Foot Strike Patterns During Overground Distance Running: A Systematic Review and Meta-Analysis

Abstract

Background: Investigations of foot strike patterns during overground distance running have foci on prevalence, performance and change in foot strike pattern with increased distance. To date, synthesised analyses of these findings are scarce. Objective: The key objectives of this review were to quantify the prevalence of foot strike patterns, assess the impact of increased running distance on foot strike pattern change and investigate the potential impact of foot strike pattern on performance. Methods: Relevant peer-reviewed literature was obtained by searching EBSCOhost CINAHL, Ovid Medline, EMBASE and SPORTDiscus (inception-2021) for studies investigating foot strike patterns in overground distance running settings (> 10 km). Random effects meta-analyses of prevalence data were performed where possible. Results: The initial search identified 2210 unique articles. After removal of duplicates and excluded articles, 12 articles were included in the review. Meta-analysis of prevalence data revealed that 79% of long-distance overground runners rearfoot strike early, with prevalence rising to 86% with increased distance. In total, 11% of runners changed foot strike pattern with increased distance and of those, the vast majority (84%) do so in one direction, being non-rearfoot strike to rearfoot strike. Analysis of the relationship between foot strike pattern and performance revealed that 5 studies reported a performance benefit to non-rearfoot strike, 1 study reported a performance benefit to non-rearfoot strike in women but not men, 4 studies reported no benefit to non-rearfoot strike or rearfoot strike, and no studies reported a performance benefit of rearfoot strike over non-rearfoot strike. Conclusion: Most overground distance runners rearfoot strike early, and the prevalence of this pattern increases with distance. Of those that do change foot strike pattern, the majority transition from non-rearfoot to rearfoot. The current literature provides inconclusive evidence of a competitive advantage being associated with long-distance runners who use a non-rearfoot strike pattern in favour of a rearfoot strike pattern.