Ask a PT: Heel Striking & Chronic RLE Pain

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Q: Is a mild heel strike bad?

Hey there Competitor!

I’ve been running for 23 years now, with the last 10 or so serious. The last five years I’ve been plagued with injury after injury, all self-diagnosed. I’ve tried a number of different shoe brands, different stack heights, etc. This winter I have started to correct my form and land midfoot/forefoot. I feel I’ve made progress. I’ve read so much about how this is supposed to be better for you.

I’m slower because of it now and have tried to purposely run like I used to and it doesn’t feel right so I continue with the new form. I see so many in social media still heel striking and are faster than me like I used to be when I heel striked. I also see some elite runners who mildly heel strike. My question is, is a mild heel strike all that bad? I don’t want to heel strike again but I do want to get back to how fast I was when I did. Is that possible? Thanks!

— John, 44
Warsaw, IN
(Question edited for grammar and clarity.)

A: Dr. Marc Robinson

Hey John, great question. The heel strike pattern is not inherently bad. Someone’s foot strike is influenced by several variables such as step rate, habitual foot strike pattern, shoe ware and training level among other factors. In fact, many marathon runners are shown to prefer a heel strike pattern.

One study found that 95 percent of 1,991 sub-elite runners chose a heel strike during a full marathon and 74.9 percent of elite, international level runners chose a heel strike during a half marathon. Even barefoot runners heel strike. According to a study in 2013 that looked at 38 habitual barefoot runners, it found the majority preferred a heel-strike or mid-foot strike pattern. This study used a small sample size but it is still interesting to note.

In contrast, another study found that habitual barefoot runners or those who transitioned to barefoot running typically choose a forefoot strike. The study also noted more impact from heel strike at the initial point of contact with the ground which indicates that heel strike running has potential to increase injury risk. However, at this time, studies do not conclusively link heel strike running to increased injuries.

As you can see, there are mixed results but the bottom line is that heel strike does not appear to be bad (unless you are overstriding). It is more important to focus on training intensity, duration, frequency and other aspects of your running mechanics such as increasing your step rate to decrease your risk for injury.

You can try sticking to the forefoot/midfoot strike and see if you can improve your speed. The forefoot strike can be very efficient when properly executed. You are probably still adjusting to this running style which is why you feel discouraged with your progress. If you decide to switch back to heel strike, this is not bad either. Just allow time for your body to adapt to the changes.

Keep making moves,

Dr. Marc

RELATED: How Running Surfaces and Speed Influence Your Risk of Injury

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