A 2012 study published in the Journal of the American College Sports and Medicine compared injury severity in competitive cross-country college runners who were either forefoot strikers, or heel strikers.
The study found that the heel strikers were 2.6 times more likely to have mild injuries, 2.4 times more likely to have moderate injuries, and had an overall injury rate that was nearly 2 times higher than the forefoot strikers. It gets even worse…

The study also compared the nature of injury in the heel strikers and forefoot strikers and found:
- injuries such as hip pain, knee pain, lower back pain, tibial stress injuries, plantar fasciitis, and stress fractures of the lower limb were 2 to 4 times more frequent in the heel strikers than the forefoot strikers.
Initially, the researchers predicted the forefoot strikers to have a higher incidence of Achilles injury and metatarsal stress fractures than the heel strikers. However, the results showed no difference between the two foot strikes.
What Makes Forefoot Striking Safer than Heel Striking?
Mechanically, forefoot striking and heel striking are polar opposites and it is a possibility that the higher incidences of injury in joggers, many of which heel strike, is the peak impact transient force (a force not produced in a forefoot strike).
All runners, heel strikers and forefoot strikers, produce impact at initial ground-contact. However, heel strikers hit the ball way out of the park as they produce an impact 2 to 3 times higher than a forefoot strike landing.
What it all boils down to is the exchange of momentum between the body and the ground is considerably greater in heel strikers than forefoot strikers.
Compelling evidence of this nature provides vital insight for redefining training methodologies to improve athletic performance in competitive runners. You want your runners running with less impact and to win, not sitting on the sidelines icing injuries.
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References:
Daoud at el. (2012). Foot strike and injury rates in endurance runners: a retrospective study.
Bretta Riches
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.
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