The effects of midfoot strike gait retraining on impact loading and joint stiffness

Abstract Objective To assess the biomechanical changes following a systematic gait retraining to modify footstrike patterns from rearfoot strike (RFS) to midfoot strike (MFS). Design Pre-post interventional study. All participants underwent a gait retraining program designed to modify footstrike pattern to MFS. Setting Research laboratory. Participants Twenty habitual RFS male runners participated. Main outcome measures Gait evaluations were conducted before and after the training. Footstrike pattern, vertical loading rates, ankle and knee joint stiffness were compared. Results Participants’ footstrike angle was reduced (p   0.155). Further subgroup analyses were conducted on the respondents (n = 8, 40% of participants) who exhibited MFS for over 80% of their footfalls during the post-training evaluation. Apart from the increased knee joint stiffness (p = 0.005, Cohen’s d = 1.14), respondents exhibited a significant reduction in the ankle joint stiffness (p = 0.019, Cohen’s d = 1.17) when running with MFS. Conclusions Gait retraining to promote MFS was effective in reducing runners’ footstrike angle, but only 40% of participants responded to this training program. The inconsistent training effect on impact loading suggests a need to develop new training protocols in an effort to prevent running injuries.