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  • Writer's pictureLuke Nelson

Hill running: why it matters for injury

Uphill & Downhill Running: Understanding the Body's Response to Avoid Injury

When it comes to running injuries, it's crucial to comprehend how the body responds to the challenges of uphill and downhill running. Here are some key points to consider:

Uphill running:

  • Requires a shorter swing phase & a greater ground contact time. (Swanson 2000)

  • Involves a shift towards more forefoot/midfoot landing. (Vernillo 2017)

  • Requires more muscle work from the calves, quads & hip muscles. (Vernillo 2017)

  • Relies more on concentric muscle strength.

  • Results in higher tibial force due to increased muscle contraction, which can contribute to tibial bone stress injuries. (Matijevich 2019)

Downhill running:

  • Involves more time spent in the flight phase with a lower cadence. (Vernillo 2017)

  • More likely to involve rear-foot striking. (Vernillo 2017)

  • Results in a straighter knee on landing. (Vernillo 2017)

  • Relies more on eccentric strength, especially in the quads. (Vernillo 2017)

  • Results in higher impact forces & significantly greater patellofemoral stress. (Gottschall 2005, Vernillo 2017)

Injury considerations

When considering injury management, keep the following in mind:

  • Individuals with a history of calf strains, Achilles tendinopathy, or tibial bone stress injuries should initially avoid uphill running. However, it can be added later in rehabilitation to strengthen these areas.

  • Those with knee issues may be better suited to uphill running than downhill running due to the increased demands and straighter knees upon landing during downhill running.

  • Uphill running may lead to increased bone stress due to heightened muscle contraction.

  • Changes in footstrike during uphill running may pose problems for individuals with forefoot issues or plantar heel pain (due to a shift towards forefoot landing). Downhill running, on the other hand, may exacerbate anterior exertional compartment syndrome (due to a shift towards heel striking).

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  • Gottschall, J. S. and R. Kram (2005). "Ground reaction forces during downhill and uphill running." J Biomech 38(3): 445-452.

  • Matijevich, E. S., et al. (2019). "Ground reaction force metrics are not strongly correlated with tibial bone load when running across speeds and slopes: Implications for science, sport and wearable tech." PLoS One 14(1): e0210000.

  • Swanson, S. C. and G. E. Caldwell (2000). "An integrated biomechanical analysis of high speed incline and level treadmill running." Med Sci Sports Exerc 32(6): 1146-1155.

  • Vernillo, G., et al. (2017). "Biomechanics and Physiology of Uphill and Downhill Running." Sports Med 47(4): 615-629.


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