Running for Exercise: Reducing Knee Pain Through Fore-Foot Strike Technique

Today’s post is by Jonathan Williams, an Exercise and Fitness Specialist from San Jose State University with a B.S. in Kinesiology. He is also the co-founder and president of Silicon Valley Applied Biomechanics (SVAB).

The new year is upon us, and many people are setting weight loss goals. Aside from buying a gym membership, a large number of people will be looking towards running and walking as a means of burning calories. There is a certain freedom of putting on your shoes and heading out the door for a run or walk. You don’t need much; a pair of shoes and maybe an iPod, making it very simple and convenient.

However, did you know that when your foot strikes the ground, you could be loading your body with up to 3 times your own body weight? With the additional weight gained during the holidays, this leaves many people in a precarious situation of wanting to lose weight, but potentially hurting their knees in the process.

So what can be done to help keep your knees safe?

There are two avenues to consider: changing how you make contact with the ground, and or changing your footwear.

Traditionally, we have been told that when running we first make contact with the ground with our heel. In fact, the majority of the running shoe industry promotes this ideology and bases their shoe technology on this assumption. Shoes that have pronation or supination control, more padding in the heel, gel technologies, and air cushions are all designed to reduce the impact forces when you make contact with your heel. However, there is a large body of research that indicates that this assumption may not be entirely true. In response to this research, companies like New Balance and Vibram have designed minimalist shoes that promote a different kind of foot striking pattern called fore‐foot striking technique. This pattern avoids a heel strike altogether, which in turn eliminates the need for extra material underneath the heel, thus reducing weight.

Controversy arises when companies (such as Nike and Adidas) conduct their own research showing that running with minimalist shoes actually increases knee pain when running. This is true, if you do not change how you make contact with the ground, which they did not instruct their research participants to do. If you are still heel-striking, and take away the cushion under the heel, then yes you will get more knee pain as you are increasing the impact forces. However, if you change the way you make contact with the ground, you can indeed reduce the amount of impact.

Retraining for the average runner who is heel-striking is a process that can take a good amount of time and effort, and is met with much resistance from traditional running ideologists. So, what should you consider when choosing to take up running to lose weight next year? Am I a heel-striker? Do I want to remain a heel-striker, or would I consider retraining? If you are invested in the traditional heel-striking ideology, then by all means keep a large pad under your heel as you will experience large impact forces when you make contact with the ground. However, if you are interested in reducing impact forces on the body, then you may want to consider retraining your running pattern to a fore-foot striking technique.

When you actually buy a pair of New Balance shoes, you will actually see a warning label that states you should retrain how you run before using their minimalist shoe, and there is information on their website about how to do so. I think most people purchasing new products in general will tear the labels off and just start using it, like other clothing items, and then have a bad experience with the product.

Here are a couple of quick tips for those who are interested in retraining their running pattern:

Land with your foot under your hip. This will reduce the tendency to land on your heel.
Take shorter strides, but more frequent strides. This may lead people to think that you will run slower, and at first you may. However, you can indeed run as fast or faster with a fore‐foot strike by increasing the stride frequency. Think about a sprinter “running on his/her toes” and simply reduce the speed. Also, you do not need to exaggerate the lifted heel as this may overstress the calf muscles.
Listen to your feet. If you hear loud footsteps, you are probably creating large impact forces. At first it may feel like you are “tip toeing” but in general the more quiet your feet are, the less impact you are creating.
Take your time to retrain. The process can be a bit humbling as you may need to reduce your overall mileage when changing how you run. This is because you are using different muscle patterns than you may be used to when heel-striking. Run a short distance (50‐100 strides) then walk to recovery, and repeat.

References:

Bonacci, J., Saunders, P.U., Hicks, A., Rantalainen, T., Vicenzino, B. T., & Spratford, W. (2013). Running in a minimalist and lightweight shoe is not the same as running barefoot: a biomechanical study. British Journal of Sports Medicine, 47(6), 387-392.

Cheung, R. T. H., & Davis, I. S. (2011). Landing Pattern Modification to Improve Patellofemoral Pain In Runners: A Case Series. Journal Of Orthopedic & Sports Physical Therapy, 41(12), 914–‐919. doi:10.2519/jospt.2011.3771

Noehren, B., Scholz, D., Davis, I. (2011). The Effect of real time gait re–‐training on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. British Journal Of Sports Medicine,(41),691–696.doi:10.1136/bjsm.2009.069112

Jonathan Williams is an Exercise and Fitness Specialist from San Jose State University with a B.S. in Kinesiology. Co-founder and president of Silicon Valley Applied Biomechanics (SVAB), a local nonprofit organization. A recipient of the Dean’s Scholar Award and best Senior Movement Project in the Kinesiology Department, he graduated with Cum Laude Honors. He has experience as a licensed amateur mixed martial artists competing in the octagon. Regularly volunteers services at local high schools, and local running events. Researcher at SJSU’s biomechanics lab with fore-foot running expert James Kao Ph.D., with a focus on reducing disabilities caused by knee pain.

Bachelors of Science Kinesiology
Personal Training from the National Academy of Sports Medicine (NASM)
National Counsel on Strength and Fitness (NCSF)
TRX Suspension Training
National Exercise and Sports Trainers Association (NESTA)

Quote from Dafne Ocana

“I never knew anything about fore-foot running until I started training with Jon, but I really wished I would have known before. His insight and knowledge about how to properly run and the mistakes I was making have made my running better, even with an ACL tear. I’m more aware about hill striking when I jog and when I focus on fore-foot running I notice better endurance and a more enjoyable run. At first it takes a little to get used to and it’s kind of weird, but it really makes a difference.”