Emerging Evidence on Footstrike Patterns in Running

Kevin Kirby · May 31, 2014

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For those who may be interested, my article Emerging Evidence on Footstrike Patterns in Running was just published in the June issue of Podiatry Today magazine.

Admin2 · May 31, 2014

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Craig Payne · Jun 1, 2014

I had to have a little laugh at what the editor wrote before the start of the article:

Given the popularity ..... associated with barefoot running and minimalist shoes....
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It was never popular (it just had an extraordinary presence online and in the media; the actual numbers doing it in the real world was always quite small) and minimalist shoe sales have fallen to <3-4% of the market --> hardly "popular"

Dennis Kiper · Jun 2, 2014

It's too bad you haven't experienced a “minimalist shoe” with the silicone orthotic. It's the perfect technology for the shoe style and gives the needed support to the shoe dynamics.

It's also very comfy as you would expect.

Kevin Kirby · Jun 2, 2014

Wait....let me do something real quick.....

This message is hidden because Dennis Kiper is on your ignore list.
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Aaahhhhh..much better now.....;):cool:

Craig Payne · Jun 2, 2014

Dennis Kiper said: ↑

It's too bad you haven't experienced a “minimalist shoe” with the silicone orthotic. It's the perfect technology for the shoe style and gives the needed support to the shoe dynamics.
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The whole 'purpose' or 'philosophy' behind a 'minimalist' running shoe is to do away with the need of these external supportive features!

toomoon · Jun 2, 2014

Craig Payne said: ↑

The whole 'purpose' or 'philosophy' behind a 'minimalist' running shoe is to do away with the need of these external supportive features!
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hahahaha.. it really should not be that complicated eh Craig? Actually.. it really should not even need to be explained! Still.. i got my Monday belly laugh in!

drdebrule · Jun 2, 2014

I really like this Pod Today article and encourage others with sports medicine patients to read this. It is fair and evidence based without the fan boy arguments I see from time to time. I was surprised at how many of these articles have been cited in Pod Arena biomechanical threads, which I have been following. It seems forefoot striking or barefoot/minimal running is really a personal choice that most runners are not making. Perhaps future studies will look more into self selection for an economical running style, which is interesting. I think the article could have put more emphasis on the decrease in minimal shoe sales or Vibram class action, but why be negative? Thanks for sharing again Kevin!

Dennis Kiper · Jun 3, 2014

I'm not stuck on sticking to someone else's philosophy. My philosophy is to think out of the box.

Working with a reliable Rx and the dynamics of the shoe style makes for what you were expecting, a very good product-mix.

Kevin Kirby · Jun 4, 2014

We're starting to get some good comments at the end of my article on the Podiatry Today website (Thanks Dave W.!). Anyone else want to contribute?

Emerging Evidence on Foot Strike Patterns in Running

Kevin Kirby · Jun 5, 2014

Marty Hoffman, MD, left a good comment at the end of my article on the Podiatry Today website on how his research group found creatine phosphokinase (CK) to be elevated in non-rearfoot striking ultramarathoners. My guess is that this elevation in CK levels in forefoot and midfoot strikers occurs due to the increased demand on their posterior leg muscles during the first half of the support phase of running to decelerate footstrike versus the rearfoot strikers.

Emerging Evidence on Foot Strike Patterns in Running

NewsBot · Jun 21, 2014

Predicting timing of foot strike during running, independent of striking technique, using Principal Component Analysis of joint angles
Sean T Osis, Blayne A Hettinga, Jessica Leitch, Reed Ferber
Journal of Biomechanics; Articles in Press

As 3-dimensional (3D) motion-capture for clinical gait analysis continues to evolve, new methods must be developed to improve the detection of gait cycle events based on kinematic data. Recently, the application of principal component analysis (PCA) to gait data has shown promise in detecting important biomechanical features. Therefore, the purpose of this study was to define a new foot strike detection method for a continuum of striking techniques, by applying PCA to joint angle waveforms. In accordance with Newtonian mechanics, it was hypothesized that transient features in the sagittal-plane accelerations of the lower extremity would be linked with the impulsive application of force to the foot at foot strike. Kinematic and kinetic data from treadmill running were selected for 154 subjects, from a database of gait biomechanics. Ankle, knee and hip sagittal plane angular acceleration kinematic curves were chained together to form a row input to a PCA matrix. A linear polynomial was calculated based on PCA scores, and a 10-fold cross-validation was performed to evaluate prediction accuracy against gold-standard foot strike as determined by a 10 N rise in the vertical ground reaction force. Results show 89%–94% of all predicted foot strikes were within 4 frames (20 ms) of the gold standard with the largest error being 28 ms. It is concluded that this new foot strike detection is an improvement on existing methods and can be applied regardless of whether the runner exhibits a rearfoot, midfoot, or forefoot strike pattern.
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NewsBot · Jul 25, 2015

Acute effect of a long-distance road competition on foot strike patterns, inversion and kinematics parameters in endurance runners
Latorre-Román, Pedro Ángel; Jiménez, Marcos Muñoz; Hermoso, Victor Manuel Soto; Sánchez, Jesús Salas; Molina, Alejandro Molina; Fuentes, Alejandro Robles; García-Pinillos, Felipe
International Journal of Performance Analysis in Sport, Volume 15, Number 2, August 2015, pp. 588-597(10)

The purpose of this study was to determine the foot strike patterns, inversion and kinematics variables in recreational runners during a long-distance road competition, determining an association between foot strike pattern's classification, inversion and kinematics variables with athletic performance and sex. Five hundred and forty-two athletes who participated in a half marathon passed through the 15 km data collection point. Photogrammetric techniques (2D) were used to measure contact time and flight time. A high prevalence of rearfoot and high rearfoot strikes was found among the most recreational distance runners. No significant differences between sexes in foot strike pattern were found, whilst significant differences between level groups in the asymmetry (first level = 96.5%, second level = 10.6% and third level = 0.4%) were found. Additionally, forefoot and high forefoot strike exhibit greater percentage for inversion. Moreover, athletes with high rearfoot and rearfoot strike showed a greater contact time and lower flight time. Foot strike patterns were influenced by running speed; thus, athletes with higher performance exhibit lower frequency of rearfoot and high rearfoot strikes. Further research could clarify the causes and consequences (performance and injury) of the current findings.
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NewsBot · Aug 26, 2015

Biomechanical Differences of Foot Strike Patterns During Running: A Systematic Review With Meta-Analysis
Matheus O. Almeida, PT, PhD, Irene S. Davis, PT, PhD, Alexandre D. Lopes, PT, PhD
Journal of Orthopaedic & Sports Physical Therapy, Ahead of Print

Objective
To determine the biomechanical differences between foot strike patterns using when running.

Background
Strike patterns during running has received attention in the recent literature due to the mechanical differences and associated injury risks between them.

Methods
Electronic databases (Medline, Embase, Lilacs, Scielo, and SPORTDiscus) were searched through July 2014. Studies (cross-sectional, case control, prospective, and retrospective) comparing biomechanical characteristics between foot strike patterns during running of distance runners with at least 18 years of age were included in this review. Two independent reviewers evaluated the risk of bias. A meta-analysis with a random-effects model was used to combine the data from the included studies.

Results
Sixteen studies were included in the final analysis. In the meta-analyses of kinematic variables, significant differences between forefoot and rearfoot strikers were found for foot and knee angle at initial contact and knee flexion range of motion. A forefoot strike pattern resulted in a plantar flexed ankle position and a more flexed knee position, compared to a dorsiflexed ankle position and a more extended knee position for the rearfoot strikers, at initial contact with ground. In the comparison of rearfoot and midfoot strikers, midfoot strikers demonstrated greater ankle dorsiflexion range of motion and decreased knee flexion range of motion compared to rearfoot strikers. For kinetic variables, the meta-analysis revealed that rearfoot strikers had higher vertical loading rates compared to forefoot strikers.

Conclusion
There are differences in kinematic and kinetic characteristics between foot strike patterns when running. Clinicians should be aware of these characteristics to help in the management of running injuries and advice on training.
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NewsBot · Sep 9, 2015

Foot strike pattern and injuries in ultramarathoners

NewsBot · Sep 24, 2015

Ankle and knee kinetics between strike patterns at common training speeds in competitive male runners
Daniel Kuhman, Daniel Melcher & Max R. Paquette
European Journal of Sport Science; in press

The purpose of this study was to investigate the interaction of foot strike and common speeds on sagittal plane ankle and knee joint kinetics in competitive rear foot strike (RFS) runners when running with a RFS pattern and an imposed forefoot strike (FFS) pattern. Sixteen competitive habitual male RFS runners ran at two different speeds (i.e. 8 and 6 min mile−1) using their habitual RFS and an imposed FFS pattern. A repeated measures analysis of variance was used to assess a potential interaction between strike pattern and speed for selected ground reaction force (GRF) variables and, sagittal plane ankle and knee kinematic and kinetic variables. No foot strike and speed interaction was observed for any of the kinetic variables. Habitual RFS yielded a greater loading rate of the vertical GRF, peak ankle dorsiflexor moment, peak knee extensor moment, peak knee eccentric extensor power, peak dorsiflexion and sagittal plane knee range of motion compared to imposed FFS. Imposed FFS yielded greater maximum vertical GRF, peak ankle plantarflexor moment, peak ankle eccentric plantarflexor power and sagittal plane ankle ROM compared to habitual RFS. Consistent with previous literature, imposed FFS in habitual RFS reduces eccentric knee extensor and ankle dorsiflexor involvement but produce greater eccentric ankle plantarflexor action compared to RFS. These acute differences between strike patterns were independent of running speeds equivalent to typical easy and hard training runs in competitive male runners. Current findings along with previous literature suggest differences in lower extremity kinetics between habitual RFS and imposed FFS running are consistent among a variety of runner populations.
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NewsBot · Jul 27, 2019

Forefoot strike, rear foot strike or running shoes. Does it matter?
David Janoušek, Pavel Stejskal
Source

The main aim of this article is to provide some insight into evidence-based data in running. The prevalence of a rearfoot strike (RFS) pattern is much more usual than a forefoot strike (FFS) even among
elite distance runners. There has been significant pressure on runners to change their running style
from RFS to FFS in recent times. Usually, this has been justified by the statement that FFS relates to a
lower injury rate. Recent studies have shown however, that this statement is probably not true. Different
types of strike pattern have an influence on loading different structures of the lower limbs, but the total
incidence of running related injury is the same regardless of the type of foot strike pattern.
We want to provide not only an objective view on running technique but also an evidence-based view
on the choice of running shoes. There are many recommendations to consider when choosing running
shoes, especially in running stores, but only a few of them are supported by research.
This article is not a meta-analysis but it provides some evidence based information about running
styles and running shoes

Changing foot strike technique for uninjured distance runners has no justifiable basis according
to evidence-based data.
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NewsBot · Sep 18, 2019

Immediate effect of visual, auditory and combined feedback on foot strike pattern
ChutimaPhanphoa1SmitaRaoab1MarilynMoffata
Gait & Posture; 16 September 2019

Highlights
•Real-time feedback during running shifts the center of pressure anteriorly.
•Particularly when foot strike modification is combined with increased cadence.
•Lower heel and midfoot loads and higher forefoot and great toe loads noted.
•Particularly with auditory feedback was combined with increased cadence.
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Background
A growing body of literature supports the promising effect of real-time feedback to re-train runners. However, no studies have comprehensively assessed the effects of foots trike and cadence modification using different forms of real-time feedback provided via wearable devices.

Research question
The purpose of the present study was to determine if a change could be made in foot strike pattern and plantar loads using real-time visual, auditory and combined feedback provided using wearable devices.

Methods
Visual, auditory and combined feedback were provided using wearable devices as fifteen recreational runners ran on a treadmill at self-selected speed and increased cadence. Plantar loads and location of initial contact were measured with a flexible insole system. Repeated measures ANOVAs with Bonferroni adjusted pair-wise comparisons were used to assess statistical significance.

Results and significance
A significant effect of condition was noted on location of center of pressure (p < 0.01). Bonferroni-adjusted post-hoc comparisons showed that feedback conditions differed from baseline as well as the new cadence conditions, however did not differ from each other. A significant interaction effect (region x feedback) was found for plantar loads (maximum force P < 0.001). Significant effects of feedback were noted at the heel (P < 0.001), medial midfoot (P < 0.001), lateral midfoot (P < 0.001), medial forefoot (P = 0.003), central forefoot (P = 0.003), and great toe (P = 0.004) but not at the lateral forefoot (P = 0.6) or lateral toes (P = 0.507).

Significance
The unique findings of our study showed that an anterior shift of the center of pressure, particularly when foot strike modification was combined with 10% increased cadence. We found lower heel and midfoot loads along with higher forefoot and great toe loads when foot strike modification using real-time feedback was combined with increased cadence. Our findings also suggest that auditory feedback might be more effective than visual feedback in foot-strike modification.
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NewsBot · Sep 18, 2019

Relationship of Foot Strike Pattern and Landing Impacts during a Marathon.
Ruder M et al
Med Sci Sports Exerc. 2019 Oct;51(10):2073-2079

PURPOSE:
Foot strike patterns (FSP) influence landing mechanics, with rearfoot strike (RFS) runners exhibiting higher impact loading than forefoot strike (FFS) runners. The few studies that included midfoot strike (MFS) runners have typically grouped them together with FFS. In addition, most running studies have been conducted in laboratories. Advances in wearable technology now allow the measurement of runners' mechanics in their natural environment. The purpose of this study was to examine the relationship between FSP and impacts across a marathon race.

METHODS:
A total of 222 healthy runners (119 males, 103 females; age, 44.1 ± 10.8 yr) running a marathon race were included. A treadmill assessment was undertaken to determine FSP. An ankle-mounted accelerometer recorded tibial shock (TS) over the course of the marathon. TS was compared between RFS, MFS, and FFS. Correlations between speed and impacts were examined between FSP. TS was also compared at the 10- and 40-km race points.

RESULTS:
RFS and MFS runners exhibited similar TS (12.24g ± 3.59g vs 11.82g ± 2.68g, P = 0.46) that was significantly higher (P < 0.001 and P < 0.01, respectively) than FFS runners (9.88g ± 2.51g). In addition, TS increased with speed for both RFS (r = 0.54, P = 0.01) and MFS (r = 0.42, P = 0.02) runners, but not FFS (r = 0.05, P = 0.83). Finally, both speed (P < 0.001) and TS (P < 0.001) were reduced between the 10- and the 40-km race points. However, when normalized for speed, TS was not different (P = 0.84).

CONCLUSIONS:
RFS and MFS exhibit higher TS than FFS. In addition, RFS and MFS increase TS with speed, whereas FFS do not. These results suggest that the impact loading of MFS is more like RFS than FFS. Finally, TS, when normalized for speed, is similar between the beginning and the end of the race.
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