Solving the Footstrike Puzzle

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It seems that just about everyone has an opinion about running.  A few years ago most of the questions I’d get were about the effect of running on joints.  Now, the talk is focused on footstrike patterns–what part of your foot you should land on when running.  Some state that we should be landing on the ball of the foot (forefoot) and that modern running shoes have created generations of heel strikers.  Many of these passionate advocates proclaim that heelstriking is bad for the body and can cause injury.

Turns out, the argument is not so cut and dry.  According to continued research, there may not actually be one right way to run.  This is music to my ears.  I’ve always held firm to the belief that there is more than one way to get something done, including parking the car in the garage…ahem.

The question comes up frequently these days, though appears in many different forms-

“Should I switch to barefoot running?”

“Isn’t landing on your heel bad for you?”

…and much more commonly as a statement,

“So, I tried to change to a forefoot strike…”

“Heelstriking is bad for you.”

“If you run without shoes, you will land on your forefoot”

“Landing on your toes prevents injuries”

Seems like everyone knows all there is to know about running and running form.  Which is actually quite funny considering the researchers and clinicians are all still trying to wrap their heads around the footstrike puzzle.

When I evaluate a runner who wants to change their form, the first question I ask is, “why?”.  We live in an age with endless information at the tips of our fingers and connect with people and groups we don’t even know through social media, many who have strong opinions, seemingly supported by research. The runners with whom I work are tech-savvy, bright, educated, curious, motivated, and sometimes even obsessed.  They collect information from various sources and have other influences–friends, coaches, personal trainers, and other healthcare practitioners who may be suggesting one form over another. It is important I understand the motivation for wanting to become a forefoot striker.  My general recommendation is that unless a runner has an injury that may be helped by modifying form, there really is no reason to try to change how they are running.

A very famous and often quoted research study became gospel truth in 2010 when it was published in Nature.  Harvard researcher Daniel Lieberman studied 5 different groups of runners, including some who had never worn shoes and others who had always worn shoes but ran barefoot.  He evaluated their footstrike patterns as they ran at an average pace of 5:00/mile on a track fitted with a forceplate.  The study concluded that those who had never worn shoes ran with a forefoot strike pattern, implying there would be a difference in the running style of people who wear shoes.  The study also showed a decreased rate of loading and lower collision forces in barefoot runners when compared to shod runners.  However, while the media (need reference) boldly claimed, “running barefoot was less likely to cause injury as a result of the lower impact forces it caused,” the article concludes with a more accurate statement, “controlled prospective studies are needed to test the hypothesis that individuals who do not predominantly rearfoot strike either barefoot or in minimal footwear, as the foot apparently evolved to do, have reduced injury rates.”

A more recent study published this January evaluated the footstrike patterns in a different group of Kenyans.  Though this group is not known for distance running, they are still physically active and, like the participants in the earlier study, do not wear shoes.  Similar to the 2010 study, these runners ran barefoot along a track fitted with a forceplate but at a comfortable, distance-running pace, averaging around 8:00 per mile.  Contrary to the results of the earlier study, 72 percent landed on their heels, 24 percent on the midfoot, and only 4 percent on the forefoot.  However, when the participants were asked to run at a sprint, many landed closer to the forefoot while only 43 percent landed on their heels.  The results of this study seem to indicate that pace may dictate footstrike patterns more than choice of footwear.

One interesting observation that may surprise some is that running barefoot does not necessarily create a forefoot landing pattern.  In my assessment of hundreds of runners over the years, I quickly learned that this commonly held belief is false.  Many runners who think they are landing on their forefoot are actually landing in the middle of their foot or even continuing to strike heel first.  Another important consideration when working with injured runners or those interested in trying barefoot running is that while loading of the knee is decreased with a forefoot landing, loads and the foot and ankle are actually increased.  This may be a reason why someone attempts to modify their landing pattern, but the recommendation must be specific to the runner, depends on many other variables, and should only be made after a thorough assessment by a qualified professional.

TherapydiaSF offers running analysis through our RunRx program.  Call 415.765.1502 or email info@therapydiasf.com for more information.

References:

Hatala KG, Dingwall HL, Wunderlich RE, Richmond BG (2013) Variation in Foot Strike Patterns during Running among Habitually Barefoot Populations. PLoS ONE 8(1): e52548. doi:10.1371/journal.pone.0052548

Kleindienst, F.I., Campe, S., Graf, E.S., Michel, K.J., & Witte, K. 2007. Differences between fore- and rearfoot strike running patterns on kinetics and kinematics. International Society of Biomechanics in Sports. Ouro Preto, Brazil.

Lieberman, DE, Venkadesan, M, Werbel, WA, Daoud, AI, D’Andrea, S, Davis, IS, Mang’Eni, RO, Pitsiladis, Y. Foot Strike Patterns and Collision Forces in Habitually Barefoot Versus Shod Runners. Nature. 2010; 463(7280):531-535. 12.

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