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

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 < 0.001, Cohen’s d = 1.65) and knee joint stiffness was increased (p = 0.003, Cohen’s d = 0.69). No significant difference was found in the vertical loading rates (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.