How to Fix Hip Pain From Running

In running, landing with a forefoot strike, not a heel strike, is central to preventing hip pain. This is because heel strike running was found to burden the hips with significantly more impact loads to the hips.

Why Heel Strike Running is Bad for High Arches
Landing heel-first when running not only produces more rigid landings, it was also found to cause inappropriate joint loading on the hips of which there’s little indication that shoe cushioning is a quick fix for preventing the impact that causes hip injury too!

Two pioneering studies in the journal of Medicine and Science in Sports and Exercise  and in the Journal of Biomechanics, confirmed and re-affirmed that  heel strike running is a major contributing factor to hip pain because of  knee extension at touchdown (shown below). In this scenario, the knee extensor muscles are unable to absorb shock when the knee is maximally extended at touchdown, which results in greater reliance or overload of passive mechanisms in the hip.

Why Heel Strike Running is Bad for Your Legs

Conversely,  data supporting forefoot running as the anecdote to hip pain came from the Journal of Applied Biomechanics which found that hip problems are proven to be solvable by forefoot striking because at touchdown, knee flexion is naturally greater, which shifts shock absorption from passive areas, such as the hips, to muscular contractions in the calf musculature.

How Do I Fix my IT Band Syndrome Fast? Land Forefoot-First, NOT Heel-First!
When you land on your forefoot (the balls of the foot, not the toes), your knee automatically bends too, which has an enormous protective value, not just on the hips, but the shins, knees and lower back.  All the evidence has verified that when you land with a forefoot strike and the bends at landing, stride length shortens, therefore an over-stride is prevented, while step-rate increases, meaning the foot spends less time on the ground, leaving less time for things to go wrong. These mechanics form the foundation to prevent exponential impact production across the entire body.

Another way forefoot running reduces overloading on the hip is through higher stride cadence. One study reported that minimalist shoes and barefoot running improved lower leg mechanics by encouraging a forefoot strike which is associated with greater efficiency, partly because stride cadence is higher [4]. Another study also found that a 5% to 10% increase in stride cadence reduced loading on the hip, suggesting that forefoot running promotes a safer landings that are more ‘hip-friendly’ than heel strike running.

The Take Home Message

Heel strike running is a  proximate cause of hip injury, since maximum knee extension and low stride cadence are the two main factors that shape the risk of hip injuries.

Conversely, forefoot running is not meant to hurt the body since humans evolved for it. Because forefoot running exclusively reduces knee extension and increases stride cadence, it therefore works best to reduce injuries at the hip.

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.

The Neuroscience of Running….Barefoot – An overview of how barefoot running boosts motor coordination patterns in the brain, helping you run with better mechanics.

Shoes for Forefoot Strikers – Read about the barefoot-inspired running shoes that help avoid heel strike.


References:

[1]. Derrick TR, Hamill J, Caldwell GE. Energy Absorption of Impacts During Running at Various Stride Lengths. Med Sci Sports Exerc. 1998; 30(1):128-135.

[2]. Voloshin A and Wosk J. An in Vivo Study of Low Back Pain and Shock Absorption in the Human Locomotor System. J Biomech. 1982; 15(1):21-27.

[3]. Edwards WB, Derrick TR, Hamill J. Musculoskeletal Attenuation of Impact Shock in Response to Knee Angle Manipulation. J App Biomech. In Press.

[4]. Gillonov et al. Effect of minimalist footwear on running efficiency: a randomized crossover trial. Sports Health, 2015;7(3):256-260.

[5]. Heiderscheit BC, Chumanov ES, Michalski MP, Wille CM, Ryan MB. Effects of step rate manipulation on joint mechanics during running. Med Sci Sports Exerc. 2011;43:296-302.

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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