Is Heel Striking When Running Bad?
Have you ever seen a race photo of yourself mid-stride, heel whacking into the pavement, and wondered if you should fix it? Or maybe your knees or shins have been barking lately and you’re starting to suspect your heel strike is to blame.
Heel striking has been one of running’s most heated debates for years. Let’s look at what the research actually says, and talk about the change that tends to make a bigger difference in how you run. (Spoiler: it’s not your foot strike at all.)
Definitions
Heel strike (rearfoot strike): Heel strikes the ground first
Midfoot strike: Whole foot lands roughly flat
Forefoot strike: Ball of the foot lands first
How Did Heel Striking Get Its Bad Rap?
In 2009, the book Born To Run was published and was a huge success. It’s actually a great book that I highly recommend! The author, Christopher McDougall, struggles to run without pain and injury. He goes to multiple healthcare practitioners who give him advice that doesn’t really work, so he goes on a mission to understand how humans started running in the first place. (1)
On his mission to uncover this “natural” human running gait, he finds a tribe in Mexico called the Tarahumara who are incredible ultra distance runners who run in these very minimalist sandals. McDougall, upon observing the runners in this tribe and starting to try to adopt their style of running, guesses that part of their running success is related to the fact that they seem to land with more of a midfoot or forefoot strike. He also finds more success in his own running when he starts to adopt that style of foot strike.
On the heels of the commercial success of Born To Run, there was an influx of research on foot strike mechanics.
An evolutionary biologist named Daniel Lieberman published a study in Nature in 2010 arguing that habitually barefoot runners tend to land with more of a midfoot or forefoot strike, and predicted that this was likely to dampen the forces of running on the body. (2)
Then, Lieberman’s research group published a study looking at cross country athletes who sustained injuries during a season, and investigated which foot strike pattern they ran with. They found that most of the runners in the study used a heel strike, and the heel strikers were more likely to have sustained injuries than the midfoot or forefoot strikers. (3)
What Does the Research Show Now?
Most runners use a heel strike, even barefoot runners
A study by Hatala and colleagues observed 38 lifelong barefoot runners in the Daasanach tribe of northern Kenya running at different speeds to find what type of foot strike they used. They found that on average, the vast majority of the subjects used a heel strike. When they ran faster, the midfoot strike usage increased, but only surpassed 50% of the trials at the fastest speed tested. (4)
Another study by Kasmer and colleagues observed the foot strike patterns of runners during the Milwaukee Lakefront Marathon. They found that 93.67% of runners adopted a heel strike, and the midfoot and forefoot strikers tended to be faster. However, they explained that they didn’t have enough information to confidently say that the athletes foot strike was the reason why they were running faster, and hypothesized that these athletes may have been coached to use this foot strike after they were already high performers. (5)
Switching doesn’t clearly reduce injury risk or make you faster
Hamill and Gruber published a literature review to critique three suggestions regarding foot strike pattern in running:
Changing to a midfoot or forefoot strike improves running economy
Midfoot and forefoot strikes reduce peak impact forces
Midfoot and forefoot strikers are less likely to sustain injuries
Upon reviewing the existing literature, they determined that none of the three suggestions had scientific backing. However, they mention that the injury risk of switching foot strike patterns needs further research to see whether a relationship exists. (6)
Load doesn’t disappear, it moves
The previous notion was that heel striking applied more force to the body, and forefoot striking applied less. What Xu and colleagues found when reviewing the literature, is that heel striking created more forces at the knee joint, and forefoot striking created more forces around the foot and ankle, most specifically, the achilles tendon. (7)
In my clinical experience, this tends to play out somewhat predictably in the real world. My clients who use a forefoot strike are much more likely to develop lower leg injuries like achilles tendinopathy than knee injuries. Additionally, runners who shift from more of a heel strike to a midfoot or forefoot strike tend to get a lot of soreness in their calves in the beginning of the transition as their calves adapt to the increased load.
The Thing That Matters More: Where Your Foot Lands
By this point I think we can confidently say that, while the way that your foot hits the ground does have an impact on how your body distributes the forces of running, there’s no good evidence that heel striking increases your injury risk.
So what characteristics of running gait DO matter?
Overstriding and cadence.
Overstriding is when your foot lands way out in front of your body, usually with your knee nearly straight. Every time that happens, it acts like a little brake. You slow down, and your knee and hip have to absorb that braking force before you can push off again. You can overstride with any foot strike. It’s just most obvious with a big heel strike, which is why heel striking gets blamed.
Cadence is how many steps per minute you take. When running, cadence often ranges from around 150-180 steps per minute (spm). Increasing your cadence while keeping your speed the same will shorten your strides and force your foot to land closer to right underneath your hips. Not only does increasing your cadence often naturally reduce heel striking, but it’s simpler to change, and supported by research to reduce the stress on your joints.
Cadence: The Simpler, Better-Supported Fix
Multiple studies have found that a small increase in cadence takes a noticeable amount of stress off your knees and hips. (8,9) And one study of college cross country runners found that runners with a higher cadence were less likely to develop bone stress injuries. For every extra step per minute, their risk was about 5% lower. That adds up: runners at 165 steps per minute had roughly 23% lower risk than runners at 160. (10)
And what’s cool about cadence, is that it’s simple to improve. Running to the beat of an audible or tactile metronome set to your cadence target is much simpler than trying to actively think about what position your ankle is in as your foot hits the ground.
How To Increase Your Cadence
First, you should figure out what your baseline is. If you use a Garmin or other smart watch, they track your cadence and you can find this information in their companion apps. Make sure you are looking at your average run cadence. If you walk to warm up or cool down, you’ll want to make sure that your average cadence doesn’t include that section.
Next, you’ll need to decide how you will cue yourself to increase your cadence. You can use:
A metronome app on your phone connected to your headphones
A playlist of songs that match your desired cadence
A haptic metronome on your smart watch. Specific models of both Garmin and Coros watches have this feature.
Last, you’ll want to pick a reasonable target cadence based on your baseline. If your baseline is 160 spm, shoot for between 165-168 (~3-5% increase). It’ll probably feel a little choppy or awkward for the first few runs. That’s normal. Start on easy runs, and give it a couple of weeks before you decide how it feels.
Keep in mind that the research supports two related ideas. Runners with a higher cadence tend to get fewer bone stress injuries, and increasing your cadence reduces the stress on your body with every stride. In my practice, I generally recommend most runners aim for an average cadence of at least 165 spm. But even if you’re already above that, a small increase can still take some load off your joints.
Is Heel Striking When Running Bad?
No! But overstriding might be. And for most runners, a small increase in cadence is a simpler, better-supported change than trying to fix your foot strike.
At Alterra, I help runners navigate injury and understand how to improve their running gait through Alterra’s Premier Runner Evaluation. If you’re a runner in Boston’s Back Bay looking to improve your running gait, I’d love to help! Book a free discovery call to see if we’re a good fit to work together.
Sources
McDougall C. Born to Run : A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen. Alfred A. Knopf; 2009.
Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010;463(7280):531-535. doi:10.1038/nature08723
Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE. Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc. 2012;44(7):1325-1334. doi:10.1249/MSS.0b013e3182465115
Hatala KG, Dingwall HL, Wunderlich RE, Richmond BG. Variation in foot strike patterns during running among habitually barefoot populations. PLoS One. 2013;8(1):e52548. doi:10.1371/journal.pone.0052548
Kasmer ME, Liu XC, Roberts KG, Valadao JM. Foot-strike pattern and performance in a marathon. Int J Sports Physiol Perform. 2013;8(3):286-292. doi:10.1123/ijspp.8.3.286
Hamill J, Gruber AH. Is changing footstrike pattern beneficial to runners?. J Sport Health Sci. 2017;6(2):146-153. doi:10.1016/j.jshs.2017.02.004
Xu Y, Yuan P, Wang R, Wang D, Liu J, Zhou H. Effects of Foot Strike Techniques on Running Biomechanics: A Systematic Review and Meta-analysis. Sports Health. 2021;13(1):71-77. doi:10.1177/1941738120934715
Adams D, Pozzi F, Willy RW, Carrol A, Zeni J. ALTERING CADENCE OR VERTICAL OSCILLATION DURING RUNNING: EFFECTS ON RUNNING RELATED INJURY FACTORS. Int J Sports Phys Ther. 2018;13(4):633-642.
Heiderscheit BC, Chumanov ES, Michalski MP, Wille CM, Ryan MB. Effects of step rate manipulation on joint mechanics during running. Med Sci Sports Exerc. 2011;43(2):296-302. doi:10.1249/MSS.0b013e3181ebedf4
Kliethermes SA, Stiffler-Joachim MR, Wille CM, Sanfilippo JL, Zavala P, Heiderscheit BC. Lower step rate is associated with a higher risk of bone stress injury: a prospective study of collegiate cross country runners. Br J Sports Med. 2021;55(15):851-856. doi:10.1136/bjsports-2020-103833
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