Table 4

Expert opinion related to practical implementation of strategies to reduce overstride and increase step rate

Themes
Subthemes
Illustrative quotes
Strategies to reduce overstride
Various methods of correcting overstride, including increased step rate“It's getting people holding the hips over the landing foot (to reduce over-striding) … We can try and change those things constructively by simple cues like giving—lifting up through the hips, getting the right mobility exercises in place to try and deliver the mobility through the hips.” (3)
“The main thing that I'll do there is (increase) cadence (to reduce over-stride).” (5)
“In terms of trying to change strike pattern or prevent that overstride it's more just thinking about landing softly is often enough.” (6)
“I find that cadence looks after overstriding in most cases.” (8)
“If you significantly change cadence with people, you tend to find the overstriding reduced. It's very difficult to overstride with a higher cadence, but I tend to use the cue of shorter, quicker, lighter steps.” (11)
“Perhaps trying to get hip flexion and knee flexion occurring, together is another way of reducing stride length.” (12)
“if you look, if your head's up and you can see your foot out in front of you, try and make your foot disappear, that's another thing, just for over striding.” (14)
“I might tell them to land their foot a little closer underneath their body rather than out so far out in front of them (to reduce over-striding).” (15)
Cues to increase step rate
Step rate considerations and potential benefits
Need to gradually increase step rate (cadence) and the relevance of working toward 180 steps per minute
Various methods to increase step rate
“A lot a time, I've had a lot of success there just working with cadence (to manage running injuries).” (3)
“Sometimes, the only cue you need to use is just get them to increase their cadence and it will change their strike pattern, it'll change their landing pattern, where they're landing relative to their centre of mass. And also, often change frontal and transverse plane motion of the hip as well.” (6)
“Even by altering step rate you can significantly alter the degree of forefoot or rearfoot pronation.” (7)
“Cadence again. It's probably a good thing for even for a foot problem, it's probably one of the key things you can do to decrease the load in general.” (10)
“Changing the cadence, we often observe positive changes in all of the things that we would like to see (to manage running injuries).” (11)
“One of the issues with cadence is that it doesn't shift centre of gravity. So it is essentially the same movement pattern. It's just a bit truncated and it's just a bit faster.” (13)
“For cadence, it depends on what was the initial cadence of that person … If I have a runner coming in with a cadence of 145, which is extremely low, I try to bring that person to 180, it will not work for sure. So, usually I go through a couple sessions; first time I go up to 155, 160, and then go up again.” (1)
“I can subscribe also to the kind of “at 5% rule” (for how much to increase cadence).” (3)
“I get them to download a metronome app, which you can download for free for your smart phone and get them to run at a beats-per-minute that matches what (step rate) they're running at naturally … Make sure they find what their beats-per-minute is and then increase it by five, and then if that feels comfortable, increase it by five again ‘til you get them up to 170, 175, 180 in a progressive manner.” (5)
“Probably don't wanna change it (step rate) more than about 10%.” (6)
“I think we can increase cadence quite easily from five to ten percent.” (9)
“I am pretty sure that it's around the 180 that we can find the best protective biomechanics … So my range is between 170 to 190.” (10)
“Evidence tells us that it's easy for people to make five percent changes (to their step rate).” (14)
“Some people, when you increase the cadence, they tend to increase the speed … So I think that the treadmill is the best place to do it (increase step rate).” (1)
“People who like to run with ear buds and iPhones and that kind of thing, I recommend them to use some apps that it can plan for playing music that have that specific cadence (they are instructed to run at).” (1)
“(I use) a device made by Garmin. It has real-time icon and step rate, so I use that. By looking at your step rate on the watch and real-time, that could be considered as external focus and that what I intend to work on most with them (to increase step rate).” (2)
“I do use metronomes (to increase step rate). I think they're great tools.” (3)
“I used to try and use metronomes and songs and things like that a lot (to increase step rate) … Most people can do it without—just getting to think about faster step rate.” (6)
“You tell them and say, ‘you need to take shorter strides’. (to increase step rate).” (8)
“Some people are more visual, so they look the second on the board and I guess say its three sets per second, one, two, three, one, two, three, one, two, three, so I combine the visual with the auditory. And for most of the people, that works (to increase step rate).” (10)
“I'm not fond of using music generally (to increase step rate) … if they've got music pumping through their ears, they're really not aware of how heavy or not that foot strike potentially is.” (11)
“Maybe music would be less noxious than the metronome (to increase step rate). I think I just don't really like the metronome. I find it kind of annoying.” (15)