Heel to Toe Running Causes Achilles Tendon Injury

Nix Achilles tendon problems by avoiding heel to toe running, and instead, run with a forefoot running style. One study found that it is hard for the muscles of the foot to manage the excessive heel movements accompanied with a heel strike running style, and may therefore, increase your risk of Achilles tendon tendinopathy.

Heel to Toe Running Causes Achilles Injury

Heel to Toe Running Causes Achilles Tendon Injury

When you run with a heel strike, your foot actually spends more time on the ground during the stance phase. During this time, the heel moves around more than it does in a forefoot strike landing, whereby in forefoot running, the foot interacts more quickly with the ground, leaving less time for undesirable rearfoot motions, putting less burden on the Achilles tendon.

According to research, the long, ground contact period coupled with the mechanics of a heel strike landing during running, causes the heel to rapidly jerk, or move about, which may cause the Achilles to bend and twist, leading to injury of the tendon.

  • The heel whip also triggers medial and lateral rotation of the foot in the transverse plane during initial swing phase of running which may also increase the risk of Achilles injury.

For the record, most recreational runners heel strike and Achilles injury is very high in these runners. In support of this, a study by Souza et al. found that the prevalence of the heel whip was quite high in recreational runners.

  • Over half of the runners in the study had a heel whip angle >5 degrees (a heel whip angle of <5 degrees is considered neutral/normal).
  • The range of the heel whip angle was between 29 degrees lateral and 32 degree medial.

Therefore, the finding is consistent with prior evidence showing that heel strike running influences a greater than normal heel whipping motion, which strainingly alters the position of the Achilles tendon.

Achilles tendon injury in runners
Fig 1. Taken from the study, measurements to quantify heel whip in recreational runners. SOURCE: Souza et al. Medial and lateral heel whips: prevalence and characteristics in recreational runners. PM&R, 2015; S1934-1482(15)00116-1

The long ground contact duration in heel strike running tends to prolong pronation, which amplifies the heel whipping motion. Another factor which worsens this mechanical flaw is heel strike running in thick, cushioned heeled running shoes, which also causes the foot to remain on the ground longer as compared with running barefoot, or in minimalist shoes, which often encourages a lighter, shorter interaction of the foot with the ground.

  • One of the reasons a thicker soled running shoe keeps the foot on the ground longer during running is because withdrawal urges are slowed, affording more time for abnormal foot movements to occur.

Forefoot Running Trumps Heel to Toe Running

Forefoot running parses out the co-occurring risk factors that contribute to a high heel whip angle. For example, many forefoot runners run barefoot or in pure minimalist shoes and present a higher step rate which decreases ground-contact time and excessive pronation. This is how forefoot running mechanically disentangles the wonky movements of the foot associated with heel strike running.

More From Run Forefoot:

Tesla Trail Running Shoe Review for Forefoot Running

Where to Buy Vibram FiveFinger Running Shoes

Merrell Trail Glove 3 Review for Forefoot Running

Why Running Faster is Safer


References:

Souza et al. Medial and lateral heel whips: prevalence and characteristics in recreational runners. PM&R, 2015; S1934-1482(15)00116-1.

Bretta Riches

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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