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

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

***
Financial Disclosure: none

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

 

Follow Neal M. Blitz, D.P.M., F.A.C.F.A.S. on Twitter: www.twitter.com/DrNealBlitz

Comments

[Andrew Philips]

01:30 PM on 06/13/2011

It's clear this doctor is not a runner and, furthermore, has never tried barefoot running. Start slow and do short distances as if you've never run before (could be psychology difficult for a marathoner to go back to running 1-2 training miles and build slowly from there). Listen to your body - pain means stop/walk. Build up the new tissues and bone structures required to support a *forefoot* strike (on the balls of you feet, not a midfoot strike on your arch - that just silliness).

[Zapmamak]

01:58 AM on 05/23/2011

I'm a barefoot runner and have been transitioning for 9 months now. Here's my .02 cents. Firstly, as far as injuries go, for a barefoot runner who actually runs barefoot (not the ones who are just thinking about it and wondering if they should or not) stepping on the "sharp and jabbies" is really not a "main" issue. For the most part, most BFRs will tell you they do a pretty good job of avoiding those little buggers. Our biggest concern for those of us who are in transition is probably calf or achilles pain. These issues are commonly due to doing too much too soon and is the result of our muscles adjusting to the absence of a heel which most modern day running shoes have.
Secondly, I'm not sure I would say that BFRs develop callouses so much as thickened plantar skin. In my personal experience, and depending on the surface I'm predominantly running on, the soles of my feet get nice and buffed. They look better now than they did when I wore shoes. Actually, its this skin that plays a vital role in keeping a new BFR from doing too much too soon which results in the calf/achilles pain. A very slow transition is needed and many times is ignored by people who decide to start out in minimal shoes and forgo running barefoot altogether.

Thanks for this article. Its a great start to a much needed conversation.

[Mark Cucuzzella MD]

10:40 PM on 05/22/2011

Neal,

Thanks for opening up the conversation. I am a family doc, do a lot of barefoot running, and promote and teach a barefoot running STYLE. Doing some total barefoot running helps one learn the softer landing. We have loads of articles and education on our site www.trtreads.org . We opened the first store selling only minimal and level shoes....and out of thousands of customers now we have not had one saying they prefer the rigid, beefy elevated heel shoe. it is a progression though and the runner must listen to their body.
For fun and learning we posted a video too showing the barefoot style. Learn evolve, run….
http://www.youtube.com/watch?v=kpnhKcvbsMM&feature=mfu_in_order&list=UL

Take your shoes off, get thinner shoes, and decide yourself. Agree that certain specific conditions need corrective footwear but the normal foot is the perfect invention and needs NO correction.
Mark Cucuzzella MD
Professor Family Medicine
West Virginia School of Medicine

[LovingFit]

02:13 AM on 05/07/2011

I personally couldn't run barefoot. It's not really for me, I have been noticing more and more people turning to bare foot running. But then again, it's best if we all do what is comfortable for us, not just because it's in the news and everyone else is doing it.
I have a fitness blog, and It gave me a good Idea to research bare foot running, but so fare I know that I need shoes on my feet in order to run

http://www.lovingfit.com

[Aquest]

03:38 PM on 04/28/2011

Should you be running is the first question.

[gutikn6]

03:01 PM on 04/28/2011

Barefoot running has been a hot topic in the past few years, especially after the book "Born to Run" surfaced on the bookshelves. This new craze, has not only been a hot topic, but one spun in a positive light. I'm skeptical about the thought that it's the shoe and not the form that matters more here. There is not a lot of research on foot injuries using different kinds of shoes or no shoes at all for me to decide this. We do know that by wearing these shoes, the foot fall pattern is different and the running form is changed. I'm of the opinion that it's the running form that is leading to less injury, not the shoes! The shoes may help people run in the better form though. I do know several people wearing the five finger shoes who have suffered different types of foot injuries specific to how these shoes make them run. The same goes for riding a bike. If you aren't properly fitted on it, such as the seat being too low, your form is bad and leads to injury. It's not the bike is the rider!

What are your thoughts on chi running? It emphasizes technique to reduce injury.

[zbaring]

01:13 AM on 04/30/2011

My understanding is that most of the injuries that happen for barefoot runners are in the "transition period" to barefoot running when the transition is too rapid. This would make the injuries that barefoot runners are experiencing actually a result of the shoes they were wearing previously.

[HealthHabits]

02:29 PM on 04/28/2011

I will be writing a review of minimalist exercise shoes in the coming month.

Some of the brands being tested are Sockwa, ZemGear, Stem Footwear & Kigo,

[subithehero]

08:08 AM on 04/28/2011

Another excellent option exists at www.invisibleshoe.com

Initially, run SLOW and SHORT! Take the time to evaluate the environmental feedback. Your feet will be upset with hotspots and new sensations. Your lower leg muscles, both front and back, and all the muscles of your feet, will feel beaten up. REST! Slow, Short, Rest: words that go-getters don't like to hear, I know, but it is a process. You can not run barefoot with the same stride that you ran in cushioned platforms. Think of lifting your knees, not pushing through the ground. Pick a song that is 140-180 bpm, and step quick and light to the beat.

After 30 days your skin will be thick and your nerves will not be as easily excited. You will run faster and more efficient, and be less sore at the end of a good run. You will feel the joy of accomplishment. Every now and then do a VERY slow run, focusing on "land and launch" and bpm, to reinvigorate your form.

I wear the huaraches everywhere polity allows. People often ask questions about them. It is an opportunity to meet people and spread the joy of good health.

As per the debate "barefoot is the only way vs. barefoot is evil," I disagree. Barefoot is ANOTHER way to learn about your body, facilitate good health and longevity, and have a good time!

Happy trails!

[mactarkus]

08:46 AM on 04/28/2011

Excellent advice? I too wear homemade huaraches. My first pair came from a kit from Invisible Shoe. Ive since made many more pairs buying rubber and cord in bulk and experimenting with different sole thicknesses, cord types, and tying strategies.

[mactarkus]

08:47 AM on 04/28/2011

That last comment should have been Excellent Advice! with an exclamation point. Sorry.

[AnastasiaBeaverhausen]

02:43 AM on 04/27/2011

I'm too much of a pansy to go totally barefoot, but I run in the Nike Free 3.0 and the Brooks Green Silence now, having ditched the super-cushioned Asics I used to train for my first marathon. Gone are the persistent calve cramps, shin splints, dead toenails and foot callouses of the past. I don't miss the cushioning in the least.

[freewayofluv]

11:19 AM on 04/26/2011

Elite runners keep getting faster and faster. Whether it is a an elite marathoner or sprinter, the shoes they wear, have with very little cushioning. What's changes is the amount and quality of training the elite athletes must endure to achieve world-class status. Running is a skill like any other sport and must be taught with proper technique. It so happens that barefoot running or minimalist shoes mimic the most efficient running technique, like how most elite runners run. Heel striking is the worst way to run. The fastest runners spend the least amount of time on the ground. The more time on the ground, the more impact to the body. Cushioned shoes will lead to injury. We must learn how to use gravity to move us forward. Check out Pose Method of Running.

[mactarkus]

04:30 PM on 04/26/2011

The great thing about running barefoot is that it is self-teaching. The feedback you get enforces proper form without having to study anything. Running is a natural motion and therefore it should happen naturally.

[PatrickSilvestri]

05:26 PM on 04/26/2011

Cushioned shoes will not lead to injury - bad form will.

[mactarkus]

11:04 PM on 04/26/2011

While that is true, cushioned shoes hinder you ability to get feedback. Cushioned shoes can allow your form to suffer indirectly.

[JustWondrin]

10:56 AM on 04/26/2011

Wear Vibrams 5 finger shoes. I was having trouble even walking with tennis shoes on, but I can run with no hurting feet or leg pain with the Vibrams on.

[D Patterson]

08:43 AM on 04/26/2011

pls also consider there are also studies showing that use of barefoot training strategies have been shown to reduce plantar surface areas - over a short term the only way this would be possible would a strengthening of the supportive musculature and/or the actualization of a less pronated foot position

It does make sense that putting anything into a restrictive environment would lead to atrophy, or for any organism that is insulated from minute strain and stress would atrophy. Both soft tissue and bone require strain and stress to continue their development and strengthening.
A major issue that is not often looked at is the issue that most people spend 10+ hours a day in shoes. There are bio-feedback based insoles that can be used in those shoes to encourage a strengthening of the foot’s supporting muscles. One thing that minimal shoes still continue to do is provide sensory insulation, putting something in direct contact with the foot’s plantar surface can provide the sensory biofeedback stimuli to encourage muscle activation and development.
I would strongly agree with the proponents of barefoot, however as a realist we still need to wear shoes – so we should be looking at bio-feedback insole systems, there is one called Barefoot Science, that make the in-shoe environment healthier and less of an atrophying environment. I’m not 100% sure that making the purist barefoot commitment is realistic for all people, and for those who can't they can still benefit from stronger feet.

[Goliadkin]

03:15 AM on 04/26/2011

Question remains: Is it safe? Should I try it?

[Erica Gott]

09:19 AM on 04/26/2011

Only you can answer those questions for yourself. I say, yes, it's safe, and yes, you should try it. However, I don't know you and where you live and what you're going to walk on or what you're going to experience.

I'm going barefoot as much as possible, but not everywhere yet, because my feet are just still too tender for all surfaces. I'm with others who don't want to be held back because I'm going too slow, feeling out surfaces. I'm also in France, not my native U.S., and have been told the stores won't allow bare feet (I do intend to challenge it, with my flip flops handy just in case). At the moment, I'm barefooted all over the homestead where I'm visiting. I wear shoes to take the dogs for a walk up the lane because of sharp gravel (and cow patties!). Once I'm back, off the shoes come.

My suggestion is to go barefoot in and around your home first. Wear flip flops or sandals as much as possible otherwise. Stay out of constrictive shoes and let your muscles develop. You will probably get sore feet and calves (I did), but every day you'll be stronger, and your soles will be tougher. Only go as far as you feel comfortable going, but stretch yourself and your comfort level a little farther each day or week. Once you've been barefoot a lot for a month, then make a decision on whether it's for you.

[Maitreya Maziarz]

01:31 PM on 04/27/2011

Erica's advice is sound. I'd like to add that there are a growing number of resources out there for those interested in barefooting. Ken Bob Saxton's web sites are a good place to start:
http://therunningbarefoot.com/how-to-run
He also runs a Yahoo newsgroup where you can get interactive guidance from experienced barefooters:
http://sports.groups.yahoo.com/group/RunningBarefoot/
I have found these resources invaluable in my own transition to running strictly barefoot. I've been hiking barefoot for years, but a particularly painful bout of Morton's Neuroma (self-diagnosed) led me to barefoot running. That said, the transition wasn't completely painless for me. When running shod, I had a tendency to take very long strides, which is not advisable when barefooting. I got some pretty bad blisters. Now, though, I'm able to run 3 miles regularly and up to 13 miles barefoot with no discomfort. Good luck!!

[Jane Eccles Payne]

03:07 AM on 04/26/2011

running bare foot is beneficial and natural but not with the pavements mankind has created. i think thats why we need shoes but with a more natural environment i would imagine walking or running barefoot would be very good

[mactarkus]

04:43 PM on 04/26/2011

I've found it is exactly opposite. The smooth hard surfaces mankind has created are best for running barefoot. They are very predictable. Natural surfaces tend to be uneven and can be littered with lots of natural debris like sharp rocks and sticks. Also, natural surfaces can give like sand or dirt and while soft they cause you to work harder and don't enforce proper form. The notion that you can't run barefoot on hard surfaces is a common misconception. Running properly, your body becomes a natural spring and you begin to glide across the surface whatever it may be. The impact lessens. I run comfortably on concrete or asphalt for miles on end.

[Jane Eccles Payne]

08:14 PM on 04/26/2011

hmm..thanks for clearing that up 4 me. my post wasn't based on personal knowledge actually but on something I either watched on tv or read online. not sure wut they based info on but said the hard concrete wasn't good & we weren't meant 2b separated from natural earth. would it be possible they mean something more tribal where it wouldn't be loose dirt but the grounds the ppl would have walked also would have been packed down. I imagine they would have paths created but from natural ground. here we have mostly paved walkways so it may be different in our modern world so I wonder if thats why it feels better on pavement? just a thought. do appreciate your insight and experience on the matter though. this is how we learn

[TeeLolly]

01:16 AM on 04/26/2011

I've run barefoot since I was a little kid growing up in NC where shoes were optional at home and in the neighborhood. I never thought of "barefoot running" as anything other than a way to get from point A to point B more quickly than walking--evan after moving north. The barefoot part has always been a matter of comfort (plus your feet don't smell if they're not bound up in layers of  socks and shoes that cut off fresh air).
 
What's the big deal?