Heel Injuries from Running

Heel injuries from running are mainly from heel striking as this style of running reduces blood flow in the heel pad, which may contribute to outside heel pain or bottom of foot heel pain.

Heel Injuries from Running

Heel Injuries From Running

New evidence confirms that the heel pad is not durable enough to dampen the ground reaction force at heel strike (De Clercq  et al), and a cushioned heeled running shoe is not fully effective at damping the force either.

The heel pad is capable of dampening minor impact associated with walking, however peak impact at heel strike when running, especially at faster speeds, reduces blood flow in the heel pad, resulting in inadequate impact absorption.

Severe Heel Pain While RunningFor instance, Weijers et al. discovered that the venous plexus (a shock absorber in the heel pad) deformed in long distance runners who were heel strikers:

  • venous congestion remained normal during walking, but decreased during heel strike running
  • heel strike runners showed decreased venous congestion of the venous plexus, indicating a loss of hydro-mechanical shock absorption in the heel pad
  • because dampening properties of a system is related to the rate of deformation, the reduced dampening effect of the heel pad suggested a higher rate of deformation
  • dampening effect of the heel pad venous plexus was no longer observed at faster speeds during heel strike running

What is more, the study found that heel strike running reduced venous congestion —heel pad venous congestion refers to the over-filling of the blood which serves to dampen impact when walking — caused the ground reaction force at heel strike to penetrate through the heel pad and up the tibia. As a consequence, heel strike running led to greater peak transient tibial deceleration.

No Luck with Running Shoes

The magnitude of the vertical ground reaction force at heel strike is so great that a cushioned heeled running shoe dampens this force by only 10%.

  • Paradoxically, heel cushion allows heel strike to feel comfortable when running, however this perception of comfort does not match the physical reality of how heel strike related-impacts interact with the body.

The good news is, these high magnitudes of impact as well as damaging heel pad pressures can be eliminated with forefoot running.


More From Run Forefoot:

Forefoot Running – Boosts performance and have faster recovery after hard running sessions.

Running Form – Comparing the biomechanical differences between a heel strike and forefoot strike landing.

Lower Leg Injury – Find out how forefoot running prevents lower leg injury.

Heel Striking – Increases stress response in the body and is one good way to get injured.


De Clercq D., Aerts P, Kunnen M. The mechanical characteristics of the human heel pad during foot strike in running: an in vivo cineradiographic studyJ Biomech (1994); 27(10):1213-22.

Wearin et al.  Force-deformation properties of the human heel pad during barefoot walking. Med Sci Sports Exerc (2014); 46(8):1588-94.

Weijers RE., Kessels AG and Kemerink GJ. The damping properties of the venous plexus of the heel region of the foot during simulated heel strike. J Biomech (2005); 38(12):2423-30


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

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