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Discussion
Response to: ’Optimising the efficacy of gait retraining'
  1. Jean-Francois Esculier1,2,
  2. Blaise Dubois2,3,
  3. Jean-Sébastien Roy3,4
  1. 1 Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 The Running Clinic, Lac-Beauport, Quebec, Canada
  3. 3 Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
  4. 4 Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
  1. Correspondence to Dr Jean-Francois Esculier, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; jean-francois.esculier{at}ubc.ca

https://doi.org/10.1136/bjsports-2017-098609

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    A recent editorial was published in BJSM 1 following a randomised clinical trial (RCT) conducted by our research team, which compared three rehabilitation programmes in runners with patellofemoral pain (PFP).2 In Dr Davis’ editorial, it was stated that our running intervention was not optimal due to a heterogeneous sample, unstandardised gait modifications and unstructured retraining schedule. While several interesting arguments were presented, readers must keep in mind that the current level of evidence on gait retraining for injured runners is far from conclusive.

    Heterogeneous sample

    Previous studies on gait retraining for runners with PFP have addressed specific running mechanics such as rearfoot striking or excessive hip adduction.3 4 However, not all runners with PFP show ‘altered’ mechanics, and PFP is not specific to rearfoot strikers (non-rearfoot strikers also develop PFP). In fact, training errors are thought to contribute to running injuries even in those with ‘optimal’ mechanics.5 Aiming to maximise the external validity of our RCT, we included runners regardless of distal or proximal kinematics, and prescribed individualised …

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    Footnotes

    • Contributors JFE drafted the paper and led the publication. BD and JSR edited the draft version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.