How to Fix Lower Back Pain From Running: Fix Your Foot Strike!

Lower back pain from running is directly related to your running form. Chances are if running is hurting your lower back, it’s because you are landing heel-first, not forefoot-first. Here’s why:

Foot strike pattern directly influences stride mechanics and upper body posture. When you land using a forefoot strike (above left), the knee automatically bends and flexes which shortens stride length. This also pulls the upper body more forward. This positional arrangement was found to make the most positive difference in reducing all-around impact levels on the entire body, which is why forefoot running ranks higher than heel strike running on preventing injuries, especially back injuries. Heel striking when running (above right) was found to cause the foot to swing out too far ahead of the torso, while pushing the torso further back behind initial foot strike position. Injuries were found to be rooted in this mechanical arrangement because it causes an over-stride that accompanies more competing forces hitting places on the body, like the lower back.

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From this, it’s easy to see that forefoot running provides essential mechanics and postural improvements that do more to lift you out of back pain than heel strike running.

There’s also more you can do, in addition to landing forefooted when running, to really safeguard your lower back from injury, and that is by allowing your trunk to rotate, while making sure both knees are kept slightly bent at ALL times.

A study in the Journal of Biomechanics reported that runners with lower back pain had different knee and trunk kinematics as compared with healthy runners.

  • The study found that runners with lower back pain had less pelvis and trunk rotation as compared with healthy runners.
  • Restricting pelvic and trunk rotation, as the runners with lower back pain did, were less resistant to  mechanical forces than the healthy runners who let their trunk and pelvis rotate.  In other words, letting your trunk rotate when running does more good to prevent rising tides of impact as compared with restricting trunk rotation.

*Here are two YouTube videos Ive done showing how to drive thoracic rotation with the proper arm swing: VIDEO 1.  and VIDEO 2. 

The study also found that runners with lower back pain landed with a more extended knee (fully unbent knee at landing) as compared with the healthy runners group.

  • Landing with an extended knee induces more shock on the body whereby a strong relation exists between an extended knee at touchdown and a loss of shock absorption in the lower leg while running.

Shown below, when comparing forefoot running to heel strike running, you’ll notice a fully unbent knee at heel strike in the heel strike running picture, whereas the forefoot striker employs a bent knee at touchdown.

As mentioned briefly, foot strike pattern directly influences stride mechanics, which includes knee-joint mechanics whereby forefoot striking automatically causes the knee to slightly bend and flex. At landing, heel striking causes the knee to fully unbend, which is why the margins of impact intensity and duration is higher in heel strike running because extended knee at landing impedes the shock absorbing characteristics of the leg.

Take Home Message

These findings fit into a continuum of complementary research proving that with forefoot running, injury prevention progress is always more possible than heel strike running, since there’s a lot of uncertainty about how to safely run with a heel strike. In fact, one study, which I wrote about here, shows that you cannot heel strike safely, even if you modify other aspects of your stride.

Here are over 25 reasons forefoot striking will be a source of tremendous progress for you as a runner!

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Hanlon, M., Anderson, R., 2006. Prediction methods to account for the effect of gait speed on lower limb angular kinematics. Gait Posture 24 (3), 280–287.

Muller et al. Low back pain affects trunk as well as lower limb movements during walking and running. J Biomech, 2015;48, 1009-1014.

Murray, M.P., Mollinger, L.A., Gardner, G.M., Sepic, S.B., 1984. Kinematic and EMG patterns during slow, free, and fast walking. J. Orthop. Res. 2 (3), 272–280.

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

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.
Bretta Riches

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!