 Rearfoot, midfoot, forefoot - oh my! The foot strike biomechanics debate remains a hot topic in the clinical and running world. Which is more efficient? Which decreases injury? Which correlates with certain shoe types? Are shoes BAD? Should I change my gait? Is that even possible? Shouldn’t we just run the way we’ve always been running?! Running used to be so simple!!! Here’s the thing, there’s no “one-size fits all” answer. If you are to purposefully assess whether you or a patient/client needs to address their foot strike patterns you mustn’t lose sight of the patient’s individual presentation and needs. I will not tell you what is the “best” way to land when you run unless I see and know who it is we are referring to. Quite frankly, neither will the research. Or a trip to an elite track meet. As with all things it is up to you, the clinician, to put the pieces together. My intention with this article is not to give a full breakdown of the hundreds of possibilities of what changes to enact. We can all agree that we must consider static, dynamic, internal and external factors about the runner in question when making decisions. I simply aim to remind you TO look for these things and to consider that all bodies are not created equal.  The purpose of running is to move your body forward using the least amount of energy to do so. Ask a person to sprint as fast as they can and you’ll see their body’s best attempt at efficiency. Sprinting cleans up your mechanics; you can’t reach your top speed by landing on your heels. Sprinting form (mid or forefoot striking) you might say is, efficient form. But it’s efficient for sprinting. Most people are recreational runners, people who are running and racing distances of 5k or greater, many of them up to the marathon distance. For a population of people who are averaging somewhere in the range of 8:00-10:00 minute miles (I said averaging!), the notion of efficiency is different. As Tom Michaud says, “the various biomechanical factors for maximizing speed and metabolic efficiency are often mutually exclusive since sprinters make terrible long distance runners and long distance runners often terrible sprinters.” In general, landing on the ground close to your center of mass (under or slightly in front of your hips) decreases the likelihood that you’ll induce a breaking effect with every stride and have to work to overcome that lost momentum. But what about foot strike? Poor foot strike in the general population could be one of the culprits for recurring injury and an indication for making a change. However, it could also mean that inducing a change in foot strike could lead to new injury. In individuals who have recurring knee pain with their running and are not effectively using their posterior chain, teaching some new mechanics may be beneficial in balancing the workload of running so that all key-player muscle groups are pulling their weight. But can we be effective in these principles of mechanics if we heel strike? Is it possible to have a variation in the way runners contact the ground and still have consistency in their performance and injury rate? For many of us, running 200m all-out barely mimics the speed at which elite runners can maintain over distance of 26 miles! We can’t neglect the pace of a given run when determining what an efficient foot strike is going to look like. In addition to this, elite runners usually have near-perfect anatomy, especially of the lower limb. That is why they are elite. For a a person whose anatomy is not perfectly built to run fast for long distances, making changes to their biomechanics must be done gradually and with a watchful eye. If you try to teach someone who is injury-prone to completely change the way they land this can almost certainly lead to injury. A change in foot strike requires changes in joint mobility, muscular activation and strength, tendon elasticity, neurological control. All of these things take time. Think carefully about what change you are trying to induce and why. Be intentional about giving your patient appropriate strengthening and stretching exercises to support this change. But you would imagine that if we were to look for an ideal foot strike and if efficiency and performance are the key outcome indicators for how ideal it is then we should look to the population who is the best at their craft. Dr. Ian Hunter, professor of biomechanics of sport and exercise at BYU, traveled to the 2012 Track and Field Olympic Trials and took a series of pictures that allow us to try and glean some information on this subject. On lap 4 of both the mens and women 10,000m run he took snapshots of the foot strike of the left and right foot of each participant. There is also video footage of this data collection. (*Thank you Dr. Hunter for allowing the citation of your study in this article!)
 You will notice that even at the elite level in athletes who are at the top of the ladder in terms of efficiency and performance in their craft (in this case, the 10k) the foot strike patterns vary tremendously. There must be more to the story than simply how one’s foot comes in contact with the ground. I think the applicable takeaway for anyone just trying to stay healthy and get a little better at running is rather simple. It’s all about improving your athleticism and efficiency in your movement. We are not anatomically identical so our “ideal” foot strike will not be identical. I find with my clients that foot strike and mechanics are most effectively altered when properly taught as part of a series of dynamic warmup drills. This frequent, repetitive, efficient movements that work to engage your neuro-muscular-skeletal system in an athletic way will lead to the most desirable and effective changes. With deliberate practice at improving your efficiency of movement with these drills, you may ultimately still heel strike with the best of them when you take to the streets for your run but the right pathways will be firing. You will be smoother and lighter on your feet. This will make you more efficient. It will probably make you faster. You will likely get hurt less. This is what we care about in the end. Have questions about what drills I use to teach improved mechanics and movement patterns for runners? Shoot me an email at [email protected] or call us at 650-690-2120 to schedule a consultation.
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