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Neal M. Blitz, D.P.M., F.A.C.F.A.S.

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Running Barefoot: Is It Safe? Should You Try It?

Posted: 04/25/2011 9:19 am

The Barefoot Runners Society has proclaimed May 1, 2011 as the Inaugural "International Barefoot Running Day." With the increasing awareness of barefoot running, it is likely that you will encounter someone running without his or her sneakers and they may even be wearing the nicely designed specialty T-shirt.

Experienced barefoot runners are passionate about the movement. Simple searches on the Internet reveal numerous people telling their stories. Some runners claim that they run "without effort" after tossing their shoes aside. Others describe a connection to the ground and earth that didn't exist prior. Previously injured runners tout how running barefoot may have cured long-standing foot problems. Some run marathons barefoot.

What's obvious is that barefoot runners describe an overwhelming positive experience. They are not selling you something but their personal account -- and I believe a powerful message. The negative stories are few and far between and only seem to revolve around early stages of running without 'protection.' There has yet to be a barefoot running tragedy.

How Running Barefoot Is Physiologically Different

Running barefoot is not just about running without sneakers, it's about re-training your body how to run. The main difference between the two styles of running center around foot strike -- the moment your foot makes contact with the ground.

When running in sneakers, your heel makes contact with the ground first (heel strike) then as your body passes over the foot, pressure rolls onto the arch then pushes off with the ball of the foot. In contrast, barefoot running requires that the arch makes first contact with ground (midfoot strike) -- not the heel. In order to run barefoot 'properly,' one has to lift up the entire leg at the knee to lift the foot off the ground. This method results in a shorter stride.

Researchers at Harvard have performed some interesting gait analysis and comparative studies illustrating that the force of impact is distributed throughout the foot when running barefoot, rather than focused on the heel. The significance of this is not entirely clear.

Oxygen consumption is slightly decreased when running barefoot, and running in sneakers increases the energy cost of running. This may be important to the competitive runner.

Common Barefoot Running Injuries

The main concern is stepping on a sharp object leading to puncture injury, and a specific area of caution from the medical community. This should not be taken lightly as foot puncture is a real risk and may lead to serious problems. I have treated severe limb-threatening infections from simple pedal scrapes. Make sure your tetanus is up to date!

Calluses are a desired response to running barefoot and are thickening of the skin to make the bottom of the foot tougher. Thicker diffuse calluses may limit blisters, cuts and scrapes.

Some barefoot runners describe foot swelling as 'normal' but may be an indicator of a bigger medical problem, such as ligament/tendon injury and/or stress fractures and should be evaluated by a health care professional. Barefoot runners may experience burns to the bottom of the foot should they run on hot pavement.

It is important to check your feet -- inspect the bottom and between the toes. Have antiseptics and antibacterial ointments available for abrasions.

Running Barefoot Is NOT for everyone

People with existing foot problems in general may not be the best candidates for barefoot running.

A flat foot is often a flexible structure that absorbs impact but often results in abnormal wear patterns in general that may lead to structural foot problems. Bunions, hammer toes, metatarsalgia are all indicators of a flexible foot and lack of support could result in injury or exacerbation of a condition. In contrast, a high arch foot is rigid structure that absorbs impact poorly.

Though these foot problems are associated with the heel to forefoot gait and/or run -- and with the midfoot strike of barefoot running, its possible that foot structure may not be an issue for those running barefoot.

You should not run barefoot if you have a sensory disorder of the foot as this may lead to serious problems and foot wounds. Diabetics are at risk for peripheral neuropathy and should seek medical advice before attempting barefoot running.

What Minimalist Foot Wear Options Are Available?

For those who cannot entertain the idea of running barefoot, minimalist sneakers exist are designed to mimic running barefoot.

Some shoes are sock-like and others are designed like an ultra-lightweight running sneaker. One minimalist shoe fits each toe separately and allows each toe to move freely. Another brand only separates the big toe from the lesser toes. Puncture resistant soles may be featured on certain models. Some brands are slipper-like and aimed to 'feel' like a second skin.

A Reconstructive Foot Surgeons Thoughts

I am neither an opponent nor advocate of running barefoot. I am not a runner.

In my practice I see collapsed feet that require surgical reconstruction, and there are a multitude of reasons for this to occur. Its not necessarily shoe gear related, and genetics are largely responsible for poor foot structure.

In general, I believe that the foot needs support. However, I also recognize that I see a small segment of the population and these patients have foot problems. It is possible that healthy feet don't require the same support as a foot with problems.

One thing the barefoot running movement has accomplished is that it has allowed runners to reexamine the way they run, and perhaps we have just been taught to 'run wrong.'

What are your thoughts on barefoot running? Tell us why you agree or disagree. If you are a barefoot runner, tell us your experience.

~ Dr. Neal M. Blitz

To learn more about Dr. Blitz, please visit www.nealblitz.com

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Financial Disclosure: none

Disclaimer: The information in this is educational and informational and does not constitute medical advice.

 

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