Is a Runner’s Footfall Pattern a Risk Factor for a Running-Related Injury? Using Data from the 4HAIE Cohort Study

Introduction: In the last several years, a controversy has arisen between which type of footfall pattern, rearfoot versus non-rearfoot, incurs the fewest running-related injuries. Purpose: The primary aims of this paper were to determine if there are differences in the occurrence of running-related injuries between rearfoot and non-rearfoot footfall pattern runners and to determine if there would be differences between rearfoot and non-rearfoot footfall pattern runners in the number of injuries at different anatomical locations. Methods: This study was a secondary analysis of the data collection from Healthy Aging in the Industrial Environment (4HAIE) study. The sub-sample of 1315 participants consisted of 738 runners (307 females/431 males) and parsed into rearfoot (N=591, 248 females/343 males) and non-rearfoot (N=147, 59 females/88 males) groups based on their strike index. The measurement protocol consisted of completing questionnaires and running biomechanics assessments. During the 1-year follow-up the running-related injury onset was derived from the weekly, self-initiated, and decreased activity questionnaires. Results: There was no statistically significant difference between the total percentage of injuries in the two footfall groups (p > 0.05) nor was the percentage of injuries at each anatomical location (p > 0.05) statistically significant. A logistic regression analysis showed no evidence of an association between footfall pattern and injury risk and that the odds of injury was the same in both groups. Conclusions: Therefore, a runner’s footfall pattern neither increases nor decreases the probability of injury.