Does being a heel striker or forefoot striker influence a runner’s incidence of injury? A February 8th New York Times article shed light on a Harvard study led by Dr. Daniel Lieberman and Adam Daoud that examined the relationship between foot strike and frequency of injury on Harvard’s men’s and women’s cross country teams over a four year period. (Yes, the same Dr. Daniel Lieberman whose research paper “Foot Strike Patterns and Collision Forces in Habitually Barefoot versus Shod Runners” unintentionally helped fuel the barefoot/minimalist shoe running movement…….more about that later)!
69% of the runners studied were heel strikers and 31% were forefoot strikers; no difference in percentages between genders. Lieberman and Daoud found that two-thirds of runners were injured seriously enough every year to miss two or more training days, roughly the same rate of injury experienced by the general running population. However, the heel strikers were twice as likely to suffer injury as the forefoot strikers!
Although clearly related to the debate of whether barefoot/minimalist running can decrease injury risk, both Daoud and Lieberman point out that their study does not address the benefits (if any) of one type of shoe compared to another. After all, some of the runners who wore minimalist shoes/racing flats suffered injury, as did some of the runners who ran in cushioned shoes.
If you are a heel striker, should you change your gait? Dr. Lieberman: “If you’re not getting hurt, than absolutely not. If it’s not broke, don’t fix it.”
What if you are an injury-prone heel striker? Daoud: “It may be worth considering a change”. Proceed very gradually, as changing your gait will definitely result in increased stress, particularly in your Achilles and calf. Daoud recommends starting with 5 minutes one run per week and gradually progressing to full time forefoot running over the course of several months.
Our take on the issue? Forefoot striking was not the magic bullet. Although the forefoot strikers exhibited fewer injuries than the heel strikers, many of the forefoot strikers still suffered injury. The study classified runners as either heel or forefoot strikers. What about the midfoot strikers?
One important variable not considered in the study was each runner’s running-specific foot and leg strength. As we stated in our July 26, 2011 article Barefoot Running/Minimalist Shoes Decrease Injury Risk – Fact or Myth?, “most running injuries are caused by a lack of running-specific strength (i.e. weakness) in muscles and tendons. They are unable to withstand the stress they are subjected to during training. Your muscles don’t care whether you run barefoot or what type of shoe you wear. They do care and let you know in no uncertain terms if they are too weak and thus have not recovered from the micro-tears that they suffered during previous runs.
If you find yourself frequently injured, the cure comes from within. Strengthen your biomechanical weak links in a running-specific way so that they can withstand the stress and strain of training and support you in reaching your running goals!” A very gradual shift to forefoot or midfoot striking (for heel strikers) in conjunction with a running-specific strengthening program may prove to be most effective.
© 2012 Savvy Runner Inc.
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