Preventing Common Knee Ligament Injuries While Running

Want to dramatically improve your knee-joint health without spending a fortune on knee braces, supplements or physical therapy? Don’t heel strike when you run!

How to Prevent Common Knee Ligament Injuries When Running

Runners who heel strike are at greater risk of common knee ligament injuries than other running styles with a more anterior foot strike pattern.

The best solution to reduce knee pain when running is to avoid heel strike, and land more on the forefoot, like most elite runners.

Preventing Common Knee Ligament Injuries While Running

Accumulating data has demonstrated that the magnitude of mechanical forces in heel striking has deleterious effects on the knee, resulting in pain and tissue degeneration.

  • In heel strike running, the knee extends at touchdown, which raises tension at the knee-joint.

Other studies have found that heel striking increases angular work on the knee, resulting in greater patellofemoral and tibiofemoral compressive forces.

Forefoot running reduces the compressive force that contributes to runners knee. How? Because knee extension is dramatically reduced at forefoot strike, thereby over-striding is prevented.

Forefoot running reduces over-striding by allowing the ankle to be in-line with the knee via increased knee flexion at touchdown. In heel strike running, the ankle lands in front of the knee at touchdown.

Forefoot Running Ends Serious Knee Pain
In forefoot running, both knees are kept slightly bent rather than fully extended as in heel striking. Softly bending the knee at foot strike, reducing tension and joint compression on the knee.
  • Reduced over-striding has been implicated in eliminating the impact transient and compressive force in forefoot running.

Most forefoot strikers also have a higher stride frequency than many heel strikers, which reduces impact magnitude and duration.

  • Increased stride frequency has been associated with reduced knee loading
  • Less eccentric angular work at the knee reduced patellofemoral and tibiofemoral compressive forces in forefoot strikers as compared with heel strikers.

The Take Home Message

The mechanics of heel striking causes the knee to be sensitive to injury. Some researchers believe that if a runner has a history of knee injury, or knee osteoarthritis, adopting a forefoot strike diminishes mechanical stress and loading on the knee, thereby improving symptoms of runners knee.

Run Forefoot Because You are Faster than You Think!

More on Heel Striking:

Heel Strike Running Deforms Heel Pad

Heel Strike-Impact Force Linked to Stress Fractures

Heel Striking Causes Lower Back Pain

Heel Striking Increases Soft Tissue Vibrations 


Arendse et al., Reduced eccentric loading of the knee with pose running method. Med Sci Sports Exerc, 2004; 36(2):272-7.

Braunstein et al., Footwear affects the gearing of the ankle and knee joints during running. J Biomech, 2010; 43(11):2120-5.

Goss, DL and Gross, MT. A review of mechanics and injury trends among various running styles. US Army  Med Dep J, 2012; 62-71.

Kerrigan et al., The effect of running shoes on lower extremity joint torques. PM R, 2009; 1(12):1058-63.

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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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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