Incidence of Low Back Pain In Runners

The incidence of low back pain in runners is astonishingly high and this is because of their heel strike running form which is linked to cushioned heeled running shoes.

Incidence of Low Back Pain in Runners

Incidence of Low Back Pain In Runners

The standard running shoe has a stacked up heel and this heel elevation is what facilitates heel strike, thus lower back pain, during running.

In the video below, Christopher McDougall, author of Born to Run, demonstrates how the standard running shoe contributes to lower back pain during running.

Running shoes that cause back pain are thick heeled shoe that cause heel strikingThe problem with a heel strike landing during running is the heel strike transient, a force that exceeds the body’s natural dampening mechanism.

The heel strike transient exposes the skeleton to greater force and past reports have directly linked the heel strike transient to lower back pain as well as osteoarthritis!

These findings indicate that heel cushioning of the traditional running shoe is an inadequate shock absorbent -only 10% reduction in impact by heel cushioning.

The cushioned material also deteriorates over time, allowing more force to penetrate through the heel pad and up the leg and into the back during heel strike running.

  • the body is comprised of viscoelastic structures, sensitive to high, repetitive loading, leaving little time to adopt to the load generated at heel strike

The belief that heeled running shoes reduces injury reflects the common notion that running is hard on the body. However, this notion doesn’t hold up in the context of forefoot running. In habitual barefoot populations, the link between running and lower back pain is non-existent because most of these runners utilize a forefoot strike, not a heel strike.

More From Run Forefoot:


Valiant, GA. Transmission and attenuation of heel strike accelerations. In: Cavanagh, PR. (Ed). Biomechanics of Distance Running. Human Kinetics Publishers, Inc. Campaign, Illinois, pp 225-47.

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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