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To Heel Strike or Not to Heel Strike, that is the Question

Updated: Jan 25, 2021

A Running Shoe Reference Guide


Barefoot Running–The Origin


Wikipedia references peer-reviewed articles describing barefoot running as “natural running” that has been around throughout history. Humans ran with no shoes or thin moccasins until plimsolls were invented by the Liverpool Rubber Company in the 1830’s. Even though barefoot running has faded in many places, it is still practiced in parts of Africa and Latin America (2021).


In the 1970’s, there was a running boom causing shoe companies to capitalize on the movement creating modern running shoes. Some researchers blame the modern running shoe claiming it encourages a heel strike pattern that leads to running injuries. In 2009, Christopher McDougall published the book Born to Run. A runner himself, McDougall studied the reclusive Tarahumara Native Mexican tribe in the Mexican Copper Canyon and their ability to run over 100 miles at a fast pace with little to no injuries. McDougall was plagued with injuries himself, and claims the modern running shoe is the cause of these injuries. He encouraged his readers to wear thin sandals like this tribe to reduce injury (Wikipedia, 2020).



Born to Run set off an explosion of barefoot runners and minimalist style running shoes still seen today. I too was caught up in this movement. I trained myself to strike on my mid-foot instead of my heel wearing minimalist running shoes for protection from rocks, sharp objects, and weather related elements. I cannot argue that my speed picked up, my knee and hip pain disappeared, and my feet and ankles were stronger. Encouraging a mid-foot strike has been growing in popularity by coaches, athletes, and researchers claiming improved performance and less injury. Even doctors were assessing gait or strides issues with mid-foot strike treatment plans. However, there is another side to this story.


Running Style vs Injury


Since this barefoot movement has grown in popularity, so has the rise in running related injuries. There has been an increase in pulled calf muscles, Achilles tendonitis, and metatarsal fractures. This is not to say that heel striking in modern running shoes are free from injury. Heel striking leads to ankle sprains, plantar fasciitis, or knee and hip pain. In the 2017 Journal of Sport and Health Science, Hamill and Gruber research if changing a foot strike is beneficial. They concluded that each individual has a unique foot strike based on our own physiology. No two individuals will strike exactly the same. We walk and run based on habitual patterns. If that pattern isn’t causing pain, injury, or decreased performance, there is no evidence that it should change. “Research suggests that there is no obvious benefit to such a change for the majority of runners. In fact, it may be that the change in foot strike may result in stressing tissue that is not normally stressed when running with one's habitual pattern, thus leading to the possibility of incurring a secondary injury. Changing one's foot strike to a mid- or forefoot strike may be beneficial to some but, based on the current biomechanical, physiological, and epidemiologic literature, it should not recommended for the majority of runners, particularly those who are recreational runners” (Hamill and Gruber, 2017).


“The American Podiatric Medical Association has stated that there is not enough evidence to support such claims and has urged would-be barefoot runners to consult a podiatrist before doing so.[24] The American Diabetes Association has urged diabetics and other people with reduced sensation in their feet not to run barefoot, citing an increased likelihood of foot injury.[25] One study showed a link to early bone damage in new barefoot runners.[26][27]” (Wikipedia, 2021).


As a personal trainer, I only encourage a change in foot strike or gait patterns if the current habit is causing significant pain or injury. I have seen cases of extreme pronation due to flat feet or one knee crashing into the other. I have even seen extreme cases of plantar fasciitis from running habits. In these special cases a combination of strike and gait correction is necessary. However, most cases are healed by improved running mechanics, proper fitting and supportive shoes, strength training the weak areas, and increased mobility.


I learned quickly that barefoot running is not for everyone. I ended up with metatarsal stress fractures in both feet and a more severe break in my right foot. As my podiatrist so eloquently said, “have you seen your tiny feet?” He said my child size feet and bones were strong, but that amount of stress and impact overtime will result in injury. The podiatrist said my feet definitely needed a supportive shoe. Americans are not running on dirt and clay out in Copper Canyon. We run mostly on pavement and concrete. Repetitive stress on these surfaces without support will lead to injury with the exception of a small population.


If you are experiencing issues from running or need help, please reach out to me at mitzi@healthyhumanitarian.com.


How to Find the Right Fit


Today we have a plethora of running shoes to choose from. In fact, too many for me to recommend in this blog. The bottom line is that you have to physically try shoes on to pick what feels the most comfortable. Does it fit like Cinderella’s glass slipper?


Before you purchase your running shoe, you need to know the following tips:


Tip 1: Buy a half to one size larger to account for foot swelling during the run.


Tip 2: Check the bottom of your current shoe to see where the worn part of the tread is. Do you run on the midfoot or the heel? The tread will tell you. Then you can alert the salesman to find shoes that support that strike pattern.


Tip 3: Make sure you are aware if your ankles or knees crash inwards as you run. Runners, typically with flat feet, need to see a podiatrist for an orthotic or a shoe designed for pronation to add support to prevent overpronation. If you supinate or run more centered, a neutral shoe is just fine.


Tip 4: Know how much padding you want or need. If you have strong feet, you won’t need a ton of cushion. If you are not sure, see a podiatrist for a recommendation or a quality running store for assistance.


Tip 5: Decide on how much you want to spend. A quality running shoe can last 1-2 years. If you want a shoe that will last, plan on spending an average of $150 for a pair of quality shoes. It is okay if you need to spend $80 or less. Just know they will wear out faster.


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