Tibial Strains are Sensitive to Speed, but not Grade, Perturbations During Running

TL;DR

This study used modeling to show that tibial strains during running are affected by speed but not by uphill or downhill grade, highlighting speed as a key factor in tibial stress injury risk.

Contribution

It is the first to systematically analyze the effects of running grade and speed on tibial strains using combined musculoskeletal-finite element modeling.

Findings

Tibial strains are sensitive to running speed.

Running grade does not significantly affect tibial strains.

Increased speed leads to higher peak strains and strained volume.

Abstract

A fatigue-failure process is hypothesized to govern the development of tibial stress fractures, where bone damage is highly dependent on the peak strain magnitude. To date, much of the work examining tibial strains during running has ignored uphill and downhill running despite the prevalence of this terrain. This study examined the sensitivity of tibial strains to changes in running grade and speed using a combined musculoskeletal-finite element modeling routine. Seventeen participants ran on a treadmill at $\pm$10{\deg}, $\pm$5{\deg}, and 0{\deg}; at each grade, participants ran at 3.33 m/s and a grade-adjusted speed - 2.50 m/s and 4.17 m/s for uphill and downhill conditions, respectively. Force and motion data were recorded in each grade and speed combination. Muscle and joint contact forces were estimated using inverse-dynamics-based static optimization. These forces were applied to a participant-informed finite element model of the tibia. None of the strain variables (50th and 95th percentile strain and strained volume $\geq$4000 $\mu\varepsilon$) differed as a function of running grade; however, all strain variables were sensitive to running speed (F(1)$\geq$9.59, p$\leq$0.03). In particular, a 1 m/s increase in running speed resulted in a 9% ($\approx$ 260 $\mu\varepsilon$) and 155% ($\approx$ 600 mm^3) increase in peak strain and strained volume, respectively. Overall, these findings suggest that faster running speed, but not changes in running grade, may be more deleterious to the tibia.