Foot strike patterns of recreational and sub-elite runners in a long-distance road race
TL;DR: Rearfoot striking was more common among the authors' sample of mostly recreational distance runners than has been previously reported for samples of faster runners and the frequency of discrete foot strike asymmetry declined from the 10 km to the 32 km location.
Abstract: Although the biomechanical properties of the various types of running foot strike (rearfoot, midfoot, and forefoot) have been studied extensively in the laboratory, only a few studies have attempted to quantify the frequency of running foot strike variants among runners in competitive road races. We classified the left and right foot strike patterns of 936 distance runners, most of whom would be considered of recreational or sub-elite ability, at the 10 km point of a half-marathon/marathon road race. We classified 88.9% of runners at the 10 km point as rearfoot strikers, 3.4% as midfoot strikers, 1.8% as forefoot strikers, and 5.9% of runners exhibited discrete foot strike asymmetry. Rearfoot striking was more common among our sample of mostly recreational distance runners than has been previously reported for samples of faster runners. We also compared foot strike patterns of 286 individual marathon runners between the 10 km and 32 km race locations and observed increased frequency of rearfoot s...
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TL;DR: In this article, a gait analysis was performed on 249 female runners to determine whether runners with high impacts are at greater risk for developing medically diagnosed injuries, and the results showed that impact loading was associated with bony and soft-tissue injuries.
Abstract: Background Running has been critical to human survival. Therefore, the high rate of injuries experienced by modern day runners is puzzling. Landing on the heel, as most modern day shod runners do, results in a distinct vertical impact force that has been shown to be associated with running-related injuries. However, these injury studies were retrospective in nature and do not establish cause and effect. Objective To determine whether runners with high impacts are at greater risk for developing medically diagnosed injuries. Methods 249 female runners underwent a gait analysis to measure vertical instantaneous loading rate, vertical average loading rate (VALR), vertical impact peak (VIP) and peak vertical force. Participants then recorded their mileage and any running-related injuries monthly in a web-based, database programme. Variables were first compared between the entire injured (INJ; n=144) and uninjured (n=105) groups. However, the focus of this study was on those injured runners seeking medical attention (n=103) and those who had never injured (n=21). Results There were no differences between the entire group of injured and uninjured groups. However, all impact-related variables were higher in those with medically diagnosed injuries compared with those who had never been injured. (effect size (ES) 0.4–0.59). When VALR was >66.0 body weight (BW)/s, the odds of being DX_INJ were 2.72 (95% CI 1.0 to 7.4). Impact loading was associated with bony and soft-tissue injuries. Conclusions Vertical average loading rate was lower in female runners classified as ‘never injured’ compared with those who had been injured and sought medical attention.
202 citations
TL;DR: Running barefoot offers no metabolic advantage over running in lightweight, cushioned shoes and for footwear conditions of equal mass, shod running had ∼3%-4% lower V˙O(2) and metabolic power demand than barefoot running (P < 0.05).
Abstract: PURPOSE Based on mass alone, one might intuit that running barefoot would exact a lower metabolic cost than running in shoes. Numerous studies have shown that adding mass to shoes increases submaximal oxygen uptake (V˙O(2)) by approximately 1% per 100 g per shoe. However, only two of the seven studies on the topic have found a statistically significant difference in V˙O(2) between barefoot and shod running. The lack of difference found in these studies suggests that factors other than shoe mass (e.g., barefoot running experience, foot strike pattern, shoe construction) may play important roles in determining the metabolic cost of barefoot versus shod running. Our goal was to quantify the metabolic effects of adding mass to the feet and compare oxygen uptake and metabolic power during barefoot versus shod running while controlling for barefoot running experience, foot strike pattern, and footwear. METHODS Twelve males with substantial barefoot running experience ran at 3.35 m·s with a midfoot strike pattern on a motorized treadmill, both barefoot and in lightweight cushioned shoes (∼150 g per shoe). In additional trials, we attached small lead strips to each foot/shoe (∼150, ∼300, and ∼450 g). For each condition, we measured the subjects' rates of oxygen consumption and carbon dioxide production and calculated metabolic power. RESULTS V˙O(2) increased by approximately 1% for each 100 g added per foot, whether barefoot or shod (P < 0.001). However, barefoot and shod running did not significantly differ in V˙O(2) or metabolic power. A consequence of these two findings was that for footwear conditions of equal mass, shod running had ∼3%-4% lower V˙O(2) and metabolic power demand than barefoot running (P < 0.05). CONCLUSIONS Running barefoot offers no metabolic advantage over running in lightweight, cushioned shoes.
196 citations
TL;DR: There are differences in kinematic and kinetic characteristics between foot-strike patterns when running and Clinicians should be aware of these characteristics to help in the management of running injuries and advice on training.
Abstract: Study Design Systematic review with meta-analysis. Objectives To determine the biomechanical differences between foot-strike patterns used when running. Background Strike patterns during running have received attention in the recent literature due to their potential mechanical differences and associated injury risks. Methods Electronic databases (MEDLINE, Embase, LILACS, SciELO, and SPORTDiscus) were searched through July 2014. Studies (cross-sectional, case-control, prospective, and retrospective) comparing the biomechanical characteristics of foot-strike patterns during running in distance runners at least 18 years of age were included in this review. Two independent reviewers evaluated the risk of bias. A meta-analysis with a random-effects model was used to combine the data from the included studies. Results Sixteen studies were included in the final analysis. In the meta-analyses of kinematic variables, significant differences between forefoot and rearfoot strikers were found for foot and knee angle ...
149 citations
TL;DR: The current commentary discusses management and prevention of BSIs in runners and information is provided on the pathophysiology, epidemiology, risk factors, clinical diagnosis, and classification of BSI.
Abstract: Synopsis Bone stress injury (BSI) represents the inability of bone to withstand repetitive loading, which results in structural fatigue and localized bone pain and tenderness. A BSI occurs along a pathology continuum that begins with a stress reaction, which can progress to a stress fracture and, ultimately, a complete bone fracture. Bone stress injuries are a source of concern in long-distance runners, not only because of their frequency and the morbidity they cause but also because of their tendency to recur. While most BSIs readily heal following a period of modified loading and a progressive return to running activities, the high recurrence rate of BSIs signals a need to address their underlying causative factors. A BSI results from disruption of the homeostasis between microdamage formation and its removal. Microdamage accumulation and subsequent risk for development of a BSI are related both to the load applied to a bone and to the ability of the bone to resist load. The former is more amenable to i...
144 citations
TL;DR: This study compared Achilles tendon loading parameters during barefoot running among females with different foot strike patterns using open-source computer muscle modeling software to provide dynamic simulations of running to show that peak Achilles tendon force occurred earlier in stance phase, which contributed to a 15% increase in average Achilles tendonloading rate among participants adopting a NRFS pattern.
Abstract: In this study we compared Achilles tendon loading parameters during barefoot running among females with different foot strike patterns using open-source computer muscle modeling software to provide dynamic simulations of running. Muscle forces of the gastrocnemius and soleus were estimated from experimental data collected in a motion capture laboratory during barefoot running for 11 runners utilizing a rearfoot strike (RFS) and 8 runners utilizing a non-RFS (NRFS) pattern. Our results show that peak Achilles tendon force occurred earlier in stance phase (p = 0.007), which contributed to a 15% increase in average Achilles tendon loading rate among participants adopting a NRFS pattern (p = 0.06). Stance time, step length, and the estimated number of steps per mile were similar between groups. However, runners with a NRFS pattern experienced 11% greater Achilles tendon impulse each step (p = 0.05) and nearly significantly greater Achilles tendon impulse per mile run (p = 0.06). This difference equates to an additional 47.7 body weights for each mile run with a NRFS pattern. Runners considering a NRFS pattern may want to account for these novel stressors and adapt training programs accordingly.
134 citations
References
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TL;DR: Kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers, and this difference results primarily from a more plantarflexed foot at landing and more ankle compliance during impact, decreasing the effective mass of the body that collides with the ground.
Abstract: Humans have engaged in endurance running for millions of years, but the modern running shoe was not invented until the 1970s. For most of human evolutionary history, runners were either barefoot or wore minimal footwear such as sandals or moccasins with smaller heels and little cushioning relative to modern running shoes. We wondered how runners coped with the impact caused by the foot colliding with the ground before the invention of the modern shoe. Here we show that habitually barefoot endurance runners often land on the fore-foot (fore-foot strike) before bringing down the heel, but they sometimes land with a flat foot (mid-foot strike) or, less often, on the heel (rear-foot strike). In contrast, habitually shod runners mostly rear-foot strike, facilitated by the elevated and cushioned heel of the modern running shoe. Kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers. This difference results primarily from a more plantarflexed foot at landing and more ankle compliance during impact, decreasing the effective mass of the body that collides with the ground. Fore-foot- and mid-foot-strike gaits were probably more common when humans ran barefoot or in minimal shoes, and may protect the feet and lower limbs from some of the impact-related injuries now experienced by a high percentage of runners.
1,261 citations
"Foot strike patterns of recreationa..." refers background in this paper
..., 2007; Walter, Hart, McIntosh, & Sutton, 1989), the potential influence of footwear (or lack thereof) on the kinematics and kinetics of running gait (De Wit et al., 2000; Divert et al., 2005; Hamill, Russell, Gruber, & Miller, 2011; Lieberman et al., 2010; Logan et al., 2010; Nigg, Bahlsen, Luethi, & Stokes, 1987; Reinschmidt & Nigg, 1995; Squadrone & Gallozi, 2009; Stacoff, Denoth, Kälin, & Stüssi, 1988; Stacoff et al., 2001), and the potential relationship between kinematic and/or kinetic variables and injury in runners (Hreljac, 2004; Hreljac, Marshall, & Hume, 2000; Milner, Ferber, Pollard, Hamill, & Davis, 2006; Oakley & Pratt, 1988; Pohl, Hamill, & Davis, 2009; Williams et al....
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...…& Ziff, 1987; Williams, McClay, & Manal, 2000), and recent research has begun to elucidate the relationship between footwear (or lack thereof) and the foot strike (De Wit, De Clercq, & Aerts, 2000; Divert, Mornieux, Baur, Mayer, & Belli, 2005; Lieberman et al., 2010; Squadrone & Gallozi, 2009)....
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...A number of studies have compared the kinetic and kinematic properties, as well as the relative metabolic efficiency, of these various foot strike patterns during running (Ardigo, Lafortuna, Minetti, Mongnoni, & Saibene, 1995; Arendse et al., 2004; Cavanagh & Lafortune, 1980; Laughton, McClay-Davis, & Hamill, 2003; Lieberman et al., 2010; Munro, Miller, & Fuglevand, 1987; Nilsson & Thorstensson, 1989; Stackhouse, Davis, & Hamill, 2004; Williams, Cavanagh, & Ziff, 1987; Williams, McClay, & Manal, 2000), and recent research has begun to elucidate the relationship between footwear (or lack thereof) and the foot strike (De Wit, De Clercq, & Aerts, 2000; Divert, Mornieux, Baur, Mayer, & Belli, 2005; Lieberman et al....
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..., 2010; Munro, Miller, & Fuglevand, 1987; Nilsson & Thorstensson, 1989; Stackhouse, Davis, & Hamill, 2004; Williams, Cavanagh, & Ziff, 1987; Williams, McClay, & Manal, 2000), and recent research has begun to elucidate the relationship between footwear (or lack thereof) and the foot strike (De Wit, De Clercq, & Aerts, 2000; Divert, Mornieux, Baur, Mayer, & Belli, 2005; Lieberman et al., 2010; Squadrone & Gallozi, 2009)....
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...…(Ardigo, Lafortuna, Minetti, Mongnoni, & Saibene, 1995; Arendse et al., 2004; Cavanagh & Lafortune, 1980; Laughton, McClay-Davis, & Hamill, 2003; Lieberman et al., 2010; Munro, Miller, & Fuglevand, 1987; Nilsson & Thorstensson, 1989; Stackhouse, Davis, & Hamill, 2004; Williams, Cavanagh, &…...
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TL;DR: There was strong evidence that a long training distance per week in male runners and a history of previous injuries were risk factors for injuries, and that an increase in trainingdistance per week was a protective factor for knee injuries.
Abstract: The purpose of this study was to present a systematic overview of published reports on the incidence and associated potential risk factors of lower extremity running injuries in long distance runners. An electronic database search was conducted using the PubMed-Medline database. Two observers independently assessed the quality of the studies and a best evidence synthesis was used to summarise the results. The incidence of lower extremity running injuries ranged from 19.4% to 79.3%. The predominant site of these injuries was the knee. There was strong evidence that a long training distance per week in male runners and a history of previous injuries were risk factors for injuries, and that an increase in training distance per week was a protective factor for knee injuries.
1,243 citations
"Foot strike patterns of recreationa..." refers background in this paper
...Williams et al. (2000) suggested that forefoot striking places a heavier eccentric load on the ankle joint and calf muscles during running, and we would thus speculate that fatigue in the triceps surae complex in the lower leg might have caused these runners to shift their gait late in the race....
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...Relating to the topic of fatigue, Willson and Kernozek (1999) reported decreased loading of the heel in fatigued treadmill runners and suggested that adoption of a midfoot landing strategy might explain this, although they did not report kinematic data....
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...In any case, given the continuing high incidence of overuse injuries in runners (Hreljac, 2004; van Gent et al., 2007; Walter, Hart, McIntosh, & Sutton, 1989), the potential influence of footwear (or lack thereof) on the kinematics and kinetics of running gait (De Wit et al., 2000; Divert et al.,…...
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TL;DR: Ground reaction forces and center of pressure (C of P) patterns were studied in 17 subjects running at 4.5 ms −1 and the implications in the areas of running mechanics, shoe design and sports injury are discussed.
1,179 citations
"Foot strike patterns of recreationa..." refers background in this paper
...For example, Cavanagh and LaFortune (1980) observed a continuum of initial foot–ground contact points along nearly the entire posterior 60% of shoe length in runners that they examined....
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...…efficiency, of these various foot strike patterns during running (Ardigo, Lafortuna, Minetti, Mongnoni, & Saibene, 1995; Arendse et al., 2004; Cavanagh & Lafortune, 1980; Laughton, McClay-Davis, & Hamill, 2003; Lieberman et al., 2010; Munro, Miller, & Fuglevand, 1987; Nilsson & Thorstensson,…...
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TL;DR: Data indicate that a history of TSF in runners is associated with increases in dynamic loading-related variables and the magnitude of tibial shock predicted group membership successfully in 70% of cases.
Abstract: MILNER, C. E., R. FERBER, C. D. POLLARD, J. HAMILL, and I. S. DAVIS. Biomechanical Factors Associated with Tibial Stress Fracture in Female Runners. Med. Sci. Sports Exerc., Vol. 38, No. 2, pp. 323–328, 2006. Purpose: Tibial stress fractures (TSF) are among the most serious running injuries, typically requiring 6–8 wk for recovery. This cross-sectional study was conducted to determine whether differences in structure and running mechanics exist between trained distance runners with a history of prior TSF and those who have never sustained a fracture. Methods: Female runners with a rearfoot strike pattern, aged between 18 and 45 yr and running at least 32 kmIwk j1 , were recruited for this study. Participants in the study were 20 subjects with a history of TSF and 20 ageand mileage-matched control subjects with no previous lower extremity bony injuries. Kinematic and kinetic data were collected during overground running at 3.7 mIs j1 using a six-camera motion capture system, force platform, and accelerometer. Variables of interest were vertical impact peak, instantaneous and average vertical loading rates, instantaneous and average loading rates during braking, knee flexion excursion, ankle and knee stiffness, and peak tibial shock. Tibial varum was measured in standing. Tibial area moment of inertia was calculated from tibial x-ray studies for a subset of runners. Results: The TSF group had significantly greater instantaneous and average vertical loading rates and tibial shock than the control group. The magnitude of tibial shock predicted group membership successfully in 70% of cases. Conclusion: These data indicate that a history of TSF in runners is associated with
724 citations
TL;DR: There is a change with speed in the complex interaction between vertical and horizontal forces needed for propulsion and equilibrium during human locomotion in walking and running.
Abstract: In this study the variation in ground reaction force parameters was investigated with respect to adaptations to speed and mode of progression, and to type of foot-strike. Twelve healthy male subjects were studied during walking (1.0-3.0 m s-1) and running (1.5-6.0 m s-1). The subjects were selected with respect to foot-strike pattern during running. Six subjects were classified as rearfoot strikers and six as forefoot strikers. Constant speeds were accomplished by pacer lights beside an indoor straightway and controlled by means of a photo-electronic device. The vertical, anteroposterior and mediolateral force components were recorded with a force platform. Computer software was used to calculate durations, amplitudes and impulses of the reaction forces. The amplitudes were normalized with respect to body weight (b.w.). Increased speed was accompanied by shorter force periods and larger peak forces. The peak amplitude of the vertical reaction force in walking and running increased with speed from approximately 1.0 to 1.5 b.w. and 2.0 to 2.9 b.w. respectively. The anteroposterior peak force and mediolateral peak-to-peak force increased about 2 times with speed in walking and about 2-4 times in running (the absolute values were on average about 10 times smaller than the vertical). The transition from walking to running resulted in a shorter support phase duration and a change in the shape of the vertical reaction force curve. The vertical peak force increased whereas the vertical impulse and the anteroposterior impulses and peak forces decreased. In running the vertical force showed an impact peak at touch-down among the rearfoot strikers but generally not among the forefoot strikers. The first mediolateral force peak was laterally directed (as in walking) for the rearfoot strikers but medially for the forefoot strikers. Thus, there is a change with speed in the complex interaction between vertical and horizontal forces needed for propulsion and equilibrium during human locomotion. The differences present between walking and running are consequences of fundamental differences in motor strategies between the two major forms of human progression.
598 citations
Additional excerpts
...…Arendse et al., 2004; Cavanagh & Lafortune, 1980; Laughton, McClay-Davis, & Hamill, 2003; Lieberman et al., 2010; Munro, Miller, & Fuglevand, 1987; Nilsson & Thorstensson, 1989; Stackhouse, Davis, & Hamill, 2004; Williams, Cavanagh, & Ziff, 1987; Williams, McClay, & Manal, 2000), and recent…...
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