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To heel strike or not to heel strike?

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PETERSON AIR FORCE BASE, Colo. -- PETERSON AIR FORCE BASE, Colo. - If you have been around anyone talking about running form in the last decade, you may have heard them say something about heel striking and how it is bad for you.

The “heel strike pattern” has to do with where the foot contacts the ground on impact. Do you land on the heel first, midfoot, or forefoot? There was a common thought that if you landed on the heel, you were “braking” while running, and therefore slowing yourself down. Not only that, but theoretically you were increasing the force that goes through your joint and this could lead to runner’s knee, bursitis or osteoarthritis.

The debate on running mechanics has been going on for a while. With popular books like “Born to Run” and the surge of the Vibram 5-Finger shoes, barefoot running tookcenter stage, and with it a forefoot strike pattern. Heel striking in big, cushiony traditional shoes became a thing of the past and was to be avoided at all costs. The excitement over the cool finger shoes may have been a bit too much, too soon.

We know that on average landing on your heel tends to increase loading rate, which is essentially a measure of how fast force is applied to the body. This could lead to an increased risk of injury. The problem is there has been no solid data to show that running barefoot or on the toes leads to fewer injuries than running on the heel.

An observational study on Olympic marathon runners revealed that one third of them contact on their forefoot, one third on the mid-foot, and one third on the heel, so it doesn’t seem to be slowing anyone down either. Where does this leave us? How should we run?

The real issue that seems to come to the forefront is the problem of over-striding. Over-striding happens when a runner loads all of their weight in front of the hips or spine, also known as your center of mass. Heel strikers and forefoot strikers alike have poor mechanics and increased risk for injury when this is the case.

One of the best methods to determine if you are over-striding is checking your cadence – counting how many steps taken per minute while running. One study found that even though Olympians all had different foot strike patterns, nearly every one of them, from the 800 meters to the marathon, runs with a 180 steps per minute cadence.

Cadence is important. Besides being economically more efficient, it may also decrease risk for injury. With a higher cadence the foot gets underneath the center of mass much faster. The foot is securely underneath hips and spine for optimal force and shock absorption. This prevents over-striding and helps decrease the tension that our tendons, ligaments, muscles, and connective tissues have to endure. A look through the research suggests that it is not so much where the foot first hits the ground, but where it is in relation to the hips and spine when all the weight is maximally loaded.

There is a lot more that could be said about this debate, but it certainly is not as simple as saying heel striking is bad or good. The next time you go out for a jog, instead of thinking about how your foot is hitting the ground, count how many steps you take in a minute. It may be that cadence and over-striding are what could be worked on before running barefoot or on your toes.

***Disclaimer: Not everyone needs to be at exactly 180 steps per minute. Differences in height, weight, gender, and genetic make-up all affect running form and cadence. You may be a little higher or lower than 180, but that is ok. The further you are from that number, however, the more you might want to consider altering your cadence.

This article was written by Capt Matthew Williams, Doctor of Physical Therapy and 2016 Olympic Marathon Trials Qualifier. He works with patients here on Peterson AFB and with several local Olympic Distance Runners.

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