Best running form to stay injury-free

Running form has been a huge topic of conversation in recent years, especially with social media running rampant. I see reels daily about why heel striking is causing all your life problems. And it drives me CRAZY. But obviously not everyone has the knowledge or expertise to know when someone is pushing false narratives to either gain more followers or spread fear to make them more money. So here I am to clear things up. 

Spoiler alert: there is no best running form to prevent injury. Honestly, there’s no best running form in general, but that’s for another time.

When discussing running form, most people are referring to a runner’s foot strike. So, let’s take a look at the 3 main patterns.

Types of foot strike—

Rearfoot (RF) strike

• Heel or back of foot landing 

  • Rearfoot striking increases the amount of stress at the knee compared to other foot striking patterns. RF/heel strikers tend to land with a straighter knee, causing them to have to control a greater range of motion at the joint. 

  • Ex: RF striker landing w/ straighter knee has to control from 15-20 deg of knee flexion (bending) at landing to 60 deg → ~45 deg of motion to control

    Compared to a midfoot striker who may land at 35-40 deg of flexion and has to control to 60 deg → ~25 deg of range to control

  •  The large majority of runners display a rear foot strike landing pattern.

Midfoot strike

• Middle of the foot landing 

  • A midfoot strike starts to shift loading from the knee to the ankle/calf complex so, this landing pattern places higher loads on the ankle and achilles tendon.  

Forefoot strike

• Front of foot landing 

  • A forefoot runner lands around the ball of the foot. This striking pattern places high loads on the ankle/calf complex, just like midfoot striking.

So which type of footstrike is best and keeps you injury-free?

None of them. No running pattern is better or worse than the other. They’re just different. 

I’m sure you’ve heard that heel strikers get injured more often, but take a closer look as to why that might be. About 80% of runners display rear foot strike mechanics. So are runners getting injured because they heel strike or does it just look that way because the vast majority of runners display that landing pattern? Correlation does not equal causation. Running form does NOT predict if you will get injured. But it can help inform running modifications to decrease stress on injured tissues.

When to contemplate changing running form 

As a PT, the only time I think about changing someone’s running form is when they’ve been dealing with a chronic injury. That could be an injury that’s been lasting for months or one that has recurred multiple times. Even so, changing form is one of the last adjustments I consider. This would only happen if changing other variables was unsuccessful at managing pain/rehabbing the injury. 

Why? Because changing a runner’s landing pattern doesn’t make stress disappear, it just shifts it to another part of the leg. For some, this can end up causing pain at the new location of stress. For example, switching from a heel strike to a midfoot strike places a lot of added stress on the ankle and achilles. Trying to make this change for an entire run is not only extremely difficult, but the high cumulative loads on the achilles could cause pain if the achilles is under prepared. IF a change is made to manage pain, the change should be short term and strategically added into your running program to prevent further injury/pain.

What I recommend instead 

Oftentimes, stress management can be accomplished with a more simple cue. Increasing running cadence 5-10% is easier to introduce and maintain than trying to change foot strike pattern. More on cadence to come in a future blog post. 

The main point I want to get across is that every body is different. We all have slightly varying anatomy and different strengths. So why would there be only one right way to run? Some people will be more efficient running with a heel strike vs running with a midfoot strike pattern because that’s what’s natural to them. My goal is to keep runners running through rehab and then to keep them healthy and as pain-free as possible throughout their career, not to overhaul your form.

If you’re injured and are feeling the need to change your form, reach out. There are so many other ways to rehab an injury that you should try first. 

If not, stop overthinking and just enjoy yourself.