Two Gait Retraining Programs for Runners with Patellofemoral Pain | Find Your Stride | Edinburgh Podiatrist

Introduction

Patellofemoral Pain (PFP) is a prevalent condition among runners, often leading to significant limitations in performance and quality of life. As running mechanics are critical to performance, interventions that target kinematic factors could potentially alleviate symptoms. The randomised controlled trial titled "Effects of two gait retraining programs on pain, function, and lower limb kinematics in runners with patellofemoral pain," authored by José Roberto de Souza Júnior et al. (2024), explores the efficacy of two distinct gait retraining programs aimed at addressing this injury. This study provides valuable insights into alternative therapeutic approaches to managing PFP, particularly through gait modification.

Gait retraining can effectively reduce pain and enhance knee function in runners suffering from PFP

Background

PFP is one of the most common musculoskeletal injuries experienced by runners, characterised by pain around the patella, especially when climbing stairs, squatting, or engaging in running activities. While there is a robust body of evidence supporting strengthening programs to alleviate symptoms, there remains a scarcity of research dedicated to the effects of gait retraining on PFP. The examination of gait retraining is particularly significant, as running biomechanics can be integral to both performance enhancement and injury prevention.

Objective

The primary objective of the study was to assess the effects of two different partially supervised gait retraining programs over two weeks on runners suffering from PFP. Specifically, the researchers aimed to evaluate changes in pain levels, functional capacity, and lower limb kinematics pre- and post-intervention. By structuring their study in this manner, the authors sought to fill a gap in the existing literature regarding non-strengthening based interventions for PFP.

Methods

The study utilised a randomised controlled trial design, involving thirty runners who were assigned to one of three groups; an impact-focused gait retraining group, a cadence-focused group, or a control group. The impact group (n = 10) received training aimed at reducing tibial acceleration by 50%, while the cadence group (n = 10) was instructed to increase their running cadence by 7.5-10%. The control group (n = 10) did not receive any intervention. Outcome measures included running pain, knee function, and an array of lower limb kinematic assessments, conducted at baseline (To), immediately post-intervention (T≥), and six months later (T24).

Results

The findings revealed a significant interaction between group and time for both running pain (p = 0.010) and knee function (p = 0.019). Notably, significant reductions in running pain were observed in both intervention groups as compared to the control at the six-month follow-up. Specifically, the mean difference for the impact group versus control was -3.2 (95% CI -5.1 to -1.3, p = 0.001), while the cadence group demonstrated a mean difference of -2.9 (95% CI -4.8 to -1.0, p = 0.002).

Conclusion

In conclusion, the study conducted by José Roberto de Souza Júnior and colleagues provides compelling evidence that gait retraining can effectively reduce pain and enhance knee function in runners suffering from PFP. Furthermore, these results suggest that either an impact-focused or cadence-focused intervention can be beneficial, paving the way for further exploration into customised gait retraining programs as a vital component in the management of PFP among runners. The findings underscore the importance of integrating biomechanical approaches into rehabilitation protocols for runners to facilitate recovery and improve overall performance.

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