Rearfoot strikers' injuries are more than double
By Amby Burfoot
Harvard’s Daniel Lieberman and students have published two new papers supporting the benefits of a forefoot stride or minimalist shoe. The first reported that Harvard University cross country runners who were forefoot strikers suffered only about half as many injuries as their rearfooting teammates. The second found that habitual barefooters or minimalist-shoe-wearers were roughly two to three per cent more economical in minimalist shoes than in traditional shoes.
The injury study – free, full text here – followed 52 Harvard varsity runners (23 women) who amassed 292,900 kilometres. There were 69 per cent rearfoot strikers, 31 per cent forefoot strikers, and no midfoot strikers, essentially eliminating that theoretical category from the real world. Approximately 74 per cent of the runners experienced a moderate or severe injury per year, presumably because they were running 65–70 kilometres a week, training hard/fast, and racing often. None had a body mass index that would put them in the overweight class.
The rearfoot strikers had approximately 2.5 times as many repetitive stress injuries as the forefooters. Interestingly, the rearfooters had an increased number of “expected injuries” in the knees, hips and back, but the forefooters did not have the expected injury increase in the achilles, foot and metatarsals. The researchers believe that forefoot striking reduces both loading forces and some important joint-torque forces, possibly explaining the lower injury rates.
As always, the Lieberman group is cautious when it comes to interpretations of its data. They jump to no hasty conclusions, stating, “There is much research to do,” and “All runners are at risk of injuries, and there are no magic bullets to prevent injuries.” They believe that running form largely trumps shoe selection, concluding: “Runners and researchers alike may profit from paying more attention to how people run than what is on their feet.” They also add this caveat: "This study, like most injury studies, has limitations and we caution against extrapolating the above results to assuming that all runners are necessarily less likely to be injured if they [forefoot strike]. For one, the population of subjects studied here, collegiate runners, are not representative of many amateur runners."
The running economy abstract, here, concluded that minimalist-shoe-wearers have a higher running economy, because such shoes encourage “more elastic energy storage and release in the lower extremity [the feet and legs].”
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