The Center for Podiatric Care and Sports Medicine

Striking the Right Note: Foot Form and Running Injuries

Posted by on Friday, February 10th, 2012


If you’re someone who runs regularly, then you’re gaining a lot of health benefits–improved heart function, lower blood pressure, stronger muscles. You’re also probably injured.

My acupuncturist once estimated to me that about 70% of the people out running every day in the park are dealing with some kind of injury, however large or small (I know, if they’re injured, why are they running? Because runners keep running until they literally can’t move. It’s a special form of idiocy.). Most people shrug, assume it comes with the territory, and just try their best to keep reasonably healthy, whether through stretching, trying out a parade of different shoes, or varying the terrain they run on. However, a recent New York Times article described a study that showed that the amount of injuries a runner suffers is related to the way they use their feet when they run.

“Foot Strike and Injury Rates in Endurance Runners: a retrospective study,” published in Medicine & Science in Sports & Exercise, focused on four years of injury data from members of the men’s and women’s cross country teams at Harvard University. The biomechanics of each runner was examined. Out of fifty-two runners, thirty-six were considered heel strikers, or runners who strike the ground heel first. Sixteen were found to be forefoot strikers, or runners who struck the ground with the ball of their foot first. While 74% of all the runners experienced an injury serious enough to cause them to miss a few at least  a few training sessions, the heel strikers had almost twice as many injuries as the forefoot strikers.

This is significant because, as you may have guessed from the size of the two groups in the study, the majority of runners are heel strikers. It certainly added fuel to the fire about barefoot running versus running in shoes–advocates of barefoot running believe that sneakers encourage people to heel strike, while barefoot running forces people to use a forefoot strike. Many barefoot running advocates have claimed that forefoot striking caused less injuries, but now they can use this as evidence.

However, the study didn’t address barefoot running (or running in minimalistic shoes that mimic barefoot running) versus running in shoes. The runners in the study all wore some kind of shoe of varying types, with many runners switching shoe types often. That means that the study can only support the idea that people who heel strike while running in shoes are more likely to suffer injuries than those who forefoot strike while running in shoes. Nevertheless, barefoot runner cheerleaders are going to feel like this is enough evidence to back them up.

I’ve run every day I can for years and I’ve had my share of injuries, maybe more than my share; some I can run through, others have knocked me out for a while. I try to give myself breaks to avoid injuries, but hate classes at the gym, and am not one of those people who can swim infinitely). I can only do so much before I find myself longing to return to running.

Last fall, I thought about switching to barefoot running style shoes (no barefoot here–I live in New York City and running barefoot here is likely to give you a nice footful of broken glass) so I began to prepare myself by trying to switch from a heel strike to a forefoot strike. It took a lot of concentration, and for a while I could only do it for very short periods of time, until I became frustrated by having to think so much while I was running. The thing that really finally helped me was running up stairs–when you run up stairs, you naturally forefoot strike. When I switch from stairs to a flat surface, though, I’m still not all the way there. I actually forefoot strike consistently on my right foot, but have a lot of trouble not heel striking on my left foot. I feel so unbalanced forefoot striking on my left foot that I’m actually not sure it’s ever going to take.

I’ll keep trying, though. When I do really get in a flow, I feel like I go a lot faster with a shorter stride, and I use different parts of my legs than I do while just heel striking–it makes me kick my knees up higher and the bouncy steps are kind of fun. It’s too early to tell if I’m preventing any injuries at all, but I’ll keep you posted.

Have you tried switching from heel striking to forefoot striking? If so, how did it go? Should you try it? The study doctors advised that people who run on their heels but don’t have many injuries should stick to what their doing, but runners do tend to jump on new trends quickly–anything for an edge.

Of course if you find that you are experiencing a lot of injuries as a runner, you should contact us at the Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.



If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.