Minimizing running load via gentle heel strike techniques: A gait modification study

Introduction: Running overuse injuries (ROIs) are among the most common running-related musculoskeletal injuries. Modifying gait has been recognised as an effective strategy for preventing ROIs. This study investigates whether gentle heel strike (GHS) running decrease the impact loading rate during 30-minute runs in healthy participants.

Methods: In this prospective cohort interventional study, twenty male participants underwent gait modification in a controlled laboratory setting, with the goal of reducing heel impact through real-time visual feedback. Comprehensive measurements, including plantar contact, force, pressure, and detailed kinetic and kinematic analyses, were employed to assess changes in gait dynamics.

Results: GHS significantly shifted plantar pressure, reducing heel forces and increasing forefoot load. Mean heel force decreased by 0.32 ± 0.1 Body Weight (BW) and heel pressure reduced by 0.1 KPa/BW. Although peak vertical ground reaction force (vGRF) and anterior-posterior ground reaction force (apGRF) did not change significantly across the entire stance phase, early stance vGRF (7-12% of the gait cycle) was reduced, leading to the disappearance of the vertical impact peak (VIP). VIP dropped from 1.45 ± 0.23 to 1.27 ± 0.25 BW. Significant reductions were also seen in the vertical instantaneous loading rate (VILR), which decreased from 68.32 ± 14.20 to 46.77 ± 13.95 BW/s, and the vertical average loading rate (VALR), which fell from 54.96 ± 14.38 to 38.84 ± 12.62 BW/s (p<0.001).

Discussion: GHS has the potential to modify running mechanics by redistributing plantar pressure and diminishing heel impact force. This reduction in heel impact force could lead to a change of landing pattern anteriorly and a decrease in loading rates, potentially reducing the risk of running overuse injuries.

Conclusion: Visual biofeedback-guided GHS are feasible in healthy participants, and it effectively reduces the loading rate in running for 30 minutes.

Key points: 1: Real-time visual biofeedback enabled runners to successfully adopt a Gentle Heel Strike, significantly reducing heel impact force and loading rates.

2: Contrary to expectations, fatigue did not compromise the sustainability of the Gentle Heel Strike technique during a 30-minute run.