Forefoot vs. Reafoot Strike Debate

This post is just a few brief thoughts on a very complicated topic. I understand it’s not very sexy to make a post saying, “it depends”, but this is not a black and white issue.  Those people that have made it appear black and white are deluding themselves, or are just not up to date on the research.

The impetus for this post is a few different runners who have presented to my office for calf pain.  When I watch them run, their heels never touch the ground…ever.  When I asked them if they were trying to run with a forefoot strike, they give me different answers, but are usually themed around the idea that, “that’s the way my coach told me to run” or, “I read on Runner’s World that heel striking is bad.”  Oh boy…here we go.

Unfortunately, some coaches are part of the problem (the black and white problem).  They apparently tell all their clients (or if it’s a high school coach they tell the whole team) that heel striking is bad and forefoot is good and they wanted everyone to avoid heel striking.  There is very little that can be said in absolute terms when it comes to running form debates, but apparently some coaches feel that everyone should run with a forefoot strike (FFS as opposed to a rearfoot strike (RFS) or however the runner feels comfortable).  While it is generally thought that a FFS will lessen the forces on the knee, those forces cannot just go away – they have to go somewhere and in the case of FFS, they tend to move to the calf muscles.  In these runners, that would likely mean that the FFS is contributing to the calf pain.

Below, I have listed some papers that have shown that a FFS is generally not more economical, does not necessarily result in a lower loading rate, does not generally lead to lower injuries and results in higher loads to the posterior calf and Achilles (moves the load).

FFS is not usually more economical – papers found here, here and here

FFS does not usually result in lower loading ratehere

Forefoot strike vs heelstrike does not change injury rateshere 

FFS results in higher loads on the posterior calf muscles (gastroc and soleus) and the Achilles tendonhere and here

Notice that I said “generally” not more economical, and “not necessarily” result in lower loading rate.  I am using vague terms because in those studies, the MEAN result and the AVERAGE result showed that a FFS is not more economical or results in lower loading rate.  There were individuals in those studies where a FFS did result in better economy and lower loading rates, but for the most part, it didn’t.  But that’s the point – we’re all individuals, and to make sweeping recommendations for EVERYONE is ridiculous. 

If you’re still reading and are hungry for more on this topic of individuality, I wrote another piece on the individuality of running shoe selection last year.   If you’re STILL hungry for more info and you want to read more, I posted this piece on cadence and ground contact times – more on the loading rates in the comments section of the post.