Say Bye-Bye to Knee Strain with Forefoot Running

The center of pressure trajectory in the foot in forefoot running is associated with less knee strain.

Knee Strain More Common in Heel Strike Runners

If you are like most runners, you probably heel strike and most likely experienced knee pain at one time. Experts have known for some time that heel strike running is related to higher incidences of knee pain.

Until recently, research has begun to explain the variables associated with heel strike running that play a factor in causing knee pain. One being a center of pressure that begins at the heel while running.

Roos et al. (2012) found that a center of pressure closer to the heel was the primary predictor of increased knee extension moment.

Heel strike runners tend to have greater knee extension moments than forefoot strikers because to allow heel strike, the knee maximally extends. In other words, runners that have the center of pressure localized at the heel at touchdown, are more likely to experience knee pain.

From this, Vannatta and Kernozek (2015) proposed that forefoot running would lead to even greater reductions in knee pain because the center of pressure in a forefoot strike is localized towards the forefoot. Because initial contact occurs on the balls of the foot, the center of pressure resides more anteriorly, away from the heel, in forefoot running.

Center of Pressure in Forefoot Running
In forefoot running, the foot is positioned parallel with the ground upon touchdown, which reflects a small inclination angle of the foot, and helps keep much of the center of pressure away from the heel.

One strategy of which forefoot running directs the center of pressure away from the heel is through a reduced inclination angle of the foot at touchdown (shown above).

A smaller inclination angle of the foot relative to the ground allows a forefoot strike landing to occur with greater ease. This task often requires a zero drop minimalist shoe or running barefoot which serves as a catalyst for averting heel strike at touchdown.

The Take Home Message

Next time you are running, make the habit of monitoring where the center of pressure initially occurs on your foot at touchdown. If it initially occurs at the heel, reframe the trajectory of the center of pressure by striking the ground on your forefoot first. Making this minor correction will have profound effects on knee-joint health and it’s one of the reasons why so many forefoot runners will tell you that they can increase weekly mileage or run on any terrain without knee pain.

More from Run Forefoot:

Why Older Runners Need to Wear Minimalist Shoes – Find out how minimalist running shoes prevent age-related biomechanical impairments in older runners.

The Cause of ITBS – Understand how running shoes that are stiff and inflexible increases a runner’s risk of ITBS.

Expensive Shoes Doesn’t Mean More Protection – A study found that cheaper running shoes were linked to less injury rates than pricier ones.

Protecting Your Joints – Discover how the best joint protection technique for running is to avoid heel strike.

Born to Run…Forefoot? Here I talk about why humans are anatomically suited for forefoot running, and not heel strike running.

Are Heel Strikers Slower? Here I uncover the 2 main reasons that may slow a heel striker down.


Roos PE, Barton N, van Deursen RWM. Patellofemoral joint compression forces in backward and forward running. J Biomech. 2012;45:1656–60.

Vannatta CN and Kernozek TW. Patellofemoral joint stress during running with alterations in foot strike pattern. Med Sci Sports Exerc, 2015;47(5):1001-1008.

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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