Systematic review and meta-analysis of overground distance running (> 10 km, 12 studies): 79% of runners rearfoot strike early and 86% with increased distance; 11% change pattern, 84% of those from non-rearfoot to rearfoot; evidence for a performance advantage of non-rearfoot striking is inconclusive (5 studies for, 1 in women only, 4 no benefit, none favouring rearfoot)
CINAHL, Medline, EMBASE and SPORTDiscus were searched from inception to 2021 for studies of foot strike in overground distance running (> 10 km). Of 2210 unique articles, 12 were included; prevalence data were pooled where possible.
Participants
n=12 studies (from 2210 screened articles); total runner count not given in the abstract.
Protocol
Random-effects meta-analysis of prevalence; narrative tally of performance findings.
Key Results
Pooled rearfoot-strike prevalence 79% early in a run, rising to 86% with increased distance.
11% of runners changed pattern with distance; of those, 84% went from non-rearfoot to rearfoot.
Performance: 5 studies reported a benefit of non-rearfoot striking, 1 in women but not men, 4 no benefit either way, none a benefit of rearfoot.
Authors' conclusion: inconclusive evidence of a competitive advantage for non-rearfoot striking.
Practical Application
A rearfoot strike is the majority pattern in distance running and becomes more common as the distance grows; coaching it away has no clear performance case from this evidence.
Inference: a runner who drifts to the heel late in a long race is doing what most runners do; on its own it is not a sign of bad form.
Limitations
12 observational studies; performance findings counted, not pooled.
Runner level, sex mix and heterogeneity statistics not given in the abstract.
Only overground runs over 10 km; nothing on injury.
How this entry was checked and changed
Why this level
systematic search and pooled prevalence, but the included studies are observational race/field recordings and the performance question is a vote count