Why Heel Strike Gait May Not Increase The Risk Of Overuse Injuries In Runners
A recent study presented at the 61st Annual Meeting of the American College of Sports Medicine showed that United States Army personnel who ran with a heel strike pattern did not suffer significantly more overuse injuries than those who ran with a forefoot or midfoot strike pattern.1
In this study, Warr and colleagues evaluated foot strike pattern, training habits and injury incidence in 1,027 soldiers from five different military bases.1 Two clinicians, experienced in musculoskeletal injury, evaluated the soldiers’ self-reported injuries. Using a high-definition video camera, researchers conducted sagittal plane gait analysis to determine the foot-strike pattern and subsequently analyzed the relationships between foot-strike pattern, gender and overuse injury. The majority of soldiers (83 percent) were heel strike runners. While more women than men (27 percent versus 14 percent) reported overuse injuries, there was no significant difference in the injury rate between heel strike runners and non-heel strike runners.
This research challenges the idea that running barefoot or in minimalist shoes causes runners to adopt a forefoot or midfoot strike pattern, and can reduce injury.2 Previous studies have supported the hypothesis that a forefoot or midfoot strike gait could reduce the incidence of overuse injuries, but the number of study participants have been relatively small in these studies. For example, Daoud and coworkers found that runners on the Harvard cross country team showed double the rate of injury if they ran with a heel strike pattern.3 However, this study included only 52 elite runners.
The research presented by Warr and colleagues may be more representative of typical recreational runners. Future, prospective and non-self-reported research is necessary to further determine optimal gait patterns to prevent overuse injuries in runners.
References
1. Warr BF, Frykman P, Shane S, et al. Army running injuries don't correlate to heel-striking. Paper presented at American College of Sports Medicine (ACSM) 61st Annual Meeting, May 30, 2014, Orlando, Fla.
2. Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations. Med Sci Sports Exerc. 1987;19(2):148-156.
3. 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.
