About Tibial Shock (Peak Positive Acceleration of the Tibia)

Peak Tibial Shock, also known as Peak Positive Acceleration (PPA) of the tibia, has been found to be strongly correlated with vertical force loading rate or impact loading(1).


A higher risk of overuse injuries such as stress fractures and MTSS (Medial tibial stress syndrome) or shin splints has been linked to high Peak Tibial Shock and high loading rate during initial foot contact(2).

A stress fracture is a serious injury, and usually athletes must refrain from running during recovery. While having extensive cardiovascular benefits, running does have a high rate of musculoskeletal injury.

The TgForce impact sensor is a tool for monitoring tibial shock when running. Athletes and runners should consult a sports health professional for prevention and treatment of running injuries.







Studies and articles about Peak Tibial Shock (Peak Positive Acceleration PPA, Peak Tibial Acceleration), gait retraining and implications:




Gait retraining using tibial acceleration sensor – feedback

-Van den Berghe, P., Gosseries, M., Gerlo, J., Lenoir, M., Leman, M., & De Clercq, D. (2020). Change-Point Detection of Peak Tibial Acceleration in Overground Running Retraining. Sensors, 20(6), 1720.

-Zhang, Janet Hanwen; Chan, Zoe Yau-Shan; Au, Ivan Pui-Hung; An, Winko Wenkang; Shull, Peter Bradley; Cheung, Roy Tsz-Hei, 2019. Transfer Learning Effects of Biofeedback Running Retraining in Untrained Conditions. Medicine & Science in Sports & Exercise: April 9, 2019.

-Bowser BJ, Fellin R, Milner CE, Pohl MB, Davis IS. , 2018.  Reducing Impact Loading in Runners: A One-Year Follow-up. Medicine & Science in Sports & Exercise, Vol 50, Issue 12. Dec 2018. p2500-2506.

-Claire M. Wood, Kristof Kipp, 2014. Use of audio biofeedback to reduce tibial impact accelerations during running. Journal of Biomechanics Vol 47, Issue 7, 1739-1741.

-Brayne, L., Barnes, A., Heller, B. et al. 2018. Using a wireless consumer accelerometer to measure tibial acceleration during running: agreement with a skin-mounted sensor . Sports Engineering.  (2018) 21: 487.

-Pieter Van den Berghe, Joren Six, Joeri Gerlo, Marc Leman, Dirk De Clercq, 2019. Validity and reliability of peak tibial accelerations as real-time measure of impact loading during over-ground rearfoot running at different speeds. Journal of Biomechanics Vol 86, 2019 232-242.  https://www.sciencedirect.com/science/article/abs/pii/S0021929019300764

-Clansey AC,Hanlon M, Wallace ES, Nevill A, Lake MJ, 2014. Influence of tibial shock feedback training on impact loading and running economy. Med Sci Sports Exerc; 2014;46(5):973-81. http://www.ncbi.nlm.nih.gov/pubmed/24121245?report=abstract

-Crowell,H.P.,Davis,I.S.,2011.Gait retraining to reduce lower extremity loading in runners. Clin.Biomech.26,7883. http://www.clinbiomech.com/article/S0268-0033(10)00251-2/fulltext

1.Crowell,H.P.,Milner,C.E.,Hamill,J.,Davis,I.S.,2010.Reducing impact loading during running with the use of real-time visual feedback.J.Orthop.SportsPhys. Ther.40,206–213. http://www.jospt.org/doi/pdf/10.2519/jospt.2010.3166

Sensor validation 

P. d. F. B, R. JS, D. B, B. L and E. JF, “Validating commercial wearable sensors for running gait parameters estimation, “ in IEEE Sensors Journal, doi: 10.1109/JSEN.2020.2982568.

Gradual Gait Modifications

Yangjian Huang, HaishengXia, GangChen, SulinCheng, Roy T.H.Cheung, Peter B.Shull, 2019.  Foot strike pattern, step rate, and trunk posture combined gait modifications to reduce impact loading during running. Journal of Biomechanics Vol 86, 102-109.   https://www.sciencedirect.com/science/article/abs/pii/S0021929019301174

-Kristine Hoffman, DPM, FACFAS, and Missy Thompson, PhD, Emerging Insights On Gait Changes In Runners, 2015, PodiatryToday, vol 28, 62-67. https://www.podiatrytoday.com/emerging-insights-gait-changes-runners

More Support for Slow Transition to Minimalism, 2013 –  http://www.runnersworld.com/minimalist-shoes/more-support-for-slow-transition-to-minimalism

Tibial Stress & Injury

Tibial Stress Syndrome (Shin Splints) (https://www.orthobullets.com/knee-and-sports/3108/tibial-stress-syndrome-shin-splints)

-HUNTER, JESSICA G.; GARCIA, GINA L.; SHIM, JAE KUN; MILLER, ROSS H. 2019, Fast Running Does Not Contribute More to Cumulative Load than Slow Running, Medicine & Science in Sports & Exercise: June 2019 – Volume 51 – Issue 6 – p 1178–1185.

-Milner CE1, Ferber R, Pollard CD, Hamill J, Davis IS., 2006, Biomechanical factors associated with tibial stress fracture in female runners. Med Sci Sports Exerc. 2006 Feb;38(2):323-8. http://www.runsnrc.org/RUNSNRC/Clinic_-_Supporting_Research_files/Milner_MSSE06.pdf

-Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D’Andrea S, Davis IS, Mang’eni RO, Pitsiladis Y.,  2010, Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010 Jan 28;463(7280):531-5. doi: 10.1038/nature08723. Article review on runbare.com Related site on Harvard University website – Running Barefoot

-Olin ED, Gutierrez GM., 2013, EMG and tibial shock upon the first attempt at barefoot running., Hum Mov Sci. 2013 Apr;32(2):343-52. doi: 10.1016/j.humov.2012.11.005. Epub 2013 May 3. Abstract

2.Davis, I., Milner, C.,Hamil, J.,2004 Does increased loading during running lead to tibial stress fracture? A prospective study. Medicine and Science in Sports and Exercise 35,S58 Supplement.  https://www.researchgate.net/publication/232139402_Does_Increased_Loading_During_Running_Lead_to_Tibial_Stress_Fractures_A_Prospective_Study