Here is my response to someone that wanted to know what is best, heel-toe or mid/forefoot running? Oh man, books have been written on this but I’ll take a quick crack at it though and try to provide my rationale. Here goes and I apologize for any egg-headedness here, but there is no way around it. For anyone that has run barefoot they know they run on the balls of their feet and do not heel strike. This is natural. For runners who run in minimalist shoes this is what they should be doing. The medial longitudinal arch absorbs the impact and attempts to disperse that energy throughout that arch and foot (while running, 3-5 times your body weight lands on each foot, so we’re talking a LOT of energy). The calf muscles, and therefore the Achilles tendon, are also absorbing the impact with an eccentric contraction (meaning the muscle contracts as it gets longer…and this is usually where muscle injuries take place). So in mid/forefoot running we’ve got the medial arch and 26 foot/ankle bones that attempt to disperse this energy as well as the knee, which would be flexed (not straight) with the quadriceps also absorbing the force, and finally the 3 big calf muscles (medial and lateral gastrocnemius and the soleus) that do the same. This is a fairly massive spring to absorb, store, and release energy, so this seems to be a pretty good absorption mechanism as well as a “spring” to launch the runner into the next stride. Regarding this article, the injuries I see to the Achilles tendon are the result of gastrocnemius and soleus muscles that are dysfunctionally tight and not stretched adequately. Heel-toe running is what most people do and what most running shoes are made for. In my opinion this is also where most foot and ankle injuries, foot stress fractures, and knee pain comes from (that is runner related, of course). The calcaneus (heel bone) is what absorbs the impact with some slight energy dispersion taking place at the talocrural joint as the calcaneus glides slightly on the talus (the ankle bone that articulates with the leg). Essentially, most of the energy is therefore absorbed directly by the calcaneus so shoes must be built up with cushioning to help disperse that energy. The tradeoff here is that a heel strike has been shown to actually slow down a runner as it sort of acts like a brake, slowing forward motion. Also, because the heel needs to be built up so much to absorb the impact it is more difficult to get a mid/forefoot strike because that large heel tends to strike the ground first. So energy really isn’t absorbed and held as “potential” energy (as it partially is in mid/forefoot striking), but is rather simply absorbed in the heel and knee joints. I would therefore argue that the mid/forefoot strike is what we should strive for by behaviorally modifying our stride (rather than forcing a stride correction with shoes which force a forefoot stride) to absorb the impact in a very long kinetic chain that is the medial arch – ankle – knee – quadriceps. When one correctly implements this type of stride the energy is absorbed and some is held as potential energy for the next stride. In a heel strike the position of the ankle and knee are in a “close-packed” position, which does not allow for much energy dispersion and storage (to really boil it down, but more complicated than this). The heel and knee takes most of the force and, therefore, are more at risk for injury. In any repetitive motion there is a chance of injury, so we do what we can to minimize that. The first thing is to make sure the joint that is taking the impact is working the way it should. As a chiropractor I know the entire body absorbs that impact and do what I can to make sure each joint works as it should to disperse that energy as it should, and this includes the foot. Sorry…this IS the boiled down version…
Posted on: Tue, 29 Oct 2013 15:41:17 +0000
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