Acute fatigue negatively affects risk factors for injury in trained but not well-trained habitually shod runners when running barefoot

Introduction: Many factors may contribute to running-related injury. These include fatigue and footwear, the combination of which has rarely been studied, in particular with reference to barefoot running, recently advocated as a method to reduce injury risk. Methods: Twenty-two runners (12 well-trained and 10 trained) participated in a 10km fatiguing trial. Knee and ankle joint kinematics and kinetics and electromyography were assessed during overground running in the barefoot and shod condition. This was performed pre- and post-fatigue using a motion capture system and force platforms. Results: Initial loading rate increased in the trained runners when barefoot but not shod. Shod knee stiffness increased in both groups after fatigue, whereas barefoot knee stiffness decreased only in the trained group. A reduction in barefoot bicep femoris pre-activation was found in both groups. During stance, a reduction in vastus lateralis and biceps femoris and an increase in tibialis anterior activity were found over time in both groups and conditions. Trained runners decreased gluteus medius and increased lateral gastrocnemius median frequency for both conditions after fatigue. Conclusion: When fatigued, gait adjustments in habitually shod runners may increase injury risk when running barefoot. Training status may be a risk factor for injury, as less-trained runners experience muscular fatigue changes that may compromise ground reaction force attenuation. Caution is recommended when transitioning to pure barefoot running.