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.


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.


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:


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).

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!

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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