Unlike forefoot running, heel striking causes lower leg pain by increasing intramuscular leg pressures which is the underlying cause of chronic exertional compartment syndrome (CECS).
How Heel Striking Leads to Chronic Muscle Soreness in the Leg
Heel striking generates a greater magnitude of the ground reaction force than forefoot running and new reports have confirmed that reducing the ground reaction force is the first stage of treating CECS .
The novel solution to reduce the ground reaction force when running is to eliminate initial ground contact on the heel . Given that reports of leg pain is common in heel strike runners, the high ground reaction force causes musculoskeletal conditions to respond unfavorably.
How does the ground reaction force in heel strike running interact with the body?
Compelling evidence has found that the magnitude of the ground reaction force causes soft tissue compartments to vibrate at a high frequency that prompts swelling [3,4].
- Increased intramuscular pressure beyond the threshold may be preceded by swelling of soft tissue compartments due to prolonged exposure to high vibrational frequencies produced at heel strike.
Forefoot Running to the Rescue
Study after study has found that heel strike runners who suffered from CECS showed remarkable improvements in symptoms after adopting the forefoot running technique . Why?
Forefoot running not only markedly lowers the ground reaction force, it also eliminates the rapid spike in impact measured in a heel strike landing.
Until recently, there was a disconnect between CECS and foot strike, which is surprising given that the body is immersed with impact when running on the heels. As a result of running this way, pressure periodically builds up inside the leg, rupturing membranes of cells, and shutting down their function, and pain results.
Studies that trained subjects to run with a forefoot strike (under proper instruction) rather than a heel strike, confirms that forefoot running is a powerful tool in eliminating the painful leg condition.
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. Diebal et al. (2011). Effects of forefoot running on chronic exertional compartment syndrome: a case series. Int J Sports Phys Therapy, 6(4):312-21.
. Nigg, BM. Impact forces in running. Current Opinion in Orthopedics (1997); 43-47.
. Friesenbichler B., Stirling, LM., Federolf P and Nigg BM. Tissue vibration in prolonged running. J Biomech(2011);44(1):116-20.
 Wakeling, JM and Nigg, BM and Rozitis, AI. Muscle activity damps the soft tissue resonance that occurs in response to pulsed and continuous vibrations. J of Appli Physio(2002);93(3):1093-1103
. Wakeling JM., Pascual SA and Nigg BM. Altering muscle activity in the lower extremities by running with different shoes. Med Sci Sports Exerc (2002); 34(9):1529-32.
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.