Tuesday, September 6, 2011

Pronation and Midfoot Striking, Forefoot Striking, and Heelstriking

Every so often I hear someone say that they know they have a neutral gait because they are a midfoot or forefoot striker, and overpronation is the domain of heelstrikers. They claim that because they don't heelstrike, it's impossible for them to overpronate and they don't need a shoe with any stability (though the idea that neutral shoes have no stability is also a myth). Similarly, I sometimes hear of someone well-meaning but ill-informed trying to push a minimal shoe on someone just because they midfoot or forefoot strike, without actually doing a gait analysis. While a midfoot or forefoot striker may or may not actually have a neutral gait, the idea that every midfoot and forefoot striker is a neutral pronator is absolutely false.

In an earlier topic, I discussed pronation, overpronation, and supination. Pronation is, in and of itself, a good thing. Without some level of pronation, your body would be unable to cushion itself, and you're at increased risk for stress related injuries, such as stress fractures and stress reactions. However, too much of a good thing is no longer good, and overpronation results in your foot not being able to form a rigid lever for push-off, decreasing efficiency and increasing your risk for torsion injuries. This rule holds true no matter how your foot lands on the ground. A forefoot or midfoot striker should still have some degree of pronation in order to cushion their landing, and like heelstrikers, many still have problems with overpronation or underpronation.


The same treadmill gait analysis that would be done for a heelstriker can and should be done for a midfoot or forefoot striker, though once their pronation level is determined, their needs will differ slightly from a heelstriker's. For example, a supinating heelstriker really benefits from a heel cushion, whereas a supinating forefoot striker would need more cushioning up front. Similarly, a firm heel counter will still help a forefoot striker's calcaneus from rotating medially, but probably not quite as much as it would stop a heelstriker's calcaneus, so an overpronating forefoot striker may need a different type of stability (medial post, arch support, etc...depends on what works best with your footstrike). On the other hand, a heelstriker may be overpronating before a medial post too close to the forefoot can help, and may benefit from a firm heel counter and a plastic piece in the arch. Since a midfoot or forefoot striker's foot mechanics are a little different, different stability and cushioning mechanisms will react to their stride differently than a heelstriker's, so a shoe that controls a heelstriker's pronation might not control a midfoot striker or forefoot striker's, and vice versa. The easiest way to actually determine which type of stability or cushioning works best for you is to try on different shoes and see how each one reacts to your stride.


To give you an example of what I'm talking about, let's look at the Brooks T7. I've worn ultralight flats like the Adizero PR and Asics Piranha, but they also tend to work best when I'm moving at half-marathon pace or faster (when I'm actually midfoot striking, and don't really care about rearfoot cushion). At marathon pace and slower, I'm a heelstriker, and the T7 has a rearfoot Hydroflow unit. That probably does nothing for a forefoot striker, and only slightly more for a midfoot striker, but wow, is that thing awesome for heelstrikers. While it does lift the heel higher (12mm heel-toe differential), it adds a lot of heel cushion for a shoe of its weight. If Brooks were to take that out so they could decrease the 12mm drop to 4mm...I'd be really upset and would probably need to go find a new pair of flats. That's not to say that the T7 is a terrible choice for midfoot strikers, but that rearfoot Hydroflow unit is really Brooks' gift to heelstrikers.


Seriously, I love this shoe. Please, Brooks, don't change it.

Another thing to keep in mind that it's not three single footstrikes: heel, midfoot, and forefoot. You can be a forefoot striker who strikes further back and is almost a midfoot striker, a forefoot striker who pretty much runs on their toes, a heelstriker who grazes the ground with their heel and weight bears the same way as a midfoot striker (proprioceptive heel strike), a heelstriker who weight bears on their heel (which is unfortunately usually caused by overstriding, and may be the one time I'd actually recommend messing with your footstrike), etc. Additionally, many heelstrikers turn into midfoot strikers at faster speeds, and most people turn into forefoot strikers when sprinting! So it's impossible to say that "this shoe will work for forefoot strikers, this shoe will work for midfoot strikers, and this shoe will work for heel strikers," since there's so much overlap!

A trend that I find very interesting is the one that's putting a lot of midfoot and forefoot strikers (natural and unnatural) in shoes with low heel-toe differential. First of all, it's very possible to midfoot or forefoot strike in shoes with a high heel-toe differential. You don't need to go zero drop to midfoot strike. All of this is dependent on the amount of dorsiflexion you have upon landing, as well as where, exactly, your foot is landing in relation to your body (and the angle of your lower leg), which is related to that whole dorsiflexion thing). Something that I do think is important to note, however, is that different muscles are being emphasized with different footstrikes. A midfoot or forefoot striker actually puts more stress on their lower legs than a heelstriker, particularly the eccentric load upon landing. Conversely, heelstrikers tend to use their upper leg and gluteal muscles more than midfoot and forefoot strikers. This isn't a bad thing, since everyone uses different muscles to different extents. Your natural stride, whatever that may be, most likely favors your stronger muscles anyway, since those were the muscles that you have developed and with which you naturally run efficiently. However, if you're trying to change your stride, it is something to be aware of, since you'll be using muscles that are not accustomed to the new stresses. That means that a natural heelstriker who is trying to force themselves into a midfoot strike and a shoe with a lower heel-toe differential is hitting their calves with the double whammy. I'm not going to tell you not to play with your stride (just make sure you're doing it for the right reasons), but please be careful with the transition and understand that you will be stressing your lower legs far more than they are used to being stressed.

8 comments:

  1. A great description of what happens as ones gait changes with speed and foot motion varies throughout the foot strike. I've seen this with myself and in my clinic. Running in any large race will also reveal this as one observes the masses.

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  2. Thanks for your comment, Brent. And I totally agree...it's so interesting to watch what's going on in a large race! I'm too focused on myself to watch other people's feet when I'm actually racing, but sitting on the side and watching reveals a lot.

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  3. The bandwagon type of folk with regards to forefoot strike and/or low heel shoes/barefeet often seem to figure that they have found the "secret" to soon be injured and confused as to why not realizing the stress loads are quite different and that bone,ligament and tendon take months and years to adapt to load changes esp with running as it's mostly eccentric contractions. Of course lax ligaments will always be lax and well....you know the stories. Some learn the hard way unfortunately. I've alway been one with very high stiff arches who gets 200-250 miles from shoes at best but requires a bit of torsional stability as my first toe has a lax transverse lig and a lot of mobility sup/inf causing the foot to tip inward a bit when tired vs the arch collapsing.Always something but running healthy which is the main thing. Have a great weekend.

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  4. "A midfoot or forefoot striker actually puts more stress on their lower legs than a heelstriker, particularly the eccentric load upon landing."

    to my knowledge, that is no longer accepted as fact. http://www.nature.com/nature/journal/v463/n7280/full/nature08723.html

    but you appear to be talking specifically about runners in traditional running shoes, so maybe the shoe preventing the foot from moving naturally, like the natural arch collapse, does result in more force for mid- or forefoot strikers.

    in any case, I think you are missing the point, which is the hypothesis that without shoes, people forefoot or midfoot strike, and that traditional running shoes with the built-up heel encourage people to heelstrike since they don't bang up their heels. the artificial heelstrike introduces force that would not otherwise exist, and a new subset of injury possibilities.

    I also am not sure why you say that many people who heelstrike turn into midfoot or forefoot strikers when running faster. Are there studies that measured this somehow? I'm seriously asking, because I've seen a lot of slow-speed film videos with gait and footstrike analysis, but I've never seen one that drew attention to a difference in footstrike at higher speeds.

    It seems like the whole minimalist shoe and rejection of pronation theory thing is a real issue for you. I'm not sure why you are so invested in treating traditional running shoe philosophy (can't think of a better word there!) as fact, when I think science is currently much less sure. You talk about things like the pronation categories and gait analysis as if they are not under real scrutiny, but are proven facts and people who reject those ideas are ill-informed wackjobs.

    Actually I am not even sure you discuss the science? Do you have reasons for doubting some of the studies in the past years talking about unshod running, midfoot striking, minimalist footwear and injury, etc? For example some of the studies discussed by Runblogger (www.runblogger.com)?

    I get it, this is a personal blog, I get that you get to discuss things how you want. I have been reading you for a while now, and noticed this particular thing come up over and over again, that is why I mention it.

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    Replies
    1. I too, am curious. Curious why advocates of barefoot/minimal running (often, not always) seem unable to let others have a differing opinion? The need to force the 'new craze' on people who have always heel-struck without injury and have no need of jumping on the bandwagon? Nobody says that there can only be one dietary theory for every person, so why only one running style?

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  5. Brent, just wondering, what shoes are you in now?


    I'll answer the easy question first, as to why I write about this particular subject. First of all, it's an interest of mine. I'm a shoe geek and a kinese nerd. Secondly, I've gotten a lot of questions about what shoes I think are best for people. Without seeing them, it's hard for me to give them a good answer, but equipping them with knowledge will hopefully send them in the right direction, or even better, encourage them to pursue more knowledge. Finally, it gets page views, and any bloggers who say they don't care about page views at all is kidding themselves. As much as I might love to sit here and write about my own training, no one wants to read the training log of a 1:25 half-marathoner.

    Okay, now the meat of your question. I'm having trouble actually reading that study you're linking to since you need to subscribe. However, to be clear, I'm not talking about ground reaction force, which is what it *looks* like they're referring to in the abstract. I'm specifically referring to which muscles are being used, in proportion to each other.

    Here's some information on the speed vs. footstrike hypothesis: http://www.sportsscientists.com/2008/04/running-technique-footstrike.html
    As you stated, yes, it's a hypothesis. I do know, however, what it does to my personal stride, as well as other people's strides that I've observed at slow motion on a treadmill, so it at least holds true for the majority of people that I've personally observed. There are certainly people who forefoot or midfoot strike at any speed, and there may be people who heelstrike at any speed, but my own observations have shown me that many people's footstrikes do change. Theoretically, if you're running faster and your cadence remains the same (though I believe changing cadence with speed is up for debate right now too), you should spend less time in single-limb support and more time airborne. The slower you go, the more time you spend in single-limb support, until you eliminate the time spent airborne and actually end up with time in double-limb support (walking). Your foot should spend more time on the ground with a heelstrike (taken to the extreme, with walking, typically initial contact is made with the heel, even with people who midfoot strike when running).

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  6. Hi Becki, I'm running a few different shoes but lately find the lunarfly a good jack of all trades shoe from 100m to long runs. The adizero tempo,brooks launch, saucony triumph all are in the rotation. I've found a pinch of mid/forefoot posting is ok or stable neutral. The newer nb 770 or 1190 would probably be ok but too thin a forefoot can be trouble. When I've used shoes with posting well into the heel retocalcaneal bursitis soon develops. For up to 10k races the adizero mana5 is good. Have you worn the hoka bondi's? I had a run in some the other day and wow... smoooth and not as slow as one would expect. Went 10 miles and other than some calf stiffness (4mm heel dif) my quads, hips and knees felt like I did nothing. LOTS of weird looks of course.

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  7. I have not worn the Hoka Bondis. They seem to be getting surprisingly good reviews though (including one from a self-described minimalist who said they wouldn't make his rotation, but they were far better than he expected). I've also heard them likened to a full-suspension bike on trails (super smooth, though sacrificing some responsiveness). My main deterrent is the same thing that's keeping me from testing the Prophecy, Newtons, or Vivo Barefoots (Barefeet?)...the pricetag! If I knew I'd like them it would be one thing, but I just don't have the money for an experiment like that right now!

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