I’m a Heel-Striker, and I’m OK

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Most runners are heel strikers.  Is that really a problem?

Can you guess which runners finished first and second in this marathon?

The topic that stirs the most passion and debate among runners these days is probably shoe selection and its impact on injury rate.  In case you are out of the loop on this one, the popular theory is that modern running shoes (as characterized by a cushioned-sole design employing a heel-to-toe drop often in the range of 10-14 mm) actually contribute to increasing injury rates, as opposed to providing the “protection” or “correction” that manufacturers claim. The argument now is that we should return to our roots and run more naturally – i.e. barefoot running, or, acknowledging the sensitivity our typically-shod feet have evolved to possess, with “minimalist” shoes with no heel-to-toe drop.

This debate started many years ago but really reached the “mainstream” with the publication of [amazon_link id=”0307266303″ target=”_blank” container=”” container_class=”” rel=”nofollow”]Christopher McDougal’s Born to Run[/amazon_link] in 2009 (previously reviewed).  The number of studies on the impact of running shoes on form and injury rate by the likes of Dan Lieberman, Pete Larson, and other evolutionary biologists has skyrocketed. The options in minimalist shoes from existing and companies new to the running shoe market (such as Vibrams, Skora RunningAltra, etc.) have likewise multiplied.

However, as with most complex topics, the debate is becoming oversimplified.  As Brian Martin points out in his preamble to a running shoe debate, there is far more involved to running injury-free than just selecting the right shoes.  In fact, it’s even debatable as to how large of a role shoe selection really does play in your performance as a runner.

The “lazy” interpretation of recent thinking is:

  • Cushioned running shoes encourage (or even “force”) you to land on your heel
  • Heel striking increases the impact felt by your legs, thus increasing injury risk
  • Moving to a midfoot or forefoot strike reduces these forces and resulting injury risk
  • Minimalist shoes are necessary to become a midfoot or forefoot striker

This oversimplifies things.  Now granted, more discriminating evangelists for minimalist running are careful to delineate the process for achieving injury reduction more clearly, but unfortunately they tend to get shouted over by those carrying the simpler (and wrong message).

First, what really drives the injury risk is the rate at which the loading forces at foot strike are transmitted through your legs.  As Jay Dicharry so vividly portrays in his analysis of various loading rates, this isn’t entirely dictated by whether you are a heel striker or a midfoot or forefoot striker.  It is more dictated by where your center of gravity is, relative to your foot, when you land.  It is conceivable, if difficult, to land on your heel but to do so with a low enough loading rate to mimic the lower injury risk that a typical midfoot striker would enjoy.

Second, there is an implication that there is some sort of bimodal distribution – you are either a heel-striker, or a midfoot-striker.  The reality is that the distribution is more continuous than this – there are varying degrees of heel-strike.  Some runners do overstride significantly, whereas others have a more appropriate stride length and “barely” land on their heel.  There is thus a “gray area” between heel- and midfoot-striking that is likely occupied by a good number of runners.

Third, heel-striking (or, more correctly, overstriding) is a symptom of running form issues, not the direct cause of the problem.  It is difficult, maybe even impossible, to focus strictly on landing on your midfoot.  Your efforts must focus on not just improving your form through various techniques, but also on making sure that you address strength and mobility imbalances, often through ancillary work, to remove any physical barriers you might have to achieving this form.

Finally, at least one study suggests that heel-striking may be a more efficient way to run.  There are two ways to increase your speed – either increase your cadence, or increase your stride length.  Heel-strikers would tend to have a longer stride, and it appears that their cadence is generally not significantly less than that of most midfoot-strikers.  Thus, they produce more speed for a given level of effort.  The ultimate runner, then, may be a slight heel-striker who can avoid injury.

So, the reality is that becoming a “better” (more injury-resistant) runner is not as simple as learning how to run in minimalist shoes.  That may be part of the solution, but the process for getting there is more involved than the simplistic view too often espoused by minimalist advocates would portray.  Like most things in life, there are no shortcuts.  Yes, a shoe strategy may certainly be an element of this journey – but maybe not.  If it is, it may be the third or fourth most important part of the transition.  There are plenty of runners who have managed to avoid injury while running in “traditional” running shoes.

It is a confusing time for runners right now, with many conflicting messages on shoe selection.  This is particularly true for runners who have faced or are facing injury.  I’m in that quandary right now, having gone through two injuries the past two spring seasons.  I don’t believe that either injury (hamstring strain last year, Achilles tendinitis this year) were directly “caused by” poor running form or wearing “traditional” shoes. In fact, if anything, I’d argue that maybe putting in too many longer runs in my Saucony Kinvara’s with their 4mm heel-to-toe drop (note – I do not classify this as a “minimalist” shoe) is more likely the cause of the latter, though in both cases overtraining relative to my capabilities at the time is probably the primary contributor.

This isn’t to say that low heel-to-toe drop shoes will not be a part of my routine going forward. It’s just that I, like any runner, need to be smart about how we use such shoes and whether we ultimately make a full transition to “minimalist” shoes or not.  They are a valuable tool for strengthening your calves and working on your form, but they are not a shortcut.  Don’t let anyone sell you otherwise.

And now for something completely different…

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  • http://saltyrunning.wordpress.com/ Salty

    I’ve been thinking a lot about running form since my injury and discuss it in today’s post a little bit. I’ll be discussing it a lot more in the coming weeks too as I embark on a little experiment. (I now the suspense is killing you! Haha) But to some extent I think we all have a running form unique to ourselves that out bodies and brains deems efficient and perhaps if we tinker too much with it and try to “perfect” it we will cause more problems, not less. There’s a reason my arms are wonky and a reason you heel strike. The body is probably protecting something else: maybe I’d have a pelvis stress fracture if my arms were more lazy or maybe you would have metatarsal problems if your strike was further up the foot. Who knows. But I agree, runners tend to have this black and white attitude about things and not be appreciative of the little quirks and “imperfections” that prevent them from being content with the runners and people they are. 

  • http://predawnrunner.com Greg Strosaker

    Hi Salty and thanks for your comment, looking forward to your post and your experiment. I think to a great extent you are correct and fighting our natural tendencies carries some risk. I don’t doubt that some runners, however, do need to consciously address their form in over to overcome limitations (either in performance/efficiency or in injury issues). And for the rest of us (I’ll speculate that my form is nominally “fine” if not “perfect”), there is value in not being content with our current form to the extent improving it would offer performance gains. However, it is easy to step over the line and tweak too much or try to shift things too quickly.

  • http://predawnrunner.com Greg Strosaker

    Hi Salty and thanks for your comment, looking forward to your post and your experiment. I think to a great extent you are correct and fighting our natural tendencies carries some risk. I don’t doubt that some runners, however, do need to consciously address their form in over to overcome limitations (either in performance/efficiency or in injury issues). And for the rest of us (I’ll speculate that my form is nominally “fine” if not “perfect”), there is value in not being content with our current form to the extent improving it would offer performance gains. However, it is easy to step over the line and tweak too much or try to shift things too quickly.

  • http://profiles.google.com/rachel1824 Rachel Caine

    I love this post, Greg. I tend to use more minimal shoes, like the Kinvara (but I agree that these are not really minimalist, just more so than, say, your typical Asics or something), and have very recently decided to try a pair of Newtons. Because of some hip and glute imbalances, I midfoot strike quite perfectly with my left foot, but have a weirder strike with my right foot. Wearing these shoes that help promote a lighter strike has helped (along with quite a bit of very consistent ancillary work) my imbalance immensely and helps me keep that better running form even at the end of tough or long runs, when it tends to break down a bit. But I also rotate different shoes quite a bit to work different muscles.  Some days a more “traditional” sneaker just feels better. I think just being aware of your form, stride, cadence, and weaknesses is the key.

  • Robert Osfield

    You’ve rather ms-intrepreted the study “Metabolic Cost of Running Barefoot versus Shod: Is Lighter…”, this study doesn’t discuss heel strike vs mid-foot/forefoot strike, it just looks at running in socks with/withut weights and running in lightweight shoes with/without weights.  So you conclusion that this study suggests that heel striking is more efficient is totally unfounded.  What this study does suggest is that lighter is more efficient, and cushioned shoe may also be more efficient that running in socks.  The first conclusion is something seen in other studies.  However, the second conclusion is rather tenable, one would have to engineer a different study to properly work this out.Given that there is disproportionately higher percentage of mid-foot and forefoot strikers in the upper places of both short and distance than at lower placed finishers it would suggest that their is some advantage to be gained with avoiding heel striking.  It isn’t a killer blow though – there are still lots of very capable heel strikers amongst elite marathon runners.  So I’d expect there to a either an small efficiency advantage, or a training advantage in avoiding injury or perhaps both when not heel striking.  The avoidance of injury does have some support as show by Dr. Lieberman’s recent study:   http://sweatscience.com/lieberman-on-foot-strike-and-injuries-on-harvards-xc-team/However, I’d caution against going all out to become a non heel striker, it will certainly help with some injuries, such as shin, knee and hip injuries, but make increase the risk of injuries of the foot, Achilles and calves especially during the transition period where the body adapts to the new loading of the body.Reducing shoe weight and upping cadence should be something that many runners will benefit from in terms of efficiency and lowering strain on the body.

  • http://designedtorun.com/ Rob Savarese

    Ok, I’ll take the bait :-)

    Just speaking for myself here Greg, but I was a 45year old heel-striker and I wasn’t OK. I was hampered by knee problems at 40 miles/wk that was a direct result of my foot-strike. While I might be an experiment of one, I spent the past year and a half completely reworking my gait and completely changing my footwear right down to training in VVFs. The result is I have nothing but PR’s to show for it at every distance from a 5k to the marathon on a 60+ mi/week schedule and other than taking off a day here or there, I haven’t lost any time to injury in over a year. My results might be anecdotal but there you have it.

    You make a good point though that it’s not the ‘heel-striking’ specifically that’s the problem. It’s cadence, CG issues, posture and several other factors that result in heel-striking. So I agree that heel-striking is a symptom and not a cause and all minimalist advocates would probably agree with you. It’s just easier to use the term in the same way you would use ‘benign’ or ‘malignant’ to describe cancer. There’s much more to cancer than that but conversationally it is an efficient convention.

    I personally don’t think the debate is being over-simplified so I’m not sure how you can make that statement. If anything it’s being discussed at a fairly high level. To be fair I think you’re over-simplifying the minimalist argument. There is a lot of research backing up this approach and a lot of success stories like mine that are a result of it. Your post seems more like you are trying to convince yourself that heel-striking is OK rather than defending it as a viable running form.

    As quick side-note, I was dealing with some Achilles issues a few months back until I realized I was still heavily heel striking when I walked. After making some adjustments to my walking gait, the problem vanished in about two weeks. Again anecdotal but typically were there’s smoke there’s fire.

    I think we can both agree though that some form changes are not advised: http://youtu.be/IqhlQfXUk7w

  • http://predawnrunner.com Greg Strosaker

    Thanks Rachel, I honestly think that most runners under appreciate the value of rotating through different types of shoes on a regular basis. While many follow the idea of alternating shoes, they do it with two shoes of the same (or similar) type and miss the opportunity to develop a broader array of muscles and ligaments. Sounds like you have it right.

  • http://predawnrunner.com Greg Strosaker

    Robert, thanks for your intelligent comment, and I think your criticism of the efficiency study is fair (and I’ve seen it elsewhere). To be clear, I didn’t state that one can conclude that heel-striking is more efficient from this study, only that one must admit the possibility. Certainly further studies aimed specifically at that variable (manner of foot strike) would be necessary to get closer to a conclusive answer.
    I would also agree that midfoot strikers tend to be better runners, though in my leading picture, the first and second place finishers were those who appear to be the biggest heel-strikers – I know because I was first – and I know that such pictures can be a bit deceptive as they show one moment in time. I do question whether the cause and effect is clear. Are these inherently gifted runners who by nature also have better form, or are they former heel-strikers who improved their form and saw resulting success?
    My view on shoes is similar to your last point (and frankly similar to the point of the “Metabolic Cost” study) – lighter is better, independent of heel-to-toe drop.

  • http://predawnrunner.com Greg Strosaker

    Rob, somehow I knew you would take the bait – in fact, I think it was some of your posts regarding your efforts to improve form / footstrike that got me thinking about writing such a post. I don’t disagree at all that for some runners who have had injuries, moving to a midfoot strike and minimalist shoes is a boon. But your comment supports my argument – it took a lot of effort and time for you to make the transition. You are to be admired for sustaining such an effort (and congratulated on the result). I suspect many runners won’t be ready to follow through on such a commitment.
    My beef with the minimalist argument is that they do, in fact, rely on the same overly simplified messages that they criticize from the traditional running shoe companies. Of course, such is marketing – you don’t have the time and space to lay out the full argument, so often have to rely on soundbites. So it’s more of a “those who live in glass houses…” argument – don’t criticize in others what you yourself are practicing (note, I don’t mean “you”, I mean the writers of the ads I just saw in Runner’s World yesterday implying that minimalism is nirvana for everyone).
    And I was probably heel-striking while cleaning our carpets last night. My Achilles hurt like he**.

  • http://designedtorun.com/ Rob Savarese

    Glad I didn’t disappoint you Greg! I see where you are coming from considering the marketing departments of both shoe companies and running magazines are now starting to look at monetizing the minimalist trend. I honestly haven’t seen much of what you described but that’s probably due to the way I’m looking at the issue. I haven’t gotten my May issue of RW yet but when I do I’ll look at it with a more discerning eye :-)

    I liked the links in your post and saw one or two I hadn’t come across yet so thanks for sharing those. One interesting thing I noted in the uvaendurosport link was in the loading graphs. While the initial load for a mid-foot strike is slightly steeper (as pointed out by the author), the top load for the heel striker is about 60% higher (2000 vs. 1200). I understand all the caveats mentioned but I just found it interesting that this wasn’t addressed and the slightly increased loading rate was.

    Have you found in your experience you can still land heal first with a high cadence and making ground contact near your CG? I’m not talking ‘grazing’ the ground with your heel (I think I still do that on occasion as evidenced by the wear on my trainers) but a firm contact? I’m curious because when I think of heel striking it’s more along the lines of heel crashing which is what I was doing 2 years ago.

  • http://predawnrunner.com Greg Strosaker

    Rob, I don’t think I have the sensitivity to my footstrike to the same degree you do – I may well “graze” the ground as you said (which is part of the point of this post – not all heel-striking is created equal). I run more loudly than I’d like, which is something I need to work on.
    I think Jay made the point that it is the rate and not the total load (or peak load) that causes injury. I don’t know how accurate that is, but it makes sense.
    And I was really struck by this particular Runners World as to the aggressiveness of the ads for minimalist shoes right in the first few pages.

  • Robert Osfield

    Hi Greg,

    > To be clear, I didn’t state that one can conclude that heel-striking is more
    > efficient from this study

    Um… you seem to forgot what you wrote:

    ” Finally, at least one study suggests that heel-striking may be a more efficient way to run. ”

    It was *you* alone that made the suggestion that the study suggested that heel-striking may be a more efficient way to run.  The study doesn’t not suggests this at all.  You are mis-representing the study. 

    In your post you try to highlight the dangers of over simplification yet you quite happily indulge in misrepresentation and simplification yourself.  Do one not see a little hypocrisy here?

  • http://predawnrunner.com Greg Strosaker

    Robert, I will grant you that I took the conclusions from Alex’s post one step further. His post states that the gains from running with shoes are due to an overstride, and I took it to also mean that if one has to “slightly” heel strike to achieve such an overstride, then so be it (i.e., heel striking may let you be more efficient). But I do take issue with your use of the word “conclude” – are the words “may” and “suggest” not enough of a hedge for you? I’m suggesting an interpretation of a study, and not making a conclusion at all. The only sentence I didn’t hedge in that paragraph is the fourth, where I state “they produce more speed for a given level of effort.” That would better be written as “they may”.
    I would debate that this is misinterpretation or hypocrisy. It is offering a suggestion on how one could interpret the results of this study.

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