Objective: To determine prospectively gait-related risk factors for lower leg overuse injury (LLOI).
Design: A prospective cohort study.
Setting: Male and female recruits from a start-to-run (STR) programme during a 10-week training period.
Participants: 131 healthy subjects (20 men and 111 women), without a history of any lower leg complaint, participated in the study.
Interventions: Before the start of the 10-week STR programme, plantar force measurements during running were performed. During STR, lower leg injuries were diagnosed and registered by a sports physician.
Main outcome measures: Plantar force measurements during running were performed using a footscan pressure plate.
Results: During the STR, 27 subjects (five men and 22 women) developed a LLOI. Logistic regression analysis revealed that subjects who developed a LLOI had a significantly more laterally directed force distribution at first metatarsal contact and forefoot flat, a more laterally directed force displacement in the forefoot contact phase, foot flat phase and at heel-off. These subjects also had a delayed change of the centre of force (COF) at forefoot flat, a higher force and loading underneath the lateral border of the foot, and a significantly higher directed force displacement of the COF at forefoot flat.
Conclusions: These findings suggest that a less pronated heel strike and a more laterally directed roll-off can be considered as risk factors for LLOI. Clinically, the results of this study can be considered important in identifying individuals at risk of LLOI.