Heel Strike Running May Cause Hamstring Injury as Compared with Forefoot Running

One reason heel strike running may be unsustainable from an injury prevention standpoint is that it may cause higher rates of tension and compression on the hamstrings as compared with forefoot running.

In many cases, landing heel-first during running is often accompanied by maximum knee extension (fully unbent knee) at touchdown (shown below). This produces an over-stride which means the initial foot-strike position (i.e the extended leg) is positioned too far ahead of the mass of the body. The major problems with this is 1. the mass of the body collides too intensively with the extended leg at touchdown and 2. the mass of the body collides with the extended leg for a prolonged period of time, too! A consistent consequence of this scenario is that a compressive wave is produced which ripples up the leg, through the hips.


Heel strike running is often associated with over-stride mechanics which causes
the mass of the body to abruptly grind to a crashing halt for an extended period of time at touchdown. This results in higher levels of a collisional force which persists longer in duration because of the long distance separation between the initial foot strike position and the mass of the body as compared with forefoot running.

Even worse, the collisional force, and therefore compressive wave, increases in proportion to speed and body-weight during running. In other words, the faster you run and/or the more you weigh, the greater the intensity and duration of the collisional force and compressive wave when you run with an over-stride coupled with landing heel-first. How can hamstring injury arise out of all this?

For one, a fully extended leg (maximum knee extension) at touchdown during running stretches the hamstrings beyond maximum tension during the phase of running (i.e touchdown phase) associated with the greatest production of impact.


The extent to which heel strike running may be a major risk factor for hamstring pain and injury is that while the foot lands squarely on the heel with a fully unbent knee (over-stride mechanics), directly causes the hamstrings to stretch to become too stained with tension. This all happens under high-impact conditions due to the heavy compressive wave caused by over-stride mechanics, putting even more stress on the hamstrings where hamstrings injury may result.

Multiple lines of research (listed below the article) speculate that this landing configuration under these high-impact conditions during running may easily give rise to a hamstring injury because of the increased amount of time the hamstrings spend in a maximally stretched state. The other concern is the over-stretched hamstrings spend an increased amount of time enduring high impact. As a result, microscopic muscle damage to the hamstrings may easily arise, and hamstring injury can manifest in this one way.

In contrast, the hamstrings may be less vulnerable to pain and injury in forefoot running because landing forefoot-first during running results in a less extended leg, and therefore less knee extension at touchdown (shown below) which in turn contributes to a shorter stride length where over-stride mechanics can be prevented. Because there’s less knee extension at touchdown in forefoot running, the hamstrings are required to stretch less which directly reduces tension on the muscles.

Even better, the reduced stride length in forefoot running accounts for a big reduction in the collisional force, therefore less compressive loads are transmitted to the hamstrings, too! 


Making the conscious effort of landing on the balls of the foot during running causes the knee to slightly bend which effectively reduces stretch force and tension on the hamstrings. Even better, the increased knee-bend at touchdown in forefoot running enables the foot to land closer to the mass of the body, reducing the brake force low enough to avoid a high compressive wave.

Ultimately, these are good reasons forefoot running may bring more help in reducing hamstring injury risk as compared with heel strike running, and is just one of the many great appeals of forefoot running. To that point, there’s a long-list of injuries forefoot running may do a better job at preventing than heel strike running. Read more about it here!

 References:

Goss DL and Gross MT. A review of mechanics and injury trends among various running style. AMEDD, Sept -2012.

Heiderscheit B.C., Hoerth D.M., Chumanov E.S., Swanson S.C., Thelen B.J., Thelen D.G. Identifying the time of occurrence of a hamstring strain injury during treadmill running: a case study. Clin. Biomech. (Bristol., Avon.) 2005;20:1072–1078. doi: 10.1016/j.clinbiomech.2005.07.005

Opar D.A., Williams M.D., Shield A.J. Hamstring strain injuries: Factors that lead to injury and re-injury. Sports Med. 2012;42:209–226. doi: 10.2165/11594800-000000000-00000.

Schache A.G., Kim H.J., Morgan D.L., Pandy M.G. Hamstring muscle forces prior to and immediately following an acute sprinting-related muscle strain injury. Gait Posture. 2010;32:136–140. doi: 10.1016/j.gaitpost.2010.03.006.

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!