Why Heel Strikers Are Injury Prone

In my mind, heel strikers must really hate running because they tend to get injured more than forefoot strikers. You can really grow to hate running when you have injury after injury. Trust me, I can relate because I have been there when I was a heel striker and always struggled with leg, ankle and foot injuries.

Experts now know that the stress wave at heel strike makes heel strike runners injury-prone. How come? Compared to other body segments, the lower leg pays the price for absorbing the impact produced at heel strike.

How Heel Striking Causes Injury

Why Heel Strikers Are Injury Prone

Light et al. (1980) reported that lower leg injuries arise in heel strike runners because the lower leg, knee included, must absorb 50%-90% of the stress wave generated at heel strike. This is tissue-expensive because the leg muscles use more energy to attenuate impact.

  • The list of injuries associated with the heel strike stress-wave is long: knee pain, medial or posterior tibial pain, Achilles tendonitis, plantar fasciitis, ankle pain, midfoot symptoms and stress fractures of the tibial, tarsal, metatarsal and femur (James et al.1978; Marti et al. 1988).

To give the tissues a break, rest or reduced mileage is the THE recommendation for heel strike runners. But what is remarkable is that forefoot running does not generate a stress wave and can prevent lower leg injuries. And, the forefoot and ankle absorbs the minimal impact produced during forefoot running.

Forefoot Strike Eases Lower Leg Stress

A forefoot strike stops the flow of impact up the leg by localizing impact absorption to the areas of the forefoot and midfoot and the rapid rise in force associated with heel impact is not apparent (Lees et al. 2015).

Daoud et al. (2012) also found that forefoot running reduces the risk of lower injury because foot-ground impact is lower than in heel strike running.

Of course, there’s the concept of ‘muscle tuning’ which dampens impact at touchdown, however the high injury rate among heel strike runners casts grave doubt that muscle tuning works for them. Moreover, the fact that barefoot runners consistently run without a stress-wave through a forefoot strike landing, suggests that forefoot running has strong biological roots that formed in our evolutionary history.

Because the stress-wave abruptly vanishes in forefoot running, heel strike runners would undeniable show improvements in lower leg injury by switching to forefoot running.


More From Run Forefoot:

Nike Frees – Are not a good shoe for forefoot running because they are not ‘barefoot’ enough.

Toe Striking – Toe striking is different from forefoot running and may cause injury.

Barefoot Running – You cannot run properly until you have run barefoot.

Dealing with Transition – There are no overnight fixes when it comes to learning a new style of running. Be patient!


Altman AR, Davis IS (2011) Comparing barefoot running to an altered strike patterns. Med Sci Sports Exerc 43(5):S717

Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE (2012) Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc. doi: 10.1249/MSS.0b013e3182465115

Forner, A., Garcia, A.C., Alcantara, E., Ramiro, J., Hoyos, J.V., and Vera, P.: Properties of shoe insert materials related to shock wave transmission. Foot Ankle Int., 16:778-786, 1995.

James, L.J., Bates, B.T., and Osternig, L.R.: Injuries to runners. Am. J. Sports Med., 6:40-50,1978.

Light, L.H., McLellan, G.E., and Klenerman, L.: Skeletal transients on heel strike in normal walking with different footwear. J. Biomech., 13:477-80, 1980.

Marti, B., Vader, J.P., Minder, C.E., and Abelin, T.: On the epidemiology of running injuries. The 1984 Bern Grand-Prix study. Am. J. Sports Med., 16:285-94, 1988.

Nigg BM (1997) Impact forces in running. Curr Opin Orthop 8(VI):43–47.

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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