Heel Strike Running Or Forefoot Running?

We are often asked at Body in Motion physiotherapy about whether a runner should land on their heel on their mid foot.

More and more research is coming out that supports forefoot or midfoot landing.

Our ancestors ran for millions of years barefoot using midfoot landing as do many Kenyans today with little or no foot, ankle and shin problems. In addition lab research analysing running kinetics also demonstrates that there may be less impact and less injuries sustained with fore/midfoot running.

So what is the research?

Most midfoot or forefoot landing does not generate the huge sudden impact that heel striking does. Therefore mid/forefoot runners do not need the generous heel cushioning that modern shoes provide.

Studies show 30{a3acb2be643effc4b7b4b3705df5cb2eae026059a1d075d54be8af4d92e7e619} of runners get injured every year (mainly shin splints, knee pain, Achilles problems and plantar fasciitis) and our data at Body in Motion Bournemouth physiotherapy also backs this up.

Many runners do heel strike and provided they have no injuries, there is no problem with that. However some evidence may suggest that landing on the heel is similar to applying the brakes. There may be some benefit to a runner’s speed by midfoot landing and well as less injury.

Should I switch?

If you are running well with no problems I would be hesitant to change.

However if you are just starting or get repeated injuries and know you need to improve your biomechanics, make any changes slowly and with patience. Start by getting a videoanalysis of your gait to see what issues may be there. Sometimes there are other issues with the back, hip or knee that should be addressed before making changes in the feet.

In the beginning it is likely you will experience some muscle soreness in the calf, lower leg and feet. If you progress too quickly, you risk causing injury to your muscles or tendons. Sports massage will allow your muscles and tendons to adapt to any changes in biomechanics more quickly.

With heel striking the foot and lower leg come to a dead stop at impact while the rest of the body continues to fall above the knee. Also the effective mass is approximately the foot plus the lower leg, which equals 6.8{a3acb2be643effc4b7b4b3705df5cb2eae026059a1d075d54be8af4d92e7e619} of total body mass in the runners measured in Lieberman et al. (2010).

However with forefoot running:

Forefoot striking produces a very slow rise in force with no distinct impact transient. There is essentially NO impact transient in a forefoot strike. The same is true of some (but not all) midfoot strikes. Even on hard surfaces runners who forefoot strike have impact forces that are 7 times lower than runners who heel strike Lieberman et al. (2010). Heel striking is equivalent to someone hitting you on the heel with a hammer using as much as 3 times your body weight. These impacts add up, since you strike the ground almost 1000 times per mile!

Many running shoes make heel strikes comfortable and less injurious because they slow the rate of loading considerably but they do not eliminate the impact transient. If you have repeated injuries with running, book a video analysis or ask your physiotherapist for advice for advice.

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