Health, Exercise, and Sports Sciences ETDs

Publication Date



Running popularity has increased resulting in a concomitant increase in running-related injuries. Of these injuries, patellofemoral pain (PFP) is the most commonly reported. PURPOSE: The purpose of this study is to determine whether gait retraining by modifying footstrike patterns from rearfoot strike (RFS) to forefoot strike (FFS) reduces PFP and improves associated biomechanical measures, and whether the modification results in increased risk of ankle injuries. METHODS: Sixteen subjects (n=16) received clearance to participate by a licensed physical therapist, and were randomly placed in the control (n=8) or experimental (n=8) group. Subsequently, the experimental group (EXP) performed eight gait retraining running sessions where footstrike pattern was switched from RFS to FFS, while the control group (CTL) performed eight running sessions with no intervention. Knee flexion (Kflex), knee valgus (Kvalg), and ankle flexion (Aflex) at initial contact, knee (KL) and ankle loading (AL), patellofemoral contact force (PFCF), patellofemoral stress (PFS), Achilles tendon force (ATF), and knee pain as reported on a visual analog scale (VAS) were recorded pre-, post-, and one-month post-running trials. RESULTS: In Exp, knee pain was significantly reduced post-retraining (mean Δ, -4.225; p<0.05) and at one-month follow-up (mean Δ, -4.276; p<0.05). Kflex was significantly increased post-retraining (mean Δ, 6.044°; p<0.05). Kvalg was significantly improved post-retraining (mean Δ, 2.782°; p<0.05) at one-month follow-up (mean Δ, 4.066°; p<0.05). Aflex was significantly different post-retraining (mean Δ, -23.958°; p<0.05), as well as AL post-retraining (mean Δ, 14.738°; p<0.05) and one-month follow-up (mean Δ, 17.192°; p<0.05). PFCF, PFS, ATF, and KL were not significantly different. CONCLUSION: Retraining from RFS to FFS results in significant reductions in knee pain in runners with PFP without increasing risk of ankle injuries.'


injury, knee, lower extremity, running


Graduate Professional and Student Association, Research Allocations Committee

Document Type




Degree Name

Exercise Science

Level of Degree


Department Name

Health, Exercise, and Sports Sciences

First Committee Member (Chair)

Kravitz, Len

Second Committee Member

Dufek, Janet

Third Committee Member

Dexter, James