Running Foot Strike, Cadence and Shoes: What Does the Research Actually Say?

In this episode of the Rehab and Performance Lab podcast, I sat down with Dr. Don Goss to discuss one of the most debated topics in sports rehab – running gait. We talked about cadence, footwear, foot strike, and most importantly, how to make this actionable in the clinic.

If you treat runners and you’re not directly assessing how they run, you’re missing critical information.

Personalizing Cadence Instead of Chasing a Number

One of the biggest mistakes we make as clinicians is looking for a magic cadence number.

Yes, research often references 170–190 steps per minute. But that range alone doesn’t solve anything. Cadence must be individualized based on the runner’s height, leg length, training history, and injury presentation.

Here’s what the research consistently shows: many injured runners present in the mid–150s to low–160s. When we increase cadence by 5–10%, we can reduce joint loading, shorten stride length (reduce overstriding), and decrease ground contact time.

That small shift often calms irritated tissues without dramatically altering the athlete’s natural gait.

Footwear Doesn’t Fix Form

We also addressed footwear – and this is where history matters.

Matching shoes to static arch height has not proven effective at reducing injury risk. Motion control, stability, cushioning – none of these categories consistently prevent injury when assigned purely by arch type.

Minimalist shoes combined with continued heel striking can dramatically increase knee stress. On the other end, maximalist shoes may encourage runners to strike the ground even harder.

The takeaway is simple: the shoe must match the runner’s mechanics.

If the runner’s mechanics are inefficient or overloaded, no shoe category will save them.

That’s where retraining comes in.

The CLASS System – A Repeatable Framework for Gait Retraining

When runners continue to get injured, we need structure to help retrain their gait. Don and his team developed a retraining framework used extensively in military populations called CLASS.

The CLASS Framework from Dr. Don Goss & Dr. Kelly Leugers

Use this acronym to guide your cues and retraining focus. The goal is to reduce ground reaction forces and joint loading.

C — Cadence

• The Why: Increasing cadence changes forces on the body and reduces work at the knee and hip. Low cadence is often linked to overstriding and increased impact.
• The Norms: Many injured runners present with a cadence of 156–162 steps/min.
• The Target: Aim for ~170–180 steps/min (or a 5%–10% increase from their baseline).
• The Fix:
  • Use a metronome app or music playlist at the target BPM.
  • Instruct the patient to match their footfalls to the beat.

L — Lean

• The Why: Proper forward lean utilizes gravity for momentum rather than muscular push-off.
• The Cue: “Lean from the ankles, not the waist.”
• Visual Check: Draw a straight line from Ankle → Knee → Hip → Shoulder → Ear.
• Analogy: Compare their posture to a sprinter (significant lean) vs. a jogger (often too upright).

A — Alignment

• The Goal: Ensure the runner maintains the straight-line posture described in Lean throughout the gait cycle.
• Common Fault: Breaking at the waist (bending forward) rather than leaning the entire body axis.

S — Soft

• The Why: High vertical loading rates (slamming the ground) increase injury risk.
• The Cue: “Run softly” or “Run quietly.”
• Analogy: “Imagine you are sneaking around the house early in the morning and don’t want to wake your family.”
• Goal: Shift from a loud “bang” to a quiet, controlled landing.

S — Strike

• The Why: A hard heel strike with an extended knee generates high impact forces.
• The Fix: Encourage a relaxed foot placement.
  • Do not force a toe strike if it causes “pawing“ at the ground.
  • Instead, combine Strike with Cadence: A faster cadence naturally shortens the stride, allowing the knee to be slightly flexed at impact.
  • Aim for the foot to land underneath the body, not way out in front.

Key Takeaway

While this framework for coaching gait mechanics is easy to implement and effective, remember that we first have to know that the person can achieve the positions and technique we are asking. Here are a couple of examples:

1. The person bends forward at the waist and has an anterior pelvic tilt. How do we know that they have the core control to be able to achieve our ideal alignment? The Selective Functional Movement Assessment, particularly when combined with the Functional Movement Screen (think trunk stability push up and rotary stability) will tell me if they can achieve the desired position.
2. With another person, we cue them for a soft landing but their balance stability is poor with single leg balance testing. If we don’t clearly identify the root of the problem (hip stability vs core stability problem), we are likely just asking for frustration and/or compensation

The CLASS sytem of gait retraining is simple. Implementation requires clinical reasoning.

You still have to assess mobility and stability from core to ankles. You still have to evaluate hip strength. You still have to determine whether they can control the positions you are asking them to achieve.

Gait retraining without movement assessment is just cueing compensation.

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You can listen to the episode at the links below. If you'd like CEUs, make sure to use the MedBridge link.

 References

Florkiewicz, E. M., East, K. H., Crowell, M. S., Weart, A. N., Freisinger, G. M., & Goss, D. L. (2025). The effects of telehealth running gait retraining on biomechanics, pain, and function in patients with lower extremity injuries: A randomized clinical trial. Clinical Biomechanics, 121, 106381. https://doi.org/10.1016/j.clinbiomech.2024.106381

Goss, D. L., Lewek, M. D., Yu, B., Ware, W. B., Teyhen, D. S., & Gross, M. T. (2015). Biomechanics of runners wearing traditional and minimalist footwear. Journal of Athletic Training, 50(6), 603–611.

Goss, D. L., Watson, D. J., Miller, E. M., Weart, A. N., Szymanek, E. B., & Freisinger, G. M. (2021). Wearable technology may assist in retraining foot strike patterns in previously injured military service members: A prospective case series. Frontiers in Sports and Active Living, 3(2), 1–11.

Heiderscheit, B. C., Chumanov, E. S., Michalski, M. P., Wille, C. M., & Ryan, M. B. (2011). Effects of step rate manipulation on joint mechanics during running. Medicine & Science in Sports & Exercise, 43(2), 296–302. https://doi.org/10.1249/MSS.0b013e3181ebedf4

Helton, G. L., Cameron, K. L., Goss, D. L., & Florkiewicz, E. (2025). Association between running characteristics and lower extremity musculoskeletal injuries in United States Military Academy cadets. Orthopedic Journal of Sports Medicine, 13(1). https://doi.org/10.1177/23259671241296148

Helton, G. L., Cameron, K. L., Zifchock, R. A., Miller, E. M., Goss, D. L., Song, J., & Neary, M. T. (2019). Association between running shoe characteristics and lower extremity injury risk in United States Military Academy cadets. American Journal of Sports Medicine, 1–10.

Leugers, K., Mathews, S., Anderson, R., Reilly, N., Haltiwanger, H., Gonnella, M., & Goss, D. (2024). Viability of structured gait retraining for improving clinical outcomes following running-related injury in active duty service members. Military Medicine.

Miller, E. M., Morris, J. B., Watson, D. J., & Goss, D. L. (2018). A reliability comparison of different methods for detecting step rate and foot strike pattern in runners using two-dimensional video. Universal Journal of Public Health, 6(6), 366–371.

Szymanek, E. B., Miller, E. M., Weart, A. N., Morris, J. B., & Goss, D. L. (2020). Is step rate associated with running injury incidence? An observational study with 9-month follow up. International Journal of Sports Physical Therapy, 15(2), 221–228.

Weart, A. N., Brown, L. C., Florkiewicz, E. M., & Goss, D. L. (2025). Using wearable sensor technology to analyze running technique and prospective running-related injuries during United States Military Cadet basic training. Orthopaedic Journal of Sports Medicine, 13(2). https://doi.org/10.1177/2325967124130927