ARTICLE IN PRESS
TagedEnFiur

Available online at www.sciencedirect.com

TagedEn

TagedFiur

TagedEn

Journal of Sport and Health Science xxx (2021) xxx-xxx
www.jshs.org.cn
1

TagedH1Can changes in midsole bending stiffness of shoes affect the onset of joint
work redistribution during a prolonged run?TagedEn

3
4
5
6
7

agedPD1X XSasa
XT
Cigoja D2X X *, D3X XJared R. Fletcher D4X X , D5X XBenno M. Nigg D6X X TagedEn
a,

Q1

10

b

a

TagedP Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, T2N 1N4, Alberta, Canada
b
Department of Health and Physical Education, Mount Royal University, Calgary, T3E 6K6, Alberta, Canada
a

8
9

53

Original article

2

TagedEn

Available online xxx

13

2095-2546/Ó 2021 Published by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/)

16
17
18
19
20
21
22
23
24
25
26
27
28
29

56
57
58
59
60
61
62
64
65
66

14
15

55

63

11
12

54

TagedPAbstract

67

Objective: To investigate if changing the midsole bending stiffness of athletic footwear can affect the onset of lower limb joint work redistribution during a prolonged run.
Methods: Fifteen trained male runners (10-km time of <44 min) performed 10-km runs at 90% of their individual speed at lactate threshold (i.e.,
when change in lactate exceeded 1 mmol during an incremental running test) in a control and stiff shoe condition on two occasions. Lower limb
joint kinematics and kinetics were measured using a motion capture system and a force-instrumented treadmill. Data were acquired every 500 m.
Results: Prolonged running resulted in a redistribution of positive joint work from distal to proximal joints in both shoe conditions. Compared to
the beginning of the run, less positive work was performed at the ankle (approximately 9%; p 
 0.001) and more positive work was performed
at the knee joint (approximately 17%; p 
 0.001) at the end of the run. When running in the stiff shoe condition, the onset of joint work redistribution at the ankle and knee joints occurred at a later point during the run.
Conclusion: A delayed onset of joint work redistribution in the stiff condition may result in less activated muscle volume, because ankle plantar
flexor muscles have shorter muscles fascicles and smaller cross-sectional areas compared to knee extensor muscles. Less active muscle volume
could be related to previously reported decreases in metabolic cost when running in stiff footwear. These results contribute to the notion that
footwear with increased stiffness likely results in reductions in metabolic cost by delaying joint work redistribution from distal to proximal joints.
TagedPKeywords: Fatigue; Footwear; Mechanics; Performance; RunningTagedEn

68
69
70
71
72
73
74
75
76
77
78
79
80
81

30

82

31

83
84

32
33
34
35
36
37
38
39
40
41
42
43
44
45
46

TagedH11. IntroductionTagedEn
T recent study reported that a prolonged (i.e., 10 km) run
agedPA
resulted in a redistribution of lower limb positive joint work,
from distal (i.e., ankle) to more proximal (i.e., knee) joints,
with increased running distance.1 Sanno et al.1 speculated that
this redistribution occurred because ankle plantarflexor
muscles might have fatigued to a greater extent during the prolonged run than the knee or hip extensor muscles. This was
based on the notion that during the prolonged run calculated
ankle joint moments were higher than calculated peak knee
and hip joint moments relative to previously reported maximum joint moments assessed during isolated strength tests.2
This confirmed previous reports of the higher relative efforts

47
48
49
50
51

TagedEn Peer review under responsibility of Shanghai University of Sport.
TagedEn *Corresponding author.
E-mail address: sasa.cigoja1@ucalgary.ca (S. Cigoja).

of the ankle extensors as compared to knee extensors during
running.3 The authors further speculated that a redistribution
of positive lower limb joint work toward more proximal joints
is disadvantageous for long-distance running performance
because muscle
tendon units (MTU) surrounding the ankle
joint (e.g., triceps surae (TS) and Achilles tendon (AT)) are
thought to be better equipped for storage and return of elastic
energy than MTUs surrounding the knee joint.4 This conclusion was made under the assumption that tendons can store
and return relevant amounts of strain energy during running,4,5
which may not necessarily be the case.6 Furthermore, if prolonged running resulted in increased positive work at the knee
joint and the MTUs surrounding this joint are not as wellequipped for energy storage and return, the additional work
must be performed by the muscle in series with the tendon.7
This muscle work would require a greater active muscle volume, thereby elevating the metabolic cost of running.7 This

https://doi.org/10.1016/j.jshs.2020.12.007

85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104

52

Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

ARTICLE IN PRESS
TagedEn2
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161

could be disadvantageous for long-distance running performance because metabolic cost is one of the key determinants
of distance running performance,8 and it increases as a function of running distance.9
11TagedEn
TagedPIt can be speculated that if the onset of lower limb joint
work redistribution was delayed, performance benefits could
be achieved as the direct result of a mitigated increase in metabolic cost during long-distance running events. One footwear
feature that has been shown to have large effects on biomechanical,12 physiological,13,14 and performance15
17 variables is the midsole bending stiffness (MBS). Although the
underlying sources behind performance improvements
achieved by running in footwear with increased MBS (by
means of inserting stiff carbon fiber plates) are not-well understood, multiple mechanisms have been proposed to explain its
function: (a) by minimizing energy loss,15 (b) by storing and
returning elastic energy,18,19 (c) by optimizing the function of
the major ankle plantarflexor muscles,20
22 and (d) by way of
the “teeter-totter” effect.23,24 In brief, the principle of minimizing energy loss suggests that athletic performance can be
improved by reducing the eccentric work performed by
muscles. The principle of storing and returning elastic energy
suggests that strain energy can be stored in the stiffening structures (e.g., carbon fiber plates) of running shoe midsoles as the
metatarsophalangeal (MTP) joint undergoes extension (i.e.,
dorsiflexion). It is speculated that some of this stored energy is
then returned to the athlete during the subsequent flexion of
the MTP joint and recoil of the carbon fiber plates. The principle of optimizing ankle plantarflexor muscle function suggests
that the TS muscle group is enabled to operate at slower shortening velocities when running in footwear with increased
MBS due to changes in gear ratio25 (i.e., the ratio between
external and internal moment arms) and longer stance
times16,22,26; this is thought to reduce the muscle energy cost.7
Running in stiff footwear typically shifts the center of pressure
further anteriorly during late stance.20 This increases
the moment arm of the ground reaction force to the ankle while
the AT moment arm remains unchanged, and therefore
increases the gear ratio. This increase in ratio between the
external and internal moment arm is believed to allow
the ankle plantarflexor muscles to operate on a more favorable
position of their force
velocity relationship,27,28 which has
been speculated to improve the energy cost of running.20
22
The “teeter-totter” effect suggests that the ground reaction
force produces a force at the heel due to the curvature of the
carbon fiber plate as the center of pressure travels anteriorly
during the stance phase of running. This heel force is supposed
to act at the right location (heel of the foot), at the right time
(during push-off), and with the right frequency to reduce the
metabolic cost of running.24TagedEn
TagedPIt was recently shown that running in footwear with
increased MBS redistributed lower limb joint work from proximal to distal joints (i.e., opposite to the redistribution introduced by prolonged running).19 Compared to running in a
control shoe, Cigoja et al.19 demonstrated that more positive
work was performed at the MTP and less positive work was
performed at the knee joint when running in stiff shoes. This

S. Cigoja et al.

was interpreted as a redistribution of positive lower limb joint
work from proximal to distal joints; however, it remained
unknown if such a redistribution could also be observed during
a prolonged run and if it could be delayed by running in footwear with increased MBS.TagedEn
TagedPFor this reason, the purpose of the present study was to
investigate whether running in shoes with increased MBS
affects the onset of lower limb joint work redistribution from
distal to proximal joints during a prolonged run. It was hypothesized that running with increased MBS would mitigate the
lower limb joint work redistribution during a 10-km run.TagedEn

162
163
164
165
166
167
168
169
170
171
172
173

TagedH12. MethodsTagedEn
TagedH22.1. ParticipantsTagedEn
T ifteen trained male runners (age: 28.5 § 6.7 years, height:
agedPF
1.79 § 0.08 m, mass: 70.6 § 10.3 kg; mean § standard deviation) visited the laboratory on 3 separate occasions. Participants were included in this study if they reported the ability to
run 10 km in less than 44 min, were free from lower limb injuries in the past 6 months, and fit Sizes 9, 10, or 11 US running
shoes. This study was approved by the University of Calgary
Conjoint Health Research Ethics Board (REB17-0171), and all
subjects gave written informed consent prior to participating
in this study. All procedures were performed in accordance
with the Declaration of Helsinki.TagedEn

174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189

TagedH22.2. Footwear conditionsTagedEn
T he control condition (Control) consisted of a Nike Free
agedPT
Run 2018 (Nike Inc., Beaverton, OR, USA) shoe. The stiff
condition was achieved by inserting straight carbon fiber plates
between the factory insole and the midsole, and along the full
length of the control shoe. The stiff condition, however, varied
between participants: 7 participants ran in footwear with carbon fiber plates of 1.5 mm thickness (Stiff), and 8 participants
ran in footwear with plates of 2 mm thickness (Stiffer). There
were no significant differences between participants who ran
in Stiff compared to participants who ran in Stiffer with
respect to age (Stiff: 27.43 § 6.90 years, Stiffer: 29.50 §
6.82 years, p = 0.285), height (Stiff: 1.78 § 0.08 m, Stiffer:
1.79 § 0.08 m, p = 0.390), mass (Stiff: 67.13 § 8.18 kg,
Stiffer: 73.65 § 11.49, p = 0.117), speed at lactate threshold
(sLT; Stiff: 4.25 § 0.22 m/s, Stiffer: 4.12 § 0.20 m/s,
p = 0.132), or shoe size (Stiff: median = 9, range = 9
11,
Stiffer: median = 9, range = 9
11, p = 0.430). The stiff condition differed between participants because previous studies
have shown that there is a subject-specific optimal MBS of
running shoes29,30; therefore, we sought to mitigate the risk of
introducing a stiffness level that may be too low or too high
for a given runner. Stiffer allowed us to compare the control
shoe to a shoe with an extreme stiffness condition, which we
speculated would result in large biomechanical effects during
a prolonged run, whereas Stiff allowed us to compare the control shoe to a stiff footwear condition, one that is more likely
to be encountered on the running footwear market.TagedEn

Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218

ARTICLE IN PRESS
TagedEnShoe Stiffness Effects on Joint Work Redistribution
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239

TagedPThe MBS of the shoe conditions was determined using a
3-point bending test.13,19 In brief, the forefoot was placed on a
structure with two supporting pins, which were 160 mm apart.
A vertical, compressive force was applied in the area of the
Q2 MTP joint using an ElectroPuls X X E10000 Linear-Torsion testing
machine (Instron, Norwood, MA, USA). The machine was set
to displace the shoe by 15 mm at a speed of 10 mm/s. This was
repeated 10 times for all shoe conditions. The force and displacement data were filtered using a dual pass second-order
Butterworth filter with a cut-off frequency of 5 Hz. The slope
of the force-displacement curve (i.e., stiffness) was determined
for all 10 loading cycles. The stiffness values were first averaged between 70% and 90% of each loading curve (i.e., linear
portion of the force
displacement curve) and then across all
10 cycles. The MBS for Control, Stiff, and Stiffer were 1.58,
6.46, 13.28 N/mm, respectively. The footwear conditions were
weight matched by inserting a total of six masses (i.e., two
at the rearfoot, two at the midfoot, and two at the forefoot)
into the control shoe. Across all conditions, the masses were
259, 280, and 296 g for the size 9, 10, and 11 US shoes,
respectively.TagedEn

240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257

TagedH22.3. Data collectionTagedEn
TagedP2.3.1. Visit 1TagedEn
TagedPOn the first visit, the individual sLT was determined based
on methods described elsewhere31 while participants ran in the
control shoe on a treadmill (Model Fully Instrumented Treadmill, Bertec Corp., Columbus, OH, USA) with no gradient. In
brief, participants first performed a 5-min warm-up at a selfselected speed. Immediately after the warm-up, a fingertip
blood sample was taken to determine resting blood lactate concentration (Lactate Pro, Sports Resource Group Inc., Minneapolis, MN, USA). After the warm-up, the treadmill belt speed
was increased by 0.8 km/h every 2 min, after which blood lactate concentration was measured. This was repeated until
blood lactate concentration rose more than 1 mmol from the
previous sample. The sLT was determined as the speed at the
stage preceding the final stage.TagedEn

258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275

TagedP2.3.2. Visits 2 and 3TagedEn
TagedPOn the second and third visits, respectively, participants
performed a 10-km run at 90% of the individual sLT while
wearing a control or stiff running shoe. The order of shoe conditions was balance randomized, so that 8 participants first ran
in the control condition and 7 participants first ran in their
stiff condition. Twenty-four retroreflective markers (diameter:
12 mm) were applied to the pelvis and right lower limb according to methods described by Cigoja et al.19 Except for the shoe,
all markers were applied directly to the skin overlying anatomical landmarks. The shoe markers were applied on the upper
material of the shoe. Three-dimensional kinematic and kinetic
data of the pelvis and right lower limb were recorded at 200
and 1000 Hz using 8 high speed cameras (Vicon Motion Systems Ltd., Oxford, UK) and a force-instrumented treadmill
(Model Fully Instrumented Treadmill, Bertec Corp., Columbus, OH, USA), respectively. A 2-min familiarization trial was

3

performed to allow participants to get accustomed to the running speed and footwear condition. Baseline kinematic and
kinetic data were measured for 30 s immediately after the
familiarization trial and subsequently recorded every 500 m
during the 10-km runs. This resulted in 21 bouts of approximately 35‒45 steps of the right leg, per subject and footwear
condition. The stance phases (i.e., where vertical ground reaction forces exceeded a threshold of 20 N32) of the middle
30 steps were identified and used for further analyses.TagedEn

276
277
278
279
280
281
282
283
284
285

TagedH22.4. Data analysisTagedEn

286

T aw data were analyzed using a custom written MATLAB
agedPR
code (Version 2019a; The MathWorks Inc., Natick, MA,
USA). To determine the three-dimensional MTP, ankle, knee,
and hip joint kinematics and kinetics, marker and force data
were filtered using a dual pass second-order Butterworth filter
with a cut-off frequency of 50 Hz. The cut-off frequency was
determined based on a residual analysis33 applied to marker
trajectory data from 10 randomly chosen steps across all participants, shoe conditions, and distances. Then, the highest frequency across all markers was chosen as the cut-off frequency
to guarantee that all relevant trajectory information was
retained in the signal. Cardan angles were calculated to
describe joint motion, and an inverse dynamics approach was
used to estimate sagittal joint moments. Mechanical joint
powers were calculated as the dot-product of joint moment
and angular velocity. Positive and negative mechanical work
were determined as the integral of the positive or negative joint
power
time curves over the stance phase, respectively. Jointspecific positive work was expressed relative to total lower
limb positive work performed during the stance phase of running. All variables of interest were first computed for each
step across all participants, shoe conditions, and running distances. Then the variables were averaged across 30 steps, and
the individual means were used for further comparisons
between shoe conditions and running distances.TagedEn

287

TagedH22.5. StatisticsTagedEn

313

T hapiro
Wilk tests were used to test for normal distribuagedPS
tions of all dependent variables. The variables of interest were
joint-specific positive work contribution relative to total positive lower limb joint work, stance times, peak flexion (i.e.,
plantarflexion) moment, angular velocity and angle of the
MTP joint, and peak extension moment, angular velocity, and
angle of the ankle and knee joints. If variables were normally
distributed, two-way repeated measures analysis of variance
(ANOVA) was used to test for main effects of distance (i.e.,
3 levels: 0, 5, and 10 km) and shoe condition (i.e., 2 levels:
control and stiff), and for interaction effects between distance
and shoe. Where significant (a = 0.05) distance main effects
or interactions were found, univariate repeated measures
ANOVAs with 20 (i.e., 0 km vs. every other timepoint) paired
Student’s t tests were performed for each shoe condition for
each lower limb joint. If variables were not normally distributed, Friedman’s tests were performed to test for significant
running distance effects for each shoe condition. Multiple

Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332

ARTICLE IN PRESS
TagedEn4
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363

S. Cigoja et al.

Wilcoxon signed-rank tests were then used where Friedman’s
tests revealed significant distance effects. The significance
level for multiple comparisons was adjusted using the Bonferroni correction and set to p = 0.003 (i.e., p = 0.05 
20 = 0.003). Effect size estimates were calculated using
Cohen’s d.34 The formula for calculating Cohen’s d was:









xi 
 xj 





ffi
d ¼ qffiffiffiffiffiffiffiffi
2
2
si þsj
2

Where xi and s2i are the sample mean and variance at baseline
(i.e., 0 km), and xj and s2j are the sample mean and variance at
any other time point during the prolonged run (i.e., 0.5 
 10
km). The minimal detectible change was calculated using the
following formula35:
pffiffiffi s
MDC ¼ 1:96  2  pffiffiffi
n
where s is the sample standard deviation for each variable at
baseline in the control condition and n is the sample size.TagedEn
TagedPA mixed model ANOVA (between-subject factor: stiffness
group (i.e., 2 levels: Stiff and Stiffer); within-subject factors:
running distance (i.e., 3 levels: 0, 5, and 10 km) was used to
test if joint work redistribution was affected differently in participants who ran in Stiff compared to Stiffer. Wilcoxon ranksum tests were used to identify whether the change in jointspecific positive work from the beginning to the end of the run
differed between participants who ran in Stiff compared to
Stiffer. All statistical analyses were performed in SPSS Statistics Version 26.0 (IBM Corporation, Armonk, NY, USA).TagedEn

work during the runs. The two-way repeated measures
ANOVA showed no significant interaction effect between
shoe and distance for the positive work performed at the
MTP (p = 0.152), ankle (p = 0.387), knee (p = 0.535), or hip
(p = 0.777) joint. Significant distance main effects were found
for the positive work performed at the MTP (p 
 0.001), ankle
(p 
 0.001), knee (p 
 0.001), but not the hip (p = 0.111) joint.
Significant shoe effects were found for the positive work performed at the MTP (p 
 0.001) but not for the ankle
(p = 0.595), knee (p = 0.883), or hip (p = 0.491) joint (Table 1).TagedEn
TagedPFriedman’s tests showed significant distance effects for
the positive work performed at the MTP joint in the control
(p 
 0.001) and stiff (p 
 0.001) condition (Supplementary
Table 1). In the control condition, positive MTP joint work
decreased at 9 km (p = 0.002, d = 1.07) for the first time
compared to 0 km (Fig. 1). After correcting for multiple
comparisons, no significant difference in positive MTP joint
work was found for any timepoints compared to 0 km in the
stiff condition (Table 1). Univariate tests showed significant
distance effects on positive work at the ankle (control: p 

0.001, stiff: p = 0.001) and knee (control: p 
 0.001, stiff:
p 
 0.001) joints for both conditions. In the control condition, positive ankle joint work was significantly different
from baseline for the first time at 5 km (p = 0.001, d = 0.43)
(Fig. 2). In the stiff condition, positive ankle joint work was
significantly reduced for the first time at 8 km (p = 0.002,
d = 0.45). For the knee joint, positive work was increased
for the first time at 5.5 km (p = 0.001, d = 0.28) and 7.5 km
(p = 0.002, d = 0.34) in the control and stiff conditions,
respectively (Fig. 2).TagedEn

366
367
368
369
370

373
374
375
376
377

392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
421

TagedH23.2. Kinematics and kineticsTagedEn

TagedH13. ResultsTagedEn
T verage sLT measured at Visit 1 was 4.18 § 0.22 m/s, which
agedPA
corresponded to 39 min 59 s § 2 min 6 s on 10 km. The average
running speed for Visit 2 and 3 (i.e., 90% of sLT) was 3.75 §
0.22 m/s, which corresponded to 44 min 36 s § 2 min 50 s.TagedEn

371
372

391

420

364
365

390

TagedH23.1. Relative joint workTagedEn
T here were no shoe (p = 0.844), distance (p = 0.784), or
agedPT
interaction effects (p = 0.958) on total positive lower limb joint

422

T ignificant shoe (p 
 0.001) and distance (p 
 0.001) main
agedPS
effects but no interaction (p = 0.554) effects were found for
stance times, with longer times observed in the stiff (216.58 §
2.76 ms) compared to the control (210.00 § 3.21 ms) condition, and with generally longer times (i.e., control: +3.31%,
stiff: +2.15%) with increasing running distance (Supplementary Table 2). Compared to the beginning of the run (control:
206.27 § 18.47 ms, stiff: 214.18 § 16.83 ms), stance times
were significantly longer at 10 km in both the control (213.11

423
424
425
426
427
428
429
430
431
432
433

TagedEnTable 1

434
435

379

Positive metatarsophalangeal, ankle, knee, and hip joint work at 0, 5, and 10 km in the control and stiff shoe condition relative to total positive lower limb joint
work (mean § standard deviation).

380

Pos. work (%total Pos. work)

437

378

381
382
383
384
385
386
387
388
389

Control
0 km
5 km
10 km
Stiff
0 km
5 km
10 km

MTP

Ankle

Knee

Hip

2.60 § 0.64
2.11 § 0.52
1.89 § 0.67*

52.06 § 8.41
48.45 § 8.20*
46.92 § 8.46*

25.13 § 9.28
27.30 § 9.36
29.89 § 9.96*

20.21 § 9.00
22.13 § 8.57
21.31 § 8.81

5.19 § 1.34
5.10 § 1.21
4.26 § 1.65

50.80 § 7.59
48.24 § 9.29
46.48 § 8.93*

25.29 § 8.72
26.46 § 9.28
29.42 § 10.86*

18.72 § 7.09
20.21 § 6.38
19.84 § 7.26

436
438

p 
 0.003, running distance effects within a shoe condition.
Abbreviations: MTP = metatarsophalangeal; Pos. = positive.
*

Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

439
440
441
442
443
444
445
446

ARTICLE IN PRESS
TagedEnTagedEnShoeTagedFiur Stiffness Effects on Joint Work Redistribution

5

447

504

448

505

449

506

450

507

451

508

452

509

453

510

454

511

455

512

456

513

457

514

458

515

459

516

460

517

461

518

462

519

463

520

464

521

465

522

466
467
468

Fig. 1. Mean § standard deviation positive metatarsophalangeal (A), ankle (B), knee (C), and hip (D) joint work in the control (blue squares) and stiff (red triangles) shoe condition during a 10-km run at 90% of individual speed at lactate threshold. Positive ankle joint work decreased and positive knee joint work increased
earlier in the control compared to the stiff condition. *p 
 0.003, compared to the beginning of the run (i.e., 0 km). Pos. = positive; MTP = metatarsophalangeal.TagedEn

473
474
475
476
477
478
479
480
481
482

525
527

470
472

524
526

469
471

523

§ 19.14 ms, p = 0.001, d = 0.36) and stiff (218.79 § 18.41 ms,
p = 0.003, d = 0.26) condition (Supplementary Table 2).TagedEn
TagedPSignificant distance main effects were found for the peak
MTP flexion moments in the control (p 
 0.001) and stiff
(p 
 0.001) conditions (Supplementary Table 3). Compared
to the start of the run (control: 
0.88 § 0.40 Nm/kg, stiff:

0.85 § 0.26 Nm/kg; Fig. 3), peak MTP flexion moments
decreased in the stiff (
0.80 § 0.27 Nm/kg, p = 0.001,
d = 0.20) but not in the control (
0.82 § 0.36 Nm/kg,
p = 0.009, d = 0.17) condition after correcting for multiple

TagedEn

comparisons. Significant main effects for distance (p 

0.001) but not shoe (p = 0.892) or interaction (p = 0.937)
were found for peak ankle extension moments (Supplementary Table 4). Compared to 0 km (control: 
2.99 §
0.53 Nm/kg, stiff: 
2.96 § 0.43 Nm/kg), ankle joint
moments were lower in the control (
2.86 § 0.48 Nm/kg,
p = 0.001, d = 0.27) but not stiff (
2.86 § 0.42 Nm/kg,
p = 0.010, d = 0.22) condition at 10 km. Although significant
distance (p 
 0.001) main effects were observed for peak
knee extension moment, no significant differences were

TagedFiur

528
529
530
531
532
533
534
535
536
537
538
539

483

540

484

541

485

542

486

543

487

544

488

545

489

546

490

547

491

548

492

549

493

550

494

551

495

552

496

553

497

554

498

555

499

556

500

557

501
502
503

Fig. 2. Ensemble mean (n = 15) metatarsophalangeal, ankle, knee, and hip joint power over the stance phase of running at 90% of individual speed at lactate
threshold for the control (top row) and stiff (bottom row) shoe condition. Green, yellow, and red lines represent joint power at the beginning, middle, and end of
the 10-km run, respectively. MTP = metatarsophalangeal.TagedEn
Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

558
559
560

ARTICLE IN PRESS
TagedEnTagedEn6 TagedFiur

S. Cigoja et al.

561

618

562

619

563

620

564

621

565

622

566

623

567

624

568

625

569

626

570

627

571

628

572

629

573

630

574

631

575

632

576

633

577

634
635

578
579
580
581

Fig. 3. Ensemble mean (n = 15) metatarsophalangeal, ankle, knee, and hip joint moments over the stance phase of running at 90% of individual speed at lactate
threshold for the control (top row) and stiff (bottom row) shoe condition. Green, yellow, and red lines represent joint moments at the beginning, middle, and end of
the 10-km run, respectively. MTP = metatarsophalangeal.TagedEn

584
585
586
587
588
589
590
591
592
593
594
595
596

637
638
639

582
583

636

found between the beginning and end of the run after correcting for multiple comparisons (Supplementary Table 5).TagedEn
TagedPSignificant shoe (p 
 0.001), distance (p 
 0.001), and
interaction (p 
 0.001) effects were found for peak MTP flexion velocity. Univariate tests revealed greater peak MTP flexion velocities in the control (
1023.31 § 48.45 ˚/s) compared
to the stiff (
816.17 § 6.89 ˚/s) condition. Compared to the
start of the run, peak MTP flexion velocities were higher at
8.5 km (p = 0.002, d = 0.57) in the control condition; no differences were observed in the stiff condition after correcting for
multiple comparisons. Significant main effects of shoe
(p = 0.002) and distance (p = 0.001) but not interaction
(p = 0.210) were found for peak ankle extension velocity. Peak

TagedEn

TagedFiur

ankle extension velocities were significantly lower in the stiff
(
497.38 § 7.55 ˚/s) than the control (
561.69 § 11.94 ˚/s)
condition. No shoe (p = 0.893), distance (p = 0.832), or interaction (p = 0.648) effects were observed for peak knee extension
velocities (Fig. 4).TagedEn
TagedPSignificant distance effects were found for the peak MTP
extension angle in the control (p 
 0.001) and stiff (p 
 0.001)
conditions. Compared to the start of the run (control: 24.8 §
4.1˚, stiff: 20.09 § 3.4˚), peak MTP joint extension angles
were significantly larger at the end of the run in the control
(27.0 § 4.6˚, p 
 0.001, d = 0.52) but not in the stiff (21.43 §
4.3˚, p = 0.008, d = 0.35) condition (Fig. 5). Significant distance (p 
 0.001) but no shoe (p = 0.152) or interaction

640
641
642
643
644
645
646
647
648
649
650
651
652
653

597

654

598

655

599

656

600

657

601

658

602

659

603

660

604

661

605

662

606

663

607

664

608

665

609

666

610

667

611

668

612

669

613

670

614

671

615
616
617

Fig. 4. Ensemble mean (n = 15) metatarsophalangeal, ankle, knee, and hip joint angular velocities over the stance phase of running at 90% of individual speed at
lactate threshold for the control (top row) and stiff (bottom row) shoe condition. Green, yellow, and red lines represent joint angular velocities at the beginning,
middle, and end of the 10-km run, respectively. MTP = metatarsophalangeal.TagedEn
Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

672
673
674

ARTICLE IN PRESS
TagedEnShoe Stiffness Effects on Joint Work Redistribution
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690

(p = 0.785) effects were found for peak ankle extension angles.
Compared to 0 km, peak ankle extension angles were higher at
8.5 (p = 0.003, d = 0.58), 9 (p = 0.002, d = 0.52), and 9.5 km
(p = 0.002, d = 0.54) in the control condition, and at 9 km
(p = 0.003, d = 0.59) in the stiff condition. Significant distance
(p 
 0.001) but no shoe (p 
 0.001) or interaction (p = 0.822)
effects were found for peak knee flexion angles. Peak knee
flexion angles were significantly lower in the control (
43.1 §
5.4˚, p = 0.003, d = 0.26) but not in the stiff (
41.6 § 4.7˚,
p = 0.006, d = 0.28) condition at the end compared to the
beginning of the run (control: 
41.6 § 5.7˚, stiff: 
40.2 §
4.8˚) (Fig. 5).TagedEn
TagedPThere were no significant effects of distance (p = 0.353) or
shoe (p = 0.869), and no interaction effects (p = 0.405) on the
striking pattern (i.e., determined as the sagittal plane ankle
angle at heel-strike) (Supplementary Table 6).TagedEn

691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710

TagedH23.3. Subgroup analysisTagedEn
T he mixed model ANOVA revealed significant distance
agedPT
effects on positive work performed at the MTP (p = 0.003),
ankle (p 
 0.001), and knee (p = 0.001) but not hip (p = 0.210)
joint. There were no interaction effects between distance
and stiffness group on positive work performed at the
MTP (p = 0.796), ankle (p = 0.572), knee (p = 0.775), or hip
(p = 0.469) joints. Furthermore, there was no effect of stiffness
group on the positive work performed at the MTP (p = 0.756),
ankle (p = 0.639), knee (p = 0.731), and hip (p = 0.296) joints.
There was no difference in the change of joint-specific positive
work contribution from the beginning to the end of the run
between the participants who ran in Stiff compared to Stiffer
for the MTP (p = 0.867, d = 0.04), ankle (p = 0.536, d = 0.08),
knee (p = 0.779, d = 0.26), or hip (p = 0.867, d = 0.19) joints
(Supplementary Tables 7 and 8).TagedEn

TagedEn

TagedFiur

7

TagedH14. DiscussionTagedEn
TagedH24.1. Muscle and tendon functionTagedEn
T he purpose of this study was to investigate whether the
agedPT
onset of lower limb joint work redistribution from distal to
proximal joints during a prolonged run can be affected by running in footwear with increased MBS. The findings of this
study showed that the positive MTP and ankle joint work significantly decreased in the control condition from baseline at
9 km and 5 km, respectively; whereas, in the stiff condition,
only positive ankle joint work decreased at 8 km with no significant changes at the MTP joint throughout the run. At the
knee joint, positive work significantly increased from baseline
at 5.5 km and 7.5 km for the control and stiff conditions,
respectively. We interpret the finding that ankle joint work
decreased while knee joint work increased sooner in the control condition than the stiff condition as an earlier onset of
lower limb joint work redistribution. It needs to be acknowledged, however, that the interaction between shoe condition
and distance was not significant, which could be related to the
low sample size or use of different plates for the stiff condition. This delayed onset of redistribution in the stiff condition
could be interpreted as a metabolically positive effect because
a redistribution of positive work toward more proximal joints
would require additional work to be performed by muscles surrounding these joints, thereby delaying the increase in metabolic cost normally seen during a run. Knee extensor muscles
(i.e., quadriceps) were reported to have longer muscle fascicles
and larger cross-sectional areas compared to ankle extensor
muscles (i.e., TS),36 which would result in increased muscle
volume activation. If similar activation levels between ankle
and knee extensor muscles are assumed, it could then be speculated that greater active muscle volume would result in more
adenosine triphosphate being consumed by the muscle, which
could in turn increase the metabolic cost of muscle contraction

732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767

711

768

712

769

713

770

714

771

715

772

716

773

717

774

718

775

719

776

720

777

721

778

722

779

723

780

724

781

725

782

726

783

727

784

728

785

729
730
731

Fig. 5. Ensemble mean (n = 15) metatarsophalangeal, ankle, knee, and hip joint angles over the stance phase of running at 90% of individual speed at lactate
threshold for the control (top row) and stiff (bottom row) shoe condition. Green, yellow, and red lines represent joint angles at the beginning, middle, and end of
the 10-km run, respectively. MTP = metatarsophalangeal.TagedEn
Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

786
787
788

ARTICLE IN PRESS
TagedEn8
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
829
830
831
832
833
834
835
836
837
838
839
840
841
842
843
844
845

S. Cigoja et al.
7

and positive work generation . This could have substantial
implications for long-distance running performance, as the
active muscle volume has been shown to be a major determinant of the metabolic cost of running.37 Also, muscles with
shorter fascicles have fewer sarcomeres in series and are
thought to consume proportionally less adenosine triphosphate
per unit force compared to muscles with longer fascicles under
similar activation levels.27TagedEn
TagedPUnder the assumption that tendons are able to store and
return relevant amounts of strain energy, a delayed onset of
joint work redistribution toward more proximal joints when
running in stiff shoes could potentially indicate that the AT
returns energy to the athlete over an extended period of time,1
thus reducing the need for additional muscle work.7 A recent
study from our laboratory investigated the effects of MBS on
in vivo gastrocnemius medialis (GM) muscle fascicle behaviour and estimated AT energy return. This unpublished study,
which is currently under review, found that the GM muscle
shortened less and with slower average shortening velocities
when an individual was running in stiffer footwear. Ankle joint
angles, however, remained similar between shoe conditions.
This suggests that if the GM muscle shortened less but ankle
angles did not change, the remaining shortening must have
been performed by some other structure than the GM muscle.
Based on findings from Lai et al.,38 it seems that all 3 TS
muscles function similarly (i.e., they shorten throughout
stance) during running. Therefore, it is plausible to speculate
that the AT performed the remaining “shortening” in the stiff
condition to maintain the same ankle joint angles and return
more strain energy. These results indicated that this additional
energy return by the AT could allow the GM (and potentially
the entire TS muscle) to operate on a more favorable position
of the muscle’s force
length
velocity relationship. This has
been hypothesized to reduce muscle fatigue and delay the
onset of joint work redistribution, therefore mitigating the
steady increases in the energy cost of running that are typically
observed during long-distance running events.9
11,39TagedEn
TagedPA recently published study investigated how running in
footwear with differently stiff carbon fiber plates can affect the
soleus muscle fascicle dynamics and running economy.40 The
authors did not find any differences in soleus fascicle pennation, force, length, velocity, or stride-average soleus active
muscle volume due to altered MBS during running. Beck
et al.40 therefore concluded that inserting carbon fiber plates in
shoes may not improve running economy. Even though it
seems that the soleus muscle function was not altered by footwear of various MBS when running at 3.5 m/s, there are two
major reasons as to why it would still be possible to see differences in muscle function in a setup similar to our study. First,
although the individual TS muscles are thought to function
similarly during running, Lai et al.38 have demonstrated that
there are subtle differences in fascicle length changes between
the soleus and gastrocnemii muscles. Namely, the GM muscle
fascicles exhibit the greatest length changes of all TS muscles
during the stance phase of running. It is therefore reasonable
to speculate that if changes in muscle fascicle shortening and/
or shortening velocity exist between stiffness conditions, they

are more likely to be found at a muscle with greater absolute
length changes during stance. Meaningful differences in muscle function could still exist between stiffness conditions, but
maybe not at the soleus. Second, Beck et al.40 tested their participants while running at 3.5 m/s, whereas participants in our
study ran at 90% of their individual sLT. Choosing a relative
speed has the advantage that participants run at relative intensities, so it better represents their substrate utilization and
energy yield per volume of oxygen.31 At higher relative speeds
and intensities, it is possible that differences in muscle function are likelier to be found at muscles containing more Type
II (or fast-twitch) fibers. Muscles of different fiber type composition could therefore be affected differently by inserting
carbon fiber plates in shoes during running.TagedEn
TagedPThe findings of this study showed that peak ankle extension
moments decreased with increasing running distance. More
importantly, these ankle joint moments started decreasing later
in the stiff than in the control condition. This could be indicative of delayed fatigue of the major ankle plantarflexor
muscles1 when running in footwear with increased MBS.
Additionally, peak ankle extension velocities were lower and
stance times were longer in the stiff condition. If it is assumed
that ankle extension velocities can be descriptive of ankle
extensor MTU function,22,25 these reduced velocities could
indicate that the TS muscle and/or the AT operate at reduced
shortening velocities. These speculations are supported by the
increased stance times observed in this study when running in
footwear with increased MBS, which would allow the MTU to
shorten at slower velocities while maintaining similar shortening lengths.TagedEn

846
847
848
849
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
866
867
868
869
870
871
872
873
874
875
876

TagedH24.2. Subgroup analysisTagedEn
agedPIT n this study, a subgroup analysis was performed to determine if running shoes with extremely stiff carbon fiber plates
(i.e., Stiffer, 13.28 N/mm) would affect joint-specific positive
work differently from the beginning to the end of a prolonged
run when compared to a footwear condition with carbon fiber
plates more likely to be found on the current sporting goods
market (i.e., Stiff, 6.46 N/mm). The findings of this study
showed no significant difference in joint-specific positive
work changes from the beginning to the end of the run between
Stiff and Stiffer. This suggests that a delayed onset of joint
work redistribution can already be achieved by using carbon
fiber plates of moderate bending stiffness. It needs to be noted,
however, that the carbon fiber plates embedded in commercially available marathon racing shoes are typically curved
near the MTP joint. The carbon fiber plates used in this study,
however, were straight. Results from a preliminary study
showed that ankle push-off moments were higher when running in shoes with straight compared to curved carbon fiber
plates.41 This suggests the likelihood that there are some differences in the functions of curved and straight carbon fiber
plates. However, both curved14,16,17 and straight plates13,30
have been shown to improve the energy cost of running. Perhaps similar effects on the onset of lower limb joint work
redistribution could be observed during a prolonged run in

Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902

ARTICLE IN PRESS
TagedEnShoe Stiffness Effects on Joint Work Redistribution
903
904
905
906

currently available marathon racing shoes, which have curved
carbon fiber plates embedded. The effects of plate curvature
on running mechanics will need to be investigated in more
detail by future studies.TagedEn

907
908
909
910
911
912
913
914
915
916
917
918
919
920
921
922
923
924
925
926
927
928
929
930
931
932
933
934
935
936
937
938
939
940
941
942
943
944
945
946
947
948
949
950
951
952
953
954
955
956
957
958
959

TagedH24.3. LimitationsTagedEn
T here are some limitations associated with this study. The
agedPT
sample used for comparing Stiff to Stiffer was low. This likely
decreased the power of our statistical analysis, causing us to
potentially underestimate the effects of differently stiff plates
on joint work redistribution. Furthermore, not all participants
were tested in all stiffness conditions. This would have
allowed us to parse out subtle distinctions between different
stiffnesses of carbon fiber plates. The control shoe used in this
study had a low MBS. It is therefore possible that when running in other commercially available running shoes, which
already have a higher MBS, the disparity in joint work redistribution may be smaller. The joint work considered in this study
consisted of the sagittal plane work alone. Another recent
study has shown that prolonged running can affect non-sagittal
plane kinematics.42 It is unknown, however, if these changes
in non-sagittal plane kinematics can alter the total work performed at joints as no kinetics were reported. Our study only
reported sagittal plane joint work because the main focus of
this investigation was to estimate the contribution of the joint
flexor/extensor muscle groups. Also, the sagittal plane work
has been shown to be the major determinant of total joint work
during human gait.43 Furthermore, we did not control for the
striking pattern of the runners. Although a recent study suggested that lower limb joint work may not be redistributed
proximally during prolonged running in habitual rearfoot strikers,44 our study confirmed previous findings from Sanno et al.1
irrespective of striking pattern. Our analysis showed that the
runners’ ankles were in a dorsiflexed position at heel-strike,
suggesting a rearfoot striking pattern (Supplementary Table
6). More important, however, there was no effect of distance
or shoe, and no interaction effect on the striking pattern. The
changes in positive lower limb joint work from the beginning
to the end of the run were 
5.14% and 4.76% for the ankle
and knee joints, respectively. This is smaller than the minimal
detectible change, which is likely related to the high betweensubject variability in relative joint work contributions when
running over a prolonged distance; however, the order of magnitude is well comparable to the findings by Sanno et al.1 (i.e.,
ankle: 8%, knee: 4%). The changes in relative joint work due
to running in differently stiff shoes were of smaller magnitude
than the changes observed due to the prolonged run (Table 1).
This, however, was expected based on previously reported
findings by Cigoja et al.19 Furthermore, we applied markers
directly on the skin overlying anatomical landmarks, which
may have resulted in vibration of the markers during running.
This vibration, however, can be considered similar between
shoe conditions and running distances as marker placements
did not change. Therefore, marker vibrations are unlikely to
have affected the conclusions of this study. Lastly, we did not
directly assess muscle and/or whole-body metabolic cost over

9

the course of the prolonged run in both footwear conditions.
Ultrasound imaging of the TS muscle (or its individual
muscles) or of the AT would have enabled us to gain a deeper
understanding of the ankle plantarflexor muscles and tendons,
which would help with estimating the energy cost of muscle
contraction and tendon energy return over the course of a prolonged run.45 The results reported in this study should be interpreted in the context of these limitations. If feasible, future
studies should attempt to record expired gases and in vivo TS
muscle fascicle or AT behaviour in order to determine the
change in energy cost of running and to estimate muscle
energy cost or tendon energy return.TagedEn

960
961
962
963
964
965
966
967
968
969
970
971
972

TagedH15. ConclusionTagedEn
T rolonged running in footwear with increased MBS
agedPP
resulted in a delayed onset of lower limb joint work redistribution from distal to proximal joints as compared to a control
condition. This delayed onset of joint work redistribution
toward more proximal joints could be metabolically beneficial
because MTUs crossing distal joints are thought to be better
equipped for elastic energy storage and return and have
smaller muscle volume compared to MTUs crossing more
proximal joints. Furthermore, this delayed onset of lower limb
joint work redistribution could also be related to previously
reported performance benefits when running in footwear with
increased MBS.TagedEn

973
974
975
976
977
978
979
980
981
982
983
984
985
986
987

TagedH1Authors’ contributionsTagedEn
T C conceptualized the study, collected, processed, and anaagedPS
lyzed the data, interpreted the results, and wrote the initial
draft of the manuscript; JRF conceptualized the study, analyzed the data, interpreted the results, and revised the manuscript; BMN conceptualized the study, interpreted the results,
and revised the manuscript. All authors have read and
approved the final version of the manuscript, and agree with
the order of presentation of the authors.TagedEn

988
989
990
991
992
993
994
995
996
997
998

TagedH1Declaration of Competing interestsTagedEn
TagedPThe authors declare that they have no competing interests.TagedEn

999
1000
1001
1002

TagedH1AcknowledgmentsTagedEn
T upported by the International Society of Biomechanics in
agedPS
Sports Student Mini Research Grant awarded to SC.TagedEn
TagedH1Supplementary materialsTagedEn
T upplementary material associated with this article can be
agedPS
found, in the online version, at doi:10.1016/j.jshs.2020.12.007.TagedEn
TagedH1ReferencesTagedEn
TagedP 1. Sanno M, Willwacher S, Epro G, Br€uggemann GP. Positive work contribution shifts from distal to proximal joints during a prolonged run. Med
Sci Sport Exerc 2018;50:2507–17.TagedEn

Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007

1003
1004
1005
1006
1007
1008
1009
1010
1011
1012
1013
1014
1015
1016

ARTICLE IN PRESS
TagedEn10
1017
1018
1019
1020
1021
1022
1023
1024
1025
1026
1027
1028
1029
1030
1031
1032
1033
1034
1035
1036
1037
1038
1039
1040
1041
1042
1043
1044
1045
1046
1047
1048
1049
1050
1051
1052
1053
1054
1055
1056
1057
1058
1059
1060
1061
1062
1063
1064
1065
1066

TagedP 2. Anderson DE, Madigan ML, Nussbaum MA. Maximum voluntary joint
torque as a function of joint angle and angular velocity: model development and application to the lower limb. J Biomech 2007;40:3105–13.TagedEn
TagedP 3. Kulmala JP, Korhonen MT, Ruggiero L, et al. Walking and running
require greater effort from the ankle than the knee extensor muscles. Med
Sci Sport Exerc 2016;48:2181–9.TagedEn
TagedP 4. Alexander RM. Elastic energy stores in running vertebrates. Am Zool
1984;24:85–94.TagedEn
TagedP 5. Alexander RM. Energy-saving mechanisms in walking and running. J Exp
Biol 1991;160:55–69.TagedEn
TagedP 6. Fletcher JR, MacIntosh BR. Achilles tendon strain energy in distance running:
consider the muscle energy cost. J Appl Physiol (1985) 2015;118:193–9.TagedEn
TagedP 7. Fletcher JR, Macintosh BR. Running economy from a muscle energetics
perspective. Front Physiol 2017;8:433. doi:10.3389/fphys.2017.00433.TagedEn
TagedP 8. Di Prampero PE, Capelli C, Pagliaro P, et al. Energetics of best performances in middle-distance running. J Appl Physiol (1985) 1993;74:2318–24.TagedEn
TagedP 9. Brueckner JC, Atchou G, Capelli C, et al. The energy cost of running
increases with the distance covered. Eur J Appl Physiol Occup Physiol
1991;62:385–9.TagedEn
TagedP10. Xu F, Montgomery DL. Effect of prolonged exercise at 65 and 80 % of
VO2max on running economy. Int J Sports Med 1995;16:309–13.TagedEn
TagedP11. Hunter I, Smith GA. Preferred and optimal stride frequency, stiffness and
economy: changes with fatigue during a 1-h high-intensity run. Eur J
Appl Physiol 2007;100:653–61.TagedEn
TagedP12. Hoogkamer W, Kipp S, Kram R. The biomechanics of competitive male
runners in three marathon racing shoes: a randomized crossover study.
Sport Med 2019;49:133–43.TagedEn
TagedP13. Roy JP, Stefanyshyn DJ. Shoe midsole longitudinal bending stiffness and
running economy, joint energy, and EMG. Med Sci Sports Exerc
2006;38:562–9.TagedEn
TagedP14. Hoogkamer W, Kipp S, Frank JH, Farina EM, Luo G, Kram R. A comparison of the energetic cost of running in marathon racing shoes. Sports Med
2018;48:1009–19.TagedEn
TagedP15. Stefanyshyn DJ, Nigg BM. Influence of midsole bending stiffness on joint
energy and jump height performance. Med Sci Sports Exerc 2000;32:471–6.TagedEn
TagedP16. Barnes KR, Kilding AE. A randomized crossover study investigating the
running economy of highly-trained male and female distance runners in
marathon racing shoes versus track spikes. Sports Med 2019;49:331–42.TagedEn
TagedP17. Hunter I, McLeod A, Valentine D, Low T, Ward J, Hager R. Running economy, mechanics, and marathon racing shoes. J Sports Sci 2019;37:2367–73.TagedEn
TagedP18. Willwacher S, K€
onig M, Potthast W, Br€
uggemann GP. Does specific footwear facilitate energy storage and return at the metatarsophalangeal joint
in running ? J Appl Biomech 2013;29:583–92.TagedEn
TagedP19. Cigoja S, Firminger CR, Asmussen MJ, Fletcher JR, Edwards WB, Nigg
BM. Does increased midsole bending stiffness of sport shoes redistribute
lower limb joint work during running? J Sci Med Sport 2019;22:1272–7.TagedEn
TagedP20. Willwacher S, K€
onig M, Braunstein B, Goldmann JP, Br€
uggemann GP.
The gearing function of running shoe longitudinal bending stiffness. Gait
Posture 2014;40:386–90.TagedEn
TagedP21. Takahashi KZ, Gross MT, van Werkhoven H, Piazza SJ, Sawicki GS.
Adding stiffness to the foot modulates soleus force-velocity behaviour
during human walking. Sci Rep 2016;6:29870.TagedEn
TagedP22. Cigoja S, Asmussen MJ, Firminger CR, Fletcher JR, Edwards WB, Nigg
BM. The effects of increased midsole bending stiffness of sport shoes on
muscle-tendon unit shortening and shortening velocity: a randomised
crossover trial in recreational male runners. Sport Med Open 2020;6:9.TagedEn
TagedP23. Nigg BM, Cigoja S, Nigg SR. Teeter-totter effect: a new mechanism to
understand shoe-related improvements in long-distance running. Br J
Sports Med. 2020.TagedEn

S. Cigoja et al.
TagedP24. Nigg BM, Cigoja S, Nigg SR. Effects of running shoe construction on performance in long distance running. Footwear Sci 2020;12:133–8.TagedEn
TagedP25. Carrier DR, Heglund NC, Earls KD. Variable gearing during locomotion
in the human musculoskeletal system. Science 1994;265:651–3.TagedEn
TagedP26. Flores N, Delattre N, Berton E, Rao G. Does an increase in energy return
and / or longitudinal bending stiffness shoe features reduce the energetic
cost of running ? Eur J Appl Physiol 2019;119:429–39.TagedEn
TagedP27. Roberts TJ, Kram R, Weyand PG, Taylor CR. Energetics of bipedal running. I. Metabolic cost of generating force. J Exp Biol 1998;201:2745–51.TagedEn
TagedP28. Fletcher JR, Groves EM, Pfister TR, MacIntosh BR. Can muscle shortening alone, explain the energy cost of muscle contraction in vivo? Eur J
Appl Physiol 2013;113:2313–22.TagedEn
TagedP29. Stefanyshyn D, Fusco C. Increased shoe bending stiffness increases sprint
performance. Sport Biomech 2004;3:55–66.TagedEn
TagedP30. Oh K, Park S. The bending stiffness of shoes is beneficial to running energetics if it does not disturb the natural MTP joint flexion. J Biomech
2017;53:127–35.TagedEn
TagedP31. Fletcher JR, Esau SP, Macintosh BR. Economy of running: beyond the
measurement of oxygen uptake. J Appl Physiol (1985) 2009;107:1918–
22.TagedEn
TagedP32. Firminger CR, Asmussen MJ, Cigoja S, Fletcher JR, Nigg BM, Edwards
WB. Cumulative metrics of tendon load and damage vary discordantly
with running speed. Med Sci Sports Exerc 2020;52:1549–56.TagedEn
TagedP33. Winter DA. Biomechanics and motor control of human movement. 4th ed.
Hoboken, NJ: John Wiley & Sons, Inc.; 2009.p.70. doi:10.1002/
9780470549148.TagedEn
TagedP34. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale,
NJ: Lawrence Erlbaum Associates; 1988.p.40.TagedEn
TagedP35. Nair PM, Hornby TG, Behrman AL. Minimal detectable change for spatial and temporal measurements of gait after incomplete spinal cord
injury. Top Spinal Cord Inj Rehabil 2012;18:273–81.TagedEn
TagedP36. Charles JP, Suntaxi F, Anderst WJ. In vivo human lower limb muscle
architecture dataset obtained using diffusion tensor imaging. PLoS One
2019;14: e0223531.TagedEn
TagedP37. Kipp S, Grabowski AM, Kram R. What determines the metabolic cost of
human running across a wide range of velocities? J Exp Biol 2018;221:
jeb184218.TagedEn
TagedP38. Lai AKM, Lichtwark GA, Schache AG, Pandy MG. Differences in in vivo
muscle fascicle and tendinous tissue behavior between the ankle plantarflexors during running. Scand J Med Sci Sport 2018;28:1828–36.TagedEn
TagedP39. Petersen K, Hansen CB, Aagaard P, Madsen K. Muscle mechanical characteristics in fatigue and recovery from a marathon race in highly trained
runners. Eur J Appl Physiol 2007;101:385–96.TagedEn
TagedP40. Beck ON, Golyski PR, Sawicki GS. Adding carbon fiber to shoe soles
does not improve running economy: a muscle-level explanation. Sci Rep
2020;10:17154.TagedEn
TagedP41. Farina EM, Haigh D, Luo G. Creating footwear for performance running.
Footwear Sci 2019;11(Suppl. 1):134–5.TagedEn
TagedP42. Willwacher S, Sanno M, Br€
uggemann GP. Fatigue matters: an intense
10 km run alters frontal and transverse plane joint kinematics in competitive and recreational adult runners. Gait Posture 2020;76:277–83.TagedEn
TagedP43. Buczek FL, Kepple TM, Siegel KL, Stanhope SJ. Translational and rotational joint power terms in a six degree-of-freedom model of the normal
ankle complex. J Biomech 1994;27:1447–57.TagedEn
TagedP44. Melaro JA, Gruber AH, Paquette MR. Joint work is not shifted proximally
after a long run in rearfoot strike runners. J Sports Sci 2020;13:1–6.
doi:10.1080/02640414.2020.1804807.TagedEn
TagedP45. Fletcher JR, MacIntosh BR. Theoretical considerations for muscle-energy
savings during distance running. J Biomech 2018;73:73–9.TagedEn

1074
1075
1076
1077
1078
1079
1080
1081
1082
1083
1084
1085
1086
1087
1088
1089
1090
1091
1092
1093
1094
1095
1096
1097
1098
1099
1100
1101
1102
1103
1104
1105
1106
1107
1108
1109
1110
1111
1112
1113
1114
1115
1116
1117
1118
1119
1120
1121
1122
1123

1067

1124

1068

1125

1069

1126

1070

1127

1071

1128

1072

1129

1073

1130

Please cite this article as: Sasa Cigoja et al., Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?, Journal of Sport and
Health Science (2021), https://doi.org/10.1016/j.jshs.2020.12.007