Br J Sports Med doi:10.1136/bjsports-2013-092160
  • Original article

Take your shoes off to reduce patellofemoral joint stress during running

  1. Paul Collins4
  1. 1Centre for Exercise and Sports Science, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
  2. 2Division of Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia
  3. 3Department of Movement Science, Biomechanics, Australian Institute of Sport, Canberra, Australia
  4. 4School of Engineering, Deakin University, Geelong, Victoria, Australia
  1. Correspondence to Dr Jason Bonacci, Centre for Exercise and Sports Science, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3216, Australia; jason.bonacci{at}
  • Accepted 13 June 2013
  • Published Online First 13 July 2013


Aim Elevated patellofemoral joint stress is thought to contribute to the development and progression of patellofemoral pain syndrome. The purpose of this study was to determine if running barefoot decreases patellofemoral joint stress in comparison to shod running.

Methods Lower extremity kinematics and ground reaction force data were collected from 22 trained runners during overground running while barefoot and in a neutral running shoe. The kinematic and kinetic data were used as input variables into a previously described mathematical model to determine patellofemoral joint stress. Knee flexion angle, net knee extension moment and the model outputs of contact area, patellofemoral joint reaction force and patellofemoral joint stress were plotted over the stance phase of the gait cycle and peak values compared using paired t tests and standardised mean differences calculated.

Results Running barefoot decreased peak patellofemoral joint stress by 12% (p=0.000) in comparison to shod running. The reduction in patellofemoral joint stress was a result of reduced patellofemoral joint reaction forces (12%, p=0.000) while running barefoot.

Conclusions Elevated patellofemoral joint stress during shod running might contribute to patellofemoral pain. Running barefoot decreases patellofemoral joint stress.

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