Thursday, February 25, 2016

Exercises to Transition to Forefoot

Did I convince you to try forefoot running? Have patience, this transition should take several months. You have been landing on your heels for years, it's not going to change in a couple minutes. It takes time for your brain to change the firing patterns of the nerves, your muscles to build strength and the movement to become natural.

If you're not already walking at home barefoot, DO IT every day. Actually, think about landing on your forefoot while you walk.


Good core strength and stability is the most important aspect in maintaining a forefoot strike running pattern. Due to the inherent forward lean of this running style, the core is always engaged. The onset of fatigue leads to poor form. The chest starts to hutch over (as oppose to forward pelvis over the foot) and hips shift backwards which leads to heel striking.

For clams, side lying leg lifts, fire hydrants and bridges:

stage 1 - perform 3 sets x 12 reps
            - hold plank 10 x 10 sec

stage 2 - hold 10 reps for 10 seconds
            - hold plank 3 x 30 sec

stage 3 - add band repeat stage 1
            - progress to single leg bridges
            - add squats and lunges: use push knee back cue
            - add plank - add knee bent plank and rotation 10 each side

stage 4  - repeat 2 with band
             - continue single leg bridges, squats, lunges and plank (lunges and squat add weight or            bend knees more)

*** Perform stage 1 every day. Stages 2-4 perform 3-4 x week.
*** Do not progress stage until the current stage feels easy.
*** You should have glute soreness after each session.
This should take a minimum of 8 weeks!!! Spend about 2 weeks per stage. 

Ankle Strength and Drills

To land on your forefoot you have to have excellent calf strength. Forefoot strike puts extra stress to the calf muscles and Achilles tendon. You are performing an eccentric heel raise with each stride! These drills help with proper form and getting the neurologic input to land on your forefoot.

Calf Raises - With a twist! By turning left and right as you come up, different muscle fibers are being used. In running, the twisting motions occur when your foot lands and when it lifts off the ground. It happens so fast you can't feel it. Start with double leg 2-3 sets of 10, then at stage 3 of core, try single leg 3 sets of 10 reps.

Wall Falls - Forefoot running requires eccentric strength of the calves. Eccentric strength is when the muscle is working while it's stretching. This strength is required during the time the forefoot hits the ground and when the heel lands. 2-3 sets of 10 reps

Falls Into Strides - This takes wall falls to the next step. Fall forward until you can't hold yourself up, then stride for about 20 yards. Keep your back straight and core tight. Please don't fall on your face!

High Knees - This works on front side form. Bring your knee up to your chest without leaning backwards and land on your forefoot. Keep your feet under your body and don't reach forward. This drill is about speed not distance of each step. 10-20 yards

Butt Kicks - This works on back side form. Kick your heel towards your glutes. The tendency is to arch your back because of tightness in the quadriceps and hip flexors. Keep your core tight and back in neutral. Land on your forefoot. Again, this is about quick feet and not distance. 10 - 20 yards

Running Program

Start slow and forefoot run for a 2-3 minutes then return to your normal form for 5 minutes to allow the new working muscles to rest. Repeat until you reach 30 minutes. Increase the amount of time you forefoot running by 1 minute each week as long on there is no pain. So forefoot run 3-4 minutes then walk 5 minute.

Week 1
Barefoot walking in the house using a forefoot pattern.
Week 2
2-3 minutes forefoot running 5 minutes running normal x 3 - 4 for 30 minutes total 2-3 times a week
Week 3
3-4 minutes forefoot running 5 minute running normal x 3 - 4 for 30 minutes total 2-3 times a week
Week 4
4-5 minute forefoot running 5 minute running normal x 3  for 30 minutes total 2-3 times a week
Week 5
5-6 minute forefoot running 4 minute running normal x 3  for 30 minutes total 2-3 times a week
Week 6-12
6-7 minute forefoot running 3 minute running normal x 3  for 30 minutes total 2-3 times a week
Repeat until you reach 3 x 10 minutes of running forefoot
Then transition
15 minutes of forefoot running 3 x week
18 minutes of forefoot running 3 x week
add 3 minutes to each run each week until you reach 30 minutes.

Do not move forward if you have pain. You should be able to comfortably run forefoot for 30 minutes without discomfort before incorporating it into harder runs.

There are a lot of different core and ankle exercises, as well as, running drills. However, I believe these are the fundamentals which build a good base for forefoot running. Remember this takes time to transition!

Look out for a future post on how footwear ( heel drop) can change your strike pattern.


The core exercises are a modified version of Dr. Chris Powers's Course Evaluation and Treatment of the Injured Runner: A Biomechanical Approach

The running program is a modified version from Dr. Irene Davis's running lecture Spaulding National
Running Center - Barefoot running Training.

Sunday, February 21, 2016

Why Forefoot Strike

In recent years, there has been significant increase in the media about forefoot strike. Is forefoot running good for you? Will it lead to injury? Is it just a fad? Research seems to show forefoot strike decreases injury and improve running performance.
I was already adjusting my stride to manage my own injury. I've tried shifting my hips side to side to load my hips, but that just gave me a bunion. I tried kicking my leg to the side as it went behind my body, but that didn't work. My recent glute activation cue of "push the knee back"while running seems to be alleviating my symptoms. I also notice this cue made me strike more forward on my foot. So I decided to investigate. Here are the benefits I learned about forefoot running.

*** Forefoot strike is not running on tip toes. Forefoot running is landing on your forefoot then allowing the foot to come down.

Why Forefoot Strike? 

Decrease Forces

For every action there is an equal and opposite reaction. That is Newton's 3rd law of motion. How does this relate to running? When looking studies using force plates, there's a big difference in  forefoot strike vs. heel strike. During forefoot strike there is 1 smooth peak of force. However, in heel strike there are 2 peaks of force. This means there is more force when you heel strike.  Your muscles work harder have to absorb extra force. It doesn't seem like that extra force is a lot but if you multiple how many steps you take per minute ( ideally 180 steps) that is over 5,400 steps over 30 minutes multiplied by that extra force. By forefoot striking, you use less energy because there is less force.
This chart shows the double peak vs single peak
difference in heel strike vs forefoot strike.

Better Body Position 

Proper running form is having foot under you as your body moves over your leg with a slight forward lean from the hips. Foot placement under the body is critical because it allows smooth transition of force. The ankle is used and a spring. In heel strike, there is a "braking" involved when the foot hits the ground. Landing on your forefoot helps to bring the body forward into slight forward lean. A forward lean helps to activate your core muscles to stabilize your body while running.

In heel strike the body trails behind the leg, this causes increase demand in quadriceps. However, during a forefoot strike the body is over the leg which allows improve loading of the whole lower extremity. Clinically this is important because many injuries arise from over use of the quadriceps and under-utilization of the gluteals. Forefoot striking improve posterior chain activation.

Forefoot strike The upper torso is  over
the ankle. This allows force to smoothly
transition over the foot.
Heel strike  The upper torso trails behind the
contact leg which increases the work load.

*** TRY this: 1) In standing shift your weight towards your heels. What do you feel? I feel my quadriceps engage. Now shift your wight into your toes. What do you feel? I feel glute and core activation . 2) Walk with the forefoot hitting the ground first. What do you feel? I feel my body lean forward and my abs are activated. Now, walk exaggerating a heel strike. What do you feel? I feel my body leaning back Or my chest comes forward and my hips move back ( this creates lumbar lordosis which leads to low back pain).

Preserving  Forward Momentum 

Heel Strike - red line demonstrates gravity pushing
down at the shoulder. The line falls behind the foot.
This means your body weight is you and
your muscles has to work harder to
push you forward.
Forefoot Strike - red line shows gravity pushing
down through the foot. This gets your weight
forward which is easier for your muscles
to propel. 

To run with proper forefoot strike, you have to lean forward at your pelvis. This moves your center of mass forward over your base of support. This allows gravity to work in your favor by pushing your body forward. When you heel strike, typically, your center of mass is behind your base. You are fighting ground reaction forces and gravity to move forward. Gravity is actually pushing you backwards. It's hard to land heel strike while maintaining a forward pelvic lean. When you forefoot strike, you lean forward at your pelvis allowing gravity to help which makes you more efficient while running.


Lean forward at pelvis

When you bring your pelvis over your feet you bring your center of mass over your base. This helps to keep your feet under your body which allows you to forefoot strike. At the same time, as mentioned above, you allow momentum to carry you forward.  Make sure to keep your core tight by bring your pelvis under your body.

180 steps per min

Research has shown 180 -190 stride rate is most effective. To establish this frequency you have to take shorter strides which help with landing forefoot. When you heel strike, the length of your stride is longer making it difficult to increase frequency. A quick Google search shows Play list for songs with 180 beats per minute.

Be light on your feet

This seems obvious. But when you're landing light and soft, it's  hard to land on your heel. Landing light also decreases the time your foot spends on the ground. This will help decrease the forces your body has to absorb.


My conclusion is running with a forefoot strike is better for body alignment and efficiency. This can in turn decrease injury and improve performance. However, it requires A LOT of ankle and core strength. FOREFOOT RUNNING ISN'T FOR EVERYONE. It takes time to get your body moving in a different pattern! In order to transition to forefoot strike safety, you be have patience and have good strength. I recommend forefoot strike only if you have a GOOD core stabilization program and calf strength. It is my personal belief that some one who has pain while attempting to forefoot strike is not  strong enough to maintain this pattern.

Please have your form evaluated by a professional. It is critical that you get feedback on your form.

I am working to transition myself to forefoot running. Those who know me know I have been battling a 6 year injury from a fall. I've had numerous imaging and injections without answers or resolution. Through the past 6 years I have been able to run but always with some symptoms. Recently, I have been focusing on REALLY improving my core and glute strength because of the possibility of a hip labral tear. I have been incorporating fore foot strike into my runs focusing on proper form. I have not had ANY symptoms. As soon as I can't maintain my form my quadriceps symptoms return.




Altman, A.R.  Davis, I.R. Barefoot Running: Biomechanics and Implications for Running Injuries. Current Sports Medicine Reports. Am. J. Sports MedVolume 11 Number 5 September/October. 2012 (244-50).

Davis, Irene.  Lecture Foot Strike, Footwear, Treatment of the Foot- An Evolution of Thought.

Divert, C. et al. Mechanical Comparison of Barefoot and Shod Running. Int J Sports Med 2005; 26: 593 – 598.

Powers, C.M. Functional Biomechanics of the Lower Quarter Lecture.

Rooney, B.D. Joint contact loading in forefoot and rearfoot strike patterns during running. J Biom,V46, 13.  September 2013, Pages 2201–2206.

Monday, February 8, 2016

STOP Stretching Your Iliopsoas

It's all over the internet. You've read about it on numerous blogs. I've even talked about it. There's stretches. There's lacrosse ball rolling. There are standing desks.  It's all to resolve tight hip flexors (Illiopsoas). "The tightness is killing you!" You're doing everything you can ... But WHY is it still tight?

When we roll, stretch and use a standing desk,  are we REALLY solving the issue?  There has to be more to the story then hip flexors contractures from sitting.

Yes, sitting can contribute to tight hip flexors. However, instability of the core and back can also cause the hip flexor to be tight. The hip flexor originates from the lumbar spine. It is a massive muscle in the center of our body. When the core is unstable the hip flexor compensates by tightening to provide the stability needed. Our body wants to be stable. Could it be that our hip flexor doesn't get tight because of the position itself? Or does it tighten because the way we sit causes or back stabilizers to shut off so the hips stiffness to provide stability?

Core Stability vs Core Strength

Core stability is the ability for the small intersegmental muscles to stabilize the joints while moving. This is important for proper bone mechanics. Core strength is the ability of the large muscles groups to the body in a big range of motion. Stabilizers are the multifidus which are short muscles that attach a every 2-3 bone segments and the transverse abdominals (TrA) which is the deep layer of the abs. Strength muscles are erector spinae and rectus abdominals (6-pack).

Note how parts of the psoas originates
from each of the vertebra 
Note the attachment of multifidus spans
3 segments

Performing crunches and back extensions will improve your core strength but not stability your core. Lack of balance between the stabilizers and strength muscles can cause shearing of the lumbar joints causing pain. This will also contribute to the tightness. Performing stability exercises will decrease low back pain and hip tightness.

Which Exercises?

The best exercises to improve stability are marches, bent knee fall out and various planks. The key is to keep the core neutral and tight during the exercises. There are many other stability exercises such as bird-dog and dead bugs. Choose 3-4 of them 3 times a week. Progress to standing functional exercises such as a variation on a chop. You can continue other core strengthening exercises but also include spine stability exercises.

Go ahead, stretch and roll out your hip flexors. It will help to manage your symptoms. But, if you find yourself constantly rolling and stretching your hip flexor, ask yourself, how is your core stability.  In order to resolve the tightness, you have to stabilize the spine by improving the endurance of the stability muscles.
* Pictures from