Heel Striking vs Fore-Foot Striking: Running Shoe Considerations – A Podiatrist’s Opinion

A common question I get asked in clinic is whether fore-foot or heel/mid-foot striking is better for you for preventing overuse injuries in long distance running.

This question is not always easy to answer as there are many variables such as running experience, conditioning, range of movement limitations and terrain for example that can determine which strike pattern could be possibly better for you.  There are also other very important running technique variables such as cadence which needs to be taken into consideration when looking at your overall running technique.

For this short piece I am concentrating on looking at how heel/mid-foot striking allows you to use features of certain running shoes to improve shock absorption, foot control and help decrease the risk of overuse injuries.

Striking on your heel or mid-foot with the correct stride length (not over-striding!) allows the average runner to use the features of traditional high mileage running shoes to dampen the 4-5 x your body weight being thrust back up into your feet and lower limbs while running on hard surfaces.  The way these shoes do this is by having shock absorbing material built under the heel.  This material is different to the one used under the fore-foot which is usually a more responsive “bouncier” material to help propel the body forward.

The other important feature for those who may require it, is over-pronation support from a stability shoe.  This support is built into the medial side of the midsole, starting at the heel and extending through and ending at approximately the end of your arch.  If you do happen to fore-foot strike and require over-pronation support then all of this support from your stability shoe is negated.

Now a common, well supported argument is that when you forefoot strike you are using the calf muscle and Achilles as a shock absorber to dampen the ground reaction forces.  This is true however this does create greater work for the calf and Achilles because they are working to both lower the heel to absorb shock and then to also propel the body forward.  For the new and/or average runner who is possibly a little overweight, not conditioned, running at a slower cadence and speed, and excessively pronating this is incredibly fatiguing on these structures and can lead to an overuse injury especially in the foot, shins, calf, Achilles and surrounding structures.

My advice to someone who is thinking about starting or changing to forefoot striking is to first see a running experienced Physiotherapist who will assess running technique, calf/Achilles strength and core strength.  They will also be able to provide you with an appropriate strength, flexibility and running program suited to the runner’s experience to gradually help build the running load.

Next is to see a Podiatrist who can discuss with you the footwear options that are available to you to ensure protection from the hard running surfaces.  Giving you advice on other footwear that you are wearing for work and casually will also be important because this can have an impact on keeping adequate range of movement and recovering between running sessions.

Aleks Baruksopulo
SportsMed Podiatrist

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