Shin Injury From Forefoot Running

There’s enough data to make it abundantly clear that when it comes to shin injury prevention in running, forefoot running may do a better job at limiting or reducing the sources of impact stress on the tibia (shin) as compared with heel strike running. 

However, if you’re a forefoot runner wrestling with a shin injury (i.e shin splints), some of the potential mechanical-wrongs you may be doing is you may either be landing too high up on your toes and/or you may not be letting your heel drop down more fully after touchdown. 

Shin Injury From Forefoot Running
If you’re a forefoot runner wrestling with shin splints, you may be making initial ground-contact way too high up on your toes coupled with not letting your heel drop down to the ground. The trouble with this landing configuration during running is that for one, it keeps pressure impulse peaks heavily concentrated and localized to the forefoot. Why? Because by not letting the heel drop down after touchdown, the center of pressure cannot evenly dissipate over a larger area of the foot. For another, research has linked this kind of forefoot pressure build-up to increases in workloads on the tibia (shin) as the shins now have to work harder in stabilizing ankle moments and absorbing greater pressure loads caused by the abrupt increases in forefoot pressure.

It turns out that the coupling of landing lower on your forefoot followed by lowering the heel down, dissipates plantar pressure over a larger area of the foot, thus preventing over-pressure peaks from heavily localizing on the forefoot. This may in turn have the direct effect of preventing pain-inducing loading levels from piling up on the shins during running.

Another fundamental problem is that many new forefoot runners think forefoot running is ‘toe running’ and from this, these runners make the mistake of running too high up on their toes. In this case, what goes unrealized is that a proper forefoot strike landing involves a MUCH flatter placement of the forefoot at touchdown, as shown below.

Shin Injury from Forefoot Running
The above illustration shows the forefoot strike landing pattern of the Tirunesh Dibaba (the runner in black shoes). As you can see, the initial strike angle of the foot at touchdown is much lower on the forefoot. This is followed by dropping of the heel. This precise movement of path of the foot in forefoot running not only fully permits a smoother, jarring-free landing, its also key in preventing impact waves from crashing into the shin by effectively spreading the center of pressure over a large area of the foot.

Bottom line, the essential take-way from this is that the heel does contact the ground in forefoot running, but its the last part of the foot to do so, and when it does, this is where the center of pressure spreads best because heel-lowering draws the center of pressure away from the forefoot AND appears to be very useful in loading less pressure through the shins. 

But where’s the hard scientific evidence validating that both a lower initial forefoot strike angle followed by heel-ground contact in forefoot running are vital component in safeguarding the shins? 

A proof of concept came from a 1994 study in the Journal of Orthopaedic & Sports Physical Therapy which found that a forefoot runner with shin splints had the center of pressure begin and end in the forefoot, indicative of a lack of heel-ground interaction. This was found to be most responsible for exerting greater demands on the connective tissues surrounding the tibia (shin) as a compensatory mechanism to disperse excessive pressure confined to the forefoot. Additional results from other studies support such a conclusion such that runners with a history of shin splints had no heel-ground interaction, either, during running.

Shin Injury From Forefoot Running

In a proper forefoot strike landing, the center of pressure begins at the forefoot, under the 4th and 5th toes and ends at the heel after heel contact. The compliment response is less pressure load shifting onto the shins. What’s so interesting about knowing all this is that it presents an altogether fresh take on how shin injury can be avoiding in forefoot runners.

Shin Injury from Forefoot Running

So, to help remedy shin splints from forefoot running, avoid running high on your toes and let your heel drop naturally to the ground to allow pressure to dissipate sufficiently over the foot, and less on the leg.

References:

Cibulka et al. (1994). Shin splints and forefoot contact running: a case report. J Orthop Sports Phys Ther 20, 98-102.

Kentor, LA. (1948). Survey of the etiology of shin splints. Master’s thesis, Springfield College, Springfield, MA.

Lieberman et al. (2010). Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature 463, 531-5.

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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

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!