Most common injuries for forefoot strikers

[00:00:00] If you spent time with me on this channel or looking at running videos, you may have looked into trying to improve your running form. You may have even gone and gone barefoot, running, thinking that’s going to fix all your problems. So what you may be doing now is forefoot striking what you think. Hey, that’s awesome. And I actually would tend to agree with you, but there are some problems that crop up specifically for forefoot runners where injuries are going to be more specific to this running style.

[00:00:40] We want to talk about improving running form or helping you be a better runner. Typically, the faster you go, the more likely it is that you mid or forefoot strike. And in other video I covered common injuries for heel strikers which has to do more so with your speed and a little bit of kind of your inherent biomechanical tendencies. But this is changeable.

[00:01:07] So if you actually heel strike, stick around, I guess, to the end or jump to the end and we’ll link to that video. But when we’re talking about forefoot striking, we’re talking about people who often are going to be running faster. And there are tendencies that you get yourself into if you forefoot strike, which you can prevent with some simple exercises.

[00:01:31] So if we think about the biomechanics of somebody who forefoot strikes, what’s going on? What are we doing? Why are we doing it? The whole idea popularized by I finally got my book back, Born to Run Christian McDougall back in 2011 I think that book came out. The idea is that your Achilles tendon is basically a spring, so when you land on your forefoot, your heel is not touching the ground yet. It goes down, loads the spring, and then when you push off, the spring is activated, pushing you far farther forward faster. Then we can do Sally sells seashells by the seashore. We can do all the tongue twisters today.

[00:02:14] Anyway, so the idea is that using this forefoot striking method is more natural, which I would tend to agree with, and that you’re using that Achilles tendon to go faster, which if you didn’t know that, subscribe to the channel. Stick around for more videos in the future every Tuesday and Thursday. So all those things I believe are true. But because we’re using our Achilles more, that also means there’s a lengthening effect that’s happening, which if you were heel striking previously, you may not be ready for.

[00:02:52] And so you have to take some care to take care of your Achilles to prevent like Achilles tendonitis or incisional tendinitis, which is something I’ve dealt with over the years. And one of the easy ways to do that is doing calf drops. So in contrast to calf raises, this is an eccentric exercise.

[00:03:14] Eccentric exercises are a really great way to deal with most injuries, especially running injuries. And the idea is that we want the tendon in this case or muscle in some other cases, in other kinds of injuries to be strong in a lengthened position. So the idea here is that you do a calf raise both with both feet going up, and then you’ll go to say one side and slowly over 3 to 5 seconds, lower yourself to the ground.

[00:03:46] Your tendons actually respond really well to load. So this is a great way to exercise this. Eventually, you work your way up to doing these calf drops, like off of a step, but it can be it’s a whole progression where you start on the ground, you work up with more weight, say, in a backpack, ten, 20, 30lbs. Then you go to the step with no weight, then ten, 20, 30lbs. Once you can do that, then you kind of hit the maximum efficacy, so to speak. There’s no real need to load it more than that, and you have strengthened that tendon.

[00:04:21] Now, this adaptation takes quite a bit of time. So when I talk to podiatrist Mark Gallagher on the Smart Athlete Podcast and the show I do here on this channel. We talked about how it used to be that we would say 12 weeks is like the adaptation time for tendons, but that’s not really accurate.

[00:04:42] I think it helps keeps you thinking about the long-term implications of how long it takes for tendons to adapt because it takes longer than muscles, but it can be a variable amount of time. And so I wouldn’t fixate so much on 12 weeks, as am I progressing through these steps without pain and without soreness, tightness, all those kinds of things.

[00:05:07] Similarly, because we are activating that Achilles more when we’re doing forefoot striking another very common injury is to your soleus and it’s kind of along these lines to your tibia. So like shin splints basically is the more common term, but your soleus injury is part of your calf, so it’s a part of your calf that’s behind the big part. We like to focus on that big chunky section of our calf. I’ll shoot some B-roll of my calf here. It’s the bottom part that goes and down and touches to your Achilles tendon.

[00:05:48] That part is being activated way more when you’re forefoot, striking than if your heel foot striking. So the exercise you do for this or bent knee calf raises same kind of idea as normal calf raises. Just bend your knee that activates the soleus more than it does the gastrocnemius, which is the big chunky section we like to focus on as our calves. But it’s actually these two muscles that kind of work together, and then there are other muscles in there. But the ones we want to focus on are those big two. And the soleus is going to be more prone to injury when you’re forefoot striking.

[00:06:24] The last really common injury of less common than the other ones, but still annoyingly common is metatarsal stress fractures. And this makes sense if we think about that, now, when we’re forefoot striking, we’re placing a lot of load on the front of our foot. Right? That’s exactly what we’re doing. We’re putting the load on the front of our foot, allowing the heel to come down, activating that Achilles, using it as a sprain, so on and so forth. So that means that potentially the metatarsals, those little finger like bones that are in our feet, are susceptible to damage. 

[00:07:04] The way to prevent this — It’s it’s a tough one to say, drink your milk. No. Good nutrition is absolutely a role in preventing stress fractures. Generally speaking, stress fractures shouldn’t happen if you’re nutritionally hitting all the marks. The exception can be these metatarsals because they’re so small and susceptible to damage. So the two of the things I would suggest focusing on, if you’re starting to get pain in those areas or pain on the top of your foot before you get a stress fracture, make sure you’re not building mileage too quickly. That’s a very common thing, is overloading basically because your bones will adapt.

[00:07:49] They’ll increase their density over time. But much like the adaptation with your tendons, it’s not something that happens overnight. So you have to be patient with that to be able to build up mileage, but also make sure that your running surface and shoes are a compatible mix. So this is something that happened to me in the last couple of years. I got unfortunately, I was trying to replace these guys. These shoes are now like five years old. Nike doesn’t make them anymore. So I was trying to find a replacement for them.

[00:08:24] I had gone to a different but similar shoe that had no outsole. Very soft shoes are very comfortable for me, but it resulted in metatarsal stress fracture because I do a lot of what I would refer to as urban running. Many of us running on sidewalks, running on asphalt streets. And because the shoe was too soft, it wasn’t taking enough of the impact. And I got a stress fracture because of it, something I didn’t even know that I had until I had been running on the stress fracture for three or four weeks. And then the pain kind of came up on me and we diagnosed it with an x ray.

[00:09:01] So it’s something that can happen when you don’t have proper fitting shoes that aren’t the right kind of thing. So those shoes, I think for somebody who maybe is a lot lighter than me, I’m not a heavy person, but maybe somebody who’s lighter not going to have quite as much impact force when they’re running or if I was doing more trail running, probably not going to be as much of an issue because of the softer surface.

[00:09:28] You’re not going to get as much of those forces when you touch down back into your foot or into your shoe as when you run on asphalt. So dirt is softer than asphalt, go figure. But the result is a softer landing. So making sure that your shoes and your running surface are compatible is another way to prevent metatarsal stress fractures.

[00:09:49] So are the other things you’re dealing with other injuries you’re dealing with, you just aren’t sure what to do. Would you like more info on common running injuries and hear them from an expert? Well, first you can check out that episode of The Sport Athlete podcast with Dr. Mark Gallagher that I did here on this channel. Subscribe. But if you’d like me to do a specific segment or ask Dr. Mark specific questions I’ve done about having him back on so he can answer these questions leading down on the comments below so I can collect them. And again, check out that conversation with Dr. Mark and I’ll see you next time on the next episode of Runner’s High.

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