Forefoot? Midfoot? Hindfoot? Barefoot? If the terminology confuses you, then join the club. With the recent mainstream popularity of barefoot running comes the daunting task of deciphering what running foot strike patterns are ideal in promoting efficient injury-free running. Current trends in sports and rehabilitation medicine have focused on modifying technique in an effort to prevent, treat, and reduce running injuries. Most of the popular running styles that have emerged promote a forefoot or midfoot-strike pattern. It has been shown that by avoiding a hindfoot-striking pattern (heel striking) and converting to a midfoot or forefoot striking pattern, that we shift the amount of collision force on the leg from the anterior compartment of the leg to a more posterior compartment leg region. A posterior position shift is possibly better equipped to handle such forces. This foot striking pattern change is also hypothesized to decrease impact reaction forces with the ground and may force you to run faster, further, and with less injury. Coaches, camps and courses proclaim to teach the unique edge in foot striking biomechanics that achieve running success. Each may offer something better than the other. But what are the fundamental differences? Evaluating footwear is our first step…or misstep…no pun intended.
Conventional Running Shoes: To cushion or not to cushion the heel…
For many of us, conventional running shoes are all we really know and our foot striking patterns have evolved based on these types of shoes. conventional running shoes are typically pronation controlling with inside arch support and provide general stability. Pronation control prevents the ankle from rolling or collapsing inward; insertable orthotics will also attempt to correct pronation and reduce flattening of the foot’s arch. They are classically disproportionally elevated and cushioned in the heel compared to other parts of the shoe. Thus, many of us have adapted a hindfoot striking pattern because this is where our running footwear cushioning has provided the most comfort and perceived stability. In an effort to eliminate the heel strike running pattern, excessive hindfoot (heel) cushioning and limited forefoot cushioning can be detrimental if attempting to transition to a midfoot or forefoot strike pattern. The answer may be to slowly transition to footwear that prevents the comforts of heel striking and promotes midfoot or forefoot striking.
Defining Hindfoot vs. Midfoot vs. Forefoot striking patterns
Hindfoot striking implies that when we run, initial contact with the ground is made on the heel of the foot. Thus, a midfoot striking pattern means to strike initially on the lateral ball of the foot. Forefoot striking is defined by landing on the ball of the foot before bringing down the heel (toe-heel-toe running). A simple lesson in physics will help answer why these different strike patterns are important.
Ground Reaction Forces: No Physics degree required!
It has been postulated that a hindfoot striking pattern creates the highest ground reaction forces (GRF) and is generally more stressful on the feet and legs. So what is a ground reaction force? A ground reaction force is an important factor in the study of the kinetics (relationship between movements and the forces that cause them) of the lower extremities during contact with the ground. Simply defined, a GRF is a force exerted by the ground in response to the forces your body exerts on it. Generally speaking, the less GRF, the better. By altering our footwear and changing our striking pattern we can decrease the forces generated on us.
Robert Kelly, DO is a sports and pain medicine physician at The Pennsylvania Pain & Spine Institute in Chalfont, PA. He completed his medical training at Harvard. Dr Kelly utilizes the most advanced rejuvenative applications through the most minimally invasive techniques in his approach to helping athletes. His contact info and bio can be found at: www.pennpain.com