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Item Enhanced Bone Size, Microarchitecture, and Strength in Female Runners with a History of Playing Multidirectional Sports(Wolters Kluwer, 2022-12) Warden, Stuart J.; Sventeckis, Austin M.; Surowiec, Rachel K.; Fuchs, Robyn K.; Physical Therapy, School of Health and Human SciencesPurpose: Female runners have high rates of bone stress injuries (BSIs), including stress reactions and fractures. The current study explored multidirectional sports (MDS) played when younger as a potential means of building stronger bones to reduce BSI risk in these athletes. Methods: Female collegiate-level cross-country runners were recruited into groups: 1) RUN: history of training and/or competing in cross-country, recreational running/jogging, swimming and/or cycling only and 2) RUN+MDS: additional prior history of training and/or competing in soccer or basketball. High-resolution peripheral quantitative computed tomography was used to assess the distal tibia, common BSI sites (diaphysis of the tibia, fibula and 2nd metatarsal), and high-risk BSI sites (base of the 2nd metatarsal, navicular and proximal diaphysis of the 5th metatarsal). Scans of the radius were used as control sites. Results: At the distal tibia, RUN+MDS (n=18) had enhanced cortical area (+17.1%) and thickness (+15.8%) and greater trabecular bone volume fraction (+14.6%) and thickness (+8.3%) compared to RUN (n=14) (all p<0.005). Failure load was 19.5% higher in RUN+MDS (p<0.001). The fibula diaphysis in RUN+MDS had 11.6% greater total area and 11.1% greater failure load (all p≤0.03). At the 2nd metatarsal diaphysis, total area in RUN+MDS was 10.4% larger with greater cortical area and thickness and 18.6% greater failure load (all p<0.05). RUN+MDS had greater trabecular thickness at the base of the 2nd metatarsal and navicular and greater cortical area and thickness at the proximal diaphysis of the 5th metatarsal (all p≤0.02). No differences were observed at the tibial diaphysis or radius. Conclusion: These findings support recommendations that athletes delay specialization in running and play MDS when younger to build a more robust skeleton and potentially prevent BSIs.Item Is running good or bad for your knees? A systematic review and meta-analysis of cartilage morphology and composition changes in the tibiofemoral and patellofemoral joints(Elsevier, 2023-02) Coburn, S. L.; Crossley, K. M.; Kemp, J. L.; Warden, S. J.; West, T. J.; Bruder, A. M.; Mentiplay, B. F.; Culvenor, A. G.; Health Sciences, School of Health and Human SciencesBackground The general health benefits of running are well-established, yet concern exists regarding the development and progression of osteoarthritis. Aim To systematically review the immediate (within 20 min) and delayed (20 min–48 h) effect of running on hip and knee cartilage, as assessed using magnetic resonance imaging (MRI). Method Studies using MRI to measure change in hip or knee cartilage within 48 h pre- and post-running were identified. Risk of bias was assessed using a modified Newcastle–Ottawa Scale. Percentage change in cartilage outcomes were estimated using random-effects meta-analysis. Certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation tool. Results Twenty-four studies were included, evaluating 446 knees only. One third of studies were low risk of bias. Knee cartilage thickness and volume decreased immediately after running, with declines ranging from 3.3% (95% confidence interval [CI]: 2.6%, 4.1%) for weight-bearing femoral cartilage volume to 4.9% (95% CI: 4.43.6%, 6.2%) for patellar cartilage volume. T1ρ and T2 relaxation times were also reduced immediately after running, with the largest decline being 13.1% (95% CI: −14.4%, −11.7%) in femoral trochlear cartilage. Tibiofemoral cartilage T2 relaxation times recovered to baseline levels within 91 min. Existing cartilage defects were unchanged within 48 h post-run. Conclusions There is very low certainty evidence that running immediately decreases the thickness, volume, and relaxation times of patellofemoral and tibiofemoral cartilage. Hip cartilage changes are unknown, but knee changes are small and appear transient suggesting that a single bout of running is not detrimental to knee cartilage.Item Short-Term Exercise In Mice Increases Tibial Post-Yield Mechanical Properties While Two Weeks of Latency Following Exercise Increases Tissue-Level Strength(2009-04) Wallace, Joseph M.; Ron, Michael S; Kohn, David H.We have previously shown that exercise during growth increases post-yield deformation in C57BL6/129 (B6;129) male tibiae at the expense of reduced pre-yield deformation and structural and tissue strength. Other research in the literature indicates that increased mineral content, cross-sectional geometry and structural strength due to exercise can be maintained or increased after exercise ends for as long as 14 weeks. It was therefore hypothesized that after our exercise protocol ended, effects of exercise on mechanical properties would persist, resulting in increased post-yield behavior and rescued strength versus age-matched control mice. Beginning at 8 weeks of age, exercise consisted of running on a treadmill (30 min/day, 12 m/min, 5° incline) for 21 consecutive days. At the end of running and 2 weeks later, in the cortical bone of the tibial mid-diaphyses of B6;129 male mice, changes due to exercise and latency following exercise were assayed by mechanical tests and analyses of cross-sectional geometry. Exercise increased structural post-yield deformation compared with weight-matched control mice, without changes in bone size or shape, suggesting that exercised-induced changes in pre-existing bone quality were responsible. Over the 2-week latency period, no growth-related changes were noted in control mice, but exercise-induced changes resulted in increased tissue stiffness and strength versus mice sacrificed immediately after exercise ended. Our data indicate that periods of exercise followed by latency can alter strength, stiffness, and ductility of bone independent of changes in size or shape, suggesting that exercise may be a practical way to increase the quality of the bone extracellular matrix.