Time under tension was matched between the ECC and ISO conditions. Seven days later, both legs performed ECC. Plantar flexor twitch torque, medial gastrocnemius (MG) fascicle length and muscle soreness were assessed before, 2 h and 2 days after each exercise bout. MG fascicle length and triceps surae surface electromyography were examined across the bouts of exercise. RESULTS: We found that both ECC and ISO conditions elicited EIMD and a RBE. ISO caused less damage 2 h after the initial bout (14% less drop in twitch torque, P = 0.03) and less protection from soreness 2 days after the repeated bout (56% higher soreness, P = 0.01). No differences were found when comparing neuromechanical properties across exercise bouts. CONCLUSION: For MG, the action of stretching an active muscle seems to be more important for causing damage than a sustained contraction at a long length.

Lower-limb muscle function is influenced by changing mechanical demands in cycling.

Although cycling is a seemingly simple, reciprocal task, muscles must adapt their function to satisfy changes in mechanical demands induced by higher crank torques and faster pedalling cadences. We examined whether muscle function was sensitive to these changes in mechanical demands across a wide range of pedalling conditions. We collected experimental data of cycling where crank torque and pedalling cadence were independently varied from 13 to 44 N m and 60 to 140 rpm. These data were used in conjunction with musculoskeletal simulations and a recently developed functional index-based approach to characterise the role of human lower-limb muscles. We found that in muscles that generate most of the mechanical power and work during cycling, greater crank torque induced shifts towards greater muscle activation, greater positive muscle-tendon unit (MTU) work and a more motor-like function, particularly in the limb extensors. Conversely, with faster pedalling cadence, the same muscles exhibited a phase advance in muscle activity prior to crank top dead centre, which led to greater negative MTU power and work and shifted the muscles to contract with more spring-like behaviour. Our results illustrate the capacity for muscles to adapt their function to satisfy the mechanical demands of the task, even during highly constrained reciprocal tasks such as cycling. Understanding how muscles shift their contractile performance under varied mechanical and environmental demands may inform decisions on how to optimise pedalling performance and to design targeted cycling rehabilitation therapies for muscle-specific injuries or deficits.

Consequences of nest site selection vary along a tidal gradient.

Parents providing care must sometimes choose between rearing locations that are most favourable for offspring versus those that are most favourable for themselves. Here, we measured how both parental and offspring performance varied in nest sites distributed along an environmental gradient. The plainfin midshipman fish Porichthys notatus nests along a tidal gradient. When ascending from the subtidal to the high intertidal at low tide, both nest temperature and frequency of air exposure increase. We used one lab and two field experiments to investigate how parental nest site choices across tidal elevations are linked to the physiological costs incurred by parents and the developmental benefits accrued by offspring. Under warmer incubation conditions, simulating high intertidal nests, offspring developed faster but had higher mortality rates compared to those incubated in cooler conditions that mimicked subtidal nests. In the field, males in higher intertidal nests were more active caregivers, but their young still died at the fastest rates. Larger males claimed and retained low intertidal nests, where offspring survival and development rates were also highest. Our results suggest that males compete more intensively for nest sites in the low intertidal, where they can raise their young quickly and with lower per-offspring investments. Smaller, less-competitive males forced into higher intertidal sites nest earlier in the season and provide more active parental care, possibly to bolster brood survival under harsh environmental conditions.

Robot Assisted Ankle Neuro-Rehabilitation: State of the art and Future Challenges.

Introduction: Robot-assisted neuro-rehabilitation is gaining acceptability among the physical therapy community. The ankle is one of the most complicated anatomical joints in the human body and neurologic injuries such as stroke often result in ankle and foot disabilities. Areas covered: Robotic solutions for the ankle joint physical therapy have extensively been researched. Significant research has been conducted on the mechanism design, actuation as well as control of these ankle rehabilitation robots. Also, the experimental evaluations of these robots have been conducted with healthy and neurologically impaired subjects. This paper presents a comprehensive review of the recent developments in the field of robot-assisted ankle rehabilitation. Mechanism design, actuation, and various types of control strategies are discussed. Also, the experimental evaluations of these ankle rehabilitation robots are discussed in the context of the evaluation of robotic hardware with healthy subjects as well as motor function outcomes with neurologically impaired subjects. Expert opinion: Significant progress in the mechanism design, control, and experimental evaluations of the ankle rehabilitation robots have been reported. However, more sensing and reference trajectory generation methods need to be developed as well as more objective quantitive evaluations that need to be conducted for establishing the clinical significance of these robots.

Parental Males of the Plainfin Midshipman Are Physiologically Resilient to the Challenges of the Intertidal Zone.

The decision of where to rear young is influenced by both the needs of offspring and the costs parents incur in certain rearing environments. Plainfin midshipman fish (Porichthys notatus) provide extended paternal care in rocky intertidal zones, where they experience regular bouts of aquatic hypoxia and air exposure during low-tide events. We investigated the physiological responses of plainfin midshipman males to three conditions for 6 h that simulate what these fish naturally experience during tidal cycles while nesting: normoxia, progressive hypoxia, or air exposure. Hypoxia- and air-exposed fish exhibited shifts in energy metabolites, driven largely by elevated lactate and glucose content and reduced glycogen content in several tissues (muscle, heart, liver, and brain), but the magnitude of these changes was relatively modest. Hematocrit increased most in air-exposed fish relative to normoxia-exposed fish, contributing to an increase in whole-blood hemoglobin concentration. Air exposure reduced swim bladder oxygen content, suggesting that internal O2 stores are drawn on during air exposure. In a second experiment, we found that aquatic surface respiration and gill ventilation frequency increased in hypoxia-exposed fish relative to normoxia-exposed fish. Overall, our results suggest that plainfin midshipman overcome the challenges of the intertidal environment through a variety of physiological strategies and exhibit little physiological disturbance in response to the fluctuating and extreme conditions created by regular low tides.

Plasticity in the antipredator behavior of the orange-footed sea cucumber under shifting hydrodynamic forces.

Marine invertebrates that move too slowly to evade unfavorable environmental change may instead exhibit phenotypic plasticity, allowing them to adjust to varying conditions. The orange-footed sea cucumber Cucumaria frondosa is a slow-moving suspension feeder that is preyed on by the purple sunstar Solaster endeca. The sea cucumber's antipredator behavior involves changing shape and detaching from the substratum, which might increase its probability of being displaced by water motion into an unsuitable environment. We hypothesized that sea cucumbers' antipredator responses would be diminished under stronger hydrodynamic forces, and that behavioral strategies would be flexible so that individuals could adjust to frequent changes in water flows. In a natural orange-footed sea cucumber habitat, individuals lived along a pronounced hydrodynamic gradient, allowing us to measure antipredator behavior under different water flow strengths. We placed purple sunstars in physical contact with sea cucumbers living at various points along the gradient to elicit antipredator responses. We then repeated this procedure in a laboratory mesocosm that generated weak and strong hydrodynamic forces similar to those observed at the field site. Subjects in the mesocosm experiment were tested in both wave conditions to determine if their antipredator behavior would change in response to sudden environmental change, as would be experienced under deteriorating sea conditions. Antipredator responses did not covary with hydrodynamic forces in the field. However, antipredator responses in the mesocosm experiment increased when individuals were transplanted from strong to weak forces and decreased when transplanted from weak to strong forces. Overall, our results indicate environmentally induced plasticity in the antipredator behavior of the orange-footed sea cucumber.

Lower-limb joint mechanics during maximum acceleration sprinting.

We explored how humans adjust the stance phase mechanical function of their major lower-limb joints (hip, knee, ankle) during maximum acceleration sprinting. Experimental data [motion capture and ground reaction force (GRF)] were recorded from eight participants as they performed overground sprinting trials. Six alternative starting locations were used to obtain a dataset that incorporated the majority of the acceleration phase. Experimental data were combined with an inverse-dynamics-based analysis to calculate lower-limb joint mechanical variables. As forward acceleration magnitude decreased, the vertical GRF impulse remained nearly unchanged whereas the net horizontal GRF impulse became smaller as a result of less propulsion and more braking. Mechanical function was adjusted at all three joints, although more dramatic changes were observed at the hip and ankle. The impulse from the ankle plantar-flexor moment was almost always larger than those from the hip and knee extensor moments. Forward acceleration magnitude was linearly related to the impulses from the hip extensor moment (R2=0.45) and the ankle plantar-flexor moment (R2=0.47). Forward acceleration magnitude was also linearly related to the net work done at all three joints, with the ankle displaying the strongest relationship (R2=0.64). The ankle produced the largest amount of positive work (1.55±0.17 J kg-1) of all the joints, and provided a significantly greater proportion of the summed amount of lower-limb positive work as running speed increased and forward acceleration magnitude decreased. We conclude that the hip and especially the ankle represent key sources of positive work during the stance phase of maximum acceleration sprinting.

Late swing running mechanics influence hamstring injury susceptibility in elite rugby athletes: A prospective exploratory analysis.

Hamstring injuries are one of the most prevalent injuries in rugby union and many other running-based sports, such as track sprinting and soccer. The majority of these injuries occur during running; however, the relationship between running mechanics and hamstring injury is unclear. Obtaining large samples of prospective injury data to examine this relationship is difficult, and therefore exploratory analysis frameworks may assist in deriving valuable information from studies with small but novel samples. The aim of this study was to undertake a prospective exploratory analysis of the relationship between running mechanics and hamstring injury. Kinematic and kinetic data of the trunk, pelvis and lower limbs were collected during maximal overground running efforts for ten elite rugby union athletes. Subsequently, hamstring injury occurrence was recorded for the following Super Rugby season, during which three athletes sustained a running-based hamstring injury. Functional principal component analysis was used to visualise patterns of variability in running mechanics during the late swing phase between athletes. Results indicated that subsequently injured athletes demonstrated a tendency for greater thoracic lateral flexion, greater hip extension moments and greater knee power absorption, compared to uninjured athletes. All variables demonstrated an ability to descriptively differentiate between injured and uninjured athletes at approximately 60% of the late swing phase. Therefore, we hypothesize that greater thoracic lateral flexion, a greater hip extension moment and greater knee power absorption between peak hip flexion and peak knee extension during the late swing phase may put rugby athletes at greater risk of running-based hamstring injury.

A retrospective analysis of hamstring injuries in elite rugby athletes: More severe injuries are likely to occur at the distal myofascial junction.

OBJECTIVES: To describe the most common hamstring injury scenarios and outcomes in elite rugby union. DESIGN: Retrospective investigation. SETTING: Hamstring injury data from an elite rugby union team was collected over five seasons and retrospectively analysed. PARTICIPANTS: 74 professional rugby players. MAIN OUTCOME MEASURES: Injuries were classified as new or recurrent. Injury severity, activity, player position, and whether the injury occurred during a match or training was determined for each injury. Injury location and grade were determined for more clinically severe injuries where Magnetic Resonance Imaging (MRI) data was available (15 injuries). RESULTS: Thirty hamstring injuries were sustained over the five seasons. The majority of injuries were new (93%), moderate in severity (60%) and occurred during running (77%). For more clinically severe injuries, the biceps femoris long head (BFlh) was the most commonly injured muscle (73%) and the distal myofascial junction (DMFJ) was the most common injury site (58% of BFlh injuries). CONCLUSIONS: Hamstring injuries most commonly occurred while running and in the BFlh muscle, which is similar to other sports. However, the most common intramuscular injury site was the DMFJ, which contrasts with reports from other cohorts. Future studies should ensure to include the myofascial junction when classifying injury location.

Late swing or early stance? A narrative review of hamstring injury mechanisms during high-speed running.

Hamstring injuries are highly prevalent in many running-based sports, and predominantly affect the long head of biceps femoris. Re-injury rates are also high and together lead to considerable time lost from sport. However, the mechanisms for hamstring injury during high-speed running are still not fully understood. Therefore, the aim of this review was to summarize the current literature describing hamstring musculotendon mechanics and electromyography activity during high-speed running, and how they may relate to injury risk. The large eccentric contraction, characterized by peak musculotendon strain and negative work during late swing phase is widely suggested to be potentially injurious. However, it is also argued that high hamstring loads resulting from large joint torques and ground reaction forces during early stance may cause injury. While direct evidence is still lacking, the majority of the literature suggests that the most likely timing of injury is the late swing phase. Future research should aim to prospectively examine the relationship between hamstring musculotendon dynamics and hamstring injury.

Longer-term effects of minimalist shoes on running performance, strength and bone density: A 20-week follow-up study.

This study investigated whether male runners improve running performance, running economy, ankle plantar flexor strength, and alter running biomechanics and lower limb bone mineral density when gradually transitioning to using minimalist shoes for 100% of weekly running. The study was a planned follow-up of runners (n = 50) who transitioned to minimalist or conventional shoes for 35% of weekly structured training in a previous 6-week randomised controlled trial. In that trial, running performance and economy improved more with minimalist shoes than conventional shoes. Runners in each group were instructed to continue running in their allocated shoe during their own preferred training programme for a further 20 weeks while increasing allocated shoe use to 100% of weekly training. At the 20-week follow-up, minimalist shoes did not affect performance (effect size: 0.19; p = 0.218), running economy (effect size: ≤ 0.24; p ≥ 0.388), stride rate or length (effect size: ≤ 0.12; p ≥ 0.550), foot strike (effect size: ≤ 0.25; p ≥ 0.366), or bone mineral density (effect size: ≤ 0.40; p ≥ 0.319). Minimalist shoes increased plantar flexor strength more than conventional shoes when runners trained with greater mean weekly training distances (shoe*distance interaction: p = 0.036). After greater improvements with minimalist shoes during the initial six weeks of a structured training programme, increasing minimalist shoe use from 35% to 100% over 20 weeks, when runners use their own preferred training programme, did not further improve performance, running economy or alter running biomechanics and lower limb bone mineral density. Minimalist shoes improved plantar flexor strength more than conventional shoes in runners with greater weekly training distances.

Six-week transition to minimalist shoes improves running economy and time-trial performance.

OBJECTIVES: This study investigated if gradually introducing runners to minimalist shoes during training improved running economy and time-trial performance compared to training in conventional shoes. Changes in stride rate, stride length, footfall pattern and ankle plantar-flexor strength were also investigated. DESIGN: Randomised parallel intervention trial. METHODS: 61 trained runners gradually increased the amount of running performed in either minimalist (n=31) or conventional (n=30) shoes during a six-week standardised training program. 5-km time-trial performance, running economy, ankle plantar-flexor strength, footfall pattern, stride rate and length were assessed in the allocated shoes at baseline and after training. Footfall pattern was determined from the time differential between rearfoot and forefoot (TDR-F) pressure sensors. RESULTS: The minimalist shoe group improved time-trial performance (effect size (ES): 0.24; 95% confidence interval (CI): 0.01, 0.48; p=0.046) and running economy (ES 0.48; 95%CI: 0.22, 0.74; p<0.001) more than the conventional shoe group. There were no minimalist shoe training effects on ankle plantar-flexor concentric (ES: 0.11; 95%CI: -0.18, 0.41; p=0.45), isometric (ES: 0.23; 95%CI: -0.17, 0.64; p=0.25), or eccentric strength (ES: 0.24; 95%CI: -0.17, 0.65; p=0.24). Minimalist shoes caused large reductions in TDR-F (ES: 1.03; 95%CI: 0.65, 1.40; p<0.001) but only two runners changed to a forefoot footfall. Minimalist shoes had no effect on stride rate (ES: 0.04; 95%CI: -0.08, 0.16; p=0.53) or length (ES: 0.06; 95%CI: -0.06, 0.18; p=0.35). CONCLUSIONS: Gradually introducing minimalist shoes over a six-week training block is an effective method for improving running economy and performance in trained runners.

Body Mass and Weekly Training Distance Influence the Pain and Injuries Experienced by Runners Using Minimalist Shoes: A Randomized Controlled Trial.

BACKGROUND: Minimalist shoes have been popularized as a safe alternative to conventional running shoes. However, a paucity of research is available investigating the longer-term safety of minimalist shoes. PURPOSE: To compare running-related pain and injury between minimalist and conventional shoes in trained runners and to investigate interactions between shoe type, body mass, and weekly training distance. STUDY DESIGN: Randomized clinical trial; Level of evidence, 2. METHODS: Sixty-one trained, habitual rearfoot footfall runners (mean ± SD: body mass, 74.6 ± 9.3 kg; weekly training distance, 25 ± 14 km) were randomly allocated to either minimalist or conventional shoes. Runners gradually increased the time spent running in their allocated shoes over 26 weeks. Running-related pain intensity was measured weekly by use of 100-mm visual analog scales. Time to first running-related injury was also assessed. RESULTS: Interactions were found between shoe type and weekly training distance for weekly running-related pain; greater pain was experienced with minimalist shoes ( P < .05), and clinically meaningful increases (>10 mm) were noted when the weekly training distance was more than 35 km/wk. Eleven of 30 runners sustained an injury in conventional shoes compared with 16 of 31 runners in minimalist shoes (hazard ratio, 1.64; 95% confidence interval, 0.63-4.27; P = .31). A shoe × body mass interaction was found for time to first running-related injury ( P = .01). For runners using minimalist shoes, relative to runners using conventional shoes, the risk of sustaining an injury became more likely with increasing body mass above 71.4 kg, and the risk was moderately increased (hazard ratio, 2.00; 95% confidence interval, 1.10-3.66; P = .02) for runners using minimalist shoes who had a body mass of 85.7 kg. CONCLUSIONS: Runners should limit weekly training distance in minimalist shoes to avoid running-related pain. Heavier runners are at greater risk of injury when running in minimalist shoes. Registration: Australian New Zealand Clinical Trials Registry (ACTRN12613000642785).

Redistribution of Mechanical Work at the Knee and Ankle Joints During Fast Running in Minimalist Shoes.

CONTEXT: Minimalist shoes have been suggested as a way to alter running biomechanics to improve running performance and reduce injuries. However, to date, researchers have only considered the effect of minimalist shoes at slow running speeds. OBJECTIVE: To determine if runners change foot-strike pattern and alter the distribution of mechanical work at the knee and ankle joints when running at a fast speed in minimalist shoes compared with conventional running shoes. DESIGN: Crossover study. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty-six trained runners (age = 30.0 ± 7.9 years [age range, 18-40 years], height = 1.79 ± 0.06 m, mass = 75.3 ± 8.2 kg, weekly training distance = 27 ± 15 km) who ran with a habitual rearfoot foot-strike pattern and had no experience running in minimalist shoes. INTERVENTION(S): Participants completed overground running trials at 18 km/h in minimalist and conventional shoes. MAIN OUTCOME MEASURE(S): Sagittal-plane kinematics and joint work at the knee and ankle joints were computed using 3-dimensional kinematic and ground reaction force data. Foot-strike pattern was classified as rearfoot, midfoot, or forefoot strike based on strike index and ankle angle at initial contact. RESULTS: We observed no difference in foot-strike classification between shoes (χ21 = 2.29, P = .13). Ankle angle at initial contact was less (2.46° versus 7.43°; t25 = 3.34, P = .003) and strike index was greater (35.97% versus 29.04%; t25 = 2.38, P = .03) when running in minimalist shoes compared with conventional shoes. We observed greater negative (52.87 J versus 42.46 J; t24 = 2.29, P = .03) and positive work (68.91 J versus 59.08 J; t24 = 2.65, P = .01) at the ankle but less negative (59.01 J versus 67.02 J; t24 = 2.25, P = .03) and positive work (40.37 J versus 47.09 J; t24 = 2.11, P = .046) at the knee with minimalist shoes compared with conventional shoes. CONCLUSIONS: Running in minimalist shoes at a fast speed caused a redistribution of work from the knee to the ankle joint. This finding suggests that runners changing from conventional to minimalist shoes for short-distance races could be at an increased risk of ankle and calf injuries but a reduced risk of knee injuries.

Human ankle plantar flexor muscle-tendon mechanics and energetics during maximum acceleration sprinting.

Tendon elastic strain energy is the dominant contributor to muscle-tendon work during steady-state running. Does this behaviour also occur for sprint accelerations? We used experimental data and computational modelling to quantify muscle fascicle work and tendon elastic strain energy for the human ankle plantar flexors (specifically soleus and medial gastrocnemius) for multiple foot contacts of a maximal sprint as well as for running at a steady-state speed. Positive work done by the soleus and medial gastrocnemius muscle fascicles decreased incrementally throughout the maximal sprint and both muscles performed more work for the first foot contact of the maximal sprint (FC1) compared with steady-state running at 5 m s(-1) (SS5). However, the differences in tendon strain energy for both muscles were negligible throughout the maximal sprint and when comparing FC1 to SS5. Consequently, the contribution of muscle fascicle work to stored tendon elastic strain energy was greater for FC1 compared with subsequent foot contacts of the maximal sprint and compared with SS5. We conclude that tendon elastic strain energy in the ankle plantar flexors is just as vital at the start of a maximal sprint as it is at the end, and as it is for running at a constant speed.

Effects of a minimalist shoe on running economy and 5-km running performance.

The purpose of this study was to determine if minimalist shoes improve time trial performance of trained distance runners and if changes in running economy, shoe mass, stride length, stride rate and footfall pattern were related to any difference in performance. Twenty-six trained runners performed three 6-min sub-maximal treadmill runs at 11, 13 and 15 km·h(-1) in minimalist and conventional shoes while running economy, stride length, stride rate and footfall pattern were assessed. They then performed a 5-km time trial. In the minimalist shoe, runners completed the trial in less time (effect size 0.20 ± 0.12), were more economical during sub-maximal running (effect size 0.33 ± 0.14) and decreased stride length (effect size 0.22 ± 0.10) and increased stride rate (effect size 0.22 ± 0.11). All but one runner ran with a rearfoot footfall in the minimalist shoe. Improvements in time trial performance were associated with improvements in running economy at 15 km·h(-1) (r = 0.58), with 79% of the improved economy accounted for by reduced shoe mass (P < 0.05). The results suggest that running in minimalist shoes improves running economy and 5-km running performance.