Effects of Striking Strategy on Lower Extremity Loading During Running

It is expected that one out of two runners has a running-related overuse injury every year. The knee joint and Achilles tendon are the most often injured sites covering both about twenty percent of all running related injuries. Runners can be grouped into rearfoot strikers, mid-foot strikers or forefoot strikers based on the landing strategy at the instant of initial ground contact. Forefoot or mid-foot striking has been shown to decrease impact peak and loading rate of the ground reaction force during early stance phase. Furthermore, the finding of the recent study suggest that forefoot striking may potentially lower the risk of running-related injuries. However, the effect of runner’s foot striking pattern on the ankle and especially on the knee loading is not well understood. Therefore, it was the authors’ purpose in this study to examine whether runners with forefoot striking exhibit different lower limb loading profile than runners who use rearfoot strike pattern. Forefoot strikers demonstrated lower patellofemoral stress compared to heel strikers. In addition, the knee frontal plane moment was lower in the forefoot strikers compared heel strikers. At the ankle level, forefoot strikers exhibited higher Achilles tendon force compared to rearfoot strikers.

The study found that forefoot strikers showed lower patellofemoral stress and frontal plane moment compared to runners with rearfoot strike pattern. The authors though this indicated that runners with forefoot strike pattern may have reduced risk of running-related knee injuries. However, parallel increase in Achilles tendon loading may increase the risk for a forefoot striker to suffer ankle and foot injuries.