Accuracy Of Self-reported Foot Strike Pattern Detection And Injury Risk Among Endurance Runners

Intrinsic gait features can affect foot strike patterns. Intrinsic and extrinsic factors such as running shoes affect the foot-ground interactions and strike pattern. Accurate foot strike pattern detection may reduce running-related injury (RRI) risk and facilitate gait modifications. PURPOSE: To determine: 1) the accuracy of self-reported foot strike pattern among runners, and 2) what shoe wear and personal factors predicted accurate foot strike detection and recent RRI. METHODS: This was a cross-sectional study of endurance runners (N = 710; 51.5% female; 35.4 ± 15.5 years) spanning from middle school cross country to master runners. Self-reported foot strike pattern (rearfoot, non-rearfoot [mid or forefoot], or don’t know) and shoe wear specifics were collected. All runners performed a single session of running at self-selected speed on an instrumented treadmill. 3D motion capture and high-speed filming verified actual foot strike. Logistic regression was used to predict accuracy of foot strike detection and RRI in the last 6 months. RESULTS: Overall accuracy of foot strike detection is low (42.7%). A total of 28.3% self-reported rearfoot strike, 47.0% self-reported non-rearfoot forefoot strike and 24.6% did not know their foot strike. Biomechanical analyses actually showed that 34% of rearfoot strikers accurately detected rearfoot strike, while 69.5% of non-rearfoot strikers self-reported accurate non-rearfoot strike (p < .05). Runners who did not know their foot strike had the highest prevalence of RRI in last six months compared to non-rearfoot and rearfoot strikers (73.0% versus 55.7% and 58.2%; p < .001). After accounting for age, BMI, speed, experience, and trying to change foot strike or shoe wear in last 6 months, shoe heel-to-toe drop was a consistent predictor of accurate strike detection (OR = 0.931 [0.875-0.991]; p = .026) and RRI in last six months (OR = 1.087 [1.014-1.165]; p = .018). RRI were also predicted by recent shoe change (OR = 2.785 [1.678-4.621]; p < .001). DISCUSSION: Accurate detection of actual foot strike by endurance runners varies by actual foot strike type and is modified by shoe characteristics. The lack of knowing actual landing patterns may relate to shoe can dampen the sensation of the ground, possibly leading to injury secondary to altered loading and less favorable biomechanics. Supported by: UF Strategic Funding Sports & Collaborative