Should You Change Your Foot Strike? What Runners Recovering from Tibial Bone Stress Injuries Need to Know

If you're an adult runner returning from a tibial bone stress injury or lower leg issue, you may have wondered: Should I change how my foot hits the ground when I run?

A recent research study titled, “Influence of Manipulating Running Foot Strike Angle on Internal Loading of the Tibia,” explored this exact question—and the results may surprise you.

What the Study Looked At

Researchers studied 19 healthy adult runners who naturally land on their heels (rearfoot strikers). They asked them to run in three different ways:

• Their normal heel-first (rearfoot) pattern

• A more exaggerated heel strike

• A forefoot strike (landing on the ball of the foot)

They measured how much stress was placed on the tibia (shinbone)—a common site for overuse injuries like stress fractures.

This Might Surprise You…

Switching to a forefoot strike actually INCREASED stress on the tibia.

In fact, runners who changed from their usual heel strike to a forefoot strike had 15% higher tibial stress compared to their normal running style.

Meanwhile, when runners exaggerated their heel strike (landing even more on the heel), tibial stress actually went down.

So if you're trying to reduce stress on your shin and avoid re-injury, suddenly changing to a forefoot strike may do more harm than good.

Why the Forefoot Strike Increased Stress

At first glance, landing on the ball of your foot (a forefoot strike) seems like a smoother, “softer” way to run. Many runners believe this style reduces the impact on the body because it feels quieter and more cushioned. And to some extent, that’s true—forefoot striking can reduce the external impact forces, like the ground reaction forces measured under your foot.

But here’s where it gets more complicated: reducing external force doesn’t always mean reducing total stress on your body—especially inside the bone.

When you strike with your forefoot, your ankle stays more flexed and your calf muscles (like the soleus and gastrocnemius) have to work much harder to support your body. These muscles actively contract to absorb and control the motion during the stance phase. While this can buffer the ground impact externally, it comes at a cost: more internal muscle force pulling on the bones, particularly the tibia (shin bone).

In biomechanics, we distinguish between:

• External forces – such as ground reaction forces measured by a force plate

• Internal forces – like muscle contractions and joint loads that occur within the body to stabilize and move you

Muscles act like shock absorbers, but they also create internal compression and bending loads on the bones they attach to. The contractile forces of the calf muscles increase internal stress on the tibia, which the study found was significantly higher with a forefoot strike than with a rearfoot strike.

In fact, the study showed that runners using an imposed forefoot strike had:

• A 15% higher peak tibial bending moment

• Nearly 40% more cumulative tibial stress per kilometer compared to exaggerated rearfoot striking

This means that although the foot might hit the ground more gently in a forefoot strike, the bone is actually working harder on the inside—especially if you're not adapted to this style.

For runners recovering from a bone stress injury, especially in the shin or lower leg, this extra internal stress can delay healing or increase risk for reinjury if the transition to forefoot striking is too abrupt or not necessary in the first place.

What This Means for You

If you're a recreational runner coming back from a tibial stress injury or lower leg pain:

• Stick with your natural foot strike (especially if you're a heel striker): There's no need to force a change unless a professional recommends it for a specific reason.

• Avoid sudden changes to your running form: Changing how your foot lands takes time and proper training. Doing it too fast may increase your risk of injury.

• Focus on rebuilding strength and gradually returning to running: Make sure your calves, shins, and surrounding muscles are strong and ready for the demands of running again. Incorporate an appropriate return to run program when cleared by your doctor to pave the way for more, healthy running in the future.

• Train smart, not trendy: Some running trends might work for others, but the best approach is always one that matches your unique body and injury history while respecting the research.

Key Takeaways for Runners

How your foot strikes the ground can influence the stress placed on your muscles, joints, and bones—but changing your foot strike isn't always the answer, especially when you're recovering from injury.

In some cases, altering foot strike mechanics may be helpful. For example, certain injuries involving the knee or foot might benefit from shifting loading patterns to different tissues. But with bone stress injuries—especially to the tibia—any change should be carefully considered. The key question isn't just whether the new pattern looks better or feels softer, but whether it reduces or increases mechanical stress on the healing tissue.

Making the wrong adjustment too soon—such as switching to a forefoot strike when your tibia is still sensitive to loading—can delay healing or make the problem worse.

If you're recovering from a tibial stress injury, you're often better off maintaining your natural gait, gradually rebuilding strength, and increasing mileage in a slow, progressive way. Let your body adapt over time. And remember, more effort from your muscles doesn't always mean less strain on your bones.

Need support as you return to running? Reach out—we specialize in personalized assessments and programs that help you train smart, stay pain-free, and reach your goals with confidence.