Performance
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min read

Injury Insights: The Connection Between Foot Strike and Running Injuries

Explore the types of foot strike patterns in running and how to optimize your running.
Written by
Christian Peters
Published on
Apr 9, 2024

In this article, we’ll review the various foot strike patterns and how they impact the body. Understanding these variations empowers you to adapt your running technique, potentially alleviating strain on specific tissues prone to overloading and minimizing your risk of overuse injuries. By exploring the nuances of foot strike mechanics, you can optimize your running form for enhanced performance and long-term physical well-being.

Source: runrepeat.com

The Three Foot Strike Patterns

The Rearfoot Strike

The rearfoot strike, also known as a “heel strike”, is the predominant running pattern among novice and intermediate runners, with studies indicating its prevalence among up to 89% of runners.1 This pattern is characterized by initial ground contact with the heel or posterior aspect of the foot. The rearfoot strike has been shown to impose higher biomechanical loads on overall ground impact, thus impacting the ankle dorsiflexors, knees, and hips more prevalently.

Source: integrity-dc.com

The Midfoot Strike

The midfoot strike is commonly thought of as the ideal running foot strike pattern. The midfoot strike is characterized by the ball of the foot and heel landed simultaneously. There are fewer studies that compare rearfoot striking to midfoot striking, but midfoot striking was found to have similar biomechanical loads to forefoot striking likely due to the reduced dorsiflexion angle at initial contact.

Source: paretoathletics.com

The Forefoot Strike

The forefoot strike is characterized by the anterior or front region of the foot making contact with the ground prior to the posterior foot (heel). The ankle is also found to be in a plantar flexed position while the knee is noted to be in a greater angle of knee flexion in comparison to a rearfoot strike pattern.

Source: integrity-dc.com

Comparing Rearfoot vs. Forefoot

Let’s look at what the research has found when comparing these foot striking patterns. A systematic review found that runners employing a rearfoot strike had elevated rates of repetitive stress injuries compared to those favoring a forefoot strike (Daoud et al., 2012).2 Rearfoot strikers were also found to have nearly two times the rate of the following injuries when compared to forefoot strikers: hip pain, knee pain, lower back pain, tibial stress injuries, plantar fasciitis, and stress fractures of lower limb bones excluding the metatarsals.3 The forefoot strike pattern is typically thought to have higher injury rates for achilles tendinopathies, foot pain, and metatarsal stress fractures, but Daoud et al. found there was not a significant difference between rearfoot strikers and forefoot strikers for these injuries.2

The Takeaway

If you are aware of the three different foot strike patterns and understand which muscles or joints they load, you can then tailor your strike pattern for a given run. Yes, you can learn how to run utilizing all three strike patterns, and it's something I would recommend you learn how to do! This can allow you to run when you are battling a sore muscle group. For example, if your Achilles tendon has been bothering you for the past two runs, you may opt to run with a rearfoot strike pattern in order to shift the loads to the anterior shin, knees, and hips. You would need to take care of the injured tissues as well with rehabilitation and progressive overloading in order to return back to your normal foot strike pattern.

Cheung et al. utilized this idea to reduce loading rates at the patellofemoral joint and reduce pain for three female runners and had positive outcomes. Naturally these women were rearfoot strikers and were educated how to initiate with a forefoot strike. After three months of running with their forefoot strike pattern, the individuals were found to have reduced vertical impact peak and rates of loading, and also reported improvements in their patellofemoral pain levels.4

Are you currently injured and unable to run?

If you are in the Birmingham, Alabama area and are presently injured and unable to run, visit Vulcan Performance. Your running journey isn't finished; age is not a barrier, and it's never too late to begin. Our team includes specialized doctors of physical therapy dedicated to aiding your recovery and facilitating your return to the road. Take the next step by scheduling an appointment through the link provided below.

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Resources

  1. 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;45(10):738-755. doi:10.2519/jospt.2015.6019
  2. Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE. Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc. 2012;44(7):1325-1334. doi:10.1249/MSS.0b013e3182465115
  3. Xu Y, Yuan P, Wang R, Wang D, Liu J, Zhou H. Effects of Foot Strike Techniques on Running Biomechanics: A Systematic Review and Meta-analysis. Sports Health. 2021;13(1):71-77. doi:10.1177/1941738120934715
  4. Cheung RT, Davis IS. Landing pattern modification to improve patellofemoral pain in runners: a case series. J Orthop Sports Phys Ther. 2011;41(12):914-919. doi:10.2519/jospt.2011.3771

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