Barefoot Running - the issues involved

Barefoot running isn't new; it has been around since the dawn of time. However it has recently gained popularity over the last few years (as at time of writing this) as a result of various running technique concepts, collectively known as method running (i.e. Pose, Chi, BK method) as well as the result of the inspiration from books (i.e. Born To Run), magazine articles and websites... all of which, usually make reference to the "mysterious tribe of Mexican Indians known as the Tarahumara" who run primarily in a sandal type footwear known as huaraches.

Once all the hype and pseudo scientific folly is peeled away from both the method running concepts and barefoot running literature, the issue that lies at the heart of the promotion for barefoot running is running injuries.

Many thousands of runners get injured every year. These are usually overuse type injuries i.e. the result of repetitive adverse forces contributing to the strain, weakness and breakdown of soft tissues (i.e. muscle, tendon, ligament) such as Plantar Fasciitis, Shin Splints etc... or of an osseous nature (i.e. bone, joint) such as Stress Fractures, Patello-Femoral Syndrome etc...

Overuse type injuries are multifactorial in nature, that meaning that they are potentially caused by a number of different factors i.e. training errors (doing too much too soon), poor running technique, adverse biomechanics (poor structural alignment i.e. medial deviated Sub Talar Joint axis → high supination resistance force), footwear etc... However, the general perspective from the barefoot running movement is that footwear is the main contributing culprit behind the injuries... thus get rid of the footwear and the injuries should resolve. Whilst this may help some runners to some degree, it is certainly not a valid reason for a lot of other runners.

What is not usually stated (if at all) by the proponents of barefoot running is the incidence of injuries or the type of injuries that can be acquired via running with no shoes. These could either be the obvious puncture type wounds (i.e. broken glass) or heel pain, arch pain, lower leg injuries such as Achilles and / or Calf strain or injury, as well Stress Fractures (i.e. to Metatarsals / toe bones). Putting aside the puncture type injuries, the other injuries stated are usually the result of the individual having a disadvantaged foot structure which contributes to poor biomechanics and subsequently adverse forces directed to the areas stated. In some cases it is due to the individual not adapting to the different stresses that barefoot running places on the lower limb / foot (i.e. increased loading forces on the Achilles and Calf muscle group).

Some barefoot proponents have strong feelings as to the correlation between injuries and footwear. Unfortunately, the nature of the agenda of some of the main exponents of the barefoot running movement have been one of... "throwing the baby out with the bathwater". Stating that shoes in general are not necessary and that running shoes cause nothing but problems. Whilst I agree that inappropriate footwear for an individual does have a role to play in the onset of injuries; It’s totally misleading to tell people that when they get injured running in shoes - "it’s the shoe’s fault", whilst when they get injured running barefoot - "it’s the athlete’s fault". It makes no sense... picking the fault to fit the barefoot paradigm is not good practice / science. You’re going to have injuries either way if you are inclined to do so. It’s just the nature the demands of running places on the body if one is not biomechanically suited, conditioned / equipped or trained properly.

I feel some in the barefoot community are quite stubborn on this topic on a few accounts. One of which, is that they like to think that the Podiatry profession (on the whole) are against barefoot running... we are not. We are in the business of helping the community with lower limb related problems... we subsequently have to analyse / critique any activity that impacts on the lower limb... barefoot running certainly fits into this category. We need to weigh up the pros and cons as well as provide educated answers to the public so they themselves can make an educated decision on the choice to involve some degree of barefoot running into their program or not. If we did not do this we would have neglected our duty of care and have a lot more people walking / hobbling through our doors. We would no doubt be then criticized for not addressing this topic.

 

I do believe that the designs and structural makeup of today's running shoes can contribute to running injuries. In fact, the public have been told that the act of "over pronation" is the main cause of running injuries, yet shoe companies have been attempting to address this issue since at least the early 1980's. However, despite the apparent 'technological advancement' in addressing such issues such as "over pronation" with running footwear since the American running boom of the 1970's, there has been no real reduction in the overall incidence of running injuries. I have read somewhere that some types of injuries have decreased in prevalence whilst other types have increased. It seems ironic that the injury preventing intentions behind some of the 'supporting / controlling & cushioning' components in running shoes may actually be contributing to the problem. A good example of this is the reasoning behind the 12-14mm height differential between the heel to forefoot. This has apparently come about due to the study that revealed a lot of people don't have adequate ankle range of motion (particularly in the dorsiflexion range). Limited ankle dorsiflexion is usually the result of the Calf muscle group being too tight - so why not encourage runners to stretch their Calf muscles to acquire more ROM to the ankle joint instead of accommodating the fault via raising the heel height which can then contribute to other problems?

I believe the main contributing factors of adverse shoe design trends found in today's general running shoes are:

- Heel pitch too high (i.e. heel height greater than forefoot height). This can contribute to a heavy heel strike gait which then can contribute to excess eccentric (i.e. muscle / tendon strain whilst elongating) and / or torsional (rotation) forces.

- Midsole thickness is too thick. This can contribute to excess degrees of foot / lower limb movement as well as reduce adequate proprioceptive feedback (see Footwear section for more on this).

- Shoe too stiff which leads towards compensatory foot strain and fatigue.

- Increase bulk and weight of shoe which can inhibit natural lower limb / foot movement.

- Poor shoe conformity to the foot which can contribute to adverse motion within the shoe thus strain to soft tissues and joints.

 

There appears to be however another reason to go barefoot. One of which I would consider as unusual justification as to the reasoning for kicking off the shoes and running barefoot. There has been an evolutionary perspective added to the cause. Support of which coming from none other than a Professor (Evolutionary Biologist) from Harvard University. This evolutionary perspective has been finding its way into many research papers, magazines (i.e. renowned science/medical journal - Nature), seminars as well as providing a bit of so called scientific (or pseudo-scientific) padding to the book 'Born To Run'. It would seem that the Nature article in question had very little editorial investigation or checking of the research's validity as there were various research faults with the study (i.e. major age difference between two of the groups studied; used 2D Kinematics - yet imply that they used 3D; the nature of impact forces on the lower limb/foot).

The basis of this evolutionary perspective has no clinical evidence to back its claims, or  role within this empirical field of study. The premise of which is riddled with conjecture and speculation on the past perceived history of anthropological findings of "primate" or "hominid" bits / pieces and fragments. The field of anthropology as been riddled with fraud and deception in the past (i.e. Java Man, Piltdown Man, Nebraska Man etc...), with clear evidence of the tampering of bones and the mixing of bone fragments from either another class of genre or specie, or even that of our own (Homo Sapien), so as to fit a preconceived agenda on the research. Statements like... "The differences between shod and unshod running have evolutionary underpinnings", as well as... "we evolved to run with no shoes so why wear them" has no scientific grounding. There are potentially far greater enlightening areas of scientific study such as the observable anatomical / physiological / biomechanical traits of humans which would play a much greater benefit in the study of running ability and subsequent running foot attire for humans.

There seems to be a common phenomenon associated with topics of this nature (apparently known as Payne's 1st Law) ... "where the amount of passion involved in supporting a 'theory' and the amount of emotional attachment to a 'theory' is inversely proportional to the amount of evidence for that 'theory' ". Research of the above calibre not only has one aspect which has history of substantiating the above law, but two... that being 1: hype associated with barefoot running & 2: the bankrupt 'theory' of evolution.

Some in the barefoot movement may be enthusiastically ambitious, however, may also appear to be more fascinated with fame and fortune than with serious science and performance. The claims made by the cardinal exponents of the barefoot brigade may have given rise to a new era in running: one of smoke and mirrors, in which style and individuality triumphs over substance, science, logic and reasoning.

 

The bottom line is that barefoot running can be beneficial for many runners if they are suited to partake in it. You don't really need to listen to anybody else say either way as your own body will let you know pretty quickly if you can or cannot run barefoot... as well as to the amount you can do at a given period. Experienced and educated advice is helpful but some will simply want to nut it out for themselves via trial and error regardless (this is just human nature).

I do feel barefoot running is more appropriate as a training tool as it quickly entrenches / reinforces efficient gait and technique. It also helps gain added strength to the lower limb as well as increase metabolic cost (due to greater muscle involvement) - all of which are good training goals and subsequently conducive for better performance (i.e. in a race). However, I don't feel barefoot running is all that conducive in a race environment (where performance / speed is usually the chief goal) due to the varied terrain, of which we have no choice over (i.e. harsh road surfaces, unforgiving/hard surfaces, broken glass etc...) as well as the higher metabolic cost that is involved (i.e. higher energy consumption due to greater muscle activity). At the end of the day the choice is yours... all the best.


♦ Footwear & Running Efficiency (economy):

Researcher and acclaimed coach Dr Jack Daniels has been involved with research involving the difference between running in shoes and running barefoot in regard to performance. These tests were carried out on a treadmill. Barefoot running revealed to be more costly (i.e. cost more energy to run at the same speed) compared to running with shoes on the harder surface. It is believed that this was because the treadmill was hard (similar to that of the road) and thus you have to use the leg muscles more to absorb the landing shock.

Tests have also revealed that each 100 grams of weight added to running shoes increases the cost of running (cost more energy to run at the same speed) by about 1 percent. “Increasing the weight of a shoe increases oxygen consumption at moderate running speeds by approximately 1% for each 100 grams of added weight”; 100 grams = 3.5 oz. (Morgan DW, Martin PE, Krahenbuhl GS. Factors Affecting Running Economy. Sports Medicine 1989; 7:310-330). This equates to about 1 minute in a marathon and about 12-15 seconds over 10km. Dr Daniels has also carried out tests which have also measured energy expenditure wearing shoes of different weight (again tests performed on a treadmill). As the shoe was lighter, the cost was less, but when the shoe was very light, the cost started going up again because very light shoes have limited shock-absorbing characteristics, so the muscles start having to work more (like with barefoot running on the treadmill).

 

♦ For further reading on this topic, the following Runner's World article... Barefoot Vs. Running Shoes: Which Is (Surprisingly) More Efficient? discusses recent research on the area... Metabolic Cost Of Running Barefoot Vs. Shod: Is Lighter Better? 

 

♦♦♦ For more information relating to the nature of this topic, please visit the Barefoot Versus Shoe Controversy (link)Footwear (link) as well as Exercise (link) sections of this site.