Running Injuries and Gait Analysis
15 March 2011
Last Updated on 10 April 2012
Dr. Runco
How many times have I heard, “Should I run more on my heels?”, or “Should I be landing more on my forefoot?” Lately I have been told by runners that they are practicing mid-foot striking. There has been alot of buzz lately around running form. This is really nothing new but the recent book “Born to Run” has rekindled an old debate. What I am about to present is a common sense approach to this debate. There are no right answers all of the time. A case can be made for all types of running form. Running form is dependent on a few variables. Let’s look at them, break them down and see how they affect our form.
Running Surface
Your form will change dramatically depending on what type of surface you are running on. Try running on soft sand and then compare your form to running on concrete. You will find that while running on soft sand you run more on your forefoot and when you switch to concrete you lessen how much you run on your forefoot. Is one way right or wrong? Neither. Your body naturally changes to adapt to the surface it was running on. Now try running uphill. The steeper the grade the more you will run on your forefoot and lean into the hill. When you run down hill the opposite will occur. You will shift more onto your heel and lean back into the hill. Is one way right or wrong? No. Your body chooses a preferred path to save energy and decrease risk of injury.
Speed
How fast you run will often dictate running form. Picture a sprinter at the starting line. Bent forward, crouched and on their toes. Now picture the 11-12 minute mile an hour runner. They are upright, bouncing up and down landing on their heels. If this slower runner tries to adopt the sprinters form they would fall over on their face. If the sprinter adopted the slower runners form they would not be sprinting any more! Which form is correct? Neither. The slower runner has adopted a form that is correct for their speed much in the way the sprinter did the same. The slower runner will never become a sprinter just because they assume the sprinters form. Form does not make speed………..speed makes form.
Comfort
Yes comfort affects running form. Imagine a blister on your foot that hurts every time your foot hits the ground. You will change your form in order to lessen the pain from the uncomfortable blister. Think about having a sharp pebble in your shoe that causes you to land on the outside of your foot throughout the course of a long run. The pebble is uncomfortable, causes pain and causes you to change your running form to avoid pain. Much in the way the blister or pebble can cause change in running form so can uncomfortable running shoes. Wearing uncomfortable shoes is a good way to negatively affect your running form. Conversely, comfortable shoes will allow you to assume a more natural running form. Wearing “gimmick” shoes such as the Newton or the Vibram Five Fingers will not improve your form (unless they are comfortable) and if they are uncomfortable they will negatively affect your running form.
Fatigue
As your muscles tire your form will break down. Muscle fatigue is responsible for overuse injuries. As larger muscles fatigue and smaller muscles overwork to compensate running form worsens making the runner more prone to injury. By being properly conditioned and having adequate muscle strength to accomplish your goals your form will be preserved. Wearing “gimmick” shoes can not replace proper training nor significantly help our muscle strength and conditioning.
Why all the hub-bub concerning running form? Because their are runners out there who think that everyone should run like them! They have written books about it, developed gimmicks for it and preach that everyone should run a certain way. While we can all agree that there are commonalities to running on two legs, upright and going forward I think common sense dictates that we should have differences. Do all baseball pitchers pitch the same? Do quarterbacks all throw the same? Do golfers all swing the same? Of course not. They all have chosen a preferred movement path that conserves energy and minimizes risk of injury……….for them! Your natural LONG DISTANCE running for will be one that you can maintain a conversation at. Your natural sprinting form will be one in which you can run as fast as you can for 40-50 yards. Trying to employ your sprinting running form to your long distance training is a recipe for disaster.
Choose running shoes based on comfort not gimmicks. Trying to have a gimmick make you better at a sport will never work. Hard work and practice will make you better not gimmicks. Consider this quote from the gimmick shoe company Newton. “When you walk you land on your heels, when you sprint you land on your toes. An optimal running gait falls somewhere in between.” I think that is obvious! But what matters is how slow you are (closer to walking) versus how fast you are (closer to sprinting). So the slower you are the more likely and natural it would be for you to heel strike. The faster you are the more likely that you will land on your toes. Buying their gimmick shoe will not cause a heel striker to become faster and instantly become a forefoot runner!
If you want to become a better runner than practice! Practice running faster. Do speed drills, tempo runs or hill repeats. Wear a speed and distance monitor and do shorter runs at a faster pace. As your body gets more conditioned and stronger you will become more efficient and assume a more efficient and natural running form. We all know gimmicks and short cuts do not work yet we are quick to buy the latest gimmick out there. Having the greatest tennis racket will not make you a better tennis player. Having the best set of golf clubs will not improve your game. Taking $$$$$$$ in supplements will not give you the perfect body. Having the gimmick shoe will not make a you a better runner.
Dr. Runco is a U.S. Navy and Gulf War Veteran. Graduating as a Doctor of Chiropractic he began private practice in San Diego in 2000. He has been a professor of Anatomy, Physiology, and Biomechanics at various colleges and continues to teach continuing education in the fields of rehabilitation, custom orthotics and athletic taping. He is also a member of the American College of Sports Medicine, National Strength and Conditioning Association and is a Certified Strength and Conditioning Specialist.
With all due respect, this is the biggest load of crap I’ve ever read.
Speed doesn’t dictate true form. Yes, when sprinting we all run far forward on our toes. However, I have to assume you were born with shoes on since this article completely and utterly ignores the fact that virtually no one lands on their heels when running barefoot. I’m not advocating running completely barefoot all the time but to figure out whatever your real form is you’ve got to at least try it.
The true problem is the shoes that have allowed all the muscles and connective tissues in our feet to become weak and all but atrophied. Feet that are allowed to work as feet can regain their strength and will allow people to have solid form regardless of distance.
About gimmicks, I’d wager that either you’ve not tried Newtons (I am a Newton runner) or if you have, you have absolutely no idea how the technology (which you call a gimmick) works. In fact, if you put a soft shoe underfoot you’re dampening the feedback that the foot gets and further disallowing a foot to act like a foot. The lugs of a Newton running shoe act the way the metatarsal heads in our feet act.
Newtons have, in irrefutable fact, made me a better runner along with countless other people. On top of that, they have allowed people who have always run with a forefoot/midfoot gait to truly optimize their gait.
Shocking.
Thanks for the feedback Brandon. Speed actually does dictate form. I quoted Newtons own Website to help illustrate that point. Here is is again. “When you walk you land on your heels. When you sprint you land on your toes. An optimal running gait falls somewhere in-between.” Try it. Whether you are wearing shoes or not this will hold true. Whether you are wearing Newtons or not this holds true. I am confused by your statements though. You point out how shoes make your feet weak and then you explain that you wear Newtons? For the record, I have a pair of Newtons, Vibrams and any other shoe made. I own a running shoe store and have absolutely no emotional attachment to any inanimate object………especially a shoe. However, a gimmick is a gimmick. You are entitled to your opinion Brandon but please actually read the point. It is not whether or not you land on your toes or heel when you are barefoot or whether or not Newtons will make you a better runner or if Vibrams will enhance your proprioception in your feet. The point is that speed will help to dicate your form, regardless of what is on your feet.
This article is greatly oversimplificated. Running and walking gaits are not the same, and to say that slower runners should be closer to heel striking than faster runners makes no sense. Different biomechanics are employed.
Newtons are no gimmick. I am a Newton runner and since switching from conventional shoes I am faster and healthier than ever. Newtons help train your body to land a natural forefoot/midfoot strike. Muscles get stronger and form improves, as does speed. Yes, the runner must do the work, but Newton’s are not a fad or gimmick, frankly I’m offended to hear it. I know plenty of runners who are happy heel-strikers. Fine. But there are those of us who have had great success with Newton.
I also own and wear Vibrams and can attest to their comfort and aid in strengthening the muscles of the foot. I truly hope your blog doesn’t turn people off to either shoe. That would be a shame.
Actually Rebecca you did not read the article. Running and walking gaits ARE NOT the same. That is the point. To quote the Newton website “When you walk you land on your heels, when you sprint you land on your toes. An optimal running gait falls somewhere in between.” You see. I never said running and walking are the same. In fact they are quite different. The point of the article is that SPEED is what seperates them. If you walk in your Newtons you will heel strike. If you run you may land on your forefoot. Try running a 13 minute mile and landing on your forefoot though. Doesn’t feel good huh? Also the definition of Gimmick is “gadget: an ingenious device, mechanism, or ploy, especially one that works in a concealed way or “something grabbing attention: something that attracts attention or publicity, e.g. a new technique or device.
There is nothing necessarily wrong with a gimmick.
The two main points are
1. Gimmicks do not make you faster. Running faster makes you faster.
2. Form is related to speed. Again, try running a 13 minute mile. Check your form. Now run an 8 minute mile.
Nough said’
The best way to actually look at this discussion is looking at studies. Right now there are just hypotheses. But let’s turn the tables a bit on the discussion. If it is function that dictates form and not form that dictates function what about chiropractic? I believe that it is a mixture of the two.
Is there an optimal form? Most of the research that I read tends to point to a resounding yes. (http://www.barefootrunning.fas.harvard.edu/5BarefootRunning&TrainingTips.html this is only 1 of many independent articles) But I am a 40 year old soccer player turned triathlete. I have been in sports since I was 4 years old. I have played at every level except Pro. This is what I have learned through my experience, I do not have a degree in exercise physiology or anything like that, take it for what it is, my experience.
I will draw from my own profession, chiropractic. We have many types of spines coming into the office. We know what an ideal spine looks like and we know what parameters range of motion is supposed to fall within. Can we get everyone to be “Perfect”? No, but we try because we know that form affects function. Structure affects function, so we council on nutrition, exercise, and any other modality as well as adjusting to get the patient as well as possible and to get them into the best form or shape they can be in so that they function optimally and more pain-free.
Running is no different. Yes you assume different postures while running. But the question is can you run in a way that the pressures on the joints are are minimalized? For me the answer is yes. The studies I have read so far seem to support the hypothesis that yes indeed there is. Dr. Runco is right about the heel striking while walking, but walking and running are two different animals. I can run a marathon heel striking. Louisville 2010 was done as a heel striker. The pain I experienced in my knees and hips almost made me give up running altogether. Then I hired a coach and the education and research started. To the point that my “FORM” is better. In Jan. I ran RNRAZ. I trained less hours, and have really only looked at, and worked on form. RNRAZ was a 3:53 Zone 1 run. Louisville was a 4:18 Zone 3 run. Topography was different. There were more hills in KY, which according to Doc would lend itself to more of a fore foot run. I kept my brand new shoes from that race because in 1 marathon I destroyed the heels in my Salomons. This is a constant reminder to me of what I do not ever want to do again. As I learn the mid foot/ fore foot running techniques, for me, I have become a better faster, and pain-free runner. I have gone from a zone 2 10:00/mile runner to a zone 2 7:40/mile runner. This transition is not easy. I am still not a natural mid/fore foot striker. During the transition I did things wrong and had calf pulls, hamstring (old soccer injury) issues and a bit of problem still in the hip. I will say the hip pain is nothing like it used to be a long run would have me dead legged at the end of the run.
Now I am know, part of that is having a coach and becoming more fit. So I did, as an experiment, try running in my old form to see if there was truly a difference or if fitness and training were the difference. I had pain really quickly, this is the way I had run for 35 years (for the record I wore out the heels on a pair of Newtons too. The company makes no assertion that their lugs make you a mid/fore foot runner).
As I get tired now (during my runs mile 6 and 8 seem to be pivotal) form changes and I start to heel strike and I will try to pull the hamstring. So it is evolving. Will I ever have perfect form? I don’t know, but I will strive for it. What is perfect form for me? Mid foot or fore foot striking, it is the fastest and least painful.
That is pretty much the resounding cry I here from my runners as I have sent them off to a local running coach. As they transition into mid/fore foot runners I can say this, they have all experienced issues from shin splints to calf pain. These are form issues that are corrected and dealt with, in the end they are all faster, have less pain and LOVE the sport of running.
So instead of hard facts, that is more of a testimonial with a anecdotal evidence.
Yes. Just for full disclosure, I do run in Newtons. My wife has Newtons, but prefers Vibrams. Oh on an afterthought, I am a gadget guy and to me if the science seems fairly sound, ie the lugs on the Newtons, then I will seek every little advantage I can. I think the word gimmick has a negative connotation, but when the definition is pointed out it may not be negative, but in current culture “gimmick” tends to be frowned upon. But if that’s the case, give me all the aero gimmicks, endurance gimmicks to make me a better, faster, stronger and more pain-free endurance athlete. :-)
Here are some studies by no means exhaustive: http://www.barefootrunning.fas.harvard.edu/5BarefootRunning&TrainingTips.html http://www.scienceofrunning.com/2010/09/running-form-and-shoe-industry-where-do.html (read the history section no one, not even the marathoners studied did a heel strike. Study funded by Vibram http://articles.cnn.com/2010-02-12/health/barefoot.running_1_shoes-harvard-study?_s=PM%3AHEALTH I think that all of this goes to one point, and Doc has touched on part as has Brandon. Everyones form is their own. Is there an optimal, yes, can we all do it, doubt it. But we should try to emulate it as much as possible because it seems to cause less injury and pace times go down.
Thank you for the comments Dr. Miller. The problem with studies and running form are………there are not many of them and none predict or prove that any form is associated with a decrease risk of injury. Sure there are many bloggers claiming certain forms or shoes make them faster or prevent them from getting injured. TV is full of infomercials claiming their abdominal machines will allow you to achieve a 6 pack in 6 weeks too. The links you provided were not actually links to studies but to people commenting on those studies. While the information is interesting it does not prove anything. It also supports what I have been saying. Speed definitely influences form. The slower you are the more likely you are to heel strike, regardless of the shoe you are wearing. I have no problem with any shoe but rather with false claims by the companies that produce them. If you would like to purchase a gimmick for $160 that will solve your injuries and make you faster that is entirely up to the individual. My point is you can achieve the same result with good, sound, hard training. I’ve seen a runner do a 50 mile ulta in a pair of Crocs! I am not sure why……….but I am assuming the person used them because in some way it helped them be more comfortable and run the 50 miles.
As I said everyone. There are many variables that affect running form.
1. Running surface. Sand vs. Concrete. Try it.
2. Speed. Walking vs. Jogging vs. Running vs. Sprinting. Try forefoot striking while walking. Weird!
3. Comfort. If you are more comfortable in a gimmick shoe (in some sense ALL shoes are gimmicks) then wear what is comfortable. Comfort is King!
4. Fatigue. Running shoes are meant to support you on long runs. If you are only running a mile you could wear just about anything (Crocs for example). The technology is meant to support you when fatigue sets in and form breaks down.
We all come in different shapes, sizes and weights. We have different arch heights, tibial curves, leg lengths and torso lengths. For this reason we all move differently. Humans avoid pain and automatically try to conserve energy. We choose the path of least resistance. Because of these variables good studies are hard to do but the scientists are trying. Want a really great, scientific read. Try Biomechanics of Sport Shoes by Dr. Benno Nigg. This guy has been pumping out studies on gait, running, running injuries, running shoes and orthotics. He is out of the University of Calgary. If you do not want to buy the book check out his studies first hand. Here is the link to the National Library of Medicine http://www.ncbi.nlm.nih.gov/pubmed?term=benno%20nigg
These are actual studies. Read them first hand. These are not a blog site but actual studies that have been published on the topics. Guys like this are using actual science to try to understand running gait, performance and injury prevention. He does not sell gimmick shoes and does not profit directly from his findings. I will leave you with this quote from his book. “There is a unique movement path for a given movement task (running) for each joint. This path is subject-specific, and is determined by the particular geometry of the leg, the strength of the elements (muscles) crossing the joint in question, and possibly other factors. It has been speculated that this path is chosen to MINIMIZE ENERGY CONSUMPTION DURING LOCOMOTION. This paradigm could explain the small changes in kinematics observed with footwear and/or orthotics. It is expected that-despite the geometric modifications created by footwear-THE BODY MAINTAINS THE PREFERRED MOVEMENT PATH BY CHANGING MUSCLE ACTIVITY IN ORDER TO PREVENT ANY DRAMATIC CHANGES IN THE GEOMETRY OF THE LEG. This concept, whcih is a particular case of the path of least resistance concept in physics, is widely seen in nature and is supported by some direct evidence.” In a nutshell, We all run different for a reason and will there will never be a “best” way.