Here is something to think about. As one midfoot strikes the foot during walking or running the individuals body mass is typically directly over the foot. When this occurs in a zero drop shoe (ie. flat, your rear and forefoot are on the same plane) the tibia-ankle is at the very least, at 90 degrees. Meaning, the tibia is at the very least at 90 degrees and is at the very least perpendicular to the ground and plane that the foot is on. And with just a little bit of forward body mass movement over the foot the critical and necessary range of 110-115 plus degrees of ankle dorsiflexion (depending on your reference source) is achieved. This means that one does not have to prostitute the foot into greater than normal pronation to drop the arch further to gain the extra amount of ankle rocker (dorsiflexion) that is necessary to pass over the foot.
However, think about this. What if that same foot is in a stacked heel shoe. There are plenty of shoes still out there that have a ramp delta that is above zero drop. So, what we have is a shoe that has the heel higher than the forefoot, a sloped shoe. IF this same foot midfoot strikes what happens now ?
Well, midfoot strike now occurs in a relatively greater plantarflexed posture (ie. heel is raised higher than the forefoot because of the shoe). This means we are not anywhere near the 115 degrees necessary for normal gait, timely heel departure, timely forefoot load, timely hip extension, timely gluteal activation etc. These timely gait events are paramount to normal gait and when they are altered injury and altered tissue loads can occur. Altered motor recruitment patterns are likely to ensue. In the scenario proposed, as the body mass moves over the slightly plantarflexed foot we might now only get to 90 degrees of ankle rocker before the body mass is far enough forward to create the passive heel rise during late-midstance phase of gait. And when the body can only get 90 degrees of ankle dorsiflexion/rocker during midstance the extra amount of dorsiflexion range may need to come from some other joint. It may come from more than normal midfoot pronation, knee hyperextension, knee valgus etc. This is potentially a long list of compensations.
Our point is simple here and at this time it is just a tip of the iceberg article for us. But we thought we would put this idea out there to share some of the things we think about on a daily basis, and some of the things that get played out in our clinics each and every day.
Changing your running form involves so much more than just changing your form. If you change to a midfoot or forefoot strike what kinds of biomechanics are you employing ? Do you have the neuromechanics to accompany these running form changes ? Do you have the necessary ranges of motion ? Do you have strength in potential compensation patterns to fend off both subtle and dramatic running form changes ? If not, you might find out that your initial response is ” I just cannot do a midfoot or forefoot strike running form. I get foot pain, or knee pain, or hip pain.”
Conversely, think about this regarding our postulation above. If you have been employing a midfoot strike or forefoot strike pattern in stacked heeled shoes and suddenly try a zero drop shoe you better be aware of symptoms such as pain, tightness or other complications. Is your body able to adapt to a new (possibly increased) ankle-midfoot rocker or the demand of a greater ankle-midfoot with the newly dropped heel? Is your body immediately adaptive enough after going through that stage of gait with the heel higher than the forefoot for years ? Just because you went to a running form clinic doesn’t mean you are ready to make that your new form tomorrow. Change takes time, so be patient with your body and let it adapt.
Food for thought, especially for those who say to others. “Hey dude, chuck your ramped shoes and go minimialism or barefoot. Just go for it. I did and I was fine !”
The Gait Guys