Barefoot Running: A doctor's opinion

author : AMSSM
comments : 7

Sports medicine doc weighs in on the pros and cons of barefoot running

Member Question:

"Is barefoot running the key to a faster and more injury-free running style?"

Answer from David Westerdahl MD
Member AMSSM:

Many of my running and multisport athletes are asking about barefoot running. Is it right for them? Will they have more or less injuries? What long term data is out there? With increasing marketing and sales of minimalist shoes like Vibram Five Fingers, let's take a moment to examine why this trend is happening and what triathletes should consider.

 Vibram Five Fingers  
Reviews of Vibram Five Fingers by BeginnerTriathlete.com membersThe Mizuno Wave series has several models of minimalist, lightweight running shoes. Read reviews. The Saucony Kinvara is a good stepping stone between a very structured shoe such as Asics, and a very light, flat shoe or Vibrams. Read reviews.

Leg overuse injuries are very common in recreational and elite runners. A 2007 study showed that approximately 56% of recreational runners and over 90% of runners training for a marathon will sustain a running related injury each year. These injuries are thought to occur due to the loads applied when the foot first contacts the ground. Some studies show that the typical "heel striking" many shod runners (runners with shoes) do results in increased force through the lower leg compared with the foot-strike seen with barefoot running. Barefoot running is thought to result in a more "natural" foot-strike along the midfoot/forefoot area. Landing this way allows the foot to absorb impact better and may result in fewer injuries which proponents of barefoot running say why we should run without shoes.

There is also recent data showing that increasing one's step rate reduces the force transmitted to the lower leg during running. Barefoot runners tend to take shorter strides and have increased step rates compared to shod runners. A study published earlier this year by the Am. College of Sports Medicine of 45 healthy shod runners who ran a minimum of 15 miles/week showed an average preferred step rate of 172 steps per minute. When they increased their preferred step rate by 5% and 10%, less force was transmitted to the knee and hip because there is less vertical center of mass on the foot at landing. This study noted that many of the biomechanical changes found when step rate increased in shod runners are similar to those observed when running barefoot or in minimalist footwear.

In summary, increasing your step rate when running in sneakers may prove beneficial in preventing and treating common running related injuries in a manner similar to barefoot running. So, is it the barefoot running or the increased step rate reducing injury risk?

Currently, there is a lack of long term data on barefoot running and injury rates. However, whether running barefoot or shod, runners will be at risk for injuries as mileage increases. It does appear that adopting a running form that increases step rate, reduces stride length, lands with a bent knee, and reduces heel striking will reduce running injury risk.

Since running form does matter, runners who suddenly switch to barefoot or a pair of minimalist shoes without a running form that has these components may be at increased risk of injury. When first running barefoot, try to run on soft surfaces like grass or sand since our 3-dimensional foot conforms to the soft 3-dimensional surface of grass or sand better than the flat road. Also, gradually build up your time and distance barefoot running.

Also, runners who have diabetes, decreased sensation (neuropathy) of their feet, are overweight, or have severe overpronation should avoid running barefoot. I encourage triathletes who mainly race on the road to focus on form and race in as much a lightweight shoe as they are comfortable using. One final thing to consider is by the time many triathletes exit T2, they are running on fatigued legs, trying to survive and get to the finish. In my opinion, unless you have done extensive training to adapt your form and condition your feet to the changes of barefoot running, the final leg is not the best time to run barefoot.


David Westerdahl MD | Sports Medicine | Department of Orthopedics
2950 Cleveland Clinic Blvd | Weston, FL 33331 | (954) 659-6164 | www.clevelandclinicflorida.org
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date: October 4, 2011

AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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