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Peer-reviewedCC BYJournal of functional morphology and kinesiology

Symptom-Region-Associated Neuromechanical Compensation During Running: Integrated 3D Kinematic, Kinetic and Electromyographic Profiling of Running-Related Injuries.

  1. 1Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave, Box 665, Rochester, NY 14642, USA.

Abstract

Background and Objectives: Running-related injuries (RRIs) are common musculoskeletal conditions associated with repetitive loading and heterogeneous biomechanical adaptations. This study evaluated the clinical utility of integrated three-dimensional (3D) biomechanical assessment for identifying interlimb asymmetries and symptom-region-specific compensatory strategies in runners with RRIs. Methods: One hundred twenty-two adolescent and adult runners referred from a Sports Medicine Physical Therapy clinic for a running-related musculoskeletal complaint were classified by primary symptomatic region (spine, n = 10; hip, n = 38; knee, n = 48; foot/ankle, n = 26); 27 asymptomatic runners served as controls. Participants completed standardized treadmill running while bilateral markerless 3D kinematics, instrumented treadmill kinetics, and surface electromyography (sEMG) were synchronously recorded. Log-transformed asymmetry indices and neuromechanical outcomes were evaluated using mixed-effects models with false discovery rate correction. Results: Distinct symptom-region-associated patterns of mechanical and neuromuscular compensation were identified. Hip-region RRIs demonstrated greater contralateral propulsive impulse (diff = 0.07; p = 0.029), whereas knee-region RRIs demonstrated greater contralateral hip extension moment (diff = 0.14; p = 0.013). Foot/ankle-region RRIs demonstrated greater contralateral knee extension moment (diff = 0.18; p = 0.017) and greater symptomatic-limb tibialis anterior activation (peak RMS: diff = 0.52; p = 0.032). The spine-region cohort demonstrated greater dominant-limb medial gastrocnemius activation (peak RMS: diff = 0.35; p = 0.037). Conclusions: Integrated 3D kinematic, kinetic, and neuromuscular profiling identified distinct regional patterns of load redistribution across the kinetic chain in runners with RRIs. This multimodal framework may complement clinical examination by identifying individualized biomechanical targets for rehabilitation and enabling longitudinal assessment of load-sharing recovery.

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BibTeX
@article{haddas2026symptomregionassociated,
  title = {{Symptom-Region-Associated Neuromechanical Compensation During Running: Integrated 3D Kinematic, Kinetic and Electromyographic Profiling of Running-Related Injuries.}},
  author = {Ram Haddas and Brett P Salazar and Ye Shu and Emily Hague and Jillian Santer and Edward M Schwarz and Katherine H Rizzone and Michael D Maloney},
  journal = {Journal of functional morphology and kinesiology},
  year = {2026},
  month = sep,
  doi = {10.3390/jfmk11040378},
  url = {https://europepmc.org/article/MED/42924657},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Symptom-Region-Associated Neuromechanical Compensation During Running: Integrated 3D Kinematic, Kinetic and Electromyographic Profiling of Running-Related Injuries.
AU  - Ram Haddas
AU  - Brett P Salazar
AU  - Ye Shu
AU  - Emily Hague
AU  - Jillian Santer
AU  - Edward M Schwarz
AU  - Katherine H Rizzone
AU  - Michael D Maloney
PY  - 2026
DA  - 2026/09/23
JO  - Journal of functional morphology and kinesiology
DO  - 10.3390/jfmk11040378
UR  - https://europepmc.org/article/MED/42924657
AB  - Background and Objectives: Running-related injuries (RRIs) are common musculoskeletal conditions associated with repetitive loading and heterogeneous biomechanical adaptations. This study evaluated the clinical utility of integrated three-dimensional (3D) biomechanical assessment for identifying interlimb asymmetries and symptom-region-specific compensatory strategies in runners with RRIs. Methods: One hundred twenty-two adolescent and adult runners referred from a Sports Medicine Physical Therapy clinic for a running-related musculoskeletal complaint were classified by primary symptomatic region (spine, n = 10; hip, n = 38; knee, n = 48; foot/ankle, n = 26); 27 asymptomatic runners served as controls. Participants completed standardized treadmill running while bilateral markerless 3D kinematics, instrumented treadmill kinetics, and surface electromyography (sEMG) were synchronously recorded. Log-transformed asymmetry indices and neuromechanical outcomes were evaluated using mixed-effects models with false discovery rate correction. Results: Distinct symptom-region-associated patterns of mechanical and neuromuscular compensation were identified. Hip-region RRIs demonstrated greater contralateral propulsive impulse (diff = 0.07; p = 0.029), whereas knee-region RRIs demonstrated greater contralateral hip extension moment (diff = 0.14; p = 0.013). Foot/ankle-region RRIs demonstrated greater contralateral knee extension moment (diff = 0.18; p = 0.017) and greater symptomatic-limb tibialis anterior activation (peak RMS: diff = 0.52; p = 0.032). The spine-region cohort demonstrated greater dominant-limb medial gastrocnemius activation (peak RMS: diff = 0.35; p = 0.037). Conclusions: Integrated 3D kinematic, kinetic, and neuromuscular profiling identified distinct regional patterns of load redistribution across the kinetic chain in runners with RRIs. This multimodal framework may complement clinical examination by identifying individualized biomechanical targets for rehabilitation and enabling longitudinal assessment of load-sharing recovery.
SN  - 2411-5142
ER  -