If you have been in the running world over the last decade you have most likely heard of or read about the “benefits” of running barefoot or in minimalist shoes compared to traditional running shoes. If are not in the “running world” this may be news to you. There has been a heated debate over the benefits of running barefoot for years now. The supporters of barefoot running insist that this is the natural way to run, that it leads to fewer injuries and requires less energy than shod running. Those that oppose barefoot running insist that there is no evidence to support this.
A large number of small studies have been done to prove and disprove these benefits. Most of these studies have been retrospective studies, meaning finding people who run barefoot and those who don’t, asking them if they about their injury history. These type of studies are considered to have little scientific value. One Harvard University study done in 2010 found that it was safe to run barefoot and that certain running styles that are more common in barefoot runners seem to decrease impact pressures. Many took this study to conclude that barefoot running was better and helped prevent injuries. This lead to an increase in the barefoot or minimalist shoe running. In fact, the study only concluded that it was safe to run this way and there may be lower impact pressures during running if you ran in a specific style. Another study done in 2012 showed lower impact pressure in runners that landed flat foot (midfoot strike) or landing on the ball of the foot (forefoot strike) as compared to landing on the heel (heel strike). Traditional running shoes have been shown to push people to heel strike, so the natural conclusion by the pro-barefoot running crowd was the barefoot running lead to less stress and lower injury rate. One of the most recent scientific studies on this subject was published in the British journal of Sports Medicine in 2015. This study looked at musculoskeletal injury rates of barefoot runners compared to shod runners. The study did show there were more musculoskeletal injuries in the group with shoes as compared to the barefoot running group. This seems to support barefoot running but when looking deeper into the study, runners wearing shoes were running twice as many miles as the “barefoot” runners. If you looked at musculoskeletal injuries per mile run between the groups there was no difference at all. In fact, the only conclusions that authors themselves could draw from the study were that people that run barefoot run fewer miles. It did appear that the type of musculoskeletal injuries was different between the two groups. Barefoot running tended to cause more Achilles tendon problems and shod running tended to cause more plantar fascia injuries. One point the study showed was the skin injuries such as blisters, cuts, bruises and stubbed toes were almost 7 times more common in the barefoot group.
So to go back to the question, is it better to run barefoot or in minimalist shoes like the ones shown above or in a more traditional running shoe. The answer to this question is clear. Maybe or maybe not. Although studies are clear that midfoot strikers or forefoot strikers, which are more common amongst barefoot runners, seems to lessen the impact stress, these same studies show that this does not necessarily lead to fewer injuries. Most people have to train themselves to become a midfoot or forefoot striker. Because we wear shoes most of the time, most of us are natural heel strikers. Just going barefoot does not mean that you will automatically change your gait and get the perceived benefits of the less impact.
When it comes to running, my advice is this, start slow, increase as tolerated and make sure you are adequately stretching before and after running. This will minimize the injuries that you have more than simply taking off your shoes. If you decide that “barefoot” running is for you, make sure you start slowly. Also, understand that you will have to train yourself to change you gait pattern. This is a process that usually takes significant time. I would also recommend that you use a minimalist shoe to help avoid the cuts and scrapes that will happen. In my opinion, “barefoot” running is not the garden of Eden that many of the strong proponents insist that it is nor is the end of civilization as we know it that the opponents are arguing. Barefoot running can be done safely if you know what you’re doing. It is not for the novice runner and should be only done after careful research. The research as it currently stands does not support the argument that it leads to fewer injuries.
Please contact us if you have any questions or concerns about your foot and ankle health or you are suffering from foot and/or ankle pain. You can view our websites www.ahicarealliance.com and www.ahinstitute.com for additional information and for further blog entries. Our videos may also be viewed on YouTube regarding your feet.
Thank you for taking the time to read this blog. Again please contact me if you have any questions.
Dr. Dirk, The Foot Guy