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The department of Military Sports Medicine of the Royal Netherlands Army has an ongoing research line ‘Exercise-Related Leg Pain’ since 2011. This study investigated which immediate changes occur in running technique while running barefoot or in minimalist running shoes on a treadmill, which proportion of service members automatically changed from a heel strike landing to a forefoot strike landing without any instruction to do so, and whether these patients experienced a subsequent gait retraining program as easier and completed it faster or with a better clinical outcome. In total, data from 53 patients with exercise-related leg pain were used to answer the research questions. Running barefoot, 24.5% of patients automatically changed from a heel strike landing to a forefoot strike landing (16.7% of the men, 54.5% of the women), in minimalist shoes the percentage of automatic strike-changers was 5.7% (2,4% of men, 16.2% of women). Running barefoot, the patients used shorter strides and a higher cadence than in traditional running shoes and the vertical ground reaction forces under the midfoot and heel were lower. Automatic strike-changers were not better candidates for the treatment program, in terms of subjective ease of the gait retraining sessions and duration or outcome of the treatment program. Running barefoot is a helpful methodology to facilitate gait retraining.

The Automatic Strike-Change Phenomenon: When Running Barefoot Patients Change from a Heel Strike to a Forefoot Strike Without Any Instruction