Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review.

Running injuries are common, and researchers have long looked for biomechanical traits in a runner's gait, such as how the hip or foot moves or how hard the foot strikes the ground, that might predict who gets injured. This systematic review pulled together prospective studies that measured such factors in healthy runners before any injury occurred, then tracked who went on to develop a running-related injury. Across 16 studies, mostly rated high quality, the picture that emerged was inconsistent rather than clear. One pattern appeared with limited evidence: greater peak hip adduction, a measure of how much the thigh angles inward during running, was linked to patellofemoral pain and iliotibial band syndrome in female runners, though this did not hold in a mixed-sex group of cross-country runners.

A commonly studied factor, the rate at which force loads the leg on impact, showed inconsistent associations with injury. The authors concluded that current evidence is too sparse and varied by population and injury type to confirm firm biomechanical risk factors.

If you run regularly, you've probably wondered whether something about your running form puts you at risk of injury. Researchers have tried to answer this by measuring things like hip movement, foot strike patterns, and impact forces in runners who hadn't been injured yet, then following them over time to see who developed problems like knee pain or shin issues. This review gathered 16 such studies and found the results were mostly inconsistent.

There was limited evidence that women who land with their thigh angling inward more than usual (called hip adduction) were more likely to develop certain knee conditions, but this pattern didn't show up in a mixed group of male and female cross-country runners. How hard the foot strikes the ground didn't show a consistent link to injury either. The honest takeaway is that science doesn't yet have reliable biomechanical warning signs that predict running injuries.

The studies varied a lot in who they included and what injuries they tracked, which makes it hard to draw firm conclusions that apply broadly.

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

This review addresses a question many physiotherapists face when assessing runners: whether specific gait or loading characteristics, identified before injury, can meaningfully predict who develops a running-related injury. Synthesising 16 prospective studies, 13 rated high quality and three moderate, the authors found the evidence base inconsistent and population-dependent rather than confirmatory. The one subgroup finding with limited support was greater peak hip adduction angle preceding patellofemoral pain and iliotibial band syndrome in female runners specifically, a pattern not replicated in a mixed-sex cross-country cohort, suggesting this association may not generalise across populations and should be treated as preliminary.

Vertical loading rate, often assumed to be a key injury risk marker, showed inconsistent relationships with injury across studies. Other kinematic, kinetic, and spatiotemporal variables were studied too sparsely to draw conclusions. This synthesis does not establish that modifying any particular movement pattern prevents injury, nor does it validate gait retraining targets; it only reports prospective associations observed before injury onset, with notable heterogeneity in methods, populations, and injury definitions across the included studies.

The authors call for further research to confirm risk factors and test whether their modification affects injury outcomes, a step this review does not itself provide.