How Heel Strike Running Causes ITBS vs Forefoot Running

The symptoms of running-related ITBS include tendon pain on the outer side of the knee whereby landing with a heel strike when running was found to be one of the main causes of this nagging condition.

How Heel Strike Running Causes ITBS vs Forefoot Running


It turns out that the heel-to-toe rollover action of the foot in heel strike running (shown below) takes the lead in significantly increasing the bending strain on the leg responsible for ITBS. For example, evidence (references below article) has found that the heel-to-toe rollover pattern in heel strike running increases rapid lateral (sideways) foot motions with excessive supination (rotational movement) at toe-off shortly after heel strike.

How Heel Strike Running Causes ITBS vs Forefoot Running
When it comes to ITBS in running, foot strike pattern plays a major role whereby the heel-to-toe action of the foot in heel strike running was found to cause the foot-ankle complex to produce straining movement patterns that ripples across the IT band.


Since the heel-to-toe rollover phase and its accompanying unwanted motions of the foot is a permanent component of heel strike running, this style of running will always predispose a runner to IT Band Syndrome, in addition to other injuries as well. This is why avoiding heel strike, and landing with a forefoot strike (shown below) instead, is very essential for injury prevention because the unstable heel-to-toe rollover phase is eliminated and overall foot-step stability is greater.
How Forefoot Running Prevents ITBS

As shown above, a forefoot strike landing is the reverse of a heel strike landing because the balls of the foot is the first part of the foot to contact the ground followed by the lowering of the heel to the ground. The foot is also more stably supinated at touchdown, while after touchdown on the forefoot, the foot dorsiflexes and everts when the heel lowers to the ground. All this is essential because this movement pattern of the foot was found to produce a contact with the ground that’s so brief that certain impact variables and abnormal foot motions are not fully produced.

Better yet, the center of mass (torso) also travels a shorter distance over the foot because initial foot strike position is close to the body in a forefoot strike [2], resulting in less ground interaction time and a more rapid removal of the foot compared to heel strike running.

How to Fix Lower Back Pain From Running: Fix Your Foot Strike!
You can achieve near-optimal landing stability when running with forefoot striking because it not only reduces ground-interaction time, it also controls the position of your torso, guiding it more forward closer to initial foot strike position, thereby preventing an over-stride. This is how forefoot running reduces the physical stressors not just off the IT band, but across the entire body, too. In contrast, heel strike running always produces excessive impact, while causing the foot to grapple with the ground for too long, which are involved in causing IT band injury.

The Take Home Message

There’s a reason  forefoot striking is a growing and popular trend among runners, and worth pursuing because you will achieve better landing stability and less all-around impact levels than heel strike running. In fact, here’s more important evidence proving that forefoot running prevents more than just ITBS, its also a known cure for runners knee and can prevent shin, hip and even lower back injury!


References:

[1]. Grau et al. Pattern recognition of ITB overuse injuries in running. J Biomech, 2006; 39 (Suppl 1).

[2]. Perl DP., Daoud AI and Lieberman DE. Effects of footwear and strike type on running economy. Med Sci Sports Exerc, 2012;44(7):1335-43.

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