Barefoot Running Training Reduces Knee Pain Injuries

We have learned that heel strike running is one of the leading causes of knee pain injuries. But if you take off your shoes and run barefoot, you may not instantly adopt a forefoot strike, but you will instantly begin adopting lower leg motions that protect the knee….even if you run barefoot with a heel strike!

Barefoot Running Reduces Knee Pain Injuries

Barefoot Running Training Reduces Knee Pain Injuries

A study by Hashish et al. 2016 found that heel strike runners with no previous experience with barefoot or minimalist running showed a significant reduction in mechanical work at the knee. Many of these runners adopted a forefoot strike landing (which is the norm when you run barefoot), but the runners that maintained heel strike when running barefoot still showed a 25% reduction in knee mechanical work, suggesting that heel strike mechanics become less pronounced when you run barefoot, which is one of the reasons severe knee injuries is rare in habitual barefoot and minimalist runners.

When you run barefoot, the ankle position is different than if you run in shoes. The difference in ankle posture when running barefoot is what draws mechanical work away from the knee. In their study, the researches found that barefoot running increased ankle plantar-flexion angle at touchdown which caused a shift in mechanical work away from the knee and into the ankle. (See this article on the definition of plantar-flexion at touchdown and why it makes for safer running). The shift in mechanical work from the knee to the ankle however, was less noticeable in the barefoot runners who maintained a heel strike because dorsiflexion angle was higher. See this article on how high ankle dorsiflexion at touchdown is problematic for injury prevention in runners.

This kind of study is important because it shows that there is a cure-all for acute knee injury and severe knee injury in runners and that cure-all is simple: run barefoot more often, especially before you do your regular runs in your shoes because doing so strengthens neuro-muscular reworking (muscle memory) for a better forefoot strike running style that guarantees less knee stress.

Because the heel strike runners did retain some mechanical work at the knee during barefoot running, the researchers strongly encourage runners to use a forefoot strike (shown below) when running barefoot, as well as when running in shoes, to keep loading rates low at the knee.

Knee Pain Injuries Reduced by Running Barefoot

More From Run Forefoot:

Why Running Barefoot Makes You Run Healthier

Outside Knee Pain When Running

Study: Motion Control Running Shoes Don’t Work

Minimalist Shoe for Longer Runs

Reviews and Recommendations on Barefoot Running Books


Hashish et al. Lower limb dynamics vary in shod runners who acutely transition to barefoot running. J Biomech, 2016; 49, 284-288.

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!