Foot Strike and Injury Rates in Endurance Runners

Read that very interesting study, published at PubMed, which concluded that runners who habitually rearfoot strike have significantly higher rates of repetitive stress injury than those who mostly forefoot strike.

Foot Strike and Injury Rates in Endurance Runners: a retrospective study.


1Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge MA 02138, USA 2Department of Athletics, Harvard University, 65 North Harvard Street, Boston MA 02163, USA 3University Health Services, Harvard University, 75 Mt Auburn Street, Cambridge MA 02138, USA 4Baylor Health Care System, Institute of Health Care Research and Improvement, 8080 North Central Expressway, Suite 500, LB 81, Dallas, TX 75206, USA.



This retrospective study tests if runners who habitually forefoot strike have different rates of injury than runners who habitually rearfoot strike.


We measured the strike characteristics of middle and long distance runners from a collegiate cross country team and quantified their history of injury, including the incidence and rate of specific injuries, the severity of each injury, and the rate of mild, moderate and severe injuries per mile run.


Of the 52 runners studied, 36 (59%) primarily used a rearfoot strike and 16 (31%) primarily used a forefoot strike. Approximately 74% of runners experienced a moderate or severe injury each year, but those who habitually rearfoot strike had approximately twice the rate of repetitive stress injuries than individuals who habitually forefoot strike. Traumatic injury rates were not significantly different between the two groups. A generalized linear model showed that strike type, sex, race distance, and average miles per week each correlate significantly (p<0.01) with repetitive injury rates.


Competitive cross country runners on a college team incur high injury rates, but runners who habitually rearfoot strike have significantly higher rates of repetitive stress injury than those who mostly forefoot strike. This study does not test the causal bases for this general difference. One hypothesis, which requires further research, is that the absence of a marked impact peak in the ground reaction force during a forefoot strike compared to a rearfoot strike may contribute to lower rates of injuries in habitual forefoot strikers.


About swimbikerun1
Devoted Father, Husband and Employee.Endurance sports fanatic (running,cycling,swimming).Triathlon athlete and coach.If only days had more than 24 hours.

2 Responses to Foot Strike and Injury Rates in Endurance Runners

  1. bgddyjim says:

    I have a few problems with the study. As usual, they’ve made their study based on, what seems to be, a preconceived notion. Cross country races are dangerous, the terrain is uneven, etc. On the other hand, the college pace is fast, around 5:30 per mile. What the study lacks though is some pertinent information such as: Who was faster, forefoot or heel striker? I’d bet it was the latter because he/she can stretch out their stride more. The middle and long distances short (8-10k according to the site that I read) so these guys have a propensity to go all out, over uneven ground and they get hurt. Like the study says, it doesn’t bother to seek the actual cause. Also they have a hypothesis that they didn’t bother translating into decent English like they did with the whole rest of the study. Oye,

    In any event, the last sentence or two are golden. Translated into proper English: This study didn’t bother to find the cause of our findings, we need more money for that. We do have a guess though, but we’re not going to look at that until we get more money… But the last part is what is most important, and it requires translation: We think in might be because some heel strikers hit the ground harder with their heel than do forefoot strikers…

    Which would mean that the problem may not necessarily lie in foot striking, but in the manner in which one strikes one’s heels on the ground – or coaching error.

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