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Barefoot running: Is it right for you?

 

It seems that you can't go into a sporting goods store these days without noticing the latest innovation in running technology; the minimalist running shoe.  Recently, I received a call from a friend who was shopping to replace her old running shoes to ask what she should make of these new shoes.  Should she switch and why?  These questions are what led Lawson, our pedorthist, and I to write this entry to our blog to help you decipher what to make of minimalist running.

 

The Who

What is barefoot running? What is minimalist running?

 

Barefoot and minimalist running has become an international trend, increasing in popularity after the release of Christopher McDougall's book, Born to Run, which has been featured in all forms of media ranging from articles in the Globe and Mail and Runner's World, news correspondence on the CBC, to dedicated minimalist running websites popping up all over the web.  McDougall argues against running in heavily cushioned shoes because this style promotes people to take large strides, which by landing on the heel (heel striking) and creating large braking forces sending increased shock up the body; this debatably increases the risk for running related injuries.  The theory behind barefoot running is that people using this form of running automatically adapt to avoid painful impact on the heel by taking shorter strides and landing on the forefoot.  Therefore, from an injury perspective the proposed advantages of barefoot running are decreased impact forces and lower rates of associated injuries. 

Even though barefoot running implies running without shoes (unshod), sportswear manufacturing companies and shoe stores have taken the opportunity of this development to sell “minimalist shoes.”  Minimalist shoes are lighter shoes with less cushioning and the heel closer to the ground than conventional running shoe.  The idea of minimalist running is to promote the same biomechanics as barefoot running but provide some protection for the skin under the foot using a minimalist shoe.  However, not all minimalist shoes are made the same.  The most well recognized minimalist shoe is the Vibram 5 Fingers, but it is the most “barefoot” within a spectrum of minimalist shoes that range in weight, cushioning, and shoe heel height.  Footwear companies have marketed the shoes to promote mixing it up: use minimalist shoes a few times a week for training purposes; or to convert running styles entirely.  At the moment, there has been no direct data in research on whether barefoot or minimalist running actually decreases injury.  Most research has been on habitual barefoot or minimalist runners; very little research has been done on runners new to barefoot or minimalist style. Then again, there is also no conclusive research arguing against barefoot or minimalist running.  However, there is so much anecdotal evidence supporting minimalist running that it is not unreasonable to try this running style as long as one considers the implications and mitigates the injury risks involved with running differently than the way you had been before.

 

The Problem

What should I consider when trying barefoot or minimalist running?

 

There are many reasons why one would want to try barefoot or minimalist running; you might be plagued by chronic injuries, wanting to improve your form, craving a return to the basics, or just plain old curious.  It is important to consider that switching into a new pair of shoes can cause a series of changes in how force is transferred through the foot and up the leg to the trunk.  With minimalist running shoes, the runner isn't just exchanging a shoe style but is potentially adopting a whole new running technique.  Such a dramatic change can lead to a number of new injuries for some.  However, if you don’t adopt the different technique then you are likely to be at even greater risk for injury because of the significant differences between minimalist shoes and conventional shoes. As you can imagine, barefoot running requires even greater consideration to running technique due to the nature of being unshod.  Therefore, it is important to be aware of your current running style at the onset of starting a minimalist or barefoot running program.  Ask yourself do you naturally land on your heels or your forefeet when you run?  Transitioning into barefoot or minimalist running needs to be done slowly; you should initially keep each weekly run in the new shoes low intensity and low mileage.  It will take a number of months for your body to fully adjust and develop the necessary muscle patterns to match your pre-barefoot style mileage efficiently and without injury.  You can augment this critical training period with an assessment and treatment by a physiotherapist and pedorthist. 

 

The Solution

What does a physiotherapist and pedorthist do for a barefoot or minimalist runner?

 

As clinicians we’ve heard common complaints from those attempting barefoot or minimalist running of calf pain, shin pain, ball of the foot pain and anterior knee pain. Such injuries are indicators of either soft-tissue, skeletal structural, or biomechanical inadequacies. Every body is unique and each has its natural talent for or limitations to barefoot and minimalist running. 

From a physiotherapist perspective it is important to have a strong core, strong foot flexor muscles, strong hip extensor muscles, relaxed but strong calf muscles, and appropriate range of motion at the big toe, ankle, and hip to adopt a barefoot or minimalist running style. The physiotherapists at Oakridge Physiotherapy can provide a baseline for where you stand in these areas and

prescribe specific strengthening and stretching exercises to address imbalances and use manual therapy techniques to optimize joint and soft tissue flexibility and function.  If you are healing from an injury we can use a variety of electrophysical agents to promote healing and use dry needling techniques of acupuncture and IMS.  A pedorthist is concerned with minimizing mechanical stress on the foot and consequently up the body; as such, emphasizes alignment and balance of both feet.  Pedorthists at Active Orthopaedic Inc. will assess your gait, biomechanics, foot and ankle range of motion, lower limb muscle function.  They can recommend and provide treatment plans to accommodate deformities or foot inadequacies with custom made orthotics, bracing and compression products, footwear recommendations, and education.  When booking with Active Orthopaedic Inc. specify that you are a minimalist runner or starting a minimalist running program to ensure the appointment is appropriately prepared for you.

 

As for my friend, I asked her a number of questions.  Do you currently run pain free?  Have you always worn the same style of shoe?  Do you enjoy running in those shoes?  In her case, the answer was yes to all three.  My advice to her was to stick with her old style of shoes to avoid developing an injury with a change of footwear.  Barefoot/minimalist running may be acceptable training methods as long as the risks are minimized; however sometimes, if it ain’t broke don’t fix it!


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