Why Heel Strike Running is So Bad for Your Legs

One of the main reasons heel striking is so bad for running is its the only cause of the painful lower leg condition known as chronic exertional compartment syndrome (CECS).

The symptoms of running-related CECS includes throbbing cramps that radiate throughout the lower leg. The pain begins as soon as you start running and gets worse with running distance, but stops when running is stopped. The good news is forefoot running was found to be the solution and therefore, the prevention of CECS.

Why Heel Strike Running is Bad for Your Legs
Many heel strike runners suffer chronic exertional compartment syndrome whereas forefoot runners don’t. This is because distinct impact forces are produced and hit the lower leg harder in heel strike running. The main reason for the unusually high forces in heel strike running is the result of the over-extended stride that is naturally accompanied when landing heel-first. This elongates the distance between the center mass (upper body) and initial foot strike position, and consequentially, causes the body to brake longer with the ground at landing. This intensive brake period produces the impact shock-wave directly involved in increasing lower leg intramuscular pressure beyond tolerance.

Research has countlessly confirmed that CECS only occurs in heel strike running because at heel strike, a prolonged brake force is produced, which means the stance leg comes to a crashing halt with the mass of the body for a prolonged period of time. This does not happen in forefoot running.

Its the prolonged, high-intensity brake force at heel strike that causes lower leg intramuscular compartment pressures to rise to pain-inducing levels. This can only be avoided by landing forefoot-first. Proof of this came from a sizeable body of evidence which found that Pose Running, a running style that advocates a non-heel strike landing while leaning forward, proved to be incredibly effective at fully resolving CECS!

Pose Running advises the following:

  • non-heel strike landing
  • leg swing that opens up more behind the body and therefore less in front
  • subtle forward lean from the ankles, not from the hips

Cause of Running-Related Chronic Exertional Compartment Syndrome and How Pose Running May Cure it!
When it comes to preventing harmful impacts when running, your  upper body posture is just as important as foot strike! Research has found that a subtle forward lean goes a long way in phasing out damaging impacts because it pushes your body weight forward, aligning it closer to initial foot strike position. This effectively closes the distance between your center mass and initial foot strike position, which is whats needed to reduce time spent braking. Even better, landing with a forefoot strike when running allows your upper body to tilt forward with greater ease whereas the farther back you land on your heel, the more your upper body leans backward!

A 2012 study in the American Journal of Sports Medicine provided clear and credible explanations on how Pose Running is a reliable way to fully resolve and prevent CECS.

The study found that participants who replaced their heel strike running style with the Pose Running Technique showed a significant reduction in the vertical ground reaction force which directly led to a sudden drop in pain-triggering intra-compartmental pressure in the lower leg. This is why foot strike pattern really does matter in running because it’s the most influencing aspect on lower leg intramuscular pressure!

How Heel Strike Running Causes Chronic Exertional Compartment Syndrome and How Pose Running May Prevent it!
Raw data from the study showing the significant reduction in leg pain (right) when a non-heel strike landing was utilized under the instruction of Pose Running (Diebel et al. 2012)

To give you a clearer sense of how Pose Running made the most positive difference in remedying CECS, the most optimistic part of the study was the Pose Running intervention led to improved run performance such that 2-mile run times were significantly faster compared with the pre-intervention values. Even better, running distance increased by 300%, and two participants even went on to complete two half-marathons shortly after!

Here’s more information about the exact Pose Running training method used in the study.

Researchers are convinced that lower leg anterior compartment pressures in running is directly influenced by foot strike pattern. This relation was clearly articulated in an 1984 study in the Journal of Bone & Joint Surgery which found that anterior compartment pressures significantly increased in healthy patients who used a heel strike landing during running.

Why Heel Strike Running is So Bad for Your Legs

More specifically, it was the full knee extension coupled with the full ankle dorsiflexion at heel strike (shown above) that resulted in increased lower leg anterior compartment pressures. The researchers reached this conclusion after finding that landing this way during running led to a constant escalation in eccentric activity in the lower leg which elevated anterior compartment pressures to an entirely new level causing pain to the related area.

Why Forefoot Running is Better for Your Legs than Heel Strike Running

The mechanical chain of events up the leg are the exact opposite in Pose Running (shown above), which prevents CECS-related mechanical strain because when you land farther away from your heel (less ankle dorsiflexion), and land on your forefoot, the knee automatically bends (less knee extension). This helps pull the foot in closer to land near your center of mass.  Meanwhile, a slight forward tilt from the ankles does more to close the distance between your upper body and initial foot strike position, which in turn, reduces braking and boosts the forward movement of your center mass.

How Heel Strike Running Causes Chronic Exertional Compartment Syndrome and How Pose Running May Prevent it!

  • Left, shows a heel strike landing which causes the ankle to lock out and the knee-joint to unbend, altogether causes a longer over-stride angle which leads to higher rates and magnitudes of  braking. This landing arrangement is also the common cause of the compressive loads that trigger abnormal rises in lower leg intramuscular pressure.  Right, shows the Pose Running Method which advocates a non-heel strike landing while leaning slightly forward from the ankles. This mechanical arrangement improves both initial foot strike and upper body positioning at touchdown which successfully prevented the impact that causes CECS.  

The study adds yet another reason to avoid heel strike running and switch to forefoot running because it’s the most effective and reliable way to avoid damaging impact burdens altogether by simply correcting high impact mechanical defections that are only caused by heel strike running!


Diebel et al. Forefoot running improved pain and disability associated with chronic exertional compartment syndrome. Amer J Sports Med, 2012; 40(5): 1060-67.

Gerahuni et al. Ankle and knee position as a factor modifying intracompartmental pressure in the human leg. J Bone Joint Surg Am, 1984;66(9):1415-1420.

Kirby, RL and McDermott, AG. Anterior tibial compartment pressures during running with rearfoot and forefoot landing styles. Arch Phys Med Rehabil, 1983; 64:262-99.

Romanov, N and Fletcher, G. Runners do not push off the ground but fall forward via a gravitational torque. Sports Biomech,3007; 6(3):434–52.

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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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