Generally speaking, coaches and runners alike love to critique form. And it makes sense. It’s exciting to think that changing one small aspect of every stride will lead to faster race finishes, less fatigue and/or a reduced likelihood for injury. One form tweak that has siphoned a lot of this attention is footstrike pattern. Prior to reading this article, you might have thought, a rearfoot strike pattern will inevitably yield a running-related injury. Although the concern is valid, given the amount of conflicting advice out there, based on my own coaching experience and research, I think we need to look at the broader picture before making changes
In this article, I will look at biomechanical factors that affect running and shed light on the question “Does a specific footstrike pattern really cause injury?”.
The Three Types of Footstrike Pattern
Footstrike pattern has been heavily researched in its role in certain running-related injuries and running economy. It is quite a controversial topic that often stirs up a lot of debate, and this debate often brings confusion. To start things off clearly, I’d like to define the three types of foot strike patterns:
- The Rearfoot or Heel Strike: where initial contact occurs at the heel or the posterior part of the foot. This foot strike pattern has been demonized and often touted as the footstrike that incurs most injury. As such, runners with this pattern are often encouraged to change it.
- The Midfoot Strike: where the posterior and anterior portions of the foot simultaneously contact the ground. Coaches commonly support this foot strike pattern as the preferred type.
- The Forefoot Strike: where the anterior region of the foot strikes the ground first. This type is most often used by sprinters.
A study by Almeida et.al 2015 concluded that 89% of runners were heel strikers (and for what it’s worth, I’m one of them.) Based on this data, and the abundance of articles citing rearfoot striking as the source of injury plaguing many runners, should we assume that these runners will all be afflicted similarly? Before we answer that question, let’s take a look at the forces imposed on the body and how they vary based on footstrike pattern.
The Forces At Work
When we change our footstrike, the forces that travel through our bodies also change. Ground reaction force, or the force exerted by the ground on a body in contact with it, are higher in rearfoot strikers than midfoot strikers.
One common occurrence among rearfoot strikers is overstriding. Overstriding is where the foot makes initial contact far from the body’s center of mass. This can create excessive and unnecessary forces around the tissues in the form of braking forces. Braking forces are best demonstrated by the scuffing or scraping sound you make as your shoe shears against the ground. Overstriding also imposes greater negative work (or the energy expended to keep you upright and balanced instead of flailing and falling forward) around the ankle muscles due to increased dorsiflexion and increased knee flexion compared to forefoot strikers. From this, we can assume that this creates more stress in and around the affected tissues and connective structures.
However, this increase in stress does not necessarily mean that people are going to get injured. Stress is inevitable when we train. Our ability to recover allows the body to repair, adapt and ultimately endure more.
Will Changing Footstrike Pattern Do Anything At All?
So, most athletes want to know if changing their footstrike pattern will make their runner faster. Not necessarily, but some research indicates that the body will naturally shift footstrike position to midfoot as pace increases, Breine et.al 2014. So doing it consciously, doesn’t seem necessary for speed gains.
It’s equally as important to ask, will my athlete’s changing footstrike patterns prevent injury? The answer, in this case, is ambiguous, yes, no, maybe…ultimately, we don’t know. While rearfoot strikers may develop similar areas of injury (knee and hips), mid and forefoot strikers also tend to experience common injury in the feet and Achilles. So, it’s a Catch 22, there are equal risks in developing an injury based on how we move.
Anderson et.al 2020 published a paper concluding that although there are clear biomechanical differences between the aforementioned footstrike patterns, changing an uninjured runner’s footstrike pattern is not advantageous. However, if these biomechanical differences cause, or at minimum, relate to injury, changing the footstrike pattern should be considered. In this case, a clinician may alter the foot strike pattern to move stress away from an affected area.
I want to leave you all with this: as coaches, we need to have a watertight ‘why’ for each choice we make for our athletes. They depend on us as their main source of sport-related expertise, so tweaking their run form, without a fully informed perspective can be problematic.
And last but not least, when it comes to footstrike pattern, the old adage holds true: if it’s not broke (or causing injury), then don’t fix it!
Anderson LM, Bonanno DR, Hart HF, Barton CJ. 2020 “What are the Benefits and Risks Associated with Changing Foot Strike Pattern During Running? A Systematic Review and Meta-analysis of Injury, Running Economy, and Biomechanics” Sports medicine (Auckland), vol.50 no.5,pp.885-917
Almeida MO, Davis IS, Lopes AD. Biomechanical Differences of Foot-Strike Patterns During Running: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2015 Oct;45(10):738-55.
Breine, Bastiaan, Malcolm, Philippe, Frederick, Edward C De Clerc, Dirkbetween Running Speed and Initial Foot Contact Patterns, Medicine & Science in Sports & Exercise: August 2014 – Volume 46 – Issue 8 – p 1595-1603.