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Runners’ gait patterns vary during a half marathon and influence the knee joint mechanics. Joint contact force is a better estimate of the net joint loadings than external joint moments and closely correlates to injury risks. This study explored the changes of lower limb joint kinematics, muscle activities, and knee joint loading in runners across the running mileages of a half marathon. Fourteen runners completed a half marathon on an instrumented treadmill where motion capture was conducted every 2 km (from 2 to 20 km). A musculoskeletal model incorporating medial/lateral tibiofemoral compartments was used to process the movement data and report outcome variables at the selected distance checkpoints. Statistics showed no changes in joint angles, muscle co‐contraction index, ground reaction force variables, and medial tibiofemoral contact force ( p  &gt; 0.05). Knee adduction moment at 18 km was significantly lower than those at 2 km ( p  = 0.002,  γ  = 0.813) and 6 km ( p  = 0.001,  γ  = 0.663). Compared to that at 2 km, lateral tibiofemoral contact force was reduced at 18 km ( p  = 0.030, Hedges’  g  = 0.690), 16 km ( p  &lt; 0.001, Hedges’  g  = 0.782), 14 km ( p  = 0.045, Hedges’  g  = 0.859), and 10 km ( p  &lt; 0.001, Hedges’  g  = 0.771) respectively. Mechanical realignment of the lower limb may be the cause of the altered knee loadings and possibly led to reduced running economy in response to a prolonged run. The injury potential of the redistributed tibiofemoral forces warranted further studies.

A half marathon shifts the mediolateral force distribution at the tibiofemoral joint