Is altering footstrike pattern beneficial to runners?

Hi, this post is following an interesting discussion with my connections on LinkedIn. The topic of the discussion focused on two aspects:

  1. Does a heel striking pattern (at initial contact) increase the risk of injuries for the runner? 
  2. Can altering or tampering the footstrike pattern to a fore-foot strike pattern reduce the risk of running-related injuries? 

Discussion A: Heel striking at initial contact. Good or bad?

Before we start with our discussion, Ill explain what the terms rear-foot and fore-foot striking indicate. Footstrike patterns are categorized depending on the portion of the foot that initially contacts the running surface. During a rear-foot strike, a runner contacts the ground with the lateral aspect of the heel. A number of studies on runners have suggested that a majority of shod runners strike with a rear-foot strike. I feel that this is logical as the weight of the shoe is generally more towards that rear-foot. This makes a natural tendency for the heel to drop earlier than the forefoot.  A mid-foot strike is one in which the runner initially contacts the ground across the metatarsal heads with the heel subsequently contacting the running surface. A forefoot strike is when the initial contact is also on the metatarsal heads but the heel never touches the ground. Coming back to our topic, I feel it is not just the pattern or type of the footstrike that impacts risk of running injuries. Additionally, it is the inclination of the landing foot to the ground during initial contact which is affects the shock absorption capability of the runner. (which is the prime aim of the initial contact phase). Increasing the foot inclination angle increases the peak vertical ground reaction force, braking impulse, knee extensor moment, and negative work performed by the knee extensors, all of which have been associated with various running-related injuries in the past. Hence, while criticizing the footstrike pattern of the runner, I think it would make more sense if we also take the foot inclination angle of the runner into account. A fore-foot strike angle of 20° could be more damaging than a heel strike angle of 5°.

Discussion B: Is changing to a fore-foot strike pattern worth it?

I’ll let past research speak for itself on this one. A study by Joseph Hamil et all, suggests that there is no obvious benefit to such a change for the majority of runners. In fact, changing the footstrike pattern may stress a tissue that is not normally stressed when running with one’s habitual pattern. Conversely, this may lead to the possibility of incurring a secondary injury. Changing one’s foot-strike to a mid- or forefoot strike may be beneficial to some but, based on the current bio-mechanical & physiological literature, it is not recommended for the majority of runners, particularly those who are recreational runners.
Lastly, every coach/clinician should focus on the entire running mechanics of the runner. Focusing on knee, hip, pelvis, trunk mechanics is as important as the foot inclination angle. Moreover, one should analyse these parameters at various moments of the gait cycle in addition to initial contact. Clinicians/coaches can use tools like slow motion video or running gait analysis software to analyse the complete running mechanics. Software like GaitON make it easy for a clinician to assess the shock absorption, weight bearing and propulsive ability of the runner. It also helps in making much more informed interventions by analyzing the knee,hip etc. mechanics during the running gait cycle.
I am no expert on this matter, but this is my opinion on probably the most discussed topic in the running community right now. If you would like to add to my opinions or believe I missed out on some point while arguing my case, feel free connect with me via LinkedIn or my email at hans.siddharth@auptimo.com

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