title: Distinct hip and rearfoot kinematics in female runners with a history of tibial stress fracture.
abstract: METHODS
  Cross-sectional controlled laboratory study.
  
  
  OBJECTIVE
  To investigate the kinematics of the hip, knee, and rearfoot in the frontal and transverse planes in female distance runners with a history of tibial stress fracture.
  
  
  BACKGROUND
  Tibial stress fractures are a common overuse injury in runners, accounting for up to half of all stress fractures. Abnormal kinematics of the lower extremity may contribute to abnormal musculoskeletal load distributions, leading to an increased risk of stress fractures.
  
  
  METHODS
  Thirty female runners with a history of tibial stress fracture were compared to 30 age-matched and weekly-running-distance-matched control subjects with no previous lower extremity bony injuries. Kinematic and kinetic data were collected using a motion capture system and a force platform, respectively, as subjects ran in the laboratory. Selected variables of interest were compared between the groups using a multivariate analysis of variance (MANOVA).
  
  
  RESULTS
  Peak hip adduction and peak rearfoot eversion angles were greater in the stress fracture group compared to the control group. Peak knee adduction and knee internal rotation angles and all joint angles at impact peak were similar between the groups.
  
  
  CONCLUSIONS
  Runners with a previous tibial stress fracture exhibited greater peak hip adduction and rearfoot eversion angles during the stance phase of running compared to healthy controls. A consequence of these mechanics may be altered load distribution within the lower extremity, predisposing individuals to stress fracture.
authors.affiliation: Department of Exercise, Sport, and Leisure Studies, University of Tennessee, Knoxville, TN 37996, USA. milner@utk.edu
authors.forename: Clare E
authors.initials: CE
authors.lastname: Milner
authors.forename: Joseph
authors.initials: J
authors.lastname: Hamill
authors.forename: Irene S
authors.initials: IS
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D012090:Cumulative Trauma Disorders; D005260:Female; D033023:Foot Joints / Q000502:physiology / Q000503:physiopathology*; D015775:Fractures, Stress / Q000209:etiology / Q000503:physiopathology*; D006621:Hip Joint / Q000502:physiology / Q000503:physiopathology*; D006801:Humans; D007719:Knee Joint / Q000502:physiology / Q000503:physiopathology; D008875:Middle Aged; D012420:Running / Q000293:injuries*; D013978:Tibial Fractures / Q000209:etiology / Q000503:physiopathology*; D055815:Young Adult