The influence of cadence and shoes on patellofemoral joint kinetics in runners with patellofemoral pain

OBJECTIVES: To determine the effect of a combination of a minimalist shoe and increased cadence on measures of patellofemoral joint loading during running in individuals with patellofemoral pain. DESIGN: Within-participant repeated measures with four conditions presented in random order: (1) control shoe at preferred cadence; (2) control shoe with +10% cadence; (3) minimalist shoe at preferred cadence; (4) minimalist shoe with +10% cadence. METHODS: Fifteen recreational runners with patellofemoral pain ran on an instrumented treadmill while three-dimensional motion capture data were acquired. Peak patellofemoral joint stress, joint reaction force, knee extensor moment and knee joint angle during the stance phase of running were calculated. One-way repeated measures ANOVA was used to compare the control condition (1) to the three experimental conditions (2-4). RESULTS: Running in a minimalist shoe at an increased cadence reduced patellofemoral stress and joint reaction force on average by approximately 29% (p<0.001) compared to the control condition. Running in a minimalist shoe at preferred cadence reduced patellofemoral joint stress by 15% and joint reaction force by 17% (p<0.001), compared to the control condition. Running in control shoes at an increased cadence reduced patellofemoral joint stress and joint reaction force by 16% and 19% (p<0.001), respectively, compared to the control condition. CONCLUSIONS: In individuals with patellofemoral pain, running in a minimalist shoe at an increased cadence had the greatest reduction in patellofemoral joint loading compared to a control shoe at preferred cadence. This may be an effective intervention to modulate biomechanical factors related to patellofemoral pain.