ACSM'S Health & Fitness Journal:
Roy, Brad A. Ph.D., FACSM, FACHE
Brad A. Roy, Ph.D., FACSM, FACHE, is an administrator/executive director at Kalispell Regional Medical Center. He is responsible for The Summit Medical Fitness Center, a 114,800–sq ft medical fitness center located in Kalispell, MT, and a number of other hospital departments. He is the editor of the Medical Fitness Association’s Standards and Guidelines for Medical Fitness Center Facilities and immediate past board chairman for the Medical Fitness Association.
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Running barefoot and running in thin-soled flexible shoes (minimalist running) are rapidly gaining popularity, partially spurred by the 2009 release of Christopher McDougall’s book Born To Run: A Hidden Tribe, Superathletes, and the Greatest Race the World has Never Seen. Proponents claim that humans were created to run barefoot and that the introduction of the modern running shoe in the late 1960s has resulted in altered mechanics and increased injuries. Clinicians, on the other hand, point to the growing number of runners limping into their offices with barefoot-related injuries and suggest that the barefoot condition is certainly not for everyone. Although there is a plethora of information available for both the shod and unshod conditions, most is of limited value and not based on sound scientific research. Instead, the information often is driven by personal experiences, passion, and sometimes questionable logic.
POTENTIAL BENEFITS AND DISADVANTAGES
Running either barefoot or in a minimalist shoe may be beneficial for some individuals. Barefoot runners typically alter gait by decreasing stride length, increasing stride frequency, and landing with a forefoot/midfoot technique rather than a heel strike. Such gait adaptations potentially reduce impact forces and often are promoted as reducing running-related injuries. Other potential benefits include the following: strengthening of the muscles in the feet, improved proprioceptive ability (feel for the surface and landing), better running economy (reduced energy expenditure at a given pace), and decreased cost (no need to purchase expensive running shoes).
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Although each footwear condition (barefoot, minimalist shoe, and high-tech running shoes) may have benefits for certain people, there is currently no scientific evidence linking any condition to reduced injuries. Technologically advanced running shoes have not reduced injury rates, possibly because of the tendency to heel plant and perhaps the false sense of protection that leads to overtraining and acceptance of poor running technique. Barefoot running also is not without risks, including surface hazards (rocks, glass, and thorns), potential thermal injury (hot or very cold surface induced), impact stress from poor running mechanics (heel landing), and potential exposure to infectious microorganisms through cuts/abrasions. Diabetics with a loss of protective sensation and select other people with structural challenges may be at high risk of injury running barefoot.
TRANSITIONING TO BAREFOOT RUNNING
Readers considering a transition to barefoot running or utilization of a minimalist shoe should proceed slowly. Currently, there are no studies that demonstrate the safest method for beginning a barefoot or minimalist shoe running program. One general recommendation is that people gradually introduce the new condition, beginning with a few minutes of run time each week and then progressively increase the amount of time spent barefoot or in the minimalist shoe during the run. It also is important to pay attention to the surface environment to avoid hazards like rocks and glass and to learn to run with appropriate technique, such as forefoot to midfoot landing, shorter and more frequent strides, and avoiding heel landings. Whether choosing to run shod or unshod, it is important to use proper running mechanics (the barefoot style) to gradually increase mileage/intensity and to incorporate rest/recovery days.
Barefoot and minimalist shoe running are increasing in popularity and may be beneficial for some people. Currently, there is a lack of supporting data, especially regarding decreased injury rates, in both the shod and unshod conditions. People desiring to transition to barefoot running should start slowly, gradually increase time spent barefoot, and use proper mechanics. Regardless of barefoot or shod condition, proper running technique and not overtraining and/or progressing too quickly are essential to minimize running-related injuries.
Disclosure: The author declares no conflict of interest and does not have any financial disclosures.