Forefoot striking and anterior compartment syndrome

By Craig Payne,

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Anterior compartment syndrome in runners is something that I did not used to like seeing. The conservative treatments were generally and often not satisfactory and many either needed to stop running or opt for surgery. The surgery was not all that bad as it was just soft tissue procedure and usually recovery was easy and uneventful.

In 2011 there was this study which took a small group of runners with anterior compartment syndrome, all facing surgery, and transition them to forefoot striking. All got better and avoided surgery! I blogged about the study here and have been talking about the study at the Clinical Biomechanics Boot Camps.

It makes for an interesting topic of discussion as the study was small and uncontrolled, so not exactly strong evidence. However, the results were dramatic and all subjects ended up not needing surgery. The results are also quite plausible as it is not difficult to see how in forefoot or midfoot striking that there is reduced activity of the tibialis anterior muscle.

The reason for it being an interesting topic for discussion is the wider context of the strength of evidence and how much evidence should be needed to change clinical practice. In a perfect world you do not change clinical practice until there us a meta analysis of all the controlled clinical trials. The above is just one small uncontrolled study.

I always happy to hear feedback from Boot Camp participants who have taken on board what I say and use it and then report back to me that it worked. It does.

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