Heel strike running causes Achilles injury more so than forefoot running mainly because pronation duration is longer than in forefoot running, allowing more time for unwanted foot movements to occur that increase strain on the Achilles.
How Heel Strike Running Causes Achilles Injury
A systematic review by Tonoli (2011) on running-related injuries found that Achilles tendinopathy was the most common injury in recreational runners, most of which were heel strikers.
Ground contact time is much longer in heel strike running whereby long ground contact time prolongs pronation in heel strikers who over-pronate.
- Smart et al. reported that prolonged pronation produces a whipping action or bowstring effect in the Achilles tendon which may result in micro-tears that may, over time, precipitate tendinosis, or partial, or even a complete rupture of the tendon
Additionally, the researchers suggested that prolonged pronation increases torsional forces on the tibia as the weight passes over the foot, which may cause vascular impairment and degenerative changes to the Achilles tendon.
Ground contact time as well as stance time is lower in forefoot strike running which may limit prolonged pronation thereby relieving tension from the Achilles tendon.
Pronation in running allows the leg to absorb impact. Changes in force at foot strike may also affect pronation.
- forefoot running reduces the peak force related to heel strike running through reflexive actions such as leg stiffness modification
In all, forefoot running may involve other impact absorbing mechanisms which may result in less pronation compared to heel strike running.
However, more work is needed to give us a better understanding of the relationship between foot strike mechanics and Achilles disorders in runners.
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Rodrigues, P., TenBroek, T and Hamill, J. Runners with anterior knee pain use a greater perceptage of their variable pronation range of motion. J Appl Biomech (2013); 29(2):141-6.
Samaan, CD., Rainbow, MJ and Davis, IS. Reduction in ground reaction force variables with instructed barefoot running. Journal of Sport and Health Science (2014); 3(2):143-151.
Willems et al. A prospective study of gait related risk factors for exercise-related lower leg pain. Gait Posture (2006); 23(1):91-8.
BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.