Is Changing Footstrike Pattern Beneficial To Runners?

By: Joseph Hamill, Allison H. Gruber

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For something as seemingly natural and simple as running, there is a tremendous amount of research that influences the recommendations made by running couches and experts. However, when breaking down the biomechanics and physiological economy of running, the simple behavior of putting one foot in front of the other at a moderate or quick pace can really become one of the most complex tasks of movement analysis. Arguably one of the most debated aspects of running is footstrike, especially whether or not it can be “optimized” for performance and injury prevention. The varying forces and stressors associated with either a forefoot, midfoot, or rearfoot strike are broken down well in this article by Hamill and Gruber, as are suggestions from other researchers for optimal economy, injury prevention, and performance.

Facts from the Article:

  • Epidemiologic data on footstrike demographics show that the rearfoot strike is one that is used by the greatest percentage of runners
  • 81% of runners at the 10- and 20-km point of a marathon used a rearfoot strike while 19% used a midfoot strike
  • In an elite half-marathon, Hasegawa et al. reported that 75% of runners used a rearfoot strike, 23% a midfoot strike, and 2% a forefoot strike
  • The prevalence of rearfoot runners has also been reported to be as high as 94% of 1991 runners in a competitive road race and 95% of 514 runners tested in a laboratory setting
  • Several studies, albeit small and thus limited in power, have compared running economy between rear- and forefoot strike and reported no significant differences in intra-subject oxygen consumption between those footstrike patterns
  • An investigation by Gruber et al. (2013) indicated that habitual rearfoot strikers, when asked to change their strike to a forefoot pattern, consumed significantly more oxygen with an “alternative” (meaning forefoot) running strike. The habitual forefoot runners did not significantly increase their oxygen consumption when switching to a rearfoot strike. Gruber was able to show that for the majority of people (rearfoot strikers), the assumption that switching to a forefoot strike is more economical was apparently unfounded
  • “The fact that there is a force resulting from the foot-ground collision not only in a rearfoot strike, but in the mid- or forefoot strikes as well, and that relationship between these kinetic parameters and injury is tenuous at best, are both evidence that the appearance or non-appearance of an impact peak in the time domain is not sufficient for changing one’s footstrike”
  • With regards to running force distribution, one footstrike does not seem significantly more universally preventative against injury than the other, although the location and distribution of forces is different between fore- and rearfoot strike (forefoot loading more plantar, ankle and Achilles tissues and rearfoot loading more knee tissues)
  • Evidence suggests that switching from one footstrike to another may result in exposure to different types of injury mechanisms rather than one footstrike being more or less injurious than the other
  • “In 3 relatively large-scale epidemiologic studies, investigators reported the injury risk on samples of 471 and 1203 runners and a sample of 341 U.S. army soldiers…Neither study reported significant differences in the injury rates between habitual rearfoot and mid- or forefoot strikers”

Summary:

According to statista.com, 64 million people in the U.S. went running or jogging in 2016. That’s an incredible number of healthy decisions! As educators and healthcare providers continue to advocate for healthy behavior and increased activity levels, we should remain mindful that there is inherent risk that we can mitigate with coaching or advice. Combining the latest research with an understanding of the common assumptions or popular beliefs of runners is crucial for providing optimal care and encouraging the best performance. One great recommendation for providers or coaches of runners to consider is summarized well by this article: “Changing one’s footstrike to a mid- or forefoot strike may be beneficial to some but, based on the current biomechanical, physiological, and epidemiologic literature, it should not recommended for the majority of runners, particularly those who are recreational runners”. Happy running!

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