Prof. Joseph Hamill,
School of Public Health and Health Sciences
University of Massachusetts Amherst
Theme: Rehabilitation of musculoskeletal injuries
What have we learned about barefoot, minimalist and forefoot running and injury risk?
Several researchers have led the running discussion in terms what style of running is better, barefoot or shod? Or what type of footfall pattern should be used? The question that most ignore is on what surface is the running taking place. On a hard surface, a habitual rearfoot runner, when running barefoot, generally changes from their habitual pattern to a forefoot pattern to avoid the pain of landing on the heel. This has led to the development of minimalist footwear. However, several running instructors and coaches have extended this concept of barefoot/forefoot running to suggest that the “optimal” footfall pattern to improve performance and reduce running injuries is the midfoot or forefoot pattern. Therefore, it has been suggested that runners, who use a rearfoot pattern, would benefit by changing their footfall pattern although there is little scientific evidence for suggesting such a change. The reasons often given for changing to a midfoot or forefoot footfall pattern are: 1) it is more economical to run with a midfoot or forefoot footfall pattern; 2) there is a reduction in the impact peak and loading rate of the vertical component of the ground reaction force (VGRF) in midfoot and forefoot footfall patterns; and 3) there is a reduction in the risk of a running-related injuries after changing to a midfoot or forefoot pattern. In this presentation, I will critique these suggestions and provide alternate explanations that may provide contradictory evidence for altering one’s pattern. We have concluded, based on examining the research literature, that changing to a midfoot or forefoot pattern does not improve running economy, does not eliminate an impact at the foot-ground contact and does not result in reducing the risk of running-related injuries. In addition, the change to minimalist footwear does not necessarily help runners with any of the above factors.