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Patellofemoral pain is one of the most common running-related pathologies among the running population. Running technique modification as a suggestive treatment strategy for mitigating patellofemoral pain in runners has been widely investigated in previous literature. The objective of this systematic review was to summarise the literature addressing the running technique modification associated with patellofemoral joint loading, to guide prevention strategy for patellofemoral pain. The English-language searches were conducted in the electronic databases of CINAHL, MEDLINE, and Web of Science for studies investigating biomechanical outcomes of the knee joint until May 2022. Study methodological quality was assessed using modified Downs and Black scales, with a meta-analysis conducted. Fourteen qualified studies were involved. The moderate evidence indicated that the forefoot strike (FFS) pattern led to a reduction in patellofemoral joint (PFJ) loading compared with the rearfoot strike (RFS) pattern. Also, moderate evidence indicated that the PFJ loading decreased progressively as the step rate increased but was inversely proportional to step length. These findings highlight the moderate evidence that running technique modifications, such as adopting FFS, increasing step rate, and decreasing step length, could be suggested to reduce PFJ loading and potentially alleviate PFJ pain in runners. Further research should focus on the long-term measurement to investigate the retention of these lower limbs' biomechanical characteristics under different running technique strategies.
Chang et al. (Mon,) studied this question.