It’s inevitable that heel strike runners will encounter stiff knee pain. Accumulating data from research demonstrates that a link between chronic knee injury and heel strike running, and that knee soreness can be prevented by switching to forefoot running.
Stiff Knee Pain From Heel Strike Running
In heel strike running, knee injury arises from maximum knee extension at touchdown coupled with the torso being behind initial foot strike position. To make this happen, the swing leg reaches far out in front of the body, which increases braking and compressive forces at touchdown.
In addition, to make heel strike achievable, over-striding must co-occur with maximum knee extension at touchdown. This increases angular work at the knee and increases braking at touchdown, making the knee-joint vulnerable to injury.
- During braking, the mass of the body collides with the extended leg, creating knee-joint torque.
- Braking also produces a compression-wave that damages the knee.
- Vannatta and Kernozek (2015) found that a more extended knee at heel strike increased total stress on the patellofemoral joint over the course of stance during running.
Tight Hamstrings Linked to Severe Knee Injury
Heel strike running causes a runner to have tighter hamstrings which may also have negative effects on knee joint health.
- Goss and Gross (2012) maintained that hamstring tightness may cause higher knee extension force production during running.
- They found that heel strike runners had greater quadricep force than forefoot runners, which exacerbated maximum knee extension and knee pain.
Targeting Other Causes of Severe Knee Injury
No matter the relative roles of muscle strength imbalance, diet, or training volume, a heel strike landing is part of the equation in knee pain. Maximum knee extension is the main if not sole cause of knee problems in joggers. Telling runners to wear thick cushioned heeled running shoes could also stall recovery by making a heel strike landing more pronounced.
The good news is, forefoot running exerts less physical impact on the knee because less angular work from the knee-joint.
At forefoot strike, knee flexion increases which helps dampen ground reaction forces (Goss and Gross 2012). Moreover, increased stride frequency in forefoot running has been strongly associated with reduced knee stress (Guiliani et al. 2011).
Therefore, learning forefoot running would help correct maladaptive landing behaviors and markedly reduce destructive forces on the knee heel strike running can induce.
More From Run Forefoot:
Arendse RE, Noakes TD, Azevedo LB, Romanov N, Schwellnus MP, Fletcher G. Reduced eccentric
loading of the knee with the pose running method. Med Sci Sports Exerc. 2004;36(2):272-277.
Goss DL and Gross MT. A review of mechanics and injury trends among various running style. AMEDD, Sept -2012.
Giuliani J, Masini B, Alitz C, Owens BD. Bare- 38. foot-simulating footwear associated with metatarsal stress injury in 2 runners. Orthopedics. 2011;34(7):e320-323.
Messier et al. (2008). Risk factors and mechanisms of knee injury in runners.
Vannatta CN and Kernozek TW. Patellofemoral joint stress during running with alterations in foot strike pattern. Med Sci Sports Exerc, 2015;47(5):1001-1008.
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.