Effects of Foot Strike on Low Back Posture, Shock Attenuation, and Comfort in Running

DELGADO, T. L., E. KUBERA-SHELTON, R. R. ROBB, R. HICKMAN, H. W. WALLMANN, and J. S. DUFEK. Effects of Foot Strike on Low Back Posture, Shock Attenuation, and Comfort in Running. Med. Sci. Sports Exerc., Vol. 45, No. 3, pp. 490-496, 2013. Purpose: Barefoot running (BF) is gaining popularity in the running community. Biomechanical changes occur with BF, especially when initial contact changes from rearfoot strike (RFS) to forefoot strike (FFS). Changes in lumbar spine range of motion (ROM), particularly involving lumbar lordosis, have been associated with increased low back pain. However, it is not known if changing from RFS to FFS affects lumbar lordosis or low back pain. The purpose of this study was to determine whether a change from RFS to FFS would change lumbar lordosis, influence shock attenuation, or change comfort levels in healthy recreational/experienced runners. Methods: Forty-three subjects performed a warm-up on the treadmill where a self-selected foot strike pattern was determined. Instructions on running RFS/FFS were taught, and two conditions were examined. Each condition consisted of 90 s of BF with RFS or FFS, order randomly assigned. A comfort questionnaire was completed after both conditions. Fifteen consecutive strides from each condition were extracted for analyses. Results: Statistically significant differences between FFS and RFS shock attenuation (P < 0.001), peak leg acceleration (P < 0.001), and overall lumbar ROM (P = 0.045) were found. There were no statistically significant differences between FFS and RFS in lumbar extension or lumbar flexion. There was a statistically significant difference between FFS and RFS for comfort/discomfort of the comfort questionnaire (P = .007). There were no statistically significant differences between other questions or the average of all questions. Conclusion: Change in foot strike from RFS to FFS decreased overall ROM in the lumbar spine but did not make a difference in flexion or extension in which the lumbar spine is positioned. Shock attenuation was greater in RFS. RFS was perceived a more comfortable running pattern.