title: Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion.
abstract: OBJECTIVE
  Running-related injuries are highly prevalent.
  
  
  OBJECTIVE
  Synthesise published evidence with international expert opinion on the use of running retraining when treating lower limb injuries.
  
  
  METHODS
  Mixed methods.
  
  
  METHODS
  A systematic review of clinical and biomechanical findings related to running retraining interventions were synthesised and combined with semistructured interviews with 16 international experts covering clinical reasoning related to the implementation of running retraining.
  
  
  RESULTS
  Limited evidence supports the effectiveness of transition from rearfoot to forefoot or midfoot strike and increase step rate or altering proximal mechanics in individuals with anterior exertional lower leg pain; and visual and verbal feedback to reduce hip adduction in females with patellofemoral pain. Despite the paucity of clinical evidence, experts recommended running retraining for: iliotibial band syndrome; plantar fasciopathy (fasciitis); Achilles, patellar, proximal hamstring and gluteal tendinopathy; calf pain; and medial tibial stress syndrome. Tailoring approaches to each injury and individual was recommended to optimise outcomes. Substantial evidence exists for the immediate biomechanical effects of running retraining interventions (46 studies), including evaluation of step rate and strike pattern manipulation, strategies to alter proximal kinematics and cues to reduce impact loading variables.
  Our synthesis of published evidence related to clinical outcomes and biomechanical effects with expert opinion indicates running retraining warrants consideration in the treatment of lower limb injuries in clinical practice.
authors.affiliation: Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia Complete Sports Care, Melbourne, Victoria, Australia Pure Sports Medicine, London, UK Centre for Sport and Exercise Medicine, Queen Mary University of London, London, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Barton
authors.affiliation: Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: D R
authors.initials: DR
authors.lastname: Bonanno
authors.affiliation: Complete Sports Care, Melbourne, Victoria, Australia Back on Track Physiotherapy, Albury, New South Wales, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Carr
authors.affiliation: Pure Sports Medicine, London, UK Centre for Sport and Exercise Medicine, Queen Mary University of London, London, UK.
authors.forename: B S
authors.initials: BS
authors.lastname: Neal
authors.affiliation: Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia Complete Sports Care, Melbourne, Victoria, Australia Centre for Sport and Exercise Medicine, Queen Mary University of London, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Malliaras
authors.affiliation: Sports Surgery Clinic Research Unit, Santry Demesne, Dublin, Republic of Ireland Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Franklyn-Miller
authors.affiliation: Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: H B
authors.initials: HB
authors.lastname: Menz
mesh_terms: D001265:Athletic Injuries / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D000068598:Data Accuracy; D005260:Female; D005684:Gait; D006801:Humans; D007407:Interviews as Topic; D007869:Leg Injuries / Q000534:rehabilitation*; D008297:Male; D064797:Physical Conditioning, Human / Q000379:methods*; D012420:Running / Q000293:injuries*
keywords: Injury; Lower limb; Rehabilitation; Running