Forefoot Strike Helps Runners Achilles Tendonitis

Runners Achilles tendonitis can be treated, not with rest, and definitely not with icing, but with running with a forefoot strike whereby eccentric loading via the heel dropping phase that occurs just after touchdown helps with the swelling.

The forefoot running technique is essentially a series of heel drops whereby shortly after the forefoot has made initial contact with the ground, the heel drops to the ground last.

The heel drop action in forefoot running is known as a form of heavy-load eccentric tensile loading of the musculo-tendinous units and was found to stimulate tendon healing, allowing for a gradual adaptation to loading during running.

Forefoot Strike Helps Runners Achilles Tendonitis
The heel-lowering phase in forefoot running is an example of eccentric loading which enhances the natural ability of the Achilles tendon to function as a spring as well as reduces scar-tissue formation in runners suffering from Achilles tendinopathy.

Forefoot Strike Helps Runners Achilles Tendonitis

This finding addresses the question whether forefoot running is a risk factor for Achilles injury, when in actuality, it may be a preventative strategy.

In fact, heel drop exercises are commonly used to treat Achilles tendinopathies in heel strike runners and have yielded remarkable results such as boosting elastic behavior of the tendon.

Therefore and theoretically, running on the forefoot with Achilles tendinosis may be therapeutically beneficial as opposed to utilizing standard forms of treatment such as immobilizing the leg or ice therapy which actually slows healing and reduces range of motion of the tendon.

Avoid Heeled Running Shoes

One thing to keep in mind is that wearing running shoes with a raised cushioned heel during forefoot running prevents the full lowering of the heel and thus limits full eccentric loading needed for positive remodeling of the tendon.

Therefore, since heel cushioning of a shoe restricts the natural eccentric lowering of the heel during forefoot running, poor force distribution may be transferred to the Achilles which may exacerbate tendinopathy symptoms.

To ensure adequate, full eccentric loading and thus the lowering of heel, barefoot inspired running shoes must be worn or run completely barefoot when running forefoot.

For more insight on the lowering mechanism of the heel in forefoot running, I always like to use the forefoot running technique of Tirunesh Dibaba as a reference point to demonstrate the proper lowering of the heel.


More from Run Forefoot:


Shang, D. Achilles tendinopathy. Review Article: The Medical Chronacle, 2013.

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

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.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!

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