How to Adapt Your Running Form During a Run to Reduce Pain and Overuse Injuries?
The controversy between heel strike running and mid-foot running continues. What if I told you that doing both may be the best option? Would you believe me?
When the ball of the foot and your heel contact the ground at the same time (Ideally ball of foot slightly before the heel known as fore-foot strike).
I just ran 13.1 miles this morning before 9am and made it for coffee at my new favorite spot in the area to sit, think, and write. That's 'Methodical Coffee' in Greenville, SC if you were wondering!
Kicking the discussion off, we are going to address the concept of stresses between the two-foot strike running patterns: mid-foot strike and heel strike.
Keeping things simple a mid-foot strike pattern is when the ball of your foot contacts the ground at the same time or slightly before your heel does. This running pattern has been found to distribute more of the forces that the ground has on the body through your muscles. You can see in the picture below that a mid-foot strike, compared to a heel strike, also has less ground reaction forces all together. It may not be much, however, think about when you run for 13.1 miles, EVERY step counts (you are a runner, you get it). Especially if you are running the recommended 170-180 steps per minute along with a landing force of 2-4 times your body weight with each step. Yeah, every step counts.
A heel strike pattern is when your heel contacts the ground first. This pattern is linked to increases in tibial stress fractures and joint pain in the knees, hips, and back. This is simply due to the increased stresses of force being distributed through the skeletal system (bones and ligaments that hold it together) with what is called 'breaking forces' each time your foot hits the ground. Imagine Fred Flintstone putting the brakes on in his car. This is what heel strikers do every time their foot hits the ground. Imagine jumping and landing on your heel with straight legs. Doesn't sound fun right? Then why would you replicate that with running?
This method of running might feel easier, especially with a nice comfy and thick heel cushioned shoe like your Hokas or Brooks running shoes, but I assure you the research doesn't support the idea that 'thicker cushioned shoes help to decrease the actual force your body undertakes with a heel strike pattern'.
Now, the musculoskeletal system is a combination between the two, muscles and bones (tendons and ligaments too), and I proposed earlier the concept of changing the stress points to not overwork or overstress one specific set of muscles (this will lead to tendonitis or muscle tears) or worse put all the forces through your bones (this will lead to stress fractures and joint related pain). Overuse injuries are very common in runners because we focus on running the same way EVERY time we run. On top of that, most runners don't compliment their 20-70+ mile weeks with anything but running. You can see where form needs to be on point the further you run. It is a compounding effect.
Overuse injuries are usually due to the body not being ready to undertake the repetitive stresses an activity places on it, NOT that you are using your body TOO much! I'm a big advocate for those who want to be able to run like Forrest Gump (for as long as you want without pain). If you are prepared to run across the country, then no “overuse injuries” will occur!
Fore-foot strike - Where the ball of your foot contacts the ground first. This is common with faster speeds and sprinting.
From an efficiency standpoint, mid-foot or fore-foot running is a more adopted method by experienced distance runners like Eliud Kipchoge, the Olympic Gold Medal Winner in the marathon from Kenya! These long-distance superstars train their muscles to undertake the distances they want to cover and do this by strength training and optimizing form in their off-run days (along with adequate rest). I know, "CRAAAZY" concept, right? BUT... changing to a small heel strike during those long runs, for short periods of time, can allow you to disperse forces differently through your body and allow a novice runner to achieve longer distances. This in turn will allow you to give those muscles a break from the same exact repetitive stress that running has.
I will, however, say that I don't highly recommend this option to push your mileage to the max. Training your body for the task you want it to perform means preparing your muscles before your run and slowly ramping up mileage as your muscles can tolerate. This process will take anywhere from 1-12 months or more to do properly. It just depends on your starting physical condition. The Olympic distance runners have been running for most of their lives and training for each and every run with intention to get where they are. Your muscles are what controls your bones. Training your muscles controls whether you succeed or fail. How you train and how you rest is what will turn you from an injury prone runner to a lifelong runner (and maybe Forrest Gump or the next Eliud Kipchoge)!
With all that being said, here is a list of methods that will change the forces on your body during a run that you can trial if something is constantly nagging at you every time you run:
1) Change from a heel strike to a mid-foot/fore-foot strike
2) Change your shoes (Zero drop shoes and wide toe box are recommended without a large cushion)
3) Change your cadence to fall between 175-180-185 steps per minute
4) Change your stride width (don’t let your feet cross midline)
5) Change your stride length (shorten or lengthen each step)
6) Change your foot angle (duck or pigeon-toed positions)
7) Change whether you land on the outside of your foot or more towards the middle of your foot.
8) Change your vertical placement (how much your body translates up and down with each stride)
9) Change your trunk angle (straight up and down to slightly leaned forward)
10) Change your arm swing pattern (ex, forward and backwards from side to side)
*Film yourself run and understand how you run (if you need help, we specialize in this)
*Strength train and be fully prepared for every run
*Nutrition, Hydration, Sleep, Cognitive Training are all important factors you also should consider
If you want to discuss this further or need some help figuring out your running form to improve performance or stop those aches and pains than give us a call or stop in to see us at Motivation Health & Wellness.
Stay Strong and Stay Healthy!
-Jayson Dahlquist DPT, CAFS, Certified Running Coach
