Musculoskeletal Loading at Common Running Injury Sites From Acute Changes in Contralateral Pelvic Drop Utilizing Real-Time Feedback.

Increased contralateral pelvic drop (CPD) during running is associated with running injuries, yet its direct influence on tissue loading remains unclear. The purpose of this study was to investigate how increased CPD affects internal loading at 4 common injury sites: the iliotibial band (ITB), Achilles tendon, patellofemoral joint (PFJ), and tibia. Eighteen healthy runners completed 2 overground running conditions at their 10 km pace: habitual running and increased CPD. Gait retraining with real-time visual feedback was used to alter pelvic drop. Kinetic and kinematic data were collected and musculoskeletal modeling estimated peak active and passive ITB strain, Achilles tendon force, PFJ contact force, and normal stress on the distal third of the tibia using elliptical beam theory. Participants increased peak CPD in the modified condition (-10.4° vs -6.0°, P < .001), resulting in increased passive and active tensor fascia latae component of the ITB strain (P < .05), with decreases in medial and lateral tibial stress (P < .05). No changes were observed in Achilles tendon force or PFJ contact force (P > .05). These results suggest increased CPD influences frontal plane mechanics and ITB loading but may not increase loading at other sites, including the Achilles tendon, PFJ, or distal tibia.