In the world of running medicine, we talk a LOT about foot strike patterns, shoe types, and core stability. Many individuals (runners, coaches, and healthcare professionals alike) believe passionately that heel striking is a curse from the devil, or that shoes with a heel drop came from hell. The truth is….we don’t really know! As I’ve mentioned in a previous post on foot strike and footwear, the research doesn’t wholeheartedly support these ideas – it doesn’t refute them either, but we would be doing a disservice to our patients and clients by telling them that heel striking is a bad thing for them to do. In fact, variety in training might actually be best for our longterm running health – to quote Chris Johnson of ZerenPT, “Wouldn’t it be great if we could do all three (forefoot, midfoot, and hindfoot striking)?” Different conditions may call for different foot strikes and we should probably have all of them in our arsenal. And as for shoes….Again, as I’ve said earlier, if your shoe is working for you, there’s probably no need to fix it. And that 10mm drop in your shoes – is it the end of the world? Chris Johnson would say that “the body isn’t that dumb” (LOL). *PS – for more shoe guidance, check out The FiT Nerd Physio running shoe guide and Kate’s previous post on shoe type and foot strike !
In terms of healthy running however, there is one variable that’s getting a lot of scientific AND media attention for the promise it shows in mitigating pain during running. I’m talking about CADENCE – the number of times your foot strikes the ground per minute. It makes intuitive sense – the faster you turn over your feet, the less time you spend on the ground, the less potential for impact-related injuries.
This concept of cadence as a therapeutic modality for running injuries was first introduced to me at a weekend course called The Athlete’s Mind. Chris Johnson was one of the instructors, and he talked a lot about how increasing cadence can resolve a lot of different running-related pain and biomechanical issues at many different joints. He even did a demo – I was the runner. I ran on a treadmill for a few minutes at my normal cadence, and then picked up the pace. Here’s what I noticed:
-No hip pain (this was pre-surgery btw)
-My midfoot strike took less conscious effort
-It was physiologically easier to run at the pace I’d set – I was able to bump it up a few notches with no increase in heart rate, respiration, or RPE.
Pretty cool, right? Upon coming home from this course, I made it a point to do all of my runs at a higher cadence. I didn’t set a metronome or use an app, but rather just chose high-cadence music and consciously focused on taking smaller strides and noticed a marked change in my ability to run without pain.
Okay, so it worked for one person……but what does the science say?
First off, let’s talk about the mechanism. Cadence isn’t the end goal, stride length is. The goal for the runner is to shorten their stride length such that
1) they are landing UNDER their center of mass, not in front of it and
2) they are spending less time on the ground, which means less forces through the leg an less work for the glutes and abductors (the muscles responsible for frontal plane stability in single limb stance).
If you’re still hung up on the foot strike thing, landing under your center of mass rather than in front MAY facilitate a mid or fore-foot strike. Maybe. Anyway, it’s really all about shortening your stride -cadence is just the external cue used to get runners to achieve the stride length goal.
Several studies suggest that increasing cadence or shortening step length (which is inevitable when you increase your foot turnover) decrease forces at the patellofemoral joint and at the plantar surface of the foot. In turn, anterior knee pain and plantar fascitis are two of the most common complaints among runners, so it follows that increased cadence or shortened step length may mitigate these problems (Lenhart; Willson; Wellenkotter). As Chris says, “5 will give you 20” -that is, a 5% increase in cadence will reduce loading on the patellofemoral joint by 20%. That same 5% increase will also lower peak achilles tendon stress/strain (Lyght et al), regardless of footstrike – indeed, the authors of the achilles tendon study found that a rearfoot strike pattern was most effective for reducing load on the achilles tendon. Fancy that.
Overall, it seems that increasing cadence = decreasing step length = decreased load on injury prone areas. This can be really great for preventing or alleviating a lot of running-related pains in the foot and knee (as described above) or higher up the chain. If you think a mid- or fore-foot strike is the optimal strike pattern for you, increasing cadence can facilitate that. How so? Try the RunCadence App, or a metronome app, or if you’ve got a good sense of rhythm, choose some fast-paced music to run to and focus on picking those feet up. (*PLEASE do not use noise-cancelling headphones when running outside with music – and use extreme caution. Stay aware of your surroundings!)
Is cadence the be all end all panacea for running injuries? probably not. Just like foot strike and shoe type aren’t mandates from the running gods, neither is cadence. And if the body likes variety, then mayyyybe it’s best to have a variety of running cadences in your arsenal. And, above all….none of this means anything without strength and motor control. If you REALLY want to be bulletproof against injuries, cadence can help, but you MUST get to the gym.
Lenhart, R. L., Thelen, D. G., Wille, C. M., Chumanov, E. S., & Heiderscheit, B. C. (2014). Increasing Running Step Rate Reduces Patellofemoral Joint Forces. Medicine and Science in Sports and Exercise, 46(3), 557–564. http://doi.org/10.1249/MSS.0b013e3182a78c3a
Lyght, M., Nockerts, M., Kernozek, T., & Ragan, R. (2016). Effects of Foot Strike and Step Frequency on Achilles Tendon Stress During Running. Journal of applied biomechanics.
J. Wellenkotter, T. W. Kernozek, S. Meardon, T. Suchomel. The effects of running cadence manipulation on plantar load in healthy runners. Int J Sports Med 2014; 35(09): 779-784
Willson, J. D., Ratcliff, O. M., Meardon, S. A. and Willy, R. W. (2015), Influence of step length and landing pattern on patellofemoral joint kinetics during running. Scand J Med Sci Sports, 25: 736–743. doi:10.1111/sms.12383
Hafer, J. F., Brown, A. M., deMille, P., Hillstrom, H. J., & Garber, C. E. (2015). The effect of a cadence retraining protocol on running biomechanics and efficiency: a pilot study. Journal of sports sciences, 33(7), 724-731.
And special thanks to Chris Johnson and NxtGenPT for their course “The Athlete’s Mind”