Epidemiologic data suggest 25% to 75% of all runners experience an overuse injury each year. Commonly cited biomechanical factors related to overuse injuries such as Achilles tendinopathy or medial tibial stress syndrome include excessive amounts or velocities of foot pronation. However, there is conflicting evidence in the literature supporting this theory. An alternative hypothesis suggests it is not necessarily the amount or velocity of pronation which is important for injury development; rather it is the duration the foot remains in a pronated position throughout stance that is the important variable. This project examined this hypothesis by first identifying biomechanical markers of prolonged pronation. Second, it assessed whether individuals currently symptomatic with injuries typically attributed to excessive pronation instead demonstrate the biomechanical markers of prolonged pronation. Finally, musculoskeletal modeling techniques were used to examine musculotendinous kinematics in injured and healthy runners, as well as healthy runners with prolonged pronation. The results suggest the two most robust measures for identifying individuals with prolonged pronation are the period of pronation and the eversion of the rear foot at heel off. Individuals with prolonged pronation can also be identified with a set of clinically feasible measures including higher standing tibia varus angles, reduced static hip internal rotation range of motion, and increased hip internal rotation during stance phase. Finally, individuals with prolonged pronation display a more medially located center of pressure trajectory during stance. Compared to healthy controls, individuals currently symptomatic with Achilles tendinopathy or medial tibial stress syndrome did not differ in the amount or velocity of pronation. However, they did demonstrate the biomechanical markers of prolonged pronation. Injured individuals also demonstrated greater average musculotendinous percent elongation than healthy controls, especially through mid and late stance. Currently healthy individuals demonstrating prolonged pronation exhibited musculotendinous percent elongations intermediate to the healthy and injured groups. As a whole, the results from this study suggest prolonged pronation may play a role in the development of common overuse running injuries. It is suggested future studies on injury mechanisms consider pronation duration as an important variable to examine. This dissertation includes unpublished co-authored material.

This autoethnographic study investigates the emotional and social dimensions of a coaching relationship from the athlete�s perspective. Autoethnography is an approach that draws on highly personalised biographical accounts in which authors tell stories about their lived experiences (Ellis & Bochner, 2000; Richardson, 2000) in order to place the "self within a social context" (Reed-Danahay, 1997, p. 9). Consequently, through the analysis of my memories and ethnographic notes, I analyse my experiences as an Olympic marathon runner and, in particular, the challenges I faced with my coach. In the process of investigating the emotional and social dimensions of the coaching process (which I have divided into three phases), I focus specifically on the creation of (1) my 'athletic identity', (2) the power relationship that developed between my coach and myself and, (3) my early retirement from running. In order to make sense of my experiences, I draw upon theories of identity (e.g. Bradley, 1996), Foucauldian concepts on 'power' (e.g. Foucault, 1980), and the literature addressing 'premature retirement' (e.g. Sparkes 1996; 2000). Finally, a conclusion summarises the main points made in addition to outlining their implications for further coaching research and practice.

The sample included 29 healthy competitive male distance runners. Bilateral measurements were taken for selected variables of the talocalcaneal flexibility by means of a mechanical goniometer, and of the peak isokinetic knee strength on a Cybex II device. The frontal and horizontal plane motions of the lower limbs of the subjects were recorded by high speed filming and videotaping while they were running on a motor driven treadmill at their training pace under two conditions: with running shoes and barefoot. A detailed description of each runner's history was obtained and bilateral dominance characteristics were determined. Significant functional asymmetries were found for subtalar joint flexibility (eversion, inversion, and eversion/inversion ratio) and peak isokinetic knee strength (flexion, extension, total, and flexion/extension ratio). Significant kinematic asymmetries were revealed during the foot support phase in lower leg angle, rearfoot angle, mediolateral velocity of the foot, and in some temporal parameters. The two running conditions differed significantly only for the pretouchdown phase of support. Significant trends of association were identified between selected components of the lower limb functional and kinematical asymmetries which were characterized by consistent laterality patterns. Multivariate asymmetry components and running injury patterns were independent. Only asymmetries in foot pronation during barefoot running tended to significantly differentiate between runners grouped by injury incidence. The phenomenon of functional and kinematic asymmetries in runners is warranted.

Background: The homeopathic preparation, Traumeel S, has been used as a valuable alternative to conventional non-steroidal anti-inflammatory drugs (NSAIDS) for over 30 years. This antihomotoxic, anti-phlogistic drug has been widely used by sportsmen and women in the treatment of lesions and inflammatory processes which result from exercise-induced skeletal muscle microtrauma. Although numerous randomised, double-blind placebo-controlled trials have confirmed the efficacy of Traumeel S as an anti-inflammatory agent, there are few in vivo studies which have specifically investigated the mechanism by which Traumeel S is effective in reducing inflammatory response to exercise-induced muscle cell damage. Aim: To establish whether the administration of Traumeel S during the five days before participation and three days following participation, significantly attenuates the systemic markers of the inflammatory response, following a 90-minute downhill running trial. Method: Twenty-four healthy athletes (14 men and 10 women), aged 20-50 years, were recruited for this study. Following baseline laboratory testing and familiarisation with the treadmill as well as a field test, subjects were matched according to gender, BMI, training age, training status, peak performance and foot strike patterns and randomised into Traumeel (TRS) and Control (PLAC) groups in a placebo-controlled, double-blind design. One Traumeel S or Placebo tablet was ingested three times per day for five days prior to and three days following a 90-minute exercise trial on a downhill (-6% gradient) at 75% V02 max- Blood samples were collected prior to the 90-minute trial (PRE), immediately after the trial (IPE) and 24 hours (24 PE), 48 hours (48 PE) and 72 hours (72 PE) following the trial. Each subject was also requested to complete a training record prior to the trial and keep a record of the daily symptoms of delayed onset muscle soreness (DOMS) both at rest (general pain) and during walking (daily living). Full blood counts (FBC), serum creatine kinase (CK), lactate dehydrogenase (LDH) and Cortisol concentrations were measured using standard haematological laboratory procedures and serum C-Reactive Protein (CRP) was determined by immunoturbidimetric assay. Sandwich ELISA's were used to determine myeloperoxidase (MPO) and plasma interleukin-6 (IL-6) concentrations. All results obtained were adjusted for changes in plasma volume as calculated from the red blood cell indices. Results: Mean ± SD characteristics of the gender-matched subjects in the experimental (TRS) and placebo-control (PLAC) groups did not differ significantly in terms of BMI, age, % body fat, FVC, FEVi, training age and status, foot strike pattern or peak running performance, maximal Heart Rate, VE, V02peak> RER, RPE during the maximal exercise test (p > 0.05). This indicated that the randomised pairs were well matched. The 90-minute downhill running protocol resulted in significant elevations in total circulating white blood cell count (WBC), neutrophil, CK, LDH, Cortisol, CPR, MPO and IL-6 concentrations (p < 0.001). When comparing the TRS and PLAC groups, mean ± SD total and differential WBC count, neutrophil count, CK, LDH, Cortisol, CPR, MPO and IL-6 concentrations did not differ (p > 0.05) over the 5 time points. At 24 PE, MPO concentrations were significantly higher in the TRS group than in the PLAC group (p = 0.03). The lower mean ± SD post-trial DOMS scores reported by the TRS group were not significantly different from those reported by the PLAC group (p > 0.05). Conclusion: Although the findings of this study did not identify differences in circulating CK, LDH, Cortisol, CPR and IL-6 concentrations between the TRS and PLAC groups, the elevated MPO concentration at 24 PE did provide preliminary novel evidence of enhanced activation of neutrophil oxidative burst activity following exercise-induced muscle damage which is hypothesized to accelerate the recovery process. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, 2008.

This autoethnographic study investigates the emotional and social dimensions of a coaching relationship from the athlete�s perspective. Autoethnography is an approach that draws on highly personalised biographical accounts in which authors tell stories about their lived experiences (Ellis & Bochner, 2000; Richardson, 2000) in order to place the "self within a social context" (Reed-Danahay, 1997, p. 9). Consequently, through the analysis of my memories and ethnographic notes, I analyse my experiences as an Olympic marathon runner and, in particular, the challenges I faced with my coach. In the process of investigating the emotional and social dimensions of the coaching process (which I have divided into three phases), I focus specifically on the creation of (1) my 'athletic identity', (2) the power relationship that developed between my coach and myself and, (3) my early retirement from running. In order to make sense of my experiences, I draw upon theories of identity (e.g. Bradley, 1996), Foucauldian concepts on 'power' (e.g. Foucault, 1980), and the literature addressing 'premature retirement' (e.g. Sparkes 1996; 2000). Finally, a conclusion summarises the main points made in addition to outlining their implications for further coaching research and practice.

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1993

Purpose: The purpose of this study was to investigate the relationship between anthropometric measurements, proximal and distal lower extremity muscle performance, core muscle endurance, lower extremity flexibility, and neuromuscular control with the incidence of injury in recreational runners over one season. Also, when a relationship was established, we sought to evaluate the predictive validity for any of the variables being investigated for risk of injury in this population. Study Design: Prospective cohort Methods: Anthropometric measurements, proximal and distal isometric lower extremity muscle performance, isometric core muscle endurance, lower extremity flexibility and neuromuscular control were measured in 75 recreational runners prior to the start of a graded marathon training program. Incidence of injury was tracked over the course of 18 weeks, May 2014 – October 2014. Data was analyzed comparing the differences between injured and non-injured groups. Results: There were 33 repetitive stress injuries yielding a gross injury rate of 46% (male n=13, female n=20). Of all the variables analyzed, 5 variables emerged as possible a predictors including age, dominant limb rear foot posture, non dominant limb ankle DF ROM (extended), limb difference of Y balance scale composite scores and limb difference in the 6 M hop test. These variables were entered into a binary logistic regression analysis. Results of the regression indicated only the composite Y balance score difference variable as yielding a significant contribution (p = 0.01), with and predictive validity, (OR = 1.46, 95% CI =1.127 – 1.892). The model predicted 69.2% of the injuries with a specificity of 82% and sensitivity of 54.5%. A cutoff point of 3.6% was determined using a receiver operating characteristic curve. Runners were 3 times more likely to get injured with an asymmetry ≥ 3.6%. Conclusions: An asymmetry of lower extremity neuromuscular control ≥ 3.6% measured by the Y balance scale has been identified as a potential risk factor for injury in recreational runners. Clinical Relevance: This test can be performed as part of a pre-training screening or physical and may be helpful in identifying recreational runners at risk for injury.

No description available.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 xiv, 61 leaves, Annexures 1-12, 20 leaves / It is well known that the lifetime incidence of lower back pain (LBP) is particularly high (Richardson et al., 1999). Most cases of LBP are self-limiting, however certain regional biomechanical deficits may be overlooked, such as core stability. As a result of this, LBP may become a chronic condition in the athletic and general population. This principle can be applied to road running, as the forces that pass through the muscles of the lower limbs and trunk cannot be properly absorbed if the trunk musculature is not properly trained. This may lead to lower back pain as a result of inadequate functioning and strength of stabilizing structures (Hedrick, 2000). The purpose of this exploratory cross-sectional study was to determine the relationship between core muscle strength and chronic lower back pain in amateur female road runners and non-runners. The focus was to determine the core stability values in mmHg between amateur female runners with and without chronic LBP, and female non-runners with and without chronic LBP; as well as to compare female runners and non-runners with regard to core muscle strength.

Thesis (MScPhysio)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Introduction: Iliotibial band syndrome (ITBS), an overuse injury, is the second most common running injury and the main cause of lateral knee pain in runners. Due to the increasing number of runners worldwide there has been an increase in its occurrence. Runners with ITBS typically experience symptoms just after heel strike at approximately 20°-30° of knee flexion (impingement zone) during the stance phase of running. A variety of intrinsic and extrinsic risk factors may be responsible for why some runners are more prone to developing symptoms during the impingement zone as opposed to others. Abnormalities in running biomechanics is an intrinsic risk factor which has been most extensively described in literature but little is known about its exact relationship to ITBS. Objectives: The purpose of this systematic review was to provide an up to date evidence synthesis of the biomechanical risk factors associated with ITBS. These risk factors may need to be considered in the prevention or management of ITBS in runners. A clinical algorithm is also presented. Methods: A systematic review with meta-analysis was conducted. An electronic search was performed in PubMed, PEDro, SPORTSDisc and Scopus of literature published up-until May 2014. Cross-sectional and cohort studies were eligible for inclusion if they evaluated the lower limb biomechanics of runners with ITBS or those who went onto developing it. All studies included in the review were methodologically appraised. Evidence was graded according to the level of evidence, consistency of evidence and the clinical impact. Data was described narratively using tables or narrative summaries where appropriate. A meta-analysis was conducted for biomechanical risk factors which were reported in at least two studies, provided that homogeneity in the outcomes and samples were present. Results: A total of 11 studies were included (1 prospective and 10 cross-sectional). Overall the methodological score of the studies was moderate. Increased peak hip adduction and knee internal rotation during the stance phase may predict the development of ITBS in female runners. These biomechanical risk factors may need to be screened for ITBS prevention, despite the evidence base being limited to a single study. Currently there is no conclusive evidence that any of the biomechanical parameters need to be considered when managing runners with ITBS. Stellenbosch University https://scholar.sun.ac.za iii Conclusion: Biomechanical differences may exist between runners with ITBS and those who may develop ITBS compared to healthy runners. Although a large variety of biomechanical risk factors were evaluated, the evidence base for screening or managing these risk factors for runners with ITBS is limited. This is due to a small evidence base, small clinical effect and heterogeneity between study outcomes and findings. Further prospective and cross-sectional research is required to ascertain if abnormalities in running biomechanics may be related to why runners develop ITBS or to ascertain which risk factors may be involved when managing these runners. / AFRIKAANSE OPSOMMING: Inleiding: Iliotibiale-band-sindroom (ITBS), ’n besering vanweë oormatige gebruik, is die tweede algemeenste hardloopbesering en die hoofoorsaak van laterale kniepyn by hardlopers. Namate die getal hardlopers wêreldwyd toeneem, neem die voorkoms van hierdie toestand ook toe. Hardlopers met ITBS ervaar tipies simptome ná die hakslag met die knie ongeveer 20-30° gebuig (die wrywingsone of “impingement zone”) gedurende die staanfase van hardloop. Verskeie intrinsieke en ekstrinsieke risikofaktore kan ’n rol speel in waarom sommige hardlopers meer geneig is as ander om gedurende die wrywingsone simptome te ervaar. Abnormaliteite in hardloopbiomeganika is ’n intrinsieke risikofaktor wat reeds omvattend in die literatuur beskryf is. Tog is weinig bekend oor presies hoe dit met ITBS verband hou. Oogmerke: Die doel van hierdie stelselmatige ondersoek was om ’n sintese te bied van die jongste bewyse van die biomeganiese risikofaktore van ITBS. Hierdie risikofaktore kan dalk oorweeg word om ITBS by hardlopers te voorkom of te bestuur. ’n Kliniese algoritme word ook aangebied. Metodes: ’n Stelselmatige ondersoek is met behulp van meta-ontleding onderneem. PubMed, PEDro, SPORTSDisc en Scopus is elektronies deurgesoek vir literatuur wat tot en met Mei 2014 verskyn het. Deursnee en kohortstudies is ingesluit indien dit gehandel het oor die biomeganika in die onderste ledemate van hardlopers wat ITBS het of later ontwikkel het. Alle studies wat deel was van die ondersoek is metodologies geëvalueer. Bewyse is aan die hand van bewysvlak, bewyskonsekwentheid en kliniese impak beoordeel. Data is narratief beskryf met behulp van tabelle of narratiewe opsommings waar dit toepaslik was. ’n Meta-ontleding is onderneem waar biomeganiese risikofaktore in minstens twee studies aangemeld is, mits daar homogeniteit in die uitkomste sowel as die steekproewe was. Resultate: Altesaam 11 studies is ingesluit (een prospektief en tien deursnee). Die metodologiese telling van die studies was oorwegend gemiddeld. Verhoogde spitsheupadduksie en interne knierotasie gedurende die staanfase kan op die ontwikkeling van ITBS by vrouehardlopers dui. Hierdie biomeganiese risikofaktore kan dalk nagegaan word vir ITBS-voorkoming, al was die bewysbasis beperk tot ’n enkele studie. Daar is tans geen afdoende bewys dat enige van die biomeganiese parameters oorweeg behoort te word in die bestuur van langafstandatlete met ITBS nie. Gevolgtrekking: Daar bestaan dalk biomeganiese verskille tussen hardlopers wat ITBS het of kan ontwikkel en gesonde hardlopers. Hoewel ’n groot verskeidenheid biomeganiese risikofaktore beoordeel is, is die bewysbasis vir die toets of bestuur daarvan by atlete met ITBS beperk. Dít is vanweë die klein hoeveelheid bewyse, die klein kliniese impak, en heterogeniteit tussen studie-uitkomste en bevindinge. Verdere prospektiewe en deursneenavorsing word vereis om te bepaal of abnormaliteite in hardloopbiomeganika ’n rol kan speel in waarom langafstandhardlopers ITBS ontwikkel, of om vas te stel watter risikofaktore ter sprake kan wees in die bestuur van hierdie hardlopers.