Should You Heel Strike When Running Uphill? NO!

15/05/2024 Bretta Riches Dealing with Running Injuries 0

In running, one aspect that has attracted a lot of attention is foot strike pattern whereby a growing body of work over the last few decades revealed a troublesome trend that landing with a heel strike is largely to blame for most injuries because the higher-than-normal impacts causes more damage to the shins, knees and the lower back than forefoot running.

Does Foot Strike Matter When Running?
Injury-free running really boils down to foot strike pattern whereby landing with a forefoot strike prevents the damaging mechanical defections, like over-striding, over-pronation, hyper-knee extension, lower cadence and excessive bouncing, which are all associated with heel strike running and major injury.

What’s worse, the heel strike-related impacts are amplified if a heel strike is used when running uphill. One study found that ultra-marathoners who got injured sustained their injury because they had greater eccentric loading while running uphill, on their heels, which already places greater mechanical demands on the leg, especially on the knees, when running on even grounds.

The researchers found:

  • When you heel strike when running up a hill, eccentric loading (muscle and tendon stretching) on the leg increases as the foot pushes the body up the hill.
  • Similarly, the knee is less flexed (more stiff) and rapidly more extended at heel strike, which also further stretches the knee ligaments.

In line with this, a similar study in the British Journal of Sports Medicine found that runners who sustained a knee injury during an ultra-marathon ran with a smaller knee flexion range when running uphill vs running downhill, suggesting that the knee-joint was more extended than tolerable, and therefore, the muscles and tendons of the lower leg eccentrically stretched too much. This kind of eccentric activity, especially under the high impact nature of heel strike running, results in excessive loading on the leg, and combined with muscle fatigue, tendon inflammation arises. (Curwin and Stanish, 1984).


Another biomechanical factor that increases eccentric loading on the legs when heel strike running uphill is the repetition of forefoot lifting (ankle dorsiflexion, shown below) to allow initial ground-contact on the heel. This action is performed by the tendons in the ankle and shin, and was found to be a common cause of lower leg injury, particularly tendinitis of the foot dorsiflexors, patellar tendon and Achilles tendon (Fallon, 1993).

Heel Strike Running is Bad For Your ACL
In order to land heel-first, the front of the foot (the forefoot) must lift up, an action called ‘ankle dorsiflexion’. The trouble with this is the repetitive forefoot-lifting was found to over-work the muscles that line the top of the ankle and shins, resulting in shin splints. This is not the case in forefoot running which does not require the forefoot to lift up at each step since initial ground-contact is made on the forefoot; there’s no need to ever lift the front of your foot, shown below:
What Foot Strike Causes Shin Splints?
In a forefoot strike, the forefoot is naturally kept neutral, and does not lift up prior to and at landing. In this way, the muscles and tendons that line the top of the shin and ankle are prevented from being over-worked. Even better, forefoot striking assembles more functional knee mechanics, allowing the knee to bend and properly flex at landing, which blunts high brake sheer forces and compressive loads to the leg and lower back, making any runner much less vulnerable to the ravages of the road.


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The Take Home Message

Any intervention aimed at preventing running-related injuries should include avoidance of heel striking, and adopting a forefoot strike because it has more influence on your entire mechanics as previously expected. Most exciting, forefoot running has been found to be a literal cure for runners knee and chronic lower pain as well as back injury! Read more on that here!

References:

Curwin S, Stanish WD. Tendinitis: its aetiology and treatment. Lexington: Collamore Press,1984:25-8.

Fallon, KE. Musculoskeletal injuries in the ultramarathon: the 1990 Westfield Sydney to Melbourne run. Br J Sports Med, 1996;30:319-323

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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

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