Does Heel Striking Cause Injury to the Shin? YES!

In running, shin injuries, such as shin splints and shin fracture are more common if a heel strike landing is used over a forefoot strike. This is because landing heel-first when running causes the knee-joint to unbend and lockout, which dramatically increases stiffness in the knee at landing. This was found to increase the margins of impact intensity and duration on the shin. Also, shin angle is pushed too far ahead of the body at landing in a heel strike landing, which was found to increase opposing forces on the shin (shown below) as compared with forefoot running (see here what a proper forefoot strike landing). From these consequences of landing heel-first come yet furthermore the mechanical stress that causes shin fracture.

Is Forefoot Running Better for Shin Splints? YES!


Scientific work (references below article) looked at the affects of an unbent knee at heel strike and its influence on impact production on the leg in running, whereby a study by Milner et al., in the journal Medicine and Science in Sports and Exercise revealed increases in knee stiffness was directly responsible for contributing to shin fracture whereas increases in knee flexion (i.e. a soft, compliant knee-joint) at landing reduced the risk factors for shin splints and fracture.

  • Their data showed that stiff knees at touchdown (initial loading) increased tibial (shin) shock, whereby high tibial shock is the main risk factor for tibial stress fracture during running.

Unsurprisingly, the runners in the study were heel strikers whereby at heel strike the knee-joint is fully extended which causes the knee to stiffen-up too much during the phase of running that produces the most impact.

The researchers noted that initial loading in heel strike running led to greater changes in vertical loading and knee moments which were considered primarily responsible for the development of a tibial stress fracture. This suggests landing heel-first when running hinders the efficient use of the knee, as well as the leg, as shock absorbers which cause forces to exceed several times the body weight at the shins.

How Heel Strike Running Causes Injury
As a consequence of landing heel-first when running, the knee increases in stiffness as it extends and fully unbends. This reduces flexion in the joint which was found to cause more impact and loading to ripple out from the foot up the leg, particularly prying into the shin. Ultimately, in a heel strike landing, the knee is never full able to engage as the shock absorber that it is, and running shoe cushioning was found to do little to absorb impact, too!


Just to recap, when you land heel-first when running, the knee is straight (less flexed), thus it losses its shock absorbing properties which causes opposing forces to be amplified at the shins.

In contrast, other reports confirmed greater knee flexion at touchdown when running dramatically reduces peak vertical forces (burst in collisional impact), making for a softer landing that unburdens the shins.

How do get your knee to have more flexion, and therefore, run with less net impact? The only way to accomplish this is to avoid heel strike and adopt a forefoot strike landing, shown below.

What Running Style is Best for Your Knees?
The knee automatically bends, increases in flexion and becomes a highly effective shock absorber when you land forefoot-first while running. This results in significantly less initial loading while reducing the distance between  initial foot placement and the torso. This was found to be the most reliable and sustainable way to prevent increases in impact from prying into the shin, and is ultimately why you have much to gain as a runner with forefoot striking.

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Furthermore, there’s less initial loading on the shin in forefoot running due to reduced heel vertical velocity. In research circles, evidence is showing strong associations with reduced impact loading and reduced heel vertical velocity in forefoot running. This is because greater knee flexion and lower heel vertical velocities, both naturally engaged by forefoot striking, reduces tibial shock, making the shin much less vulnerable to fracture.

The Take Home Message

Shin injuries will always be on the rise if you heel strike when you run as research has confirmed and re-affirmed that foot strike pattern has the biggest influence on impact production. Research shows that adopting a forefoot strike landing delivers more concrete results for shin injury prevention through minimizing stiffness at the knee which maximizes impact protection at the shins. Speaking of the knee, forefoot running has been shown over and over again to be the cure for runners knee. Read more on that here!

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If you’ve enjoyed my post, you’ll love the content over at my YouTube channel, here, where I show why forefoot running works and heel strike running hurts.


References:

Gerritsen KGM, van den Bogert AJ, Nigg BM. Direct dynamics simulation of the impact phase in heel-toe running. J Biomech. 1995;28(6):661–8.

Milner et al. Are knee mechanics during early stance related to tibial stress fracture in runners? Clin Biomech, 2007; 22:697-703.

Milner, C.E., Ferber, R., Pollard, C.D., Hamill, J., Davis, I.S., 2006. Biomechanical factors associated with tibial stress fracture in female runners. Med. Sci. Sports Exerc. 38, 323–328.

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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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