title: Foot-strike pattern and performance in a marathon.
abstract: OBJECTIVE
  To determine prevalence of heel strike in a midsize city marathon, if there is an association between foot-strike classification and race performance, and if there is an association between foot-strike classification and gender.
  
  
  METHODS
  Foot-strike classification (forefoot, midfoot, heel, or split strike), gender, and rank (position in race) were recorded at the 8.1-km mark for 2112 runners at the 2011 Milwaukee Lakefront Marathon.
  
  
  RESULTS
  1991 runners were classified by foot-strike pattern, revealing a heel-strike prevalence of 93.67% (n = 1865). A significant difference between foot-strike classification and performance was found using a Kruskal-Wallis test (P < .0001), with more elite performers being less likely to heel strike. No significant difference between foot-strike classification and gender was found using a Fisher exact test. In addition, subgroup analysis of the 126 non-heel strikers found no significant difference between shoe wear and performance using a Kruskal-Wallis test.
  
  
  CONCLUSIONS
  The high prevalence of heel striking observed in this study reflects the foot-strike pattern of most mid-distance to long-distance runners and, more important, may predict their injury profile based on the biomechanics of a heel-strike running pattern. This knowledge can help clinicians appropriately diagnose, manage, and train modifications of injured runners.
authors.affiliation: Dept of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Kasmer
authors.forename: Xue-Cheng
authors.initials: XC
authors.lastname: Liu
authors.forename: Kyle G
authors.initials: KG
authors.lastname: Roberts
authors.forename: Jason M
authors.initials: JM
authors.lastname: Valadao
mesh_terms: D000328:Adult; D054874:Athletic Performance / Q000502:physiology*; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D005528:Foot / Q000502:physiology*; D018409:Foot Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D005684:Gait / Q000502:physiology*; D006365:Heel / Q000502:physiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012420:Running / Q000502:physiology*; D012727:Sex Characteristics; D012775:Shoes; D013178:Sports Medicine / Q000379:methods