Heel Strike Running Bad for Knees Even at Slow Speeds

Heel strike running was found to be incredibly damaging to the knee joint at slower running speeds.

A study by Peterson et al. published in the Journal of Orthopedics and Sports Physical Therapy found that heel strike runners who ran slowly had greater knee pain than heel strike runners who ran fast.

The researchers found that running at slow speeds while landing on the heel increases cumulative loading on the knee-joint as compared to heel strike running at faster speeds.

Why Heel Strike Running is the Worst for Your Knees — The problem with running slow with a heel strike is that it increases the number of strides per given distance.

You would assume that running at a slower pace with would reduce overall impact, but this was not the case in the current study.

At slow running speed’s, the heel striker’s increased their cadence (the number of times the feet contact the ground per minute) which in turn, increased the cumulative load at the knee-joint.

But, increasing cadence is a good thing in running, right? Not if you land heel-first.

Numerous reports have proven that a higher cadence is very clinically effective for reducing knee pain and preventing severe knee injury in other running styles, like forefoot running (see here what a proper forefoot strike looks like), but the same cannot be said for heel strike running. A higher cadence is advantageous only if a forefoot strike is utilized, but loses its effectiveness if a heel strike is engaged.

How to Fix Lower Back Pain From Running: Fix Your Foot Strike! — In a forefoot strike landing (above left), the foot is uniquely positioned to play a leading role in preventing an over-stride, while enabling the feet to interact more brief with the ground, which collectively, was found to be best for preventing injury to the knee as compared with heel strike running (above right), which is a major source of high impact since it drives healthy mechanics out of range. This proves that there are certain mechanical adjustments that you can only make through landing forefoot-first that will guarantee less net-impact on the knee.

In forefoot running, a higher cadence was found to decrease step length (i.e. a shorter stride) and reduced joint energy absorption (negative work) during the first half of gait. Furthermore, a higher cadence in forefoot running also reduces the distance between the center of mass (i.e. torso) and the heel during initial ground-contact, which was found to be responsible for preventing increases in impacts from spreading out onto the knee.

As for heel strike runners, it is not possible to reduce loading on the knee by increasing cadence because heel striking is associated with more impact-related variables that result in a higher burst of impact pressures and loading rates compared to forefoot running.

The Take Home Message

For decades, experts urged caution, especially for inexperienced runners, to run slow because of the ‘high impact’ nature of running. At slower running speeds, it was assumed that the body had the capacity to absorb impact. But, not if you run on your heels!

The surest way to resolve and prevent running-related knee pain and injury is to ditch your heel strike and land with a forefoot strike because forefoot runners show a 47% lower average loading rate, regardless of speed, compared to heel strike runners.

Its also important to realize that protection from impact does not happen with increased underfoot cushioning, but with adopting a forefoot strike because it is the only foot strike that allows barefoot runners to run without injury of any kind. Read more on that here!

if you’ve enjoyed my post, you’ll love my Youtube channel, here, where I show why forefoot running works and heel strike running hurts!

References:

Heiderscheit et al. EFfects of step rate manipulation on mechanics during running. Med Sci Sports Exer, 2011; 43(2):296-302

Kulmala et al. Forefoot strikers exhibit lower running-induced knee loading than rearfoot w strikers. Med Sci Sports Exer, 2013; 45(12):2306-2313.

Peterson J, Sorensen H and Nielsen, RO. The cumulative loads increase in the knee-joint at slow speed running compared with Faster running: a biomechanical study. J Ortho Sports Phys Ther, 2015;1:1-22.

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