Not really suprised, but great to get some real data on the aspect of impact forces. I think this falls nicely into evidence that what counts is NOT the softness or hardness below the feet, including surface and cushioning of the shoes. What counts is HOW the foot and leg is able to distribute the impact forces. Another study I have refered to showed that the leg stiffness changed immediately in response to changes of surface hardness, meaning that the leg tried to keep a constant internal load pattern to work optimally as a kind or spring. It has also been shown that runners react to cushioned shoes in that heel striking or sloppy use of the foot is possible due to the very attenuated feel from the surface since it is dampened in the sole, but the impact forces still travel up the leg.
I have a background from running in terrain (outside the trails) and obviously part of the injuries will be ankle or fall related. I guess this shared study looks beyond those obvious injuries and to the impact forces.
Now there is one big difference in running at flat and smoot surfaces compared to uneven and that is the work the foot, ankle and calf, as well as core and balance needs to do. I think it is obvious that the foot and ankle strength (to balance and counteract the changing uneven surface) will be improved by trail running and that is a good thing. That does not mean one cannot be injured if the strength is not enough, so progression is needed.
Now, I have known that soft surface does not necessarily reduce impact for some time and my take on this is that running on trail can give strength and balance benefits and not the least give a more varied load to the leg so that the repetitiveness is less and injuries connected to repetitive and similar movements could be less. Maybe I am right, maybe wrong and this study kindof do not support my view. On the contrary we believe in alternating between shoes when running flat to prevent injury and if this is true, then variation of load is important.
My experience with trail or road running is that if I run trail for let us say a week or two, then I will experience slight DOMS when returning to the road, so definately the profile of the impact forces is different.
I still would recommend running on varied surfaces and both flat and hilly. I think the legs will be stronger, more resilient and the aerobic ability better in more of the muscles, giving a better endurance in the long run