Are alterations in running biomechanics associated with running injuries? A systematic review with meta-analysis.

Researchers wanted to know whether changes in how runners move their bodies can predict who will get injured. They searched five major medical databases and found 82 studies involving over 5400 runners, then pooled data from 51 of those studies to look for patterns. The results were surprisingly thin: only one biomechanical variable, peak hip adduction angle (how much the hip rotates inward during running), showed a consistent link to injury, and even that finding was heavily shaped by just two studies from the same research group.

The authors conclude that we simply don't have strong evidence yet that running biomechanics predict injury, partly because different studies measure movement in different ways and use different definitions for the same terms.

If you've been told your running injury is caused by the way you move, you might wonder how certain that diagnosis really is. This study looked at what scientific evidence actually supports linking body movement to running injuries, and the honest answer is that the connection isn't as straightforward as it might seem.

Researchers found that one movement pattern, called hip adduction (the inward rotation of your hip during running), appeared more common in injured runners, but this finding wasn't as strong as it looked because a small number of studies drove most of the result. The bigger picture is that when researchers try to measure how running movement connects to injury, they often measure and define things differently, making it hard to see clear patterns across studies. This doesn't mean your injury wasn't caused by how you run, but it does mean we're still figuring out which specific movement changes actually matter for injury risk.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review and meta-analysis offers a sobering look at the biomechanical prediction literature. Across 82 studies of over 5400 runners, only one kinetic or kinematic variable stood out statistically: greater peak hip adduction angle in injured versus uninjured runners.

But this result warrants caution, since two studies from the same research group disproportionately influenced the pooled estimate, raising questions about replicability and generalisability. The heterogeneity problem is real and substantial. Differences in how movement is captured (lab versus field, marker sets, sampling rates), how variables are named and computed, and which populations are studied make it genuinely difficult to synthesize findings.

The authors note that studies included in the meta-analysis showed inconsistency in biomechanical variable definitions and evaluation conditions. This doesn't invalidate clinical observation of movement faults, but it does suggest that individual biomechanical predictors of injury remain poorly characterised in the current literature.