Effects of two gait retraining programs on pain, function, and lower limb kinematics in runners with patellofemoral pain: A randomized controlled trial.

Runners with patellofemoral pain (pain around the kneecap that often flares during running) are usually advised to strengthen their muscles, but gait retraining, changing how they run, is less studied. This small randomized controlled trial compared two different two-week gait retraining programs, one focused on reducing impact through tibial acceleration and one focused on increasing running cadence, against a control group that received no intervention. Both retraining programs led to greater improvements in pain during running compared to no intervention, an effect still present six months later.

The impact-focused program also showed a greater improvement in knee function shortly after the intervention. No differences between groups were found for usual pain or for the lower limb movement patterns measured. With only ten runners per group, the findings are preliminary and should be read as an early signal rather than confirmed evidence of superiority for either approach.

If you run and deal with pain around your kneecap, you may have heard that changing your running style, not just strengthening exercises, could help. This study tested that idea directly, comparing two gait retraining approaches, one aimed at softening the impact of each stride and one aimed at taking quicker, shorter steps, against a group that made no changes. Both retraining approaches were linked to greater improvements in pain during running compared to not intervening, and this difference was still visible six months later.

The impact-focused approach also showed better improvement in knee function right after the two-week program. However, the study did not find differences between groups for everyday pain (not just pain while running) or for the actual movement patterns of the hip, knee, and ankle that were measured. The trial was very small, with only ten runners in each of the three groups, so these results are encouraging early findings rather than settled proof that one running style change is better than another.

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

This randomized controlled trial enrolled 30 runners with patellofemoral pain, allocated ten each to an impact-reduction gait retraining group (targeting a 50% reduction in tibial acceleration), a cadence-increase group (7.5 to 10% increase), and a no-intervention control, with assessments at baseline, immediately post-intervention, and six months later. A significant group by time interaction was found for running pain and knee function.

Both intervention groups showed greater improvement in running pain versus control at six months (impact versus control mean difference -3.2, 95% CI -5.1 to -1.3; cadence versus control mean difference -2.9, 95% CI -4.8 to -1.0), while only the impact group showed greater improvement in knee function versus control immediately post-intervention (mean difference 10.8, 95% CI 1.0 to 20.6). No between-group differences emerged for usual pain or for any of the six lower limb kinematic variables assessed, including contralateral pelvic drop, hip adduction, knee flexion, ankle dorsiflexion, tibial inclination, and foot inclination. The abstract does not report a head-to-head statistical comparison between the impact and cadence groups, so relative superiority between the two active interventions is not established.

With ten participants per arm, these findings warrant cautious interpretation pending larger trials.