Forefoot Running vs Heel Strike Running for Achilles Injury Prevention

What is the best way to run to avoid an Achilles injury: forefoot running vs heel strike running? Unfortunately, past studies on how running may cause Achilles tendon injury is woefully incomplete, until the spot light was shown on the forefoot running technique in terms of its ability to prevent most lower leg injuries.

Best running form to avoid Achilles injury - forefoot running vs heel strike

Forefoot running (shown above) is actually easier on the Achilles tendon because there is less braking, or deceleration impact between the body and the ground. Heel strike running (shown below) however, has more rampant exchanges of impact between the body and the ground which puts consdirable stress on the Achilles tendon.

Forefoot running vs heel strike Achilles tendon injury

Forefoot Running vs Heel Strike Running for Achilles Injury Prevention

A recent study by Lorimer and Hume (2014) reported that high braking forces during running is a strong biomechanical variable for increasing Achilles tendon tear.

High braking is a by-product of heel strike running and is significantly lower, if not abolished in forefoot running.

In heel strike running, a braking force is created because of an upright positioned trunk causes the center of mass (COM) to remain behind initial foot strike position, shown below.

Forefoot Running vs Heel Strike in Preventing Achilles Injury

  • In heel strike running (above), the COM (arrow) remains behind initial foot strike position which causes the body to come to a sudden stop, exerting compression on the Achilles tendon

If the COM is behind initial foot strike position, compression on the Achilles significantly increases; whereas a COM more parallel with initial foot strike position greatly reduces compressive forces, shown below.

Forefoot Running vs Heel Strike Running - Achilles Injury Prevention

  • Braking is reduced in forefoot running because the COM is closer to or parallel with initial foot strike position.

Moreover, a high value of the vertical ground reaction force is loaded under the heel, exposing the Achilles tendon to greater shock than in forefoot running.

The positional discrepancy between the COM and initial foot strike position results in inappropriate loading at heel strike as well as poor shock absorption on the Achilles tendon. The repetitive overload stress associated with heel strike running initiates degenerative changes within the tendon.

The researchers recommended gait retraining by directing the COM further forward to reduce high braking forces. The best way to direct the COM forward is by tilting the body forward coupled with utilizing the forefoot running technique.

How to Avoid Braking

The answer is straightforward: forefoot running.

It is much easier to tilt the body forward by landing on the front part of the foot first rather than the heel.

Forefoot Running vs Heel Strike Running - Achilles Tendon Health

  • To reduce braking in forefoot running, you want to tilt your body relative to the red dashed-line instead of running ‘up right’ as indicated by the white dashed-line (above).

Begin by standing in one place, slightly bend both knees and tilt your body forward to initiate movement.

Never initiate running by lunging out with the leg while maintaining an upright trunk position -this will cause the COM to remain behind foot strike.

The key to reduce braking in forefoot running is by initiating running by tilting the body forward first followed by leg action whereby leg action occurs more behind the body (COM) rather than in front as in heel strike running, shown below.

More on the Benefits of Forefoot Running:


References:

Lormier, AV and Hume, PA. Achilles tendon injury risk factors associated with running. Sports Med, 2014; 44(10):1459-72.

Bretta Riches

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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