Sports Med 2009; 39 (11): 903-921

REVIEW ARTICLE 0112-1642/09/0011-0903/$49.95/0

ª 2009 Adis Data Information BV. All rights reserved.

Neuromuscular Adaptations to Training,

Injury and Passive Interventions
Implications for Running Economy
Jason Bonacci,1,2 Andrew Chapman,1,3,4,5 Peter Blanch2 and Bill Vicenzino1
1 Musculoskeletal Pain and Injury Research Unit, University of Queensland, Brisbane,
Queensland, Australia
2 Department of Physical Therapies, Australian Institute of Sport, Canberra, Australian Capital Territory,
Australia
3 School of Kinesiology, Simon Fraser University, Vancouver, British Columbia, Canada
4 Applied Research Centre, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
5 Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada

Contents
Abstract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 903
1. Literature Search . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 905
2. Adaptations of Muscle Recruitment to Single-Discipline Endurance Training . . . . . . . . . . . . . . . . . . . . 906
3. Adaptation of Muscle Recruitment to Multidiscipline Endurance Training . . . . . . . . . . . . . . . . . . . . . . . 907
4. Neuromuscular Characteristics and Running Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 907
5. Training, Shoes, In-Shoe Orthoses, Musculoskeletal Injury and Running Economy. . . . . . . . . . . . . . . . . 909
5.1 Resistance Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 909
5.2 Plyometric Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 910
5.3 Stretching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 911
5.4 Multidiscipline Sports and Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 912
5.5 Shoes and In-Shoe Orthoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 914
5.6 Musculoskeletal Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915
6. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 916
7. Future Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 916

Abstract Performance in endurance sports such as running, cycling and triathlon

has long been investigated from a physiological perspective. A strong
relationship between running economy and distance running performance is
well established in the literature. From this established base, improvements in
running economy have traditionally been achieved through endurance
training. More recently, research has demonstrated short-term resistance and
plyometric training has resulted in enhanced running economy. This
improvement in running economy has been hypothesized to be a result of
enhanced neuromuscular characteristics such as improved muscle power
development and more efficient use of stored elastic energy during running.
Changes in indirect measures of neuromuscular control (i.e. stance phase
contact times, maximal forward jumps) have been used to support this
hypothesis. These results suggest that neuromuscular adaptations in response
904 Bonacci et al.

to training (i.e. neuromuscular learning effects) are an important contributor

to enhancements in running economy. However, there is no direct evidence to
suggest that these adaptations translate into more efficient muscle recruit-
ment patterns during running. Optimization of training and run performance
may be facilitated through direct investigation of muscle recruitment patterns
before and after training interventions.
There is emerging evidence that demonstrates neuromuscular adaptations
during running and cycling vary with training status. Highly trained runners
and cyclists display more refined patterns of muscle recruitment than their
novice counterparts. In contrast, interference with motor learning and neuro-
muscular adaptation may occur as a result of ongoing multidiscipline training
(e.g. triathlon). In the sport of triathlon, impairments in running economy
are frequently observed after cycling. This impairment is related mainly to
physiological stress, but an alteration in lower limb muscle coordination
during running after cycling has also been observed. Muscle activity during
running after cycling has yet to be fully investigated, and to date, the effect of
alterations in muscle coordination on running economy is largely unknown.
Stretching, which is another mode of training, may induce acute neuromus-
cular effects but does not appear to alter running economy.
There are also factors other than training structure that may influence
running economy and neuromuscular adaptations. For example, passive
interventions such as shoes and in-shoe orthoses, as well as the presence of
musculoskeletal injury, may be considered important modulators of neuro-
muscular control and run performance. Alterations in muscle activity and
running economy have been reported with different shoes and in-shoe
orthoses; however, these changes appear to be subject-specific and non-
systematic. Musculoskeletal injury has been associated with modifications in
lower limb neuromuscular control, which may persist well after an athlete has
returned to activity. The influence of changes in neuromuscular control as a
result of injury on running economy has yet to be examined thoroughly, and
should be considered in future experimental design and training analysis.

Endurance sports such as running, cycling and
triathlon are performed by many people at the
recreational and competitive levels. At competi-
tion level, each of these sports requires extensive
training. Triathlon is unique in that it is a multi-
discipline sport requiring athletes to balance the
training demands of three separate disciplines
(i.e. swimming, cycling, running). The physiolo-
gical and metabolic adaptations that occur in
response to training have been extensively investi-
gated. Oxygen consumption, blood lactate
threshold, heart rate intensity, respiratory ex-
change ratio and the pulmonary ventilation
threshold are common measures used to reflect
endurance performance or adaptation to training.[1]
The steady-state oxygen consumption at a given
running velocity is defined as running economy,[2,3]
and reflects the metabolic cost or metabolic de-
mand of running. A strong relationship has been
demonstrated between running economy and
endurance running performance.[2,4-7] These mea-
sures highlight the relationship between the cardio-
respiratory system and performance; however,
they do not reflect the contribution of the neural
system, which controls and coordinates human
movement. The interaction between the neural and
muscle systems (i.e. neuromuscular system) is
fundamental to all movement, and effectively
translates cardiorespiratory capacity into efficient
movement and therefore into performance.

ª 2009 Adis Data Information BV. All rights reserved. Sports Med 2009; 39 (11)
Neuromuscular Adaptations and Running Economy
The neuromuscular system has the capability
to adapt to training, not unlike the cardio-
respiratory system. Studies over the past two
decades have provided strong evidence that con-
tinued practice of a task (i.e. training) facilitates
neuromuscular adaptations, which are charac-
terized by more skilled control of movement and
muscle recruitment patterns.[8-11] Training-
induced adaptations of descending motor com-
mands reflect learning within the CNS and can be
represented by changes in muscle electro-
myography (EMG) function (i.e. motor recruit-
ment).[11] Like training, musculoskeletal pain and
injury[12,13] – and passive interventions such as
shoes and in-shoe orthoses[14-17] (which are often
prescribed for pain and/or injury) – have been
shown to induce acute adaptations in motor
recruitment. Musculoskeletal overuse injury is a
significant adverse effect of training that con-
stitutes a major impediment to training and ulti-
mately performance, through missed training
and/or diminished training quality. The pre-
valence of lower extremity injury in recreational
and competitive athletes ranges from 19.4% to
79.3% in running athletes[18] and 37–91% in ath-
letes participating in triathlons.[19] An injury-
induced restriction in training can result in
detraining, which may negatively affect perfor-
mance, cardiorespiratory health and neuro-
muscular control.[20,21]
It is apparent within the literature that training
can induce positive changes in running econo-
my.[22,23] Training also appears to induce adap-
tations in motor recruitment.[8,9,11] Less well
known are the neuromuscular adaptations that
occur with different modes of training (i.e. run-
ning, cycling, multidiscipline training, resistance
training) and how these changes in neuromus-
cular control can be coupled with running econ-
omy. It has recently been hypothesized that
improvements in running economy following
strength and resistance training were due to
neuromuscular adaptations.[24-26] Inferences have
also been made that optimal lower limb muscle
recruitment is critical for superior running eco-
nomy.[27] However, these hypotheses have been
based on indirect measures of neuromuscular
control such as stance phase ground contact
ª 2009 Adis Data Information BV. All rights reserved.
905
times and leg strength during isolated tasks as
evidence for neuromuscular adaptations. If
neuromuscular adaptations are responsible for
the changes in running economy then it would be
reasonable to suggest that there would be altera-
tions in motor recruitment during running fol-
lowing training.
It is important to appreciate that adaptations
in motor recruitment as a result of training re-
present a learning effect. Positive adaptations
infer that an individual learns to produce specific
patterns of muscle recruitment that are asso-
ciated with optimal performance of the task. This
is inherently different to the alterations in neuro-
muscular function that occur with fatigue during
prolonged exercise.[28] Fatigue in itself is a com-
plex phenomenon and much attention has
already been directed toward better under-
standing the mechanisms of fatigue and regula-
tion of output during endurance exercise.[29-32]
Accordingly, the intent of this review is not to
revisit this information nor discount the impor-
tance of fatigue in modulating exercise perfor-
mance but rather to discuss the adaptations in
motor recruitment (i.e. learning effects) that
occur with different modes of training, injury and
passive interventions and the implications this
may have for running economy. Therefore,
the aims of this review are to: (i) examine the
adaptations of lower limb muscle recruitment
(i.e. neuromuscular adaptations) to different
modes of training (i.e. running, cycling, multi-
discipline); (ii) examine what aspects of neuro-
muscular control are associated with running
economy; and (iii) investigate whether neuro-
muscular adaptations induced by training, pas-
sive interventions and injury can be coupled with
changes in running economy.
1. Literature Search
The databases Cinahl, MEDLINE, PubMed,
SportDiscus and Web of Science were searched
using the following combination of terms: (‘run-
ning
. economy‘ or ‘oxygen consumption’ or
‘VO2’) and (‘EMG’ or ‘muscle activity’ or ‘neuro-
muscular’) or (‘EMG’ or ‘neuromuscular’ or
Sports Med 2009; 39 (11)
906
‘running economy’ or ‘oxygen consumption’) and
(‘orthoses’ or ‘orthotics’ or ‘shoes’ or ‘resistance
training’ or ‘plyometrics’ or ‘injury’ or ‘cycling’
or ‘triathlon’). The reference lists of the articles
obtained were searched manually to obtain
further studies not identified electronically. All
relevant studies in the English language were
included.
2. Adaptations of Muscle Recruitment to
Single-Discipline Endurance Training
Motor learning studies have demonstrated
that continued practice of a task results in more
skilled control of movement, characterized by
decreased amplitude and duration of muscle acti-
vity,[8-10] decreased muscle co-activation[9,11,33]
and less variability of movement.[9,11,34] How-
ever, these studies examined novel hand and arm
movements over a short training period (e.g. 1–2
days), and their results provide little insight into
the adaptations of muscle recruitment that may
occur in response to years of continued training
by athletes. Furthermore, there is very little
research that has directly measured the neuro-
muscular adaptations that occur in response to
endurance training such as cycling and running,
which involve repetitive, rhythmical actions.
Initial studies comparing muscle recruitment
patterns of trained cyclists to their novice coun-
terparts presented conflicting findings and are
limited by small sample sizes, EMG methodo-
logical limitations, and inadequate regard for
kinematics (i.e. kinematics were not controlled or
measured and any difference in EMG activity
may have been due to kinematic changes).[35,36]
Similarly, running studies[37,38] are hindered by
the heterogeneity of participants and inadequate
inclusion criteria, making it difficult to determine
the specific training status of included athletes.
Only recently has evidence emerged that
trained cyclists and runners display different
patterns of muscle recruitment to their novice
counterparts. Novice cyclists with 1.4 – 0.4 years
of cycling experience, who cycled 36.1 – 10.3
km/wk, exhibited greater individual variance (i.e.
variability of muscle activity between pedal
ª 2009 Adis Data Information BV. All rights reserved.
Bonacci et al.
strokes for individual cyclists), greater popula-
tion variance (i.e. variability of muscle recruit-
ment between athletes), more extensive and more
variable muscle co-activation and longer dura-
tions of muscle activity than highly trained
cyclists with 10.2 – 1.4 years’ experience, cycling
393.9 – 32.5 km/wk[39] (figure 1[40]). A similar
finding emerged when moderately trained run-
ners (6.6 – 1.3 years’ experience, 61.4 – 8.8 km/wk)
were compared with novice runners (3.4 – 2.8
km/wk).[41] Specifically, novice runners were char-
acterized by greater individual variance (i.e. varia-
bility between strides) and greater population
variance. These findings are consistent with pre-
vious short-term training studies of arm and hand
movements,[8,9,33] suggesting that ongoing neuro-
muscular adaptations occur as a result of con-
tinued training. The cross-sectional nature of the
cycling and running studies is a clear limitation.
However, given the limitations of the aforemen-
tioned studies, and the difficulties of tracking
athletes over many years of training, this is the
strongest evidence of continuing neuromuscular
adaptations to endurance training available at
present.
Trained triathlete Trained cyclist Novice cyclist
TA
TP
PL
GL
SOL
0° 180° 360° 0° 180° 360° 0° 180° 360°
Crank angle Crank angle Crank angle
Fig. 1. Rectified electromyogram (EMG) of tibialis anterior (TA),
tibialis posterior (TP), peroneus longus (PL), lateral gastrocnemius
(GL), and soleus (SOL) muscles during cycling at 77.5 rpm. Data for
ten non-contiguous pedal strokes from a representative highly
trained triathlete, highly trained cyclist and novice cyclist are shown.
EMG amplitude is shown as a percentage of the maximum measured
amplitude (0–100%). Muscle activity is plotted for each complete
pedal stroke from upper vertical position of the crank (0) through to a
range of 360 (reproduced from Chapman et al.,[40] with permission).
Sports Med 2009; 39 (11)
Neuromuscular Adaptations and Running Economy
3. Adaptation of Muscle Recruitment to
Multidiscipline Endurance Training
Multidiscipline endurance sports such as
triathlon carry high training demands and are
likely to provide an immense challenge to the
human motor control system. Triathlon com-
prises sequential swimming, cycling and running,
and triathletes often practice two or more of these
disciplines in the one training session or practice
each discipline separately with only short re-
covery periods (i.e. 2–4 hours). Short-term motor
learning studies (i.e. 1–7 days of training) provide
strong evidence that interference with acquisition
of a new skill occurs when another task is prac-
ticed in sequence or within short interim peri-
ods.[42-45] Specifically, when multiple tasks are
practiced in sequence or within short interim
periods (i.e. <6 hours), learning of the second
movement task was biased by the previous task in
the sequence, and with each change of task,
training adaptations were overwritten.[42-44,46]
These studies provide evidence of interference
with motor learning in the initial stages of train-
ing. However, the nature of triathlon training
(i.e. athletes who practice multiple disciplines
with no recovery periods or only short recovery
periods) may provide an appropriate model to
investigate the ability of the neuromuscular
system to adapt (i.e. adaptations of muscle
recruitment) to ongoing multidiscipline training.
Evidence suggests that running and cycling
performance of triathletes is less than that for
cycling and running athletes who train for the
single discipline (i.e. those who only train for
running or who only train for cycling).[47] It could
be argued that the decrement in performance is
due to less time spent training the single discipline
despite similar total training times. However,
Chapman et al.[40] have shown that patterns of leg
muscle activity in highly trained triathletes
are less developed than in cyclists matched for
cycling training loads. Specifically, triathletes
show greater variation between pedal strokes,
more extensive and variable muscle co-activity,
less modulation of muscle activity (i.e. greater
amplitude of muscle activity in periods between
primary bursts), and display patterns of muscle
ª 2009 Adis Data Information BV. All rights reserved.
907
activity similar to that of novice cyclists (figure 1).
The authors suggested that the similarity of leg
muscle recruitment during cycling between highly
trained triathletes and novice cyclists may reflect
ongoing interference with motor learning and
neuromuscular adaptation as a result of multi-
discipline training.[40] Unlike cycling, multi-
discipline training does not appear to adversely
affect adaptation of running muscle activity in
highly trained triathletes.[41] The difference in leg
muscle recruitment during cycling between
triathletes and cyclists only highlights a disparity
between groups at a point in time. However, in
order to provide stronger evidence that ongoing
multidiscipline training interferes with adapta-
tions of muscle recruitment, researchers would
have to use a longitudinal motor learning para-
digm. This would require strict control of train-
ing structure and continued re-assessment over
years of training, and would be especially difficult
to undertake.
4. Neuromuscular Characteristics and
Running Economy
In the late 1980s, Noakes[48] suggested that
endurance performance may be limited not only
by aerobic power but also by ‘muscle power’
factors related to force and velocity character-
istics of the neuromuscular system. Later investi-
gations used a battery of tests to determine the
influence of neuromuscular characteristics on
performance. In a homogenous group of. highly
trained endurance runners with similar VO2max
values, those athletes with faster 10 km and 5 km
run times displayed shorter stance phase contact
times and higher relative muscle pre-activation
(i.e. prior to touchdown), accompanied with
lower relative electromyographic (iEMG) activity
during the propulsion phase than those athletes
with slower run times.[49,50] Furthermore, there
was a significant correlation between running
economy and mean stance phase contact times
during constant velocity running.[49] The authors
speculated that in addition to aerobic power and
running economy, the ability of the neuro-
muscular system to repeatedly produce rapid
force during maximal and submaximal running
Sports Med 2009; 39 (11)
908 Bonacci et al.

plays an important role in determining distance 900 Gluteus maximus

running performance in highly trained athletes. It

has been suggested that shorter stance phase 500
contact times and greater muscle pre-activation
may represent enhanced leg muscle stiffness,
leading to a faster transition from the braking to 100
propulsive phase of ground contact.[50,51]
Dalleau et al.[52] highlighted the importance of
neuromuscular factors by demonstrating that 900 Biceps femoris
running economy was related to the stiffness of
the propulsive leg, with greater stiffness eliciting
500
the best running economy.[52] Leg stiffness is
modulated by neuromuscular activation, and
changes in stiffness have been shown to occur as a 100
result of neuromuscular adaptation to training
(i.e. learning of more efficient or more skilled
patterns of motor recruitment).[53] In support of 900 Vastus lateralis
the association between motor recruitment and
leg stiffness, a reduction in EMG pre-activation
EMG (µV)

was shown to be significantly related to a de- 500

crease in post-landing leg stiffness following

fatiguing exercise.[54] Greater duration of muscle
100
co-activation of bi-articular leg muscles during
stance has also been significantly associated with
better running economy.[55] Muscle co-activation 700 Gastrocnemius
modulates leg stiffness during running and may
alter running economy through utilization of 500
stored elastic energy, which has no additional
metabolic cost. 300
Kyrolainen et al.[56] found that as running
100
speed increased so did EMG preactivation and
ground reaction forces, along with their rate of
force production (figure 2). Preparatory muscle
600 Tibialis anterior
function is an important function of the stretch
shortening cycle (SSC). The SSC is a combination
400
of a high velocity eccentric muscle contraction
followed immediately with a concentric contrac-
200
tion. SSC muscle function enhances performance
during the final phase (concentric action),[57] and
the increase in preparatory muscle activity with
higher running speeds was suggested to be a 200 ms
mechanism to tolerate higher impact loads, reg- Fig. 2. Muscle activity patterns of five muscles from the slowest
ulate landing stiffness[58] and improve running speed of 3.25 m/s (thin line; mean of 170 contacts) up to the maximal
economy.[56] However, in that study, the increase speed (thick line; mean of 34 contacts). Data are the mean rectified
electromyogram (EMG) measurements from a representative
in EMG activity may also be explained by the subject. The dashed lines indicate the respective EMG curves at
associated change in running kinematics with the three medium running speeds and the vertical lines indicate the
beginning of the contact phase. Note the greater EMG activity prior to
higher running speeds. A more recent study contact (i.e. preactivation) with higher running speeds (reproduced
showed that a greater ratio of eccentric to from Kyrolainen et al.,[56] with permission).

ª 2009 Adis Data Information BV. All rights reserved. Sports Med 2009; 39 (11)
Neuromuscular Adaptations and Running Economy
concentric vastus lateralis muscle activity was
associated with a lower metabolic demand during
running (i.e. better running economy).[59]
Taken together, the findings from these studies
suggest that neuromuscular characteristics may
play an important role in running economy,
especially in athletes with similar physiological
attributes. The timing and amplitude of muscle
activity has shown the most consistent asso-
ciation with running economy. Greater muscle
activity prior to and in the initial phase of ground
contact may enhance running economy by
increasing leg stiffness and maximizing exploita-
tion of stored elastic energy.
5. Training, Shoes, In-Shoe Orthoses,
Musculoskeletal Injury and Running
Economy
Trained runners have a superior running
economy to lesser trained or untrained run-
ners,[22,23,60] indicating positive adaptations in
response to training programmes. Training pro-
grammes can potentially improve running eco-
nomy through physiological, biomechanical and
neuromuscular adaptations. Interventions such
as altitude training and training in the heat are
aimed at improving cardiorespiratory function,
and have previously been reviewed in this jour-
nal.[3] Resistance training, plyometrics, stretching
and multidiscipline training are training inter-
ventions that feasibly have the potential to alter
running economy through neuromuscular adap-
tations. Passive physical interventions such as
use of shoes and in-shoe orthoses may also have
the potential to elicit similar effects on neuro-
muscular control and running economy. Muscu-
loskeletal pain and injury can result in a loss
of training time and impaired neuromuscular
control,[61-64] with potential consequential altera-
tions in running economy. In order to evaluate
the effect of injury and training interventions on
running economy it is first useful to understand
the typical intraindividual variation in this mea-
sure. Well controlled studies using moderate to
highly trained subjects report intraindividual
variations in running economy of between 1.5%
and 5%.[65-71] Further to this, Saunders et al.[70]
ª 2009 Adis Data Information BV. All rights reserved.
909
have recommended that alterations in running
economy in highly trained distance runners must
exceed 2.4% to be confident a practically worth-
while change has occurred.
5.1 Resistance Training
It is well documented that initial performance
gains following resistance training are a result of
neuromuscular adaptations rather than within-
muscle adaptations (i.e. hypertrophy).[72,73]
These adaptations include increased motor unit
recruitment and motor unit synchronization.[72-74]
Resistance training may improve running econ-
omy through improved leg muscle coordi-
nation and co-activation and decreasing stance
phase contact times, thereby allowing a faster
transition from the braking to the propulsive
phase through elastic recoil.[26,50,56,72] For resis-
tance training to improve running economy, a
positive ‘transfer of learning’ would need to oc-
cur. Transfer occurs when the training for one
task affects the performance or learning of a
subsequent task. As a general principle, a positive
transfer would require that a specific pattern of
muscle recruitment associated with optimal per-
formance of a resistance training task enhances
running economy if it was expressed during run-
ning.[75] EMG analysis may allow for the identi-
fication of the transfer of learning from resistance
or plyometric training to running.
In a group of . moderately trained female dis-
tance runners (VO2max = 51 mL/kg/min), 10 weeks
of traditional weight training combined with en-
durance training significantly improved . running
economy (4%) without any changes in VO2max.[24]
In further support of this training modality,
two further studies have reported a 7%[76] and
5%[77] improvement in running economy with
heavy resistance training (table I). Improvements
in maximal strength were reported in all experi-
mental groups, indicating positive neuromus-
cular adaptations occurred. However, resistance
training was performed in addition to normal
endurance training volumes, therefore the im-
provements in running economy may be related
to the increased volume of training rather
than the resistance training itself. Støren et al.[77]
Sports Med 2009; 39 (11)
910 Bonacci et al.

Table I. Comparison of the effect of resistance and plyometric training programmes on running economy
Study (year) Subjects Volume Frequency Control Results
and duration strength/force RE
(%) (%)
Johnston et al.[24] (1997) 12 moderately 2–3 sets of 6–20 3 d/wk for Endurance › 24.4–33.8 › 4
trained runners RM in addition to 10 wk running
endurance training
Millet et al.[76] (2002) 15 highly trained 3–5 sets of 3–5 RM 2 d/wk for Endurance › 17–25 › 5.6–7
triathletes in addition to 14 wk training
endurance training (swim, cycle,
run)
Støren et al.[77] (2008) 17 moderately 4 sets of 4 RM in 8 wk Endurance › 33.2 › 5
trained runners addition to running
endurance training
Paavolainen et al.[26] (1999) 22 moderately 15–90 min/session 9 wk Endurance › 24.4–33.8 › 8.1
trained cross- running and
country runners circuit training
Turner et al.[78] (2003) 18 recreational 1 set of 5–25 reps 3 d/wk for Endurance 2 › 2–3
distance runners in addition to 6 wk running
endurance training
Spurrs et al.[79] (2003) 17 moderately 2–3 sets of 8–15 2–3 d/wk for Endurance › 11.4–13.6 › 4.1–6.7
trained runners reps in addition to 6 wk running
endurance training
Saunders et al.[80] (2006) 15 highly trained 30 min/session in 3 d/wk for Endurance 2 › 4
runners addition to 9 wk running
endurance training
highly trained = national/international level and maximal oxygen consumption >65 mL/min/kg; moderately trained = weekly running volume
>30 km/wk; RE = run economy; recreational = weekly running volume <30 km/wk; reps = repetitions; RM = repetition maximum; › indicates
increase; 2 indicates no change.

suggested the main training response from the
heavy resistance training was a change in muscle
recruitment patterns, yet no direct measurement
of muscle recruitment (i.e. EMG) was provided
to support this notion.
5.2 Plyometric Training
Explosive resistance training or plyometrics is
a specific form of strength training that aims to
enhance the ability of muscles to generate power
through the SSC by use of explosive activities
such as jumping, hopping and bounding.[78]
The SSC utilizes the ability of soft tissues to store
and return elastic energy, thus reducing energy
expenditure.[81-83] It has been speculated that
stiffness of the musculotendinous system may
determine the body’s ability to use such energy,[84]
and that plyometric training has the potential to in-
crease musculotendinous stiffness.[79] Paavolainen
et al.[26] examined the effects of substituting 32%
of endurance training hours with explosive
strength training over 9 weeks on selected neuro-
muscular characteristics and performance mea-
sures in moderately trained runners. Velocity of a
maximal 20 m sprint, distance of a series of five
continual forward jumps and stance phase con-
tact times during constant velocity running were
used as indirect measures of neuromuscular
characteristics. These variables are thought to
represent the ability of the neuromuscular system
to repeatedly produce rapid force during intense
exercise, and the capability to store and utilize
elastic energy.[26,49,50] A significant improvement
in 5 km run performance (3.1%), running econo-
my (8.1%), five-jump distance (4.6%), and velo-
city over a 20 m sprint (3.4%) was found, along
with a concurrent decrease in stance phase con-
tact times.[26] The authors suggested that the
improved performance was a result of enhanced

ª 2009 Adis Data Information BV. All rights reserved. Sports Med 2009; 39 (11)
Neuromuscular Adaptations and Running Economy
neuromuscular characteristics that were trans-
ferred into improved muscle power and running
economy.
Three further studies have provided support
that simultaneous plyometric and endurance
training improves running economy in moder-
ately and highly trained athletes[78-80] (table I).
Proposed explanations for the improvement in-
clude increased lower body musculotendinous
stiffness, and enhanced muscle power develop-
ment and elastic energy return. Turner et al.,[78]
however, reported no change in four indirect
measures of the ability of the muscles to store and
return elastic energy following plyometric train-
ing, despite an improved running economy.
Countermovement jumps and static jumps on an
inclined sled were used as measures of elastic
energy return as opposed to the running-specific
measures described by Paavolainen et al.[26] The
mechanics of jumping on a sled are different to
the mechanics of running at speed and it is likely
that the measures used were insufficient to detect
any change in elastic energy return during run-
ning. A direct method to quantify elastic energy
utilization has yet to be developed, yet there is a
consensus that this phenomenon contributes to
economy of movement.[27,82,83,85]
It has been proposed that more efficient motor
recruitment patterns as a result of training, whe-
ther at the neural or muscular level, may decrease
the oxygen cost at a given running velocity.[24] If
the rate of force development and peak force
is enhanced, a longer recovery period between
muscle contractions is possible, leading to
improved muscle blood perfusion and thereby
improving economy.[86,87] In support of this, a
recent investigation found 8 weeks of concurrent
endurance and explosive strength training signif-
icantly improved leg extensor rapid force pro-
duction and activation, along with a significant
improvement in work economy (7% – 6%) during
a constant velocity double-poling action in mod-
erately trained cross-county skiing athletes.[88]
Despite the different mode of testing, the weight-
bearing nature of the double-poling test could
indicate these results are applicable to running
economy. While it is difficult to determine the
exact mechanisms responsible for the improved
ª 2009 Adis Data Information BV. All rights reserved.
911
economy following resistance training, these
findings add some weight to the model of en-
durance performance described by Paavolainen
et al.[49,50] whereby endurance performance is in-
fluenced by neuromuscular characteristics along
with aerobic power, and that endurance perfor-
mance may be improved through enhanced
neuromuscular function. However, this premise
is based on indirect measures of neuromuscular
function and elastic energy return such as contact
times and vertical jump height. Enhancements in
strength and power development during isolated
tasks may reflect neuromuscular adaptations but
this has not been confirmed by more direct mea-
surements of muscle recruitment, such as EMG.
Thus, it is not possible to infer that these adap-
tations translate into more efficient muscle
recruitment patterns during running, or that they
are responsible for the enhanced running economy
following resistance and plyometric training.
5.3 Stretching
There are two diametrically opposed hypo-
theses for the effect of stretching on energy
requirements. It has been suggested that if
stretching decreases the visco-elastic properties of
muscle and tendon,[89,90] then less energy may be
required to move the limb. Alternatively, the
decreased compliance may reduce the storage of
elastic energy, increasing energy require-
ments.[91,92] Stretching has indeed been shown
to alter the compliance of human tendons
in vivo.[93,94] There is also evidence to suggest that
stretching induces acute neuromuscular effects.
Numerous studies have demonstrated a decrease
in a muscle’s ability to produce force immediately
after passive stretching,[95-99] along with de-
creases in EMG amplitude during iso-
metric[95,98,99] and concentric[97] muscle actions.
In contrast, an acute bout of assisted and un-
assisted static quadriceps stretches did not alter
peak torque or EMG amplitude of the quadriceps
muscle group during an eccentric muscle ac-
tion.[100] A further study found that four sets of
three different dynamic stretches did not alter
peak torque, but increased EMG amplitude
of the biceps femoris muscle during maximal
Sports Med 2009; 39 (11)
912
isometric contractions at 81 and 101 knee flex-
ion.[101] Methodological differences in the mode
(i.e. static vs dynamic) and duration of stretching
may explain the inconsistent findings between the
various studies. It is likely the observed neuro-
muscular effects are specific to the mode of
stretching and the subsequent muscle activity
(i.e. isometric vs isokinetic). Further research is
required to understand the differential effects of
various modes of stretching on acute neuro-
muscular control during exercise.
Early studies examined the relationship be-
tween flexibility and running economy. Gleim
et al.[102] found that untrained subjects with the
least flexibility on a number of active and passive
measures about the trunk and lower extremity
were more economical during walking and run-
ning. Similarly, Craib et al.[103] reported reduced
active hip external rotation and passive ankle
dorsiflexion range of motion was associated with
better running economy in moderately trained
distance runners. Both investigators attributed
the superior economy to increased storage and
return of elastic energy and a reduction in energy-
expensive stabilizing muscle activity, though they
did not provide evidence for these assumptions.
Most importantly, both these investigations were
correlative studies and neither study provides
evidence that altering flexibility through various
interventions will result in an enhanced running
economy.
To date, three studies have examined the ef-
fects of stretching programmes on running eco-
nomy in recreationally active athletes. Two
of these found stretching over a period of
3 weeks[104] or 10 weeks[105] had no impact on
running economy despite significantly improving
flexibility. Conversely, Godges et al.[106] found
that an acute bout of end-range stretching re-
sulted in an immediate, significant reduction
(4–7%) in oxygen consumption at. workloads
equivalent to 40%, 60% and 80% VO2max. The
discrepancies reported may relate to different
methodological procedures. The study by
Godges et al.[106] was limited to seven subjects
with tight hip flexor or extensor muscles. In
addition, running economy was only measured
immediately post-stretching and follow-up mea-
ª 2009 Adis Data Information BV. All rights reserved.
Bonacci et al.
sures were not performed. In their subsequent
investigation with a larger population over a
3-week period, Godges et al.[104] found no effect
of stretching on running economy. Furthermore,
the technique employed in their original study
involved passive stretching at end of range with
restraints and suspended weights, a technique
that neither recreational nor elite athletes are
likely to employ. A recent systematic review
concluded that an acute bout of stretching pre-
exercise may improve running economy, but
regular stretching over time has no effect on
economy.[91] These findings do not suggest
stretching should be discounted as a training
modality, because stretching exercises are
commonly prescribed to running athletes for the
maintenance and promotion of range of mo-
tion,[107] especially after injury.
5.4 Multidiscipline Sports and Training
Impairments in overground[108,109] and tread-
mill[110-113] running economy have frequently
been observed in moderately trained athletes
following cycling (i.e. when running ‘off-
the-bike’) compared with an isolated control
run. Further investigation in the same area found
that running economy after maximal cycling is
not increased compared with a control run in
elite level triathletes.[114] The increase in oxygen
consumption during running after cycling varies
from 1.6% to 11.6% and is thought to be a reflec-
tion of ability level, with more experienced ath-
letes displaying less impairment in running
economy.[115]
Proposed explanations for the increased oxy-
gen consumption during running after cycling
include glycogen depletion,[108,109,113,115] ventila-
tory muscle fatigue,[113] dehydration[108,109,112]
and leg muscle fatigue.[111,112] Hausswirth
et al.[112] attributed the increased metabolic cost
of running at the end of a triathlon to bio-
mechanical variables such as stride length and
trunk gradient. In contrast, several others have
reported no change in running kinematics fol-
lowing cycling.[109,113,116,117] A recent review
suggested that if the consequence of previous ex-
ercise is to reduce subsequent running economy,
Sports Med 2009; 39 (11)
Neuromuscular Adaptations and Running Economy
then it is more likely to be through physiological
rather than biomechanical factors.[3] While this
seems the most logical rationale, it fails to con-
sider the influence of the neuromuscular system,
and the possibility that movement patterns may
be preserved but muscle activity altered.[116] The
transition from bike to run involves a switch
from a predominantly concentric type of muscle
activity to a combined eccentric-concentric
action.[114,115] This requires rapid neuromuscular
adjustments to be made in order to effectively
utilize stored elastic energy. The quantity of
elastic energy stored and re-used is influenced by
leg stiffness, and lower limb stiffness has been
shown to be correlated to running economy.[52]
Only neuromuscular activation is able to mod-
ulate leg stiffness.[52]
Initial EMG studies of the cycle-run transition
report small and sometimes only transient chan-
ges in muscle activation that may be attributed to
alterations in kinematics, running speed or fati-
gue.[118,119] More recently, Chapman et al.[116]
used a new paradigm to discriminate the influ-
ence of fatigue and altered running speed on leg
kinematics and muscle activation. They found
that a select proportion of highly trained triath-
letes (30%) exhibited muscle activity in the post-
cycling run leg that more closely resembled
that used during cycling rather than the muscle
activity used during the control pre-bike run. The
altered muscle activity was evident as soon as
running commenced and persisted for the dura-
tion of the 30-minute run off-the-bike. Moreover,
despite the altered muscle activity, no changes in
running kinematics were observed. As only the
tibialis anterior muscle was investigated, further
work is required to determine if similar altera-
tions in activation exist in the other leg and thigh
muscles.
Interference with execution of optimal pat-
terns of muscle recruitment when switching from
cycling to running may alter muscle stiffness
regulation and hinder the athlete’s ability to
effectively utilize elastic energy during run-
ning.[120] Recovery of elastic energy is known
to reduce energy expenditure.[81-83] Certainly,
physiological stress appears to be the primary
reason for the increased cost of running after
ª 2009 Adis Data Information BV. All rights reserved.
913
cycling.[3] However, it is probable that alterations
in patterns of muscle recruitment after cycling
may also be a contributing factor to the increased
metabolic cost of running in some athletes.[120]
Two recent studies have indeed shown that
alterations in run performance after variable
cycling compared with steady-state cycling may
occur in the absence of physiological changes.
Run time to exhaustion was found to be signi-
ficantly greater following a variable cycling
intensity (–20% of 90% lactate threshold) com-
pared with a constant intensity (90% of lactate
threshold).[121] Conversely, a 5 km run time trial
was significantly better (4.4%) following a 20 km
constant intensity cycle compared with a variable
intensity cycle.[122] Although these are conflicting
findings, both protocols that reported improve-
ments in run performance completed the final
stages of the cycle leg as a low intensity segment.
Hence it appears that completing the final
stages of the cycling phase at a high intensity is
detrimental to subsequent run performance.
Interestingly, despite considerable within-subject
changes .in run performance, no differences in
average VO2, ventilation, heart rate or rating of
perceived exertion were detected between the
controlled or variable conditions during both the
cycle and the subsequent run leg. While cycling at
a lower intensity in the final portion of the
cycle leg may allow for a greater metabolic re-
covery,[121] it is also possible that alterations in
neuromuscular control may be responsible for
the difference in run performance.
A recent study with a small sample size of
triathletes demonstrated a similar magnitude of
neuromuscular fatigue following constant-versus
variable-intensity cycling.[123] The authors con-
cluded that in the field of triathlon, variations
in run performance cannot be attributed to dif-
ferent levels of neuromuscular fatigue following
constant-versus-variable cycling. Perhaps then it
is the change in lower limb muscle coordination
during running after cycling,[116] independent of
neuromuscular fatigue, that contributes to the
difference in run performance. Further work ex-
amining lower limb muscle coordination during
running after cycling is required to explore this
supposition.
Sports Med 2009; 39 (11)
914
5.5 Shoes and In-Shoe Orthoses
With every ground contact during running,
energy is transferred between the athlete and
supporting surface. The interaction between the
athlete and surface is coupled by the shoe and
insert or orthoses. Theoretically, performance
can be influenced by the shoe and shoe insert or
orthosis through its mass, its potential to change
movement patterns and alter muscle activity, and
by minimizing the energy that is lost by the ath-
lete.[124,125] In a landmark review paper, Nigg
et al.[126] proposed a new concept for use of shoes,
inserts and orthoses in sport: (i) the skeleton has a
preferred path for a given movement task; (ii) if
an intervention (shoe, insert, orthoses) supports
the preferred path, muscle activity can be re-
duced; (iii) an optimal shoe, insert or orthosis
feels comfortable because it reduces muscle acti-
vity and the resulting fatigue; and (iv) perfor-
mance should increase with an optimal shoe,
insert or orthosis since muscle activity is minimized
and thus energy expenditure is reduced. Early
work has indeed shown that orthoses elicit short-
term effects on lower limb muscle activity during
walking and running.[14-16,127] The demonstrated
changes in muscle activity have shown high
intersubject variability,[14-16,127] indicating the
individual nature of neuromuscular responses to
orthoses.
Shoe mass is an example of how manipulation
of footwear can affect energy requirements.
When different types of footwear were compared
it was found that wearing heavier models signi-
ficantly elevated oxygen consumption in trained
runners without concomitant changes in stride
length.[128] When identical shoe types are mod-
ified only with respect to their mass, oxygen
consumption is significantly greater with the
heavier shoes during walking and running.[129,130]
Modifying shoe material properties can also
influence economy of locomotion. The use of air-
soled shoes elicited a superior running economy
compared with regular ethylene vinyl acetate
(EVA), midsoles in trained distance runners.[131]
Nigg et al.[17] attempted to verify their concept of
an optimal shoe by examining the effect of shoe
materials on lower limb EMG and running
ª 2009 Adis Data Information BV. All rights reserved.
Bonacci et al.
economy. Oxygen consumption and EMG acti-
vity during running were compared between a
medium hardness elastic shoe and a softer viscous
shoe. They found that running economy re-
sponses to the shoes were highly individual, i.e.
some athletes consumed less oxygen for the
elastic shoe condition while others consumed less
for the viscous shoe condition. The EMG data
also showed muscle- and subject-specific re-
sponses to the shoes. An interesting finding was
that all runners who consumed more oxygen
in the viscous shoe showed higher vastus medialis
pre-activation in that shoe; similarly, the runners
who consumed more oxygen in the elastic
shoe demonstrated higher vastus medialis pre-
activation in that shoe. This seems counter-
intuitive, given that EMG pre-activation is
thought to modulate leg stiffness and enhance
elastic energy return, which has been shown to be
metabolically more efficient.[52,54,58] However, all
changes in running economy were £2.0% and the
running economy and EMG measurements were
not made simultaneously, so it is difficult to draw
any solid conclusions from this study other than
that changes in running economy and muscle
activity with different shoes are subject specific.
Surprisingly, the effect of orthoses on running
economy has received very little attention, despite
being commonly prescribed to running athletes.
Furthermore, no studies have simultaneously
measured running economy and EMG activity of
the leg muscles. The studies that have investi-
gated the effect of orthoses on muscle activity
have shown high intersubject variability in the
EMG responses to orthoses.[14-16,127] Whether the
changes in muscle activity associated with ortho-
sis prescription correspond to an alteration in
running economy has yet to be determined.
Three studies have investigated the direct effect
of orthoses on running economy. Two of the stu-
dies found that running economy was not altered
with orthosis use in recreational[132] and moder-
ately trained runners.[133] In contrast, the other
study found that both flexible and semi-rigid
orthoses significantly increased oxygen consump-
tion in runners who had a history of running-
related injuries.[134] This is the only investigation
that included a symptomatic population, to whom
Sports Med 2009; 39 (11)
Neuromuscular Adaptations and Running Economy
orthoses are commonly prescribed as a tool for
symptomatic relief. However, no detail was given
as to the type or site of injury, the mechanism of
injury or current state of symptoms. Further-
more, analysis of data reveals the increase in
oxygen consumption when running in rigid
and flexible orthoses was only 2.0% and 1.7%,
respectively, which is within intraindividual
variation[66,68,70,71] and may not be a practically
worthwhile change.[70]
Taken collectively, it is likely that orthoses
elicit subject-specific short-term effects on neuro-
muscular control during running, but there is in-
sufficient evidence to date to support the concept
proposed by Nigg et al.[126] that an optimal ortho-
sis reduces muscle activity, minimizes energy
expenditure and improves run performance.
5.6 Musculoskeletal Injury
Musculoskeletal overuse injury is arguably the
most significant adverse effect of participation in
endurance exercise and constitutes a major im-
pediment to participation in physical activity.
The knee and shin are the most common sites
of injury in endurance athletes,[135-137] and the
majority (50–75%) of all running injuries are
reported to be overuse in nature.[135,137,138]
Alterations in neuromuscular control – in-
cluding muscle imbalances, altered muscle
timing, muscle fatigue and muscle weakness –
have been associated with musculoskeletal
injury and pain in numerous independent
reports.[61-64,139,140] Unfortunately, much of the
research has been retrospective, and our under-
standing of overuse injury causation is limited.
Moreover, knowledge of the direct effect of
musculoskeletal injury and neuromuscular im-
pairments on running economy is limited. While
it is presumed that injury and subsequent pain
and functional impairments hinder performance
through loss of training hours and competition,
many athletes may continue to participate with
sequelae of injury (e.g. pain, swelling, proprio-
ceptive deficits). Furthermore, alterations in
muscle recruitment that occur with injury and
ensuing pain have been exhibited up to 66 months
post-injury.[141,142] It is possible that without
ª 2009 Adis Data Information BV. All rights reserved.
915
targeted interventions, the specific neuromuscular
impairments that occur following injury[61-64,139]
may persist well after the athlete has returned to
training and competition.
The literature to date fails to provide any in-
sight into the possible effect that any injury in an
endurance athlete may have on running econo-
my. Therefore, to explore this area we present
some available evidence from a wider model.
There is some evidence that walking gait econo-
my is decreased in those with knee joint osteo-
arthritis – a progressive form of musculoskeletal
injury and pain.[143-146] Anterior cruciate-
deficient patients have also demonstrated an 8%
decrement in running economy compared with
healthy controls,[147] and anterior cruciate liga-
ment deficiency has been associated with in-
creased hamstring muscle activity during running
and cutting manoeuvres.[141,142] Whilst these in-
juries and the activities used to test economy
(e.g. walking economy) only partially resemble
the routine laboratory test intensity, and injuries
sustained by endurance athletes, they provide
a snapshot of how musculoskeletal injury may
affect running economy in endurance athletes.
Exercise-induced muscle damage (EIMD) is a
further paradigm with which to investigate the
effect of musculoskeletal pain and injury on
performance. EIMD occurs after performing
unaccustomed exercise or exercise of increased
intensity or duration; it results in muscle stiffness,
swelling, impairment of muscle function and
delayed-onset muscle soreness.[148] For a compre-
hensive review of the alterations in neuromus-
cular function that follow EIMD the reader is
directed to a recent review in this journal.[148] In
short, documented outcomes of EIMD include
reflex inhibition of muscle activity, decreased
strength and power-generating ability, and a de-
crease in the force to electromyographic (iEMG)
activity ratio.[148] In relation to performance,
EIMD from a bout of isokinetic resistance
exercises[149,150] and downhill running[151] did not
alter running economy in recreationally active
subjects.[149-151] In contrast, a 3.2% reduction in
running economy and stride length was found
48 hours after performing a single bout of
downhill running (resulting in considerable
Sports Med 2009; 39 (11)
916
muscle soreness) in moderately trained triathletes
and distance runners.[152] Perhaps changes in
running economy and kinematics due to EIMD
are less sensitive in untrained subjects because of
their less refined movement and muscle activity
patterns. A similar protocol using trained and
untrained subjects may provide further support
for this idea.
6. Conclusions
The purposes of this review were to: (i) examine
the adaptations of lower limb muscle recruitment
(i.e. neuromuscular adaptations) to different
modes of training (i.e. running, cycling, multi-
discipline); (ii) examine what aspects of neuro-
muscular control are associated with running
economy; and (iii) examine whether neuromuscular
adaptations induced by training, passive inter-
ventions and injury can be coupled with changes
in running economy. It had previously been
assumed that superior cycling and running
performance was evidence for greater neuro-
muscular adaptation in trained athletes. Recent
scientific knowledge supports this belief, with
evidence that ongoing single-discipline training
leads to more refined patterning of leg muscle
recruitment. This is thought to be a positive
neuromuscular adaptation to endurance training,
which may reduce metabolic demand and en-
hance performance. A difference in leg muscle
recruitment during cycling has been demon-
strated between multi- and single-discipline
athletes. This highlights a difference in neuromus-
cular adaptation to single- and multidiscipline
training. However, it is uncertain whether these
specific neuromuscular adaptations are beneficial
or detrimental to sport-specific endurance per-
formance.
Available evidence suggests that in athletes
with similar physiological attributes, neuromus-
cular characteristics play an important role in
endurance running performance. The consistent
finding from studies of improvements in running
economy following strength and plyometric
training appears related to neuromuscular adap-
tations (e.g. improvements in strength, force
production). Whether these adaptations alter
ª 2009 Adis Data Information BV. All rights reserved.
Bonacci et al.
leg muscle recruitment during running remains
unknown.
The adverse effect of cycling on subsequent
running economy in triathletes is most likely due
to physiological stress, although alterations in
muscle recruitment patterns should not be dis-
counted as a potential contributor. There is in-
sufficient evidence for the alteration of running
economy through stretching, shoe material
modifications, in-shoe orthoses and musculoske-
letal injury in endurance athletes. Exercise-
induced muscle damage reduces running economy
in moderately trained athletes through altera-
tions in kinematics, which may be associated with
changes in neuromuscular control.
7. Future Directions
Future sport performance research needs to
consider the role of the neuromuscular system in
endurance activities. The available evidence sug-
gests that adaptations of leg muscle recruitment
do occur in response to ongoing endurance
training. Research is yet to establish the optimal
duration and intensity of training to promote
these adaptations and whether further improve-
ments can be achieved through training inter-
ventions once at the elite level. These questions
warrant future investigation. Further knowledge
of the relationship between leg muscle recruit-
ment and running economy may divulge
information about optimal patterns of muscle re-
cruitment for economical running. Measurement
of leg muscle recruitment pre- and post-training
interventions would help explain whether run-
ning economy is altered through adaptations in
leg muscle recruitment.
In recent times, investigators have directed
their attention to the neuromuscular effects of
shoes and in-shoe orthoses. The available evi-
dence suggests that changes in leg muscle activity
with various shoe materials and orthoses may be
specific to an individual, and thus an optimal
shoe or orthosis for performance would also re-
quire individual consideration. However, the
relationship between shoes, in-shoe orthoses,
muscle activity and performance remains unclear
and requires further investigation.
Sports Med 2009; 39 (11)
Neuromuscular Adaptations and Running Economy
More knowledge of the effect that cycling has
on subsequent leg muscle activation during run-
ning in triathletes is required, along with its
relationship to running economy. Similarly,
knowledge of how various cycling intensities affect
leg muscle activation and subsequent run perfor-
mance may help to structure triathlete training and
race day performance. As evidenced in the litera-
ture, cycling affects leg muscle recruitment during
running in some athletes, but not others. There-
fore, researchers should consider the impact of
various cycle intensities on the individual in addi-
tion to the group. It is likely that a strategy effective
for one athlete may not be effective for another.
Running and triathlon training are associated
with high occurrences of musculoskeletal injury.
There is preliminary evidence that ongoing mul-
tidiscipline training may interfere with neuro-
muscular adaptation. Numerous reports have
associated alterations in neuromuscular control
with musculoskeletal injury. However, the effect
of any training-induced interference in neuro-
muscular adaptation on injury manifestation is
yet to be determined. Furthermore, the effect of
the sequelae of injury (e.g. pain, swelling, muscle
weakness) on running economy remains un-
known. Future work aimed at investigating the
effect of training structure on muscle activity,
musculoskeletal injury and running economy will
improve our understanding of the relationship
between training, musculoskeletal injury, neuro-
muscular control and performance.
Acknowledgements
Jason Bonacci and Andrew Chapman are supported by
the Australian Research Council. No sources of funding were
used to assist in the preparation of this review. The authors
have no conflicts of interest that are directly relevant to the
content of this review.
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Correspondence: Prof. Bill Vicenzino, Division of Physio-
therapy, School of Health and Rehabilitation Sciences,
University of Queensland, Brisbane, QLD 4072, Australia.
E-mail: b.vicenzino@uq.edu.au
Sports Med 2009; 39 (11)
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.