When it comes to fixing knee pain from running, forefoot running proved to fully resolve knee pain in ways that maintains as compared with landing heel-first.
Forefoot running was found to reduce straining frontal plane moments, which means there’s less loading on the front and back of the knee as compared with heel strike running.
Forefoot running was also found to be more effective in limiting side-to-side rotations of the knee-joint than heel strike running.
From this, the obvious assumption is foot strike does matter in running since forefoot running has been confirmed repeatedly to perfectly prevent all the major risk factors of heel strike running that directly causes knee injury.
Case in point, a study in the journal Medicine and Science in Sports and Exercise, discovered that forefoot runners had significantly lower frontal plane moments at the knee and therefore were less likely to develop knee-joint degeneration than heel strike runners.
The study found that forefoot running was effective in reducing side-to-side knee-joint rotations by eliminating knee extension at touchdown which in turn enabled the foot to land closer to the body (i.e center mass). This prompted better dynamic stability during stance as compared with heel strike running which produced more knee extension at touchdown and over-striding which are the basis for chronic knee pain.
Why Heel Strike Running Severally Stresses the Knee
As per the study, heel strike running increases frontal plane moments on the knee-joint by causing the knee to maximally extend (fully unbend) at touchdown (shown below). The big problem with this is it causes the foot to not only heel strike, but pushes initial foot strike position too far ahead of the body. This landing arrangement increases compressive forces on the knee while making the joint increasingly unstable because it’s locked out and stiff when fully unbent.
Worse still, another way heel strike running causes knee injury is the foot rollover phase that occurs after heel strike causes the foot to grapple with the ground longer. This adds complications to the knee because the foot has more chances of being forced into extreme positions when it’s lingering on the ground longer than it should, and as a consequence, more rotational stress transfers up to the knee.
In contrast, a double incentive to forefoot running is it naturally increases step rate which allows the foot to spend more time in the air, and ultimately, results in contact of the foot with the ground that’s so brief that unwanted knee movements don’t have time to occur.
The Take Home Message
There’s more findings that discredits the belief that foot strike pattern doesn’t matter in running, when it certainly does! Consistent with the research, forefoot running is completely justified in doing a significantly better job at safeguarding your knees than heel strike running. These findings also mesh with countless anecdotal reports, too!
In that light, if you are struggling with knee pain and you are a heel strike runner, you can make tremendous progress and much more to come with forefoot running!
References:
Kulmala et al. Forefoot strikers exhibit lower running-induced knee loading than rearfoot strikers. Med Sci Sports Exerc, 2013; 45(12):2306-13.
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Bretta Riches
BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
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Great insight for helping with knee pain! Glad I came across it, and appreciate the reference included. I may have to use it.