Forefoot Running May Prevent Tibial Fracture as Compared with Heel Strike Running

Many studies have demonstrated that forefoot running correlates with less impact stress on the shins because landing forefoot-first during running has the direct effect of vertically aligning the shin at touchdown which may help protect the shins from opposing forces, such as tibial acceleration in the vertical and anteroposterior (front and back) directions [1].

Even better, past reports have shown that high power tibial acceleration frequencies –a risk factor for tibial fracture – were lower in forefoot running than in heel strike running [2].

Forefoot Running May Prevent Tibial Fracture as Compared with Heel Strike Running
When you land towards the front of your foot (forefoot strike) during running, doing so instantly aligns a more vertical tibia upon and at touchdown which was found to help bring down the impact forces blamed for tibia fracture.

What is more, another study found that landing with a forefoot strike during running prompted sharp increases in pre-activations of the calf musculature which was directly related to greater shock attenuation (i.e. reduced shock) on the tibia which in turn led to a lesser fraction of tibial shock absorption as compared with heel strike running [1]. In other words, the calves may play more of an active role in drawing impact away from the shin bone in forefoot running than in heel strike running.

Last but not least, forefoot running may provide another layer of impact protection on the shins because forefoot striking while running engages a more compliant ankle-joint at ground-contact which holds the foot more stable while tamping down impact shock on the tibia [4].

By these measures, forefoot running may be hugely significant in the prevention of not only a tibial fracture, but other lower leg injuries such as shin splints and CECS.

In contrast, heel strike running appears to put the shin under stronger pressure at touchdown because striking heel-first while running tilts the tibia away from the upper body, or the center of mass (shown below) which causes the center of mass to crash head-on with the stance leg [3]. In this way, tibial shock and anteroposterior axis accelerations may increase to exceed normal which may cause the shins to dangerously overheat and become more vulnerable to pain and injury [4]. 

Forefoot Running May Prevent Tibial Fracture as Compared with Heel Strike Running
Forefoot striking during running (right) aligns the tibia more vertically at touchdown which was found to be most relevant in reducing impact shock accelerations on multiple sites of the shin as compared with heel striking during running (left) which involves a tilted position of the tibia at touchdown. Although the differing tibial positions between the two foot strike patterns at touchdown may look subtle, minor deviations from a vertical alignment of the tibia at touchdown when running results in high impact forces that can lead to tibia fracture. Knowing this has important implications for how we think about foot strike pattern in running in that forefoot running has consistently been found to do more to significantly limit mechanical stress on the lower leg as compared with heel strike running.

If you’ve enjoyed this article, you’ll love my content over at my YouTube channel, here, where I discuss more on the performance and injury prevention benefits of forefoot running vs heel strike running. 


References:

[1].  Giandolini et al. Foot strike pattern and impact continuous measurements during a trail running race: proof of concept in a world-class athlete. Footwear Sci, 2015; 7(2):127-137.

[2]. Gruber, A.H., Boyer, K.A., Derrick, T.R., & Hamill, J. (2014). Impact shock frequency components and attenuation in rearfoot and forefoot running. Journal of Sport and Health Science

[3]. Giandolini, M., Arnal, P.J., Millet, G.Y., Peyrot, N., Samozino, P., Dubois, B., & Morin, J.B. (2013). Impact reduction during running: Efficiency of simple acute interventions in recreational runners. European Journal of Applied Physiology, 113(3), 599 -609.

[4]. Lieberman, D.E., Venkadesan, M., Werbel, W.A., Daoud, A.I., D’Andrea, S., Davis, I.S., . . . Pitsiladis, Y. (2010). Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature, 463(7280), 531-535.

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!