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Mark E. Kasmer, Xue-cheng Liu, Kyle G. Roberts, and Jason M. Valadao


To determine prevalence of heel strike in a midsize city marathon, if there is an association between foot-strike classification and race performance, and if there is an association between foot-strike classification and gender.


Foot-strike classification (forefoot, midfoot, heel, or split strike), gender, and rank (position in race) were recorded at the 8.1-km mark for 2112 runners at the 2011 Milwaukee Lakefront Marathon.


1991 runners were classified by foot-strike pattern, revealing a heel-strike prevalence of 93.67% (n = 1865). A significant difference between foot-strike classification and performance was found using a Kruskal-Wallis test (P < .0001), with more elite performers being less likely to heel strike. No significant difference between foot-strike classification and gender was found using a Fisher exact test. In addition, subgroup analysis of the 126 non-heel strikers found no significant difference between shoe wear and performance using a Kruskal-Wallis test.


The high prevalence of heel striking observed in this study reflects the foot-strike pattern of most mid-distance to long-distance runners and, more important, may predict their injury profile based on the biomechanics of a heel-strike running pattern. This knowledge can help clinicians appropriately diagnose, manage, and train modifications of injured runners.

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Jan Schroeder, Franziska Erthel, and Karsten Hollander

argued that differing foot strike patterns (FSP) lead to altered impact forces during ground contact. 9 , 10 A rear foot strike (RFS) has been reported to be associated with 25% higher vertical impact forces than a forefoot strike (FFS). 9 , 10 Considering that impact (running) and nonimpact (cycling

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Michael Lyght, Matthew Nockerts, Thomas W. Kernozek, and Robert Ragan

Achilles tendon (AT) injuries are common in runners. The AT withstands high magnitudes of stress during running which may contribute to injury. Our purpose was to examine the effects of foot strike pattern and step frequency on AT stress and strain during running utilizing muscle forces based on a musculoskeletal model and subject-specific ultrasound-derived AT crosssectional area. Nineteen female runners performed running trials under 6 conditions, including rearfoot strike and forefoot strike patterns at their preferred cadence, +5%, and –5% preferred cadence. Rearfoot strike patterns had less peak AT stress (P < .001), strain (P < .001), and strain rate (P < .001) compared with the forefoot strike pattern. A reduction in peak AT stress and strain were exhibited with a +5% preferred step frequency relative to the preferred condition using a rearfoot (P < .001) and forefoot (P=.005) strike pattern. Strain rate was not different (P > .05) between step frequencies within each foot strike condition. Our results suggest that a rearfoot pattern may reduce AT stress, strain, and strain rate. Increases in step frequency of 5% above preferred frequency, regardless of foot strike pattern, may also lower peak AT stress and strain.

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Ricardo Pires, Thays Falcari, Alexandre B. Campo, Bárbara C. Pulcineli, Joseph Hamill, and Ulysses Fernandes Ervilha

foot contacts the ground. It has been reported that shod and barefoot running do not lead to different muscle activation time patterns after foot strike; however, shod and barefoot running changed in EMG intensity before foot strike. 5 In the aforementioned study, it was concluded that, considering

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Peter Francis, Cassie Oddy, and Mark I. Johnson

In a 27-year-old female triathlete, magnetic resonance imaging revealed mild thickening and edema at the calcaneal insertion of the plantar fascia, in keeping with a degree of plantar fasciitis. After 6 weeks of conservative treatment failed to elicit a return to sport, the patient engaged in six sessions of barefoot running (15–30 min) on a soft grass surface, without further conservative treatment. After two sessions of barefoot running, the patient was asymptomatic before, during, and after running. This outcome was maintained at the 6-week follow-up period. This is the first case report to use barefoot running as a treatment strategy for chronic heel pain. Barefoot running has the potential to reduce the load on the plantar fascia and warrants further investigation using a case series.

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Tomonari Takeshita, Hiroaki Noro, Keiichiro Hata, Taira Yoshida, Tetsuo Fukunaga, and Toshio Yanagiya

Generally speaking, runners use their preferred foot strike pattern, classified into forefoot strike (FFS), midfoot strike, and rearfoot strike (RFS). 1 Previous researchers have investigated the effect of foot strike patterns on the running performance from the viewpoint of biomechanical

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Christopher Napier, Christopher L. MacLean, Jessica Maurer, Jack E. Taunton, and Michael A. Hunt

contribution of hip flexion angle or shank angle at initial contact to kinetic outcomes associated with running-related injury risk. Foot strike angle at initial contact has also been reported to change significantly with greater changes (±10%) in step length, with a more dorsiflexed ankle at initial contact

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Dylan C. Perry, Christopher C. Moore, Colleen J. Sands, Elroy J. Aguiar, Zachary R. Gould, Catrine Tudor-Locke, and Scott W. Ducharme

approach for communicating ambulatory PA intensity guidelines and improving health. 4 One method for prescribing cadence recommendations involves instructing individuals to synchronize or entrain their foot strikes to rhythmic auditory cues (RAC). 6 , 7 The RAC take advantage of existing intimate neural

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Adam M. Fullenkamp, Danilo V. Tolusso, C. Matthew Laurent, Brian M. Campbell, and Andrea E. Cripps

rest). Motion analysis data collected during the treadmill conditions (MT or NMT) were captured from the last 30 seconds of a 90-second trial. Data Analysis Processed 3D marker trajectories were first analyzed to determine foot strike events and partition trial data into gait cycles. 19 Individual

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Martin Buchheit, Mathieu Lacome, Yannick Cholley, and Ben Michael Simpson

over all the foot strikes, F peak , N), and propulsion efficiency (ie, the ratio between velocity and force loads, Vl/Fl). Velocity load is calculated using player body mass and the running velocity across the entire sequence, and it increases by the power of 2 as speed increases. Force load is also