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Changing to Heel-Strike to Prevent Injury?

In a recent case study published in Physical Therapy in Sport, researchers detailed a runner whose gait was changed to fix a recurring injury. But, it may not be the changes you expect! This runner was having recurrent calf strains. Upon video analysis of running form, the therapist discovered that this patient was landing in a forefoot strike pattern on the injured side. (Side note: my personal guess is that this patient was also never letting that heel touch the ground). This forefoot strike was causing the runner to have never-ending calf tone and tension and never allowed the muscle to function properly during gait. The therapist then changed the runner’s foot strike to a rearfoot strike, otherwise known as heel-strike, with spectacular results.

This can be confusing if you have thought previously that all heel-striking is bad, and we should all change to midfoot or forefoot strikers! However, the research over the past decade has started to show us that foot strike pattern is perhaps not as important as we once supposed. For this runner’s case, the therapist instructed the runner to change to a rearfoot strike pattern. What happened then? Well, the runner went on to have 6 months without a calf strain which they had been experiencing on a recurring basis.

While we should be cautious to interpret these results for a general population, since it is only a case study, we can nevertheless take a lesson away. We should always assess each runner for their individual needs and injury history! I have personally coached several clients away from a forefoot strike due to recurring Achilles, calf, and hamstring pain – with great results. If you or your therapist are trying to apply general “principles” without looking at your individual form and body, then you may be missing out on improvements!

Here’s to individualized treatment and turning paradigms upside down!

Thanks for reading,



1. Baquet, A., Mazzone, B., Yoder, A., & Farrokhi, S. (2020). Conversion to a rearfoot strike pattern during running for prevention of recurrent calf strains: A case report. Physical Therapy in Sport, 41, 64-70.


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