Different Running Styles

Running continues to be the most popular form of fitness exercise, so it is important to continue our search for the best possible, least injury-prone form of foot strike.

The foot has 26 bones and 33 joints that must function in varied sequences to adapt to changes in surfaces underfoot. Athletes use various foot-strike methods to run, but some are more efficient and cause fewer injuries than others.

  • Forefoot Strike/Barefoot Running

Providers treating running athletes continue to be concerned about barefoot running, as the number of injuries from this style is rapidly climbing. Many of the injuries are complex and may result in chronic disability and may get worse over time. Bone injury to the metatarsal heads or soft-tissue injury to any of the metatarsal bursa or plantar plates is high on the list of possibilities. These injuries can cause immediate running disability and can continue with a cascade of complications in the years going forward. That being said, barefoot running has caused many of us to reinvest in examining running-style options. Hardly a day goes by that I don’t have an opportunity to read a sports-medicine study on running form and associated injuries.

  • Rear-foot Strike

The rear-foot strike is the most common running form, as it is really an extension of walking. The whole running phenomenon was, and still is, based on heel-strike, toe-off running. Mostly all of the research that is used for the running shoe design is based on this style of running. We have known that the problem with this style is absorbing the shock created by the increased gravitational forces at heel strike. This may be as high as 12 times the normal body weight of the runner. The major shoe companies have been dealing with this problem with shoes designed to absorb shock, yet allow the foot to function normally. They have had limited success, mostly because of the complexity of foot anatomy.

Forefoot Strike First

Little doubt remains in my mind that the forefoot-strike technique is a more efficient style of running and will yield fewer injuries. It is a more natural form of running, but not at all like walking, so it must be learned. When the forefoot strikes first, the entire lower extremity chain works to absorb shock. The metatarsals in the foot have a large protective fat pad that initially absorbs the first shock at touchdown. The metatarsals then come into play with some dorsal excursion followed very rapidly by the sliding and gliding motions in the tarsal or rear-foot bones. The ankle pistons downward absorbing even more shock and the knee, which is somewhat bent when the foot strikes the ground, is absorbing even more shock. Whatever shock is left from the gravitational forces moves onto the hip and very little then transfers to the back. Take a moment and examine this process and compare it to heel strike first.

Can You Teach an Old Dog New Tricks?

Sure you can, but it will take time, fearless determination, strength, and trust. You will experience muscle aches and pains, a complete lack of gracefulness, and even risk some injuries. To avoid all of these very disturbing hurdles, the key is to take time, lots of time, to alter your style. Determination and constant thoughtfulness of form are keys to success.

How Can You Do It?

You need no special equipment; in fact, I feel that the transition will be easier if you use your present running shoes. I like the extra cushion in the forefoot and the higher heel-to-toe design. Both of these will work in your favor during the change in form. Most runners over stride. They take a longer stride than is necessary, and this is often a primary cause of runners’ injury. Keep your hips directly under your body and your feet directly under you hips. Never exceed a foot strike beyond the surface under your hip. Increase speed by leg turnover not increased stride length.

The first thing you will notice is that your quads are working overtime, and this is the first clue that this undertaking will take a long time to learn. Muscle memory and strength must be developed to go the distance. Begin with a jogging style, slow and easy. If you have been running for years, all of this may not seem worth the effort, but I think differently. If you love running as a sport, and as an efficient method of staying in shape, the forefoot strike will keep you running longer with fewer injuries.

The arduous process to change style may take as long as a year. At one point in time, running was thought to be nothing more than an extension of walking—just faster. Running is very different from walking, and it takes special muscle strength. Think of the choreographer and the dancer. The dancer/athlete performs with grace and ease because muscles have been trained and strengthened to achieve this result. Running with a forefoot strike first may be your best dance.

Rob Rinaldi DPM

Robert Rinaldi is a board-certified podiatrist and podiatric surgeon at the Gifford Medical Center in Randolph, VT. He is a fellow and a founding member of the American Academy of Podiatric Sports Medicine, and a podiatric consultant to the Dartmouth College track and cross-country teams. He is a former nationally ranked long-distance runner, having competed in 25 world-class marathons. You can reach him at Gifford Sports Medicine and Surgery Clinics in Randolph, VT, or at the Sharon Health Clinic in Sharon, VT, 802-728-2490 or 802-763-8000 or at rrinaldi@giffordmed.org.