Arizona Physical Therapy: Runners – Heel Strike or Forefoot Strike?

Mar 31, 2015

Kevin Davi

by Kevin Davi
PT | Sun City Location

Kevin Davi, PT, is a physical therapist located at our Sun City facility. He is here to explain forefoot versus heel striking when running and how to improve your running form.
As a physical therapist, I see injured runners every day. Many of them love to run, but many do not know the best way to run. Form is important in running. Whether it’s keeping your head up or your arms relaxed, runners who use proper form will perform better.
One hot-button issue within the running community is the heel strike versus forefoot strike argument.
A heel strike is when you run and when your foot lands, it hits your heel first. A forefoot strike is when your foot lands near the front, on the ball of your foot.
As a professional, I have seen the effects of heel strike injuries and so I side with forefoot striking. Although heel striking can be natural to a runner, it usually indicates that they over-stride when running. A forefoot strike allows a runner to utilize the eccentric strength of their lower extremity musculature to dissipate the ground reaction force created with every step. In other words, forefoot strikes are less impacting, with the foot’s impact spreading around the muscles. It seems only logical to forefoot strike because a heel strike pattern would translate that same ground reaction force, but directly to joints.
But it should also be known that any runner who tries to switch cold turkey will find themselves not having the muscle strength or endurance to quickly adapt without significantly increasing their risk of injury.
So what is a runner to do if they have a harsh heel strike pattern?
My favorite phrase when treating a runner is “tissue adaptation time.” Regardless of a runner’s past history or competitive level, any corrections to running form will drastically impact the stresses placed on the body due to the repetitive nature of the activity. As a professional I must recognize this and incorporate sport specific training protocol to prepare the body before switching a runner’s mechanics.
For example, one of my patients, a middle-aged man with no prior running injuries, started a running program to kick start his health. Unfortunately, he found that in his second week of training he began to have bilateral knee pain. When assessing his running form, he displayed a “loud” running style: a high impact heel strike bilaterally. It was putting immense stress on his knees, so I immediately considered helping him transition to a softer, forefoot strike pattern.
However, knowing the repetitive motions that distance running will have on the lower extremities, we had to develop a program together based on his consultation. To train his muscles, we slowly incorporated new mechanics into his running style. The program also added several plyometric activities, including box jumps and jump ropes to prepare his body for the upcoming transition.
Once his initial pain subsided, we began to merge the corrections with his running form. The patient would perform his usual one-mile run, with the last tenth of the mile being performed with a forefoot strike rather than his usual heel strike. As the patient became more comfortable with this new form, we increased his forefoot striking percentage by ten percent each week.
With the combination of plyometric training and slow transition to a new running form, my patient was able to avoid his previous knee pain and increase the mileage of his running program!
Correcting running form is no cakewalk, in fact, it’s a challenge many ignore. But if you are serious about starting a running program or are suffering from chronic pain when running, book a consultation with a Foothills Rehab expert today. To learn more about Foothills Sports Medicine Physical Therapy, and what our certified experts can do for you, check out the Foothills blog.
 
Image courtesy of Josiah Mackenzie.

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