The purpose of this study was to examine the independent effects of anterior knee pain (AKP) on bilateral ground reaction force (GRF) during running, with a focus on GRF applied to the uninvolved leg, which, prior to this study, had never been evaluated. Twelve volunteers completed three data collection sessions, that corresponded to one of three conditions (control, sham, and pain), in a counterbalanced order. For each session, subjects ran for five minutes. For the pain and sham sessions, respectively, hypertonic and isotonic saline were infused into the infrapatellar fat pad of the right leg during the running, while no infusion was involved in the control session. GRF data were collected during the final 30 seconds of running. Functional statistics were used to determine the effects of session and leg (right and left) on vertical and anterior-posterior GRF throughout the stance phase of running. A mixed model ANOVA was used to determine the effect of session and leg on vertical GRF load rate, impulse due to vertical, propulsive, and braking GRFs. A repeated measures ANOVA was used to determine the effect of session and time on subject-perceived pain. Alpha was set to 0.05 for all statistical comparisons. Unexpectedly, no significant session × leg interaction existed for vertical GRF at any time point during stance phase of running. Similarly, the experimental AKP did not affect impulse due to vertical GRF or load rate for the vertical GRF. There was, however, a significant session × leg interaction for anterior-posterior GRF. For the pain session, involved-leg braking GRF was 11% greater than uninvolved-leg braking GRF, during the first 9% of stance phase. There was also a significant between-session difference for involved-leg braking impulse (p = 0.023) and uninvolved-leg propulsive impulse (p = 0.027). The mean involved-leg braking impulses were 11.3 Ns (± 0.6), 13.2 Ns (± 0.6) and 13.2 Ns (± 0.6) for the pain, control, and sham sessions, respectively. Mean uninvolved-leg propulsive impulses were 14.8 Ns (± 1.3), 13.6 Ns (± 1.3), and 13.5 Ns (± 1.3) for the pain, control, and sham sessions, respectively. These differences in anterior-posterior GRF might reflect a compensatory unloading of the involved leg due to AKP.



College and Department

Life Sciences; Exercise Sciences



Date Submitted


Document Type





anterior knee pain, ground reaction force, running