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Barefoot Running: Great Idea or Disaster in Disguise?

The barefoot running trend has its pros and cons.

Barefoot running is also known as natural running. The first Olympians in Ancient Greece ran barefoot (bare everything, according to legend). Abebe Bikila became a barefoot running sensation in the 1960 Summer Olympics when he won the gold medal in the marathon event, running without shoes just as he had trained in his native Ethiopia (He later won gold again in the same event in 1964, this time wearing shoes). Bikila’s triumph, however, did not spark a barefoot running trend. In fact, running shoes in the late 70s through the 90s sported thick cushioning in the heel, creating a high heel-to-toe difference or ratio.

Barefoot running did not catch the world’s attention until Christopher McDougall’s book, Born to Run, came out in 2009. He tells the story of how he successfully overcame running injuries by simulating the techniques of the Tarahumara, an indigenous Mexican group known for their extreme running abilities. His book sparked an interest in running barefoot and in minimalist footwear with a very low heel-to-toe ratio. 

In the early 2000s, the Vibram footwear brand marketed Vibram Fivefingers, a rubber foot glove with a zero heel-to-toe ratio, as a more natural, healthier running shoe, similar to running barefoot. These shoes were so popular that they quickly took a two percent share of the running shoe market. Minimalist shoes sales soared to $400 million in 2012.

So, which is better? Running barefoot or shod?

The truth is that studies are mixed, and there are supporters on both sides. Here are some relevant finds:

Barefoot runners and shod runners have similar injury rates, but different types of injuries.

A joint study by University of Delaware and Harvard professors showed that barefoot runners actually had similar injury rates when overall mileage was taken into account, but barefoot runners had fewer musculoskeletal injuries. Shod runners produce a different heel strike than barefoot runners, typically striking with their heels first. They also have longer step duration and a shorter step rate. 

Heel strikes place greater stress on the foot than mid or forefoot strikes like the kind typically experienced by barefoot runners. Heel strikes lead to Achilles tendinitis, stress fractures, shin splints, and plantar fasciitis. Barefoot runners, however, received more injuries to the soles or plantar surfaces of their feet.

Foot Bone Damage

New barefoot runners in one Brigham Young University study showed a marked increase in bone marrow edema, a swelling in the foot bones. The study’s recommendation was that runners new to barefoot running or wearing shoes that approximate it should proceed slowly in adopting the style.

Mid and forefoot strikers have fewer injuries

A 2012 Harvard study reported that competitive collegiate runners have a high rate of injury: 75 percent of the runners studied reported an injury, but those who were rear-foot strikers had double the number of forefoot strikers. Barefoot runners tend to be forefoot strikers; their initial strike is in the front or middle of their foot. They also have a shorter step duration and higher step rate. These factors can indeed lower the impact and stress from running.

But maximalist shoes are the latest trend!

Minimalist shoe purchases have been declining since 2012, however, and in May 2015, Vibram settled a class action lawsuit which alleged that the company’s health benefit claims for their FiveFinger shoes were false. And now, it seems the pendulum has swung the other way completely. Leo Manzano, an Olympic medalist in the 1,500 meters, runs in maximalist shoes with two times the cushioning of regular running shoes. Manzano switched to these Hoka One One brand shoes in order to find relief from plantar fasciitis, and sales of this footwear are picking up.

Diabetics should not go barefoot

This is something everyone agrees on! Poor blood flow makes it hard for some people’s injuries to heal and shoes provide much more protection from cuts and bruises than barefoot running. The American Diabetes Association recommends that diabetics who have a loss of sensation or those with circulation issues should not undertake barefoot running

Conclusion? It’s still up in the air!

The American Podiatric Medical Association’s position is that there isn’t enough research yet to support barefoot running, and it encourages anyone thinking about running barefoot to consult a podiatrist before beginning, especially if you decide to switch to either minimalist or maximalist shoes, or to change your striking pattern. Your podiatrist can analyze your gait and make recommendations.

Dr. Nina Coletta has over 20 years of experience helping runners with a range of sports injuries. She can conduct a comprehensive gait analysis which can reveal the source of a number of musculoskeletal or circulation problems. By analyzing your bone structure and the way you move, stand, and walk, she will be able to check your range of movement and look for any weaknesses or malalignments before making running shoe recommendations that will keep you healthy, safe, and in the running for any event. Contact her today at (954) 452-4590 or through our online contact form.

Dr. Nina L. Coletta has been practicing Podiatry for over twenty years. Her practice remains on the cutting edge of advancements in Podiatric Medicine, providing state of the art laser treatments, three-dimensional technology to construct custom orthotics and braces, and in-house arterial and venous studies of the lower extremity. From pediatrics to mature adults, her staff provides superior care in a warm, welcoming environment.

Nina L. Coletta, DPM, PA

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