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Minimalist Running: To Shoe or Not to Shoe?

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What's with all the minimalist running paraphernalia out there these days, and what do we make of it all? If you're a runner, you've probably heard the characteristic slap of the soft soles hitting the pavement on your tail. Most of us have seen the five-finger running shoes in stores. So why the craze and is this style of running better or safer for the casual or even addicted runner?

The craze was started in part by the popularity of the NYT bestseller Born to Run by Christopher McDougall that came out in 2009, and by the publication of articles comparing gait patterns in shod vs. unshod runners in the science journal Nature. Minimalist running has taken off as the major sneaker suppliers compete for new product share.

The concept behind barefoot and minimalist running is basically the same. By running with a more "natural" forefoot or midfoot-strike pattern, the muscles in the foot and ankle build up, and the forces generated by the foot hitting the pavement are better dispersed. This, as is argued by the touters of the style, saves habitual runners from injuries such as stress fractures and tendon problems. Minimalist runners use shoes that have minimal cushion and support, but do protect the foot from debris on the ground.

There is some science behind this concept, though limited.[1] In experienced barefoot runners, forces generated across the ankle were less in the forefoot or midfoot-strike barefoot style than in the traditional heel-strike style. While this data is compelling, there are no studies to date that show a decreased injury rate in minimalist or barefoot runners.

Dr. A. Holly Johnson, an orthopedic surgeon from Massachusetts General Hospital in Boston, specializes in foot and ankle problems and has seen many minimalist runners in her practice. She is an accomplished marathoner, and has tried minimalist running herself. "I've observed stress fractures and tendon issues in patients who have been running for years and didn't have many injuries before they switched over to the minimalist style. Generally problems arise when runners abruptly switch styles and don't allow the body to adapt properly."

For instance, in one case a marathoner tried out a minimalist pair of running shoes and ran over five miles on three consecutive days. He developed irritation of his Achilles tendon that knocked him out of running for four months. In another instance, an experienced runner started training for a marathon in minimalist sneakers for the first time and developed a stress fracture in her heel after two months of training.

"Typically injuries occur when the runner doesn't adequately alter their running style to the forefoot strike pattern and continues to heel strike in the minimalist shoe," stated Dr. Johnson. In this case, the bones aren't used to hitting the ground without the cushion of the standard running shoe. "I've also seen Achilles tendon problems that occur because the minimalist shoes lack the heel lift that is inherent in typical running shoes. The tendon is stretched more in the flat shoe or bare foot, and can become quite irritated."

When asked whether or not she discourages runners from trying out the barefoot style, Dr. Johnson said she did not. "There is merit to the concept. Barefoot runners exist all over the world and have for thousands of years, so this is certainly not a new concept. I would just caution anyone who wishes to start to study the technique or even take a lesson first. Then progress slowly, and listen to your body."

References:

[1] Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D'Andrea S, Davis IS, Mang'eni
RO, Pitsiladis Y. "Foot strike patterns and collision forces in habitually barefoot versus shod
runners." Nature. 2010 Jan 28;463(7280):531-5.

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Flickr photo by Adele Prince

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