Approximately 75-80% of runners initially contact the running surface on their heel and thus are considered to have a rearfoot or heel-toe footfall pattern. The remaining 20-25% initially contact the ground on the metatarsal heads with a subsequent heel contact (midfoot pattern) or on their forefoot with no heel contact (forefoot pattern). It is unclear why different footfall patterns exist or why some runners naturally use different patterns. We have suggested in a prior study that the choice of a particular footfall pattern is task-related and has a different functional role for different types of running. However, some contemporary training programs advocate the adoption of a mid- or forefoot footfall pattern but there is little scientific evidence that a particular footfall pattern is better than the others. By changing one.s footfall pattern from a rearfoot to a mid-or forefoot pattern, three majors points that have little scientific evidence are generally suggested: 1) changing to a mid- or forefoot pattern is metabolically more efficient; 2) changing to a mid- or forefoot pattern reduces running-related injuries; and 3) changing to a mid- or forefoot pattern specifically alters the force applied to the Achilles tendon. We propose that one.s footfall pattern is an intrinsic dynamic of the runner.s system and thus very difficult to alter. Therefore, the change from a rearfoot to a forefoot pattern or from shod to barefoot running often requires an alteration in footfall pattern that may ultimately lead to injury.
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