Open Access

Luca Braun, Patrick Mai, Markus Hipper, Yannick Denis, Bastian Anedda, Janina Helwig, Dominic Gehring, Steffen Willwacher

• The study aimed to establish dose-response relationships between systematically altered anterior trunk leaning (ATL) and lower extremity cumulative joint loading (angular impulse x number of strides) as well as cost of transport (COT) in distance running. Twenty-eight recreational runners underwent a series of six treadmill runs (2.5 m/s) with five predefined ATL conditions (from -4° extension toThe study aimed to establish dose-response relationships between systematically altered anterior trunk leaning (ATL) and lower extremity cumulative joint loading (angular impulse x number of strides) as well as cost of transport (COT) in distance running. Twenty-eight recreational runners underwent a series of six treadmill runs (2.5 m/s) with five predefined ATL conditions (from -4° extension to 28° flexion) and one self-selected ATL condition for five minutes with 3D motion capture and spirometry. Increasing ATL systematically decreased cumulative knee joint loading and increased cumulative hip joint loading in all conditions. However, running outside the preferred running style increased COT. Designing ATL-based overuse load management interventions shows promise, but clinical implementation requires careful consideration of the COT and joint loading trade-offs.…