How to Fix Hip Pain From Running? Avoid Heel Striking!

In running, foot strike pattern (i.e. how you land on your feet when you run) directly determines the trajectory of your entire stride mechanics and impact generation. For instance, landing with a forefoot strike (see here what a proper forefoot strike looks like) was found to be central in preventing most injuries, especially hip pain and injury as compared with heel strike running (shown below). This is because heel strike running was found to burden the hips with significantly more impact loads that cushioned running shoes can’t reduce!

Two pioneering studies in the journal of Medicine and Science in Sports and Exercise and in the Journal of Biomechanics confirmed and re-affirmed that heel strike running is a major contributing factor to hip pain because of the hyper-knee extension and long over-stride angle at touchdown (shown below). In this scenario, the knee extensor muscles cannot absorb shock when the knee is maximally extended (fully unbent) at touchdown, which results in greater reliance or overload of passive mechanisms in the hip.

Conversely, data supporting forefoot running as the anecdote to hip pain came from the Journal of Applied Biomechanics which found that hip problems were completely solvable by forefoot striking because at landing the knee flexes (greater knee flexion) which shifts shock absorption from passive areas, like the hips, to muscular contractions in the calf musculature. Basically the science tells us that landing forefoot-first when running automatically puts in motion more functional mechanics that are key to preventing high impacts that damage the hips.

How Do I Fix my IT Band Syndrome Fast? Land Forefoot-First, NOT Heel-First! — When you land on your forefoot (the balls of the foot, not the toes), your knee automatically bends. This knee bend at landing, directly engaged by forefoot striking, was found to have enormous protective value, not just on the hips, but the shins, knees and lower back. All the evidence has verified that when you land with a forefoot strike and the bends at landing, stride length shortens, therefore an over-stride is prevented, while step-rate increases, meaning the foot spends less time on the ground, leaving less time for things to go wrong. These mechanics form the foundation to prevent exponential impact production across the entire body.

Another way forefoot running reduces overloading on the hip is through a higher stride cadence (the number of times the foot contacts the ground per minute). One study reported that minimalist shoes (barefoot-inspired footwear) and barefoot running improved lower leg mechanics by encouraging a forefoot strike which was associated with greater efficiency, partly because stride cadence was higher [4].

Another study found that a 5% to 10% increase in stride cadence reduced loading on the hips, farther suggesting that forefoot running promotes a safer landing that’s overall more ‘hip-friendly’ than heel strike running.

The Take Home Message

Foot strike pattern in running forms the basis of impact production whereby the high impact nature of heel strike running is the primary cause of hip injury, since high impact mechanics like maximum knee extension and a low stride cadence go hand-in-hand in this style of running, and are the two main factors that exponentially increase the risk of hip injuries.

Its for all these reasons studies consistently point to the importance of forefoot striking when running as the most sustainable solution to preventing injuries to the hip simply because forefoot running comes with mechanical corrections necessary to keep impact low everywhere across the body.

In that regard, here’s the mounting evidence that proves forefoot running is not only safer than heel strike running, but more economical too!

If you’ve enjoyed my post, you’ll love my YouTube channel, here, where I show why forefoot running works for everyone!

References:

[1]. Derrick TR, Hamill J, Caldwell GE. Energy Absorption of Impacts During Running at Various Stride Lengths. Med Sci Sports Exerc. 1998; 30(1):128-135.

[2]. Voloshin A and Wosk J. An in Vivo Study of Low Back Pain and Shock Absorption in the Human Locomotor System. J Biomech. 1982; 15(1):21-27.

[3]. Edwards WB, Derrick TR, Hamill J. Musculoskeletal Attenuation of Impact Shock in Response to Knee Angle Manipulation. J App Biomech. In Press.

[4]. Gillonov et al. Effect of minimalist footwear on running efficiency: a randomized crossover trial. Sports Health, 2015;7(3):256-260.

[5]. Heiderscheit BC, Chumanov ES, Michalski MP, Wille CM, Ryan MB. Effects of step rate manipulation on joint mechanics during running. Med Sci Sports Exerc. 2011;43:296-302.
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