Kinematic Adaptations during Running:

Effects of Footwear, Surface, and Duration

ELIZABETH C. HARDIN1, ANTONIE J. VAN DEN BOGERT1, and JOSEPH HAMILL2
1
Department of Biomedical Engineering, The Cleveland Clinic Foundation, Cleveland, OH; and 2Department of Exercise
Science, University of Massachusetts, Amherst, MA

ABSTRACT
HARDIN, E. C., A. J. VAN DEN BOGERT, and J. HAMILL. Kinematic Adaptations during Running: Effects of Footwear, Surface, and
Duration. Med. Sci. Sports Exerc., Vol. 36, No. 5, pp. 838 – 844, 2004. Repetitive impacts encountered during locomotion may be modified
by footwear and/or surface. Changes in kinematics may occur either as a direct response to altered mechanical conditions or over time as active
adaptations. Purpose: To investigate how midsole hardness, surface stiffness, and running duration influence running kinematics. Methods:
In the first of two experiments, 12 males ran at metabolic steady state under six conditions; combinations of midsole hardness (40 Shore A,
70 Shore A), and surface stiffness (100 kN·m⫺1, 200 kN·m⫺1, and 350 kN·m⫺1). In the second experiment, 10 males ran for 30 min on a
12% downhill grade. In both experiments, subjects ran at 3.4 m·s⫺1 on a treadmill while 2-D hip, knee, and ankle kinematics were determined
using high-speed videography (200 Hz). Oxygen cost and heart rate data were also collected. Kinematic adaptations to midsole, surface, and
running time were studied. Results: Stance time, stride cycle time, and maximal knee flexion were invariant across conditions in each
experiment. Increased midsole hardness resulted in greater peak ankle dorsiflexion velocity (P ⫽ 0.0005). Increased surface stiffness resulted
in decreased hip and knee flexion at contact, reduced maximal hip flexion, and increased peak angular velocities of the hip, knee, and ankle.
Over time, hip flexion at contact decreased, plantarflexion at toe-off increased, and peak dorsiflexion and plantarflexion velocity increased.
Conclusion: Lower-extremity kinematics adapted to increased midsole hardness, surface stiffness, and running duration. Changes in limb
posture at impact were interpreted as active adaptations that compensate for passive mechanical effects. The adaptations appeared to have the
goal of minimizing metabolic cost at the expense of increased exposure to impact shock. Key Words: LOWER-EXTREMITY GEOMETRY,
MIDSOLES, SURFACE STIFFNESS, GRADE, SHOCK

L
oading is necessary for maintenance of cartilage, modify impact forces are foot inversion, ankle dorsiflexion,
bone, and muscle health (9,18,34,49). An optimal and knee flexion (2,10,21,22,37,40). Although experimental
loading window for tissue health can be character- evidence of kinematic adaptations to impact is limited (19),
ized by repeated impacts of certain magnitude, duration, and this may be because some effective kinematic adaptations
frequency, but these variables and their interaction are not are too small to be measured or because of the limited
well understood (42). Beyond the optimal loading window, conditions under which adaptations are examined.
repeated impacts can cause osteoarthritis (45,47) in animal Conditions such as footwear and surface are external
models. Although no direct experimental evidence of this influences on the foot/ground impact, of which footwear has
exists in humans, there is general agreement that repeated received more attention from runners and researchers. Run-
impact loading can lead to injury. For example, higher rates ning shoe midsoles have commonly been designed to cush-
of injury have been associated with greater running mileage ion impact, but their effectiveness has been debated (6,39).
(28,31,35). There is some evidence, however, that properly cushioned
It is unclear how the human musculoskeletal system footwear can decrease injuries (30). Shoes with less cush-
adapts during repetitive loading such as running, and how ioning, on the other hand, have been shown to cause in-
any adaptations within a session of running are influenced creased knee flexion velocity (20,51) and increased energy
by footwear, surface or running duration. It is known, how- cost (20). With respect to the running surface, harder sur-
ever, that changes in joint rotations affect the impact im- faces have been associated with injuries (41) whereas a
posed on the body (8,21). The kinematic changes that may “tuned” surface can alleviate injures and enhance speed
(36). Furthermore, surface stiffness modifications can cause
leg stiffness to change in order to keep the same combined
Address for correspondence: E. C. Hardin, Ph.D., Department of Biomed- stiffness of the runner and surface (16,32), although this
ical Engineering (ND-2), Cleveland Clinic Foundation, 9500 Euclid Ave- concept of leg stiffness is reflective of a whole body re-
nue, Cleveland, OH 44195; E- mail: [email protected]. sponse rather than an adaptation at a particular joint.
Submitted for publication January 2003. There may be a cumulative injury risk with each running
Accepted for publication June 2003.
stride (31) because longer distances run per week have been
0195-9131/04/3605-0838 associated with injury, both in the general population
MEDICINE & SCIENCE IN SPORTS & EXERCISE® (33,35) and in military trainees where diet and activities are
Copyright © 2004 by the American College of Sports Medicine controlled (31). It seems then that over longer distances
DOI: 10.1249/01.MSS.0000126605.65966.40 runners may function near the limit of healthy loading.
838
 TABLE 1. Subject characteristics for both experiments; subjects were similar in body maximal vertical deflection of the treadmill bed (Motion
mass, height, and average running distance per week.
Analysis Corp., Santa Rosa, CA) at each of the three com-
Average Running
Body Mass Height Distance per Week
pliance settings and assuming that a 75-kg runner would
Subjects (kg) (m) (km) exert 2.5 times body weight at midstance (43).
Experiment 1
Mean ⫾ SD (N ⫽ 12) 69.4 ⫾ 4.44 1.75 ⫾ 0.053 20.0 ⫾ 7.4 Shoes
Experiment 2
Mean ⫾ SD (N ⫽ 10) 74.0 ⫾ 6.97 1.76 ⫾ 0.058 22.7 ⫾ 11.9
All subjects wore shoes designed specifically for these ex-
periments. These shoes were identical in mass and construc-
Furthermore, when distance running occurs on a downhill tion. For experiment 1, they differed only in midsole hardness,
grade, runners encounter greater impact magnitude (23,27) 40 Shore A, and 70 Shore A (soft and hard, respectively). For
and require greater negative work from the lower extremi- experiment 2, all subjects wore the hard shoes (70 Shore A).
ties (4). In fact, prolonged downhill running has been used
to study the influence of duration on the attenuation of Protocol
impact shock (38). The kinematic mechanisms that are Experiment 1. After a standard treadmill warm-up, sub-
responsible for such adaptations are not well understood. jects ran at 3.4 m·s⫺1 for 6 min in each of six conditions with
The primary purpose of this paper was to investigate the treadmill at level grade. Condition order was a combi-
adaptations in sagittal plane kinematics to midsole hardness, nation of midsole hardness and surface stiffness (Table 2),
surface stiffness and running duration. and order was balanced across the 12 subjects using a Latin
square. This duration was chosen to assure that subjects had
METHODS reached metabolic steady state. Kinematic and metabolic
data were collected from the third to sixth min during each
Subjects of the six conditions. Between conditions, subjects rested
The subjects for both experiments were volunteers from a until their heart rate was less than 120 bpm and they re-
university population and had similar body mass, height, ported readiness for the following condition. Subjects were
and weekly mileage characteristics (Table 1). In both ex- assured to be running at metabolic steady state from the
periments, an informed consent document and Physical Ac- third to sixth minute, as there were no statistically signifi-
tivity Readiness Questionnaire were read and signed by the cant differences in oxygen uptake between these minutes.
subjects in accordance with University of Massachusetts Experiment 2. Subjects ran on a hard-surfaced tread-
Amherst policy. Each subject was a heel-toe runner, was mill for 30 min at 3.4 m·s⫺1 with the treadmill positioned to
free from lower-extremity injury, and had previous treadmill a ⫺12% grade while kinematic and metabolic data were
running experience. Heel-toe runners were used because collected. This grade and duration was chosen because it
footstrike pattern influences ankle stiffness (48) and if not represented a heightened impact exposure compared with
controlled can confound lower-extremity measurements. the subjects’ normal daily run, both in impact number and
The experimental sample size was estimated from previous magnitude, yet the grade was not so steep that the nature of
running kinematic data (25) using a power analysis (7). For the task changed. In addition, this duration is a recom-
experiment 1, 12 subjects were used to keep the condition mended daily exercise duration for these individuals to
order balanced, but 10 were deemed necessary to provide develop and maintain fitness (1,17). Indeed, we were spe-
the statistical power (0.80) to detect parameter differences cifically investigating adaptations to multiple impacts, not
of 20%. Similarly, 10 subjects were deemed sufficient for those to cardiorespiratory fatigue. This type of running does
experiment 2. not elicit cardiorespiratory fatigue. Kinematic and metabolic
data were collected during six 5-min intervals (0 –5, 5–10,
Treadmill 10 –15, 15–20, 20 –25, and 25–30 min).
Subjects ran on a treadmill with modifiable bed compli-
Kinematics
ance in experiment 1 (Precor, M9.3s, Bothell, WA). Three
compliance settings were chosen to simulate different sur- Right sagittal view kinematic data were recorded at 200
face hardnesses which corresponded to stiffnesses of 100 Hz with retroreflective markers placed on the skin over the
kN·m⫺1 (soft), 200 kN·m⫺1 (medium), and 350 kN·m⫺1 humeral head, greater trochanter, femoral condyle, lateral
(hard). Treadmill stiffness was calculated by measuring malleolus, lateral aspect of the calcaneus, and the fifth

TABLE 2. Midsole hardness and surface stiffness for each of the six conditions in Experiment 1 (S40 ⫽ soft surface and 40 Shore A midsole; M40 ⫽ medium surface and 40
Shore A midsole; H40 ⫽ hard surface and 40 Shore A midsole; S70 ⫽ soft surface and 70 Shore A midsole; M70 ⫽ medium surface and 70 Shore A midsole; H70 ⫽ hard
surface and 70 Shore A midsole).
Independent Variable S40 M40 H40 S70 M70 H70
Midsole hardness 40a 40a 40a 70a 70a 70a
Surface stiffness 100b (soft) 200b (medium) 350b (hard) 100b (soft) 200b (medium) 350b (hard)
a
Shore A scale; b kN䡠m⫺1.
Condition order was balanced across the 12 subjects using a Latin square.

KINEMATIC ADAPTATIONS DURING RUNNING Medicine & Science in Sports & Exercise姞 839
metatarsal. Markers were digitized using a video processor RESULTS
(VP-110, Motion Analysis Corp.) and marker paths were
Experiment 1. Stance time and stride cycle time were
edited and then digitally filtered with a low pass Butterworth
invariant across conditions. Oxygen consumption was great-
filter at 12 Hz. This frequency was determined from a
est for the soft surface (P ⬍ 0.001) and decreased with
residual analysis (29). Hip, knee, and ankle angles and
increasing surface stiffness (Fig. 1). There were no signif-
angular velocities were calculated from the filtered marker
icant differences in the heart rate (surface: P ⫽ 0.007;
paths. The hip angle that is calculated with this method
midsole: P ⫽ 0.681). Kinematic adaptations to the surface
reflects the angle between the upper body and the thigh,
occurred at the hip and knee, whereas adaptations to the
rather than the angle between the pelvis and the femur. In
midsole were found only at the ankle (Fig. 2). The most
experiment 1, mean values of the kinematic variables were
striking kinematic differences were seen at the knee. On the
obtained from ten random footfalls between minutes 3 and
hard surface, the hip and knee were at greater extension at
5 for each subject during each condition. In experiment 2,
foot contact than on the medium or soft surface (P ⫽ 0.0001
mean values were obtained for each subject from 10 stance
for each joint). Maximum hip flexion was significantly less
periods collected during each of six 5-min intervals (0 –5,
on the hard surface (P ⫽ 0.0001), whereas maximum knee
5–10, 10 –15, 15–20, 20 –25, and 25–30 min). Kinematic
flexion did not change (P ⫽ 0.936). Joint velocity differ-
variables from the hip, knee and ankle which were used in
the statistical analysis were: 1) angle at contact, 2) maxi- ences were found between the surfaces. Peak angular ve-
mum angle during stance, 3) angle at toe-off, 4) maximum locity of the hip, knee, and ankle were greatest on the hard
angular velocity, and 5) minimum angular velocity.
Footstrike and toe-off were determined with a pressure
sensor under the treadmill. This signal was interfaced to a
microcomputer and sampled with a 12-bit A/D converter at
1 kHz. Mean stride frequency and stance time were calcu-
lated from the 10 stride cycles for the time periods within
each condition in both experiments.

Oxygen Consumption and Heart Rate

Metabolic data were obtained in both experiments from
an AeroSport TEEM 100 Metabolic Analysis System that
was calibrated according to manufacturer specifications be-
fore each data collection session. The oxygen (O2) and
carbon dioxide (CO2) analyzers were calibrated with known
concentrations of gas. A high-flow pneumotach was used
for all subjects and was calibrated with a calibrated 3-L
syringe. Heart rate was measured with a Vantage Perfor-
mance telemetry system. Metabolic and heart rate data were
sampled every 20 s. Minute values of oxygen consumption
(V̇O2) and heart rate were calculated using the average of
three, 20 s samples. In experiment 1, the per-minute values
at 3, 4, and 5 min were averaged to obtain a grand mean for
each subject in each condition and used for statistical anal-
ysis. In experiment 2, the per-minute values within each
5-min interval (0 –5, 5–10, 10 –15, 15–20, 20 –25, and
25–30 min) were averaged to obtain six mean values rep-
resenting each 5-min interval per subject, and these were
used in the statistical analysis.

Statistical Analysis
In experiment 1, midsole hardness and surface stiffness
were the main effects tested with a two-way repeated-
measures ANOVA. In experiment 2, time was the main
effect tested with a one-way repeated-measures ANOVA.
FIGURE 1—Oxygen consumption (a) and heart rate (b) values for the
For both experiments, simple effects and contrasts were six conditions of midsole hardness and surface stiffness averaged over
tested for kinematic, stride cycle, and oxygen cost variables all subjects and trials in experiment 1 (mean ⴞSD). Stars (*, **, ***)
with a significant effect (P ⬍ 0.05) using the Tukey pair- denote significant main effect of surface condition (P < 0.0033) with
the number of stars corresponding to distinct groups. Oxygen consump-
wise comparisons of means and Bonferroni adjustment pro- tion was greatest for the soft surface and decreased with increasing
cedure in order to control the type 1 error (P ⬍ 0.0033). surface stiffness. There were no significant differences in the heart rate.

840 Official Journal of the American College of Sports Medicine http://www.acsm-msse.org

FIGURE 2—Hip, knee, and ankle kinematics at contact ([a], [b], [c]), and maximal flexion and dorsiflexion during stance of the hip, knee, and ankle
([d], [e], [f]) and peak angular flexion and dorsiflexion velocity of the hip, knee, and ankle ([g], [h], [i]) averaged over all subjects and trials in
experiment 1 (mean ⴞ SD). Greater flexion (hip and knee) or dorsiflexion (ankle) is represented by increasing positive angles. The ankle was neutral
at 0°. Stars (*, **, ***) denote significant main effect of surface condition (P < 0.0033) with the number of stars corresponding to distinct groups.
Diamonds (䉫, 䉫䉫) denote the significant main effect of midsole condition (P < 0.0033) with the number of diamonds corresponding to distinct
groups. Increased surface stiffness caused greater hip and knee extension at contact ([a], [b]), decreased maximal hip flexion ([d]), and greater peak
angular flexion and dorsiflexion velocity of the hip, knee, and ankle ([g], [h], [i]). Maximal knee flexion and ankle dorsiflexion remained the same.
Increased midsole hardness independently resulted in greater peak ankle velocity ([i]).

surface and increased with surface stiffness (P ⬍ 0.001 for hill running. The accompanying changes in heart rate and
all joints). Increased midsole hardness independently re- oxygen uptake were also quantified. With increased surface
sulted in greater peak ankle velocity (P ⫽ 0.0005). stiffness (experiment 1), the lower extremity was in greater
Experiment 2. Kinematic adaptations over time oc- extension in the hip and knee at contact, maximal hip
curred at the ankle and hip joints. The hip joint was in a flexion angle decreased, and peak angular velocity increased
more extended position at contact in the last 15 min versus in all joints (Fig. 2). At the same time, there was a decrease
the first 5 min of running (P ⫽ 0.0017) (Fig. 3). Ankle in oxygen uptake with increasing surface hardness (Fig. 1).
adaptations consisted of increased plantarflexion at toe-off Shoe hardness only affected the kinematics at the ankle (Fig.
after 5 min of running (P ⫽ 0.0000), and increased peak 2). With increased duration of downhill running (experiment
dorsiflexion and peak plantarflexion velocity (P ⫽ 0.0008 2), kinematic adaptations occurred only at the hip and ankle
and P ⫽ 0.0002) during the last 15 min of running versus the (Fig. 3), whereas oxygen uptake and heart rate both in-
first 5 min. Ankle angle at contact and maximum dorsiflex- creased significantly over time (Fig. 4). Our intention in
ion during stance were invariant (P ⫽ 0.0121 and P ⫽ 0.5816). presenting results from these two experiments was to find
There were no adaptations in knee kinematics. Stance time and common principles that govern kinematic adaptations dur-
stride cycle time were invariant over the running duration. ing running. We will start with a comparison to other results
Oxygen consumption and heart rate gradually increased over and theories presented in the current literature, and then
the 30 min of running (P ⫽ 0.0000) (Fig. 4). proceed to develop a comprehensive understanding based
on our own results.
A recent study on the effect of surface compliance on
DISCUSSION
running showed that the metabolic cost was lowest for the
The primary purpose of this paper was to investigate most compliant surface (32). This is contrary to our
adaptations in sagittal plane kinematics induced by changes findings. Earlier studies found no effect of surface on
in shoe and surface hardness as well as by prolonged down- energy cost (3,44). These inconsistencies may be caused
KINEMATIC ADAPTATIONS DURING RUNNING Medicine & Science in Sports & Exercise姞 841
FIGURE 3—Hip, knee and ankle kinematics at contact ([a], [b], [c]), and maximal flexion and dorsiflexion during stance of the hip, knee, and ankle
([d], [e], [f]) and peak angular flexion and dorsiflexion velocity of the hip, knee, and ankle ([g], [h], [i]) averaged over all subjects and trials in
experiment 2 (mean ⴞ SD). Stars (*, **) denote significant main effect of surface condition (P < 0.0033) with the number of stars corresponding
to distinct groups. Greater flexion (hip and knee) or dorsiflexion (ankle) is represented by increasing positive angles. The ankle was neutral at 0°.
Hip extension at contact increased during the last 15 min, as did maximal dorsiflexion velocity. Maximal plantarflexion velocity and plantarflexion
angle at toe-off also increased significantly (not shown). Knee kinematics remained the same over time.

by differences in surface construction. Our subjects men- seems to be more pronounced on harder surfaces (Fig. 1)
tioned a sensation of “running on sand” indicating that and our hardest surface was less hard than that generally
the surface may have had too much damping or inertia to used for overground laboratory running.
effectively produce a “rebound” effect as in other sur- With increased duration of downhill running, we found
faces used (32). Two previous studies found that a harder increased peak dorsiflexion velocity, and no change in knee
surface resulted in lower leg stiffness (16,32) with leg kinematics as has been previously observed (38). During
stiffness being defined as the peak force divided by the level running under cardiovascular fatigue, some have ob-
length change of the leg. This is consistent with our served that the knee angle at contact is more flexed (12),
observation that posture at time of initial contact was whereas others have found lower-extremity segments to be
more extended on the hard surface, whereas the maxi- more vertical at contact (14,50). We found increased exten-
mum knee flexion angle remained unchanged. sion at the hip joint that, as measured, was reflective of a
Harder midsoles have been found to cause an increase in more vertical position of upper body mass relative to the hip
knee flexion velocity (5). We found this result as well, but rather than a change in the angle of the pelvis. This upper
it was not statistically significant (P ⫽ 0.099). We did find body position should require less muscle activation for
an increase in dorsiflexion velocity that is similar to obser- support, which would be a desirable adaptation considering
vations in subjects with knee pain (46). This increase in that this type of running produces muscle damage (27).
flexion velocities can be explained as a passive mechanical Cardiovascular fatigue did not occur during this downhill
response to the earlier rise of the ground reaction force that run as was evident from the oxygen uptake and heart rate
occurs with increased shoe or surface hardness or, possibly, responses at the end of 30 min. These levels were still below
during knee pain. This mechanism may help regulate impact the steady-state values found in experiment 1.
force magnitude (51). Earlier studies found increased met- Increased ankle, knee, and hip flexion velocities occurred on
abolic cost with hard shoes (20). Our findings were similar the harder surfaces. We agree with others that these changes in
but once again not statistically significant. This may be joint angular velocities are a passive, mechanical response of
because the effect of shoe properties on metabolic cost the system, an uncontrollable response to the impact forces,
842 Official Journal of the American College of Sports Medicine http://www.acsm-msse.org
 vertical ground reaction force upon contact (22). In this par-
ticular situation, regulation of metabolic cost therefore ap-
peared to be more important to the runners than regulation of
impact shock. This is similar to the finding that runners choose
a stride length that minimizes metabolic cost rather than impact
shock (24). The kinematic adaptations that occurred during
prolonged downhill running (Fig. 3) were less pronounced than
those due to surface but those that were found (more extended
hip at impact, faster dorsiflexion velocity) were similar to those
caused by increased shoe or surface hardness.
Alternatively, kinematic adaptations may be interpreted
in terms of leg stiffness using a mass-spring model
(11,16,32). If subjects land with a more extended hip and/or
knee, this gives them an increased amount of flexion before
they reach the same invariant maximum knee angle at mid-
stance. This would then be interpreted as a greater change in
leg length and hence a decrease of average leg stiffness.
Such a decrease in leg stiffness has been interpreted as a
desire to maintain the same combined leg-surface stiffness
as surface stiffness increases and has also been observed for
single steps and hopping (15,16,36). Kinematic adaptations
to achieve this in hopping occur at the ankle (15). Similarly,
our results from experiment 2 could indicate that the runners
want to maintain the same leg stiffness as running duration
increases. Although lower-extremity stiffness was not di-
rectly measured in our experiments, our kinematic results
are consistent with the idea that leg stiffness and surface
stiffness are invariant when combined serially. It is inter-
esting to note that a decrease in average leg stiffness, as
defined using a mass-spring model (16,32) can occur at the
same time as an increase in instantaneous leg stiffness when
FIGURE 4 —Oxygen consumption (a) and heart rate (b) during the 30
min of running of experiment 2 (mean ⴞ SD). Stars (*, **, ***) denote the knee is more extended at impact. The term “leg stiff-
significant main effect of surface condition (P < 0.0033) with the number ness” must therefore be carefully defined and not loosely
of stars corresponding to distinct groups. Oxygen consumption and heart used without a specific definition.
rate gradually increased over the running duration and was statistically
less from 5 to 10 min vs 10 to 30 min. These differences represented the
typical oxygen cost and heart rate drift for this type of running.
CONCLUSIONS
and the chosen posture at time of contact geometry (13,51). If Based on the results of our two studies, we can conclude
no adaptation of the initial angles or muscle activation would that:
occur, this would quickly drive the knee to a greater amount of 1) Kinematic adaptations occurred with changes in mid-
knee flexion. This would cause metabolic cost to rise due to the sole hardness, surface stiffness, and over time.
increase in the knee extensor moment required for weight 2) The changes in limb posture at the time of impact were
support and push-off from a more flexed posture (37). We interpreted as active adaptations that compensate for passive
observed that runners avoided this scenario by landing on the mechanical effects.
hard surface with a more extended knee and hip. As a result, 3) The goal of these adaptations appears to be the mini-
maximum knee flexion was invariant; this variable did not mization of metabolic cost, at the expense of increased
change by more than one degree for any of the conditions exposure to impact shock.
studied (Figs. 2[e] and 3[e]). Sport and clinical relevance. These observations
When considering the implications for impact loading, it may be some of the natural adaptations to surface and
was surprising that runners adopted a more extended posture at duration. Although they may be desirable from an energetics
impact on the harder surface. Such a postural adaptation is point of view, they may contribute to the high risk of
thought to increase landing stiffness, or increase effective mass overuse injury in distance runners, especially those who run
(10). This scenario would increase impact shock (26) as well as on a hard surface.

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