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Tibial bone stress injury is a common overuse injury experienced by runners, which results from repetitive tissue forces. Wearable sensor systems ( wearables ) that monitor tibial forces could help understand and reduce injury incidence. However, there are currently no validated wearables that monitor tibial bone forces. Previous work using simulated wearables demonstrated accurate tibial force estimates by combining a shoe-worn inertial measurement unit (IMU) and pressure insole with a trained algorithm. This study aimed assessed how accurately tibial bone forces could be estimated with existing wearables. Nine recreational runners ran at a series of different speeds and slopes, and with various stride patterns. Shoe-worn IMU and insole data were input into a trained algorithm to estimate peak tibial force. We found an average error of 5.7% in peak tibial force estimates compared with lab-based estimates calculated using motion capture and a force instrumented treadmill. Insole calibration procedures were essential to achieving accurate tibial force estimates. We concluded that a shoe-worn, multi-sensor system is a promising approach to monitoring tibial bone forces in running. This study adds to the literature demonstrating the potential of wearables to monitor musculoskeletal forces, which could positively impact injury prevention, and scientific understanding.

Tibial bone forces can be monitored using shoe-worn wearable sensors during running