I used to receive incredulous looks years ago when I began advocating for forefoot running over the "traditional" heel strike running. But now that the evidence supporting forefoot running has been published and articles espousing its benefits have been printed, more people are coming around to the idea of changing their running gait to prevent injury.

"It looks like this is how our ancestors have been running for a million years or more," Dr. Dan Lieberman says. "It's only been in the last 10,000 years that we've had any kind of shoes, really."

Dr. Lieberman, an anthropologist at Harvard University, published a study^1,2 in the journal Nature demonstrating the forces involved in forefoot running vs. heel strike running. As one may expect, the calf muscles do a much better job absorbing shock than the smaller and considerably weaker anterior lower leg muscles. The more shock absorbed by the calves translates to less shock making its way up the kinetic chain to the knees, hips, and lower back. Also, the foot's arch and its associated soft tissues function like a spring while running, further increasing the efficiency of the gait.

"Most runners, when they land and they heel-strike — they land on their heel — they generate this sudden impulse, this sharp spike of force. So it's like someone hitting you on the heel with a hammer, about 1 1/2 to 3 times your body weight," Dr. Lieberman says.

Transitioning to forefoot running isn't as trivial as it sounds since it's likely your calf muscles and lower leg connective tissues are not as robust as they need to be for distance running. Even if you're used to long distance running, gradually making the shift to forefoot running will help eliminate discomfort associated with the gait modification.

Dr. Lieberman cautions that his study does not focus on the rate of injuries using one running style over the other. But I have found that once I acclimated to forefoot running wearing minimal shoes — $30 Nike Waffle Racers to be exact — I have had no issues with plantar fasciitis, shin splints, TFL pain, knee pain, or any other pain associated with running on hard surfaces. The same holds true for my patients who have modified their gaits. Another benefit I'm hoping Dr. Lieberman addresses in a future study is that forefoot running appears to better strengthen the foot's intrinsic muscles, improving its arch without the use of orthotics or arch support.

If you'd like to learn more, read this NPR article detailing Dr. Lieberman's work including a video showing the difference between running styles.

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1. Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D'Andrea S, Davis IS, Mang'eni RO, Pitsiladis Y. (2010) Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature 463: 531-5.
2. Lieberman DE (2010) Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature Supplementary material.