Running with an exotendon reduces compressive knee contact force.

Stingel, Jon; Haralabidis, Nicos; Hicks, Jennifer; Uhlrich, Scott; Delp, Scott · J Biomech · 2026

biomechanical · Level V

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Abstract

An exotendon-a spring that couples the legs when attached to a runner's shoes-reduces the energetic cost of running, but the effects on joint contact forces are unknown. This study examined whether running with an exotendon alters the forces in the hip, knee and ankle. We used muscle-driven simulations of experimental data to compute compressive and shear contact forces at the hip, knee, and ankle joints for seven participants running at 2.7 m/s with and without an exotendon. We found that runners using the exotendon experienced a 8.4% reduction in peak knee compressive contact force (1.0 ± 0.7 BW; P = 0.026), and no change in the peak knee shear contact force. The primary contributor to this reduction was lower forces in the quadriceps muscles, which decreased their contribution to peak knee compressive contact force by 12.2% (-0.8 ± 0.7 BW; P = 0.018). We observed no change in the peak compressive or shear contact forces in the hip or ankle joints. Though the exotendon was not originally designed to reduce joint forces, our findings highlight the ability of this simple device to make changes to gait that reduce both energetic cost and compressive knee force.

Medical subject headings