Heel Strikers and Forefoot Strikers: No Difference in Achilles Tendon Properties

A new study found that heel strikers and forefoot strikers showed no difference in Achilles tendon properties.  This finding casts doubts on whether forefoot running is a higher risk factor for Achilles injury than heel strike running.

Higher Demands of Achilles Tendon in Forefoot Strikers

Many experts believe that forefoot running requires more work from the Achilles tendon. Why?
No difference in Achilles tendon property in heel strikers and forefoot strikers

Forefoot running utilizes greater storage and release of elastic energy from the Achilles whereas heel striking involves less elasticity use and more muscular effort from the leg.

In a sense, the lack of elastic contributions of the Achilles tendon in heel strike running is a crucial link to Achilles injury in heel strike runners who switch to forefoot running.

However, a recent study by Kubo et al., compared the properties of the Achilles tendon based on stiffness, maximal strain, and cross-sectional area in highly trained long distance runners who were either forefoot strikers or heel strikers and found no significant differences in these properties.

Because forefoot running requires greater demands of the Achilles tendon, the researchers expected the forefoot strikers to have larger and more stiff Achilles tendons compared to the heel strike runners, but differences in the tendon’s property was not found.

So, if the properties of the Achilles tendon are the same among elite heel strike and forefoot strike distance runners, why do many heel strikers suffer from Achilles pain and injury when transitioning to forefoot running?

The best explanation is most forefoot running learners are not elite runners and may have poorly conditioned Achilles tendons. Or, an even better explanation would be that forefoot running learners unfavorably transitioned and develop a foot strike that is either up on the toes, or the heel never makes contact with the ground, or both.

Adopting a flatter foot strike placement, as in a proper forefoot strike, would offset the risk of Achilles injury. And, it doesn’t help that forefoot running is often referred to as toe-running which is woefully misleading as the toes do not make initial contact with the ground in a proper forefoot strike.

The Take Home Message

The best formula for preventing Achilles injury when transitioning from heel strike to forefoot strike running is to remember that 1. A forefoot strike landing is a much flatter foot placement than you think as shown below, 2. makes sure the heel is the last part of the foot to contact the ground.

Forefoot strike is a much flatter foot placement
A proper forefoot strike is one that is flatter with the ground which removes burden on the Achilles tendon.

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References:

Hasegawa et al., Foot strike patterns of runners at the 15-km point during an elite-level half marathon. Journal of Strength and Conditioning Research, 21, 888-893.

Hayes, P and Caplan, N. Foot strike patterns and ground contact times during high-calibre middle-distance races. J Sports Sci, 30, 1275-1283.

Kubo et al., Relationship between Achilles tendon properties and foot strike patterns in long distance runners. J Sports Sci, 2014; 10:1-5.

Larson et al., Foot strike patterns of recreational runners and sub-elite runners in a long distance road race. J Sports Sci, 2011, 1665-1673.

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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