The Automatic Strike-Change Phenomenon: When Running Barefoot Patients Change from a Heel Strike to a Forefoot Strike Without Any Instruction

Wes Zimmermann,Naomi Van Valderen

doi:10.11648/j.ijsspe.20210601.11

Abstract

The department of Military Sports Medicine of the Royal Netherlands Army has an ongoing research line ‘Exercise-Related Leg Pain’ since 2011. This study investigated which immediate changes occur in running technique while running barefoot or in minimalist running shoes on a treadmill, which proportion of service members automatically changed from a heel strike landing to a forefoot strike landing without any instruction to do so, and whether these patients experienced a subsequent gait retraining program as easier and completed it faster or with a better clinical outcome. In total, data from 53 patients with exercise-related leg pain were used to answer the research questions. Running barefoot, 24.5% of patients automatically changed from a heel strike landing to a forefoot strike landing (16.7% of the men, 54.5% of the women), in minimalist shoes the percentage of automatic strike-changers was 5.7% (2,4% of men, 16.2% of women). Running barefoot, the patients used shorter strides and a higher cadence than in traditional running shoes and the vertical ground reaction forces under the midfoot and heel were lower. Automatic strike-changers were not better candidates for the treatment program, in terms of subjective ease of the gait retraining sessions and duration or outcome of the treatment program. Running barefoot is a helpful methodology to facilitate gait retraining.

Highlights

Gait retraining as a therapy for overuse injuries of the lower extremity has received increasing attention in recent years. [1] In the sports medical context, gait retraining refers to a training / rehabilitation program in which a permanent change in running technique is the goal
Diagnoses in which changing running technique may contribute to a reduction of reinjury rates include PatelloFemoral Pain Syndrome (PFPS), Iliotibial Band Friction Syndrome (ITBS), Medial Tibial Stress Syndrome (MTSS), Chronic Exertional Compartment Syndrome (CECS), Achilles Tendinopathy and Plantar Fasciopathy (PF)
It has been established that lower leg symptoms (MTSS and CECS) are in the top three of injuries that lead to dropout in basic military training

Summary

Introduction

Gait retraining as a therapy for overuse injuries of the lower extremity has received increasing attention in recent years. [1] In the sports medical context, gait retraining refers to a training / rehabilitation program in which a permanent change in running technique is the goal. Gait retraining as a therapy for overuse injuries of the lower extremity has received increasing attention in recent years. [1] In the sports medical context, gait retraining refers to a training / rehabilitation program in which a permanent change in running technique is the goal. [3] This article reports on a study of the “automatic strike-change” phenomenon, which occurs when running barefoot and in minimalist running shoes, in some patients with lower leg overuse injuries who receive gait retraining. [1, 4] The goal of gait retraining as therapy is to reduce the vertical ground reaction forces that the runner encounters per step (for example in the case of MTSS and PF), or to reduce the work of the muscles that are overloaded, such as the m. Gait retraining as part of a comprehensive treatment protocol was introduced more than 10 years ago and criteria for application of interventions have been established (see Table 1)

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Discussion

Conclusion