- Running Mechanics and Injury
- Muscle-Tendon Injuries
- Post-Surgical Recovery
- Athlete Well-Being
While running is a basic form of human movement, how an individual runs can provide immense insight regarding injury risk and recovery. Our lab measures running biomechanics using a combination of 3D optical motion capture, an instrumented treadmill with forceplates, and wireless inertial measurement units (IMUs). This allows us to measure running mechanics quickly and precisely to meet our goals of identifying those at an elevated risk of future injury and monitoring recovery after injury. Specifically, we assess running mechanics to address the following areas:
Normative Running Mechanics
It is challenging to identify abnormal running mechanics if we are unsure what “normal” mechanics are. Through years of data collection across a wide variety of sports and running speeds, we have developed a normative database of running mechanics and between-limb asymmetries for spatiotemporal, ground reaction force, and joint kinematic and kinetic variables. This database facilitates comparison of a particular athlete to sport- and running-speed matched normative values to better identify if their mechanics have returned to “normal” following injury or are outside of typical values and potentially reflecting increased injury risk.
We know that beyond the physical consequences of injury, there are subsequent sports performance and mental health consequences that often accompany injury. Identifying runners most at risk of future injury can help reduce injuries and contribute to their physical and mental health and well-being. We perform running analyses on cross country runners each pre-season to assess injury risk and provide recommendations for reducing injury risk based on our research. We primarily focus identifying runners most as risk overuse injuries, such as bone stress injuries and tendinopathies.
While preventing injury is important for racing well, among runners who are otherwise healthy, running mechanics may differentiate those with slower versus faster performances during the season. Through yearly monitoring of running mechanics and race results, we have started to characterize mechanics associated with faster PR times and describe how running mechanics change over a runner’s career and what impact that may have on race performance.
Muscle-tendon injuries, such as hamstring strains, are some of the most frequently occurring sport-related injuries and result in a high burden for athletes and teams as a result of time away from sport and costs associated with treatment and rehabilitation. Additionally, muscle-tendon injuries have some of the highest recurrence rates, with 30% or more of athletes sustaining a repeat injury. Despite their frequent occurrence, our ability to accurately identify athletes who are most at risk for these injuries is limited. Generally agreed-upon risk factors include history of injury and age; however, both of these are non-modifiable. Subsequently, the primary goal of this area of research is to identify modifiable risk factors for injury and re-injury by studying the following areas:
Eccentric strength has been the primary focus of much prior work on modifiable risk factors for hamstring strain injuries (HSI). Our research has found, however, that the size of the association between eccentric hamstring strength alone and future HSI is, at best, small. Ultimately, hamstring strength is one portion of a much larger muscle injury puzzle and measuring strength in conjunction with other measures related to muscle function and structure may provide the best chance of identifying risk factors and implementing injury-reduction strategies.
On-Field Sprinting Mechanics
During sprinting, the hamstrings are active, rapidly lengthening, and absorbing energy to decelerate the limb prior to foot contact. Our research has revealed that hamstring muscle force increases ~1.3-fold as running velocity increases from 80% to 100% of maximum and the greatest MTU stretch is incurred by the biceps femoris long head during high-speed running. As such, “poor” running mechanics that increase muscle-tendon strain have long been considered a causative factor for HSI; however, there is limited empirical data to indicate if running mechanics influence HSI risk.
From a structural perspective, variations in hamstring muscle and tendon morphology have been associated with an increase in tissue (mechanical) strain. A larger ratio of hamstring muscle width to aponeurosis width (i.e. a large muscle relative to a smaller aponeurosis) results in higher levels of tissue strain at the muscle-tendon junction (the most common site of HSI) during running. Moreover, biceps femoris long head architecture has been shown to be a key risk factor for HSI, with short fascicle lengths associated with a ~4-fold increase in HSI risk.
Abnormal lower extremity biomechanics and neuromuscular performance are a barrier to successful return to sport following common orthopaedic procedures, such as anterior cruciate ligament reconstruction and hip arthroscopy.
Our laboratory performs detailed, longitudinal assessments throughout the pre- and post-surgery process to address the following goals:
1) Comprehensively evaluate muscle strength, power, and activation patterns;
2) Assess lower-extremity joint kinetics and kinematics during athletic tasks, such as running and jumping;
3) Evaluate common clinical measures of recovery, such as hopping tasks and patient-reported outcomes;
4) Characterize the long-term effects of these injuries on bone and joint health, physical activity levels, and quality of life.
The ultimate objectives of this line of work are to better understand the neuromuscular implications of musculoskeletal trauma and advance treatment and clinical decision-making to facilitate improved outcomes and long-term quality of life in both collegiate and recreational athletes.
Taking care of athletes means more than just helping when they are sick or injured. Our research spans several areas that evaluate mental health and well-being in athletes, as well as the ways in which they interact with injuries and illnesses. The overarching goals of this work is to promote athlete health and performance by reducing injury and illness risk, as well as identifying actionable ways to promote mental health and well-being. We currently work in multiple overlapping but distinguishable areas outlined below:
Sleep, well-being and injury
Based on our work and others’, we now recognize that psychosocial factors play a large role in the risk of injury in athletes. Impairments in sleep and well-being appear to have sport-specific and independent impacts on short-term injury risk. Our current work seeks to use this information to generate actionable, real-time injury risk predictions that can be used to intervene and prevent injury on an individual level.
Athlete mental health
Mental illness is unfortunately common among adolescents and young adults and has been exacerbated by the COVID-19 pandemic. Our work continues to explore the unique factors that influence mental illness in athletes and how this has changed during COVID-19. Through increased recognition of the factors that impact mental heath in athletes, we can better identify individuals at risk and intervene on their behalf.
Psychosocial impacts of injuries
Within sports medicine, we are increasingly recognizing that injuries do not just have physical consequences, but can result in significant psychosocial impacts on athletes. These represent not only a threat to athlete health, but can significantly impede return to sport and performance, independent of physical recovery. We are working to identify those individuals at greatest risk, in order to intervene in a timely and impactful way to improve mental health and well-being after injuries.
Mindfulness in athletes
Mindfulness represents an efficacious, low-risk, and low-cost intervention to improve mental health and well-being within a broad range of patient populations. Early research suggests that it may also reduce injury risk, aid performance, and improve well-being among athletes. Our work is exploring how mindfulness impacts mental health and well-being in athletes, particularly during the COVID-19 pandemic.