For most distance runners foot strike is irrelevant to performance (1). Naturally foot strike occurs through a continuum, depending on speed. Sprinters benefit from forefoot running to maintain explosive quick movements. Frequent short strides are taken to get moving quicker and propel forward faster. However, healthy long distance runners show no clear benefit from the type of initial contact, and most runners have a rear foot strike (1). It is normal to have a heel strike as stride length increases.
When would mid-forefoot strike be beneficial? One study suggests that a 6:25 pace per mile is the transition point where mid/forefoot striking may be more efficient (2). However, this may be best for elite runners that choose a mid foot initial contact and are biomechanically sound. The majority of long distance runners chose heel strike, and it is not necessarily wrong (3). As with any type of training it is not recommended to suddenly increase or change training habits. Changing habits too quickly can result in injury.
Force with each running style is almost identical, however it is spread differently to the body. Forefoot runners absorb more vertical force in their foot and ankle, while heel strike runners absorb more force up the chain specifically in their knees (4).
In a 2017 study, Hamill suggests that changing style of contact is not beneficial for most runners, as it can result in injury, however changing style of running may be beneficial for some (1).
Chronic lower extremity pain including achilles tendonitis, plantar fasciitis, and patellofemoral pain may be taken into consideration. Runners with chronic anterior knee pain and clicking at the patellofemoral joint may benefit from slowly transitioning to more of a mid foot style running to decrease knee joint forces. This should be done gradually. Other biomechanics should be considered as well, such as achilles flexibility and arch type. Decreased ankle dorsiflexion and high arches may result in achilles tendonitis, plantar fasciitis, or metatarsal stress fractures, especially if the transition occurs too quickly. Individuals with high arches may also be succeptible to ankle sprains with this running style. On the other hand if you are an elite runner who typically runs with mid foot strike, transition towards heel strike may be beneficial if you are struggling with achilles tendonitis.
Bottom line, for most, heel strike running is sufficient. However, the above considerations may be beneficial with certain conditions. It is best to consult with a professional to help answer these questions as everyone is unique and if your body is in pain, it is telling you to back off.
1.) Hamill J, Allison G. Is changing foot strike pattern beneficial to runners. Journal of Sprite and Health Science. Vol. 6, issue 2, June 2017, Pages 146-153
2.) Ogueta-Alday A, Rodriguez-Marroyo JA, Garcia-Lopez J. Rearfoot Striking Runners Are More Economical than Midfoot Strikers. Med Sci-Fi Sports Exerc. 2013 Aug 30
3.) M.O. de Almeida, B.T. Saragiotto, T.P. Yamato, A.D. Lopes. Is the rearfoot pattern the most frequently foot strike pattern among recreational shod distance runners? Phys Ther Sport, 16 (2015), pp. 29-33
4.) Hamill J, Allison H. Derrick G, et al. Lower extremity joint stiffness characteristics during running with different footfall patterns. European J Sports Sci. Oct 15, 2012.
Marathon Season Recovery
Congratulations and special shout out to everyone who participated in the Baltimore Running Festival! It is marathon season and you have just completed 26.2 miles! It is a lifetime achievement to be proud of and something that not many people can dream of accomplishing. The amount of preparation, hard work, and determination it takes to complete a marathon has paid off.
But now what? More than likely you never trained for the whole 26.2 miles, but rather only about 20 miles for your longest run and then relied on adrenaline and determination to get you to the finish line. By that 20 mile marker you could start to feel it deep in your muscles and joints. Asymmetries are bound to form as one calf tightens, you start to cramp in a hamstring, or your IT band becomes irritated as you push your body to its limits to reach the finish line. The soreness is from over-stressed muscles, which have caused micro tears within the muscle. Don't worry, this is a normal occurrence and your body will work to rebuild and become stronger. It does not change the fact that you may be sore.
Initially a hot/cold alternating shower to improve circulation, then refueling your body with proper fluids and protein should be taken into consideration. Starting the second day, a combination of rest with non-stressful movements to promote blood flow to sore muscles will be important to decrease tension. Try an easy walk, swim, stretching routine, or easy yin style yoga. You hope these areas of tension go away on their own with rest, but they often hang around feeling restrictions even with daily activities. After the initial rest period when you begin back training these muscle imbalances can hinder your body from performing at its peak ability and can lead to more serious injury.
It is advised that you follow up with a knowledgable physical therapist who can work these imbalances out through deep tissue work or even myofascial decompression. They will also teach you strengthening exercises to improve your running form by targeting the specific areas of weakness that lack the necessary endurance for such a long distance. If treated early you will often only need 2-3 sessions to get back to your baseline, plus you will have greater knowledge to maintain your body in the future. This is all at a relatively low cost considering registration fees, running shoes, hotel room, and your desire to continue your lifestyle in a worry free manner.
Pioneer PT has the ability to come directly to you via a mobile clinic and provide one-on-one care with a doctor of physical therapy for a full hour. Service is direct care meaning you will not need to waste crucial time going to your doctor or a specialist for a prescription. Pioneer PT is your musculoskeletal expert and direct point of access for heath related needs.
James Dulkerian, DPT
Active outdoorsman with an honest soul and a passion for health.