Forefoot strike, rear foot strike or running shoes. Does it matter?
The main aim of this article is to provide some insight into evidence-based data in running. The prevalence of a rearfoot strike (RFS) pattern is much more usual than a forefoot strike (FFS) even among elite distance runners. There has been significant pressure on runners to change their running style from RFS to FFS in recent times. Usually, this has been justified by the statement that FFS relates to a lower injury rate. Recent studies have shown however, that this statement is probably not true. Different types of strike pattern have an influence on loading different structures of the lower limbs, but the total incidence of running related injury is the same regardless of the type of foot strike pattern.
We want to provide not only an objective view on running technique but also an evidence-based view on the choice of running shoes. There are many recommendations to consider when choosing running shoes, especially in running stores, but only a few of them are supported by research.
This article is not a meta-analysis but it provides some evidence based information about running styles and running shoes.
Ahn, A. N., Brayton, C., Bhatia, T., & Martin, P. (2014). Muscle activity and kinematics of forefoot and rearfoot strike runners. Journal of Sport and Health Science, 3(2), 102–112. https://doi.org/10.1016/j.jshs.2014.03.007
Almonroeder, T., Willson, J. D., & Kernozek, T. W. (2013). The effect of foot strike pattern on achilles tendon load during running. Annals of Biomedical Engineering, 41(8), 1758–1766. https://doi.org/10.1007/s10439-013-0819-1
Ardigò, L. P., Lafortuna, C., Minetti, A. E., Mognoni, P., & Saibene, F. (1995). Metabolic and mechanical aspects of foot landing type, forefoot and rearfoot strike, in human running. Acta Physiologica Scandinavica, 155(1), 17–22. https://doi.org/10.1111/j.1748-1716.1995.tb09943.x
Beynnon, B. D., Renström, P. A., Alosa, D. M., Baumhauer, J. F., & Vacek, P. M. (2001). Ankle ligament injury risk factors: a prospective study of college athletes. Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society, 19(2), 213–220. https://doi.org/10.1016/S0736-0266(00)90004-4
Cavanagh, P. R., & Lafortune, M. A. (1980). Ground reaction forces in distance running. Journal of Biomechanics, 13(5), 397–406. https://doi.org/10.1016/0021-9290(80)90033-0
de Almeida, M. O., Saragiotto, B. T., Yamato, T. P., & Lopes, A. D. (2015). Is the rearfoot pattern the most frequently foot strike pattern among recreational shod distance runners? Physical Therapy in Sport: Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, 16(1), 29–33. https://doi.org/10.1016/j.ptsp.2014.02.005
Forrester, S. E., & Townend, J. (2015). The effect of running velocity on footstrike angle--a curve-clustering approach. Gait & Posture, 41(1), 26–32. https://doi.org/10.1016/j.gaitpost.2014.08.004
Gillinov, S. M., Laux, S., Kuivila, T., Hass, D., & Joy, S. M. (2015). Effect of Minimalist Footwear on Running Efficiency: A Randomized Crossover Trial. Sports Health, 7(3), 256–260. https://doi.org/10.1177/1941738115571093
Grier, T., Canham-Chervak, M., Bushman, T., Anderson, M., North, W., & Jones, B. H. (2016). Minimalist Running Shoes and Injury Risk Among United States Army Soldiers. The American Journal of Sports Medicine, 44(6), 1439–1446. https://doi.org/10.1177/0363546516630926
Gruber, A. H., Umberger, B. R., Braun, B., & Hamill, J. (2013). Economy and rate of carbohydrate oxidation during running with rearfoot and forefoot strike patterns. Journal of Applied Physiology, 115(2), 194–201. https://doi.org/10.1152/japplphysiol.01437.2012
Hasegawa, H., Yamauchi, T., & Kraemer, W. J. (2007). FOOT STRIKE PATTERNS OF RUNNERS AT THE 15-KM POINT DURING AN ELITE-LEVEL HALF MARATHON. The Journal of Strength & Conditioning Research, 21(3), 888.
Hatala, K. G., Dingwall, H. L., Wunderlich, R. E., & Richmond, B. G. (2013). Variation in foot strike patterns during running among habitually barefoot populations. PloS One, 8(1), e52548. https://doi.org/10.1371/journal.pone.0052548
Knapik, J. J., Trone, D. W., Swedler, D. I., Villasenor, A., Bullock, S. H., Schmied, E., … Jones, B. H. (2010). Injury reduction effectiveness of assigning running shoes based on plantar shape in Marine Corps basic training. The American Journal of Sports Medicine, 38(9), 1759–1767. https://doi.org/10.1177/0363546510369548
Kulmala, J.-P., Kosonen, J., Nurminen, J., & Avela, J. (2018). Running in highly cushioned shoes increases leg stiffness and amplifies impact loading. Scientific Reports, 8(1), 17496. https://doi.org/10.1038/s41598-018-35980-6
Larson, P., Higgins, E., Kaminski, J., Decker, T., Preble, J., Lyons, D., … Normile, A. (2011). Foot strike patterns of recreational and sub-elite runners in a long-distance road race. Journal of Sports Sciences, 29(15), 1665–1673. https://doi.org/10.1080/02640414.2011.610347
Lenhart, R. L., Thelen, D. G., Wille, C. M., Chumanov, E. S., & Heiderscheit, B. C. (2014). Increasing running step rate reduces patellofemoral joint forces. Medicine and Science in Sports and Exercise, 46(3), 557–564. https://doi.org/10.1249/MSS.0b013e3182a78c3a
Lieberman, D. E. (2012). What we can learn about running from barefoot running: an evolutionary medical perspective. Exercise and Sport Sciences Reviews, 40(2), 63–72. https://doi.org/10.1097/JES.0b013e31824ab210
Malisoux, L., Ramesh, J., Mann, R., Seil, R., Urhausen, A., & Theisen, D. (2015). Can parallel use of different running shoes decrease running-related injury risk? Scandinavian Journal of Medicine & Science in Sports, 25(1), 110–115. https://doi.org/10.1111/sms.12154
Mündermann, A., Stefanyshyn, D. J., & Nigg, B. M. (2001). Relationship between footwear comfort of shoe inserts and anthropometric and sensory factors. Medicine and Science in Sports and Exercise, 33(11), 1939–1945.
Neal, B. S., Griffiths, I. B., Dowling, G. J., Murley, G. S., Munteanu, S. E., Franettovich Smith, M. M., … Barton, C. J. (2014). Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis. Journal of Foot and Ankle Research, 7(1), 55. https://doi.org/10.1186/s13047-014-0055-4
Nielsen, R. O., Buist, I., Parner, E. T., Nohr, E. A., Sørensen, H., Lind, M., & Rasmussen, S. (2014). Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. British Journal of Sports Medicine, 48(6), 440–447. https://doi.org/10.1136/bjsports-2013-092202
Nichols, R., Germano, C., Burke, M., Nolan, K., Youngs-Grand, K., & Girard, J. (2016). The effects of foot strike on running economy in distance runners: a narrative review. Physical Therapy Reviews, 21(1), 32–37. https://doi.org/10.1080/10833196.2016.1193970
Razeghi, M., & Batt, M. E. (2002). Foot type classification: a critical review of current methods. Gait & Posture, 15(3), 282–291. https://doi.org/10.1016/S0966-6362(01)00151-5
Reinschmidt, C., Stacoff, A., & Stüssi, E. (1992). Heel movement within a court shoe. Medicine and Science in Sports and Exercise, 24(12), 1390–1395.
Roper, J. L., Doerfler, D., Kravitz, L., Dufek, J. S., & Mermier, C. (2017). Gait Retraining From Rearfoot Strike to Forefoot Strike does not change Running Economy. International Journal of Sports Medicine, 38(14), 1076–1082. https://doi.org/10.1055/s-0043-110225
Schubert, A. G., Kempf, J., & Heiderscheit, B. C. (2014). Influence of stride frequency and length on running mechanics: a systematic review. Sports Health, 6(3), 210–217. https://doi.org/10.1177/1941738113508544
Stearne, S. M., Alderson, J. A., Green, B. A., Donnelly, C. J., & Rubenson, J. (2014). Joint kinetics in rearfoot versus forefoot running: implications of switching technique. Medicine and Science in Sports and Exercise, 46(8), 1578–1587. https://doi.org/10.1249/MSS.0000000000000254
Warr, B., Fellin, R., Frykman, P., Sauer, S., Goss, D., & Seay, J. (2014). Footstrike Patterns do not Influence Running Related Overuse Injuries in U.S. Army Soldiers: 2977 Board #263 May 30, 3. Medicine & Science in Sports & Exercise, 46, 812. https://doi.org/10.1249/01.mss.0000495935.37415.aa
Willson, J. D., Sharpee, R., Meardon, S. A., & Kernozek, T. W. (2014). Effects of step length on patellofemoral joint stress in female runners with and without patellofemoral pain. Clinical Biomechanics (Bristol, Avon), 29(3), 243–247. https://doi.org/10.1016/j.clinbiomech.2013.12.016
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.