2 Reasons Heel Strike Running Causes Chronic Lower Leg Pain vs Forefoot Running

In running, strong evidence (references below article) points to heel striking as the main cause for a specific form of chronic lower leg pain known as ‘exercise induced compartment syndrome,’ but to remedy this, forefoot running (see here what a proper strike looks like) has been repeatedly affirmed to be bring full resolve to the painful condition.

There are 2 known factors of heel strike running that directly increases the risk of exercise induced compartment syndrome: (1) full knee extension (fully unbent knee), coupled with (2) full ankle dorsiflexion (which means the front of foot lifts up) upon and at touchdown. Its this combination that causes compartment pressure in the lower leg  to exceed tolerance, resulting in throbbing lower leg cramps.


The specific patterns in mechanics of heel strike running were found to be the main contributions that cause compartment pressure in the lower leg to continuously rise to pain-inducing levels as compared with forefoot running which was found to sustainably improve these symptoms.

It turns out, the action of landing heel-first when running over-uses the dorsiflexors (muscles that line the shins), fatiguing these muscle groups at each step, which was found to cause a sharp rise in compartment pressure in the front of the shin, resulting in persistent lower leg cramps.

How Heel Strike Running Causes Shin Splints
There’s a group of muscle in the shins called dorsiflexors that are used to lift the front of the foot up at heel strike. The constant forefoot-lifting engaged by the dorsiflexors at each step was found to cause compartment pressure in the shins to rise to pain-inducing levels.


Another contributing factor to painful lower legs in heel strike running is the higher-than-normal anterior (front) – posterior (back) braking and vertical ground reaction forces that are always produced at heel strike, but are completely eliminated in forefoot running, shown below:

Is Forefoot Running Better for Your Legs than Heel Strike Running? Yes!
Landing forefoot-first when running (above right) automatically positions the shin, ankle and foot under the knee and results in an overall foot placement closer to the upper body. This mechanical alignment was found to be the primary antidote to prevent opposing forces that cause throbbing lower leg pain (lower leg compartment syndrome) as compared with heel strike running (above left). Landing heel-first when running clearly has the opposite effect to forefoot striking because heel striking pushes the shin and ankle farther away from the upper body, thereby creating an over-stride that causes the body to come to an unusually long crashing halt with the foot at touchdown.


In the final equation, both the excessive braking and ground reaction forces that natural occurs in heel strike running exacerbates the rise in compartment pressure of the lower leg, farther intensifying the pain.

Why Forefoot Running is Always Better Than Heel Strike Running

In contrast, Diebal et al. found that forefoot running completely eliminated lower leg compartment syndrome as a result of the combination of less ankle dorsiflexion (less forefoot-lifting) at upon and at landing and higher knee flexion (more knee bend) at landing (shown below).

Does Barefoot Running Hurt the Knees?
Landing with a forefoot strike (above right) while running has a vital smoothing effect against the high impacts that cause lower leg compartment syndrome. Forefoot striking does this by reducing forefoot-lift upon and at landing, while causing the knee-joint to slightly bend upon and at landing. What this does is it eliminates the burst in collisional impact that’s always produced in heel strike running (above left).  The action of heel striking when running causes the knee-joint to unbend and lock-out at landing, resulting in an over-stride where the foot lands ahead of the ankle, knee and hip. Its this landing arrangement produces a sizable burst in collisional impact that pries into the shins and the knee-joint, too.

Ultimately, its the avoidance of excessive, repetitive forefoot-lifting upon and at landing in forefoot running that provides a consistent enforcement of reductions in net impact across not just the shins, but the entire body! In fact, here are 30 evidence-backed reasons forefoot running is safer and faster than heel strike running!

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If you’ve enjoyed my blog post on forefoot running vs heel strike running, you’ll love the content at my YouTube channel, here, where I SHOW why forefoot running works and heel strike running hurts!


References:

Divert C, Mornieux G, Baur H, Mayer F, Belli A. Mechanical comparison of barefoot and shod running. Int J Sports Med. 2005;26(7):593-598.

Gershuni DH, Yaru NC, Hargens AR, 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, McDermott AG. Anterior tibial compartment pressures during running with rearfoot and forefoot landing styles. Arch Phys Med Rehabil. 1983;64:296-299.

Zifchock RA, Davis I, Hamill J. Kinetic asymmetry in female runners with and without retrospective tibial stress fractures. J Biomech. 2006;39(15):2792-2797.


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