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  • Dori Nissenson

Run, Run, RUN!


What do running experts agree good form is? My patients who are runners as well as coaches, physiologists, form gurus, and shoe designers will all agree: good running form is upright postural alignment with a slight forward tilt, a compact arm swing, and short strides that result in a cadence of 180 steps per minute or higher.

What many people in the running world disagree upon is footstrike. Which is better form: rearfoot or midfoot/forefoot strike…..???? In my travels through the research on the footstrike topic, I have found various studies that outline the pros and cons of each style.

Why The Switch From Heel Strike To Forefoot Strike?

In the last 10 years, running experts have been designating heel striking as an indication of bad running form. Initially, this resulted from the notion that heel striking causes overstriding and over striding is a "no no" and considered poor running form.

There is a good amount of research out there that supports that heel striking causes more injuries to runners. They belive that because our feet have been protected by shoes for so long, we have started landing on our heels because we could no longer feel the dangerous forces resulting from heel striking. Therefore, we continue to heel strike and injury results. By changing to a more natural midfoot strike, we should avoid injury and run more efficiently.

A lot of running gurus believe that mid/forefoot striking reduces the impact loads and enhances the storage and return of energy in our tendons, making us faster and more efficient. BUT IS THIS TRUE???

Here Is What We Know About Rearfoot vs. Forefoot Striking:

  • The belief that switching to a mid or forefoot initial contact point will alter injury rates and improve efficiency has never been proven.

  • A lot of running gurus believe that foot striking is not the real issue with running related injuries. They feel that overstriding and core instability are the culprits of bad running form.

  • Research has shown that many heel strikers do not overstride while many forefoot strikers do. It is over-striding and weak core and gluteal muscles that cause the metabolic inefficiency and muscle and joint injury in running, NOT the location of foot striking.

  • Research has shown that only elite runners who naturally strike on the mid/forefoot tend to avoid injury. It is the conversion of a natural heel strike runner into a mid/forefoot strike runner that causes injury rates to increase. Recreational runners who are flat-footed and transition to a forefoot strike tend to get inner foot and ankle injuries such as plantar fascitis and achilles tendonitis. High arched runners who transition from a rear to a forefoot strike frequently experience sprained ankles and metatarsal stress fractures.

  • Research shows that heel strikers and mid/forefoot strikers absorb the same amount of overall force at initial contact with the ground. The difference lies with where the force is absorbed. Forefoot strikers absorb the force in their arches and calves and rearfoot strikers absorb more force with their knees.

  • Research has shown that rearfoot striking in recreational runners has a larger metabolic advantage. In other words, at slower speeds rearfoot striking is metabolically advantageous. It is only at the faster speeds (usually with the more elite runners) that forefoot striking becomes more metabolically sound.

What Is The Bottom Line???

  • The bottom line is that before you consider switching your point of initial contact with the ground during running, make sure that it is clinically safe for you. If you have a history of running related injuries, the decision on where to strike becomes more important.

  • Generally speaking, runners who suffer from knee pain: patello-femoral joint problems, patellar tendonitis, or meniscal and/or ligamentous issues should consider mid/forefoot strike patterns because these patterns significantly reduce the stress on the knee joint. This is especially true for runners with a wide forefoot and flexible achilles tendons.

  • Runners with a history of ankle and foot pain and injuries: achilles tendonitis, plantar fasciitis, metatarsal pain and bunions and bunionettes should make initial contact with the ground on the outside of the heel. This point of contact will decrease the stress on the ankle and foot and is safer and more metabolically efficient.

  • According to the running experts, if you want to be a better runner, switch your focus from where you should footstrike to strength and conditioning. It is extremely important to make sure that you maintain strength in your abdominal, gluteal, and paraspinal muscles as these muscles support the front and back of the body. Strength in these muscles will make your running safer, faster and more metabolically efficient.

How Should You Make Your Running Better?

  1. Get out of the back seat: Run with an upright, slightly forward-leaning posture.

  2. Land close to your body: Don’t overstride. Shorten your stride and increase your stride cadence. You can still heel strike and still shorten your stride.

  3. Vary the surfaces that you run on: You will sharpen your proprioceptive sense, your balance and muscle reactiveness when you run on different surfaces, especially ones that are not flat or smooth.

  4. Run softly: Try to run with as little impact as possible. This does not mean avoid a heel strike! This means control your leg and foot as it hits the ground. This will also help to prevent shin splints.

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