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Rami Hashish, DPT

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Barefoot Running: The Science Behind the Fad

Posted: 08/14/2012 4:16 pm

Have you seen those weird and stunningly trendy glove-like shoes that have five toe compartments? Or people running on the side of the road in a shoe that seemingly has less support than a sandal? Or, better yet, people running without wearing any shoes at all? Well, as you are surely aware, we have dialed back the clocks and are now entrenched in the barefoot running era.

Current evidence suggests that relative to traditional shoe running, conditioned barefoot runners -- such as those in Kenya -- demonstrate a tendency to run with a forefoot strike pattern (i.e., landing on the balls of the feet). This allows for a slow lowering of the body through eccentric (lengthening muscle contraction) activity of the calf muscles. In contrast, habitual shoe runners strike the ground with the heel, and then use the foot as a rocker for the body to fall forward.

2012-08-14-barefootrunning.png
Reconstruction of foot contact patterns and lower extremity kinematics during typical heel-strike (left) and forefoot strike (right) running. The red arrow represents the vertical ground reaction force.


Relative to a heel-strike, the forefoot strike of barefoot running is associated with a reduction in the rate at which the body collides with ground, and, presumably, the muscle and ligamentous demand to the knee, both of which are associated with risk of knee injury. According to our preliminary findings at the University of Southern California, however, the catch-22 is that in barefoot running there is a shift in demand from the knee to the ankle and its supporting structures. Unsurprisingly, recent anecdotal and clinical reports have linked this running style with an increased potential for plantar fasciitis, tibial stress fractures, and calf pain.

Similar to their conditioned barefoot running counterparts, when habitual shoe runners run barefoot, or in barefoot shoes, there is an immediate change from a heel-strike to a forefoot strike. This inherent change occurs in order to prevent collision between the heel and the ground. However, per our initial reports, unlike habitual barefoot runners, the calf of a novice barefooter is typically not conditioned to maintain this increase in demand, leading to calf muscle fatigue. As a result, there is a reversion to the traditional heel-strike pattern following a short bout of barefoot running, but now without the shock-absorbing layer of a shoe. Consequently, the rate of collision with the ground can rise upwards of 150-percent higher than initial barefoot running, likely increasing the knee-injury risk. It appears that the only way to prevent this is to train the foot and calf to this new running pattern, highlighting the importance of a long-term transition to barefoot running prior to ditching your shoes.

The purpose of a transition to barefoot running would be to develop the motor pattern, as well as muscular strength and endurance to optimize barefoot running performance, while dually minimizing injury risk. Thus emphasis would be placed upon eccentric training of the calf in order to develop the ability to consistently land on the balls of the feet. In contrast to a concentric exercise (muscle shortening), eccentric exercise aims to strengthen the muscle when it's being lengthened. During eccentric activity, the load being resisted exceeds that of the muscle force output; thus the muscle is effectively absorbing energy. This is akin to what occurs when you forefoot strike and rely on the calf -- in its now-lengthened position -- to slowly lower the body and prevent collision with the ground. As a result of the altered loading mechanism, eccentric exercise is associated not only with strength gains but increases in the size of fast-twitch muscle fibers.

Running magazines would lead you to believe that barefoot running reduces injury risk and potentially maximizes performance. However, it appears that, as this is a new trend, there is simply insufficient prospective data to say otherwise. But, as in all changes in life, there may be a few trade-offs. From an injury perspective, does the forefoot strike and reduction in loading rate now synonymous with (conditioned) barefoot running counteract the increase in demand to the calf, Achilles, and ankle-joint complex? Will this increase in energy absorption induce muscle tears or tendonitis? And does the reduction in knee-joint loading warrant a lengthy and strict adherence to a barefoot running transition protocol? As all good scientists say when posed with difficult questions and trying to buy more time to answer them: It depends. But only time will tell.

 

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HUFFPOST SUPER USER
2Paco
Vegan and loving it!
01:54 PM on 08/19/2012
Well after reading all the posts below I have come to the conclusion that you are all a bit confused about how research is conducted. First this is not a made up image. This is taken from an actual person running. Additionally I am not sure any of you know about running gait. Yes the hip goes into flexion in this phase of swing. If any of you are truly interested there is published research on running gait. Great job Rami and good luck on your Phd. Surprising how argumentative people are. I guess the word "fad" got them upset.
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Stephanie Eaton Agosta
are you talkin' to me?
02:25 PM on 08/18/2012
The article is disappointing. The heel does come down in barefoot running or minimalist running. Check the feet of a barefoot runner, the heel will be callused.

The difference is that with traditional built up heel running shoes, it is difficult to get the forefoot to land simultaneously with the heel or forefoot first then heel touchdown because having an elevated heel on the shoe prevents this - so what you have is a heel strike first followed by a breaking motion.

Barefoot running articles and books have failed to really point out the fact that even if your forefoot is landing first, the heel does touch down (I hope) and you will not see an Olympic 10,000 meter or marathoner running without any heel touchdown. I hope no one is running on the forefoot only for more than 200 meters.

We need a better description of he barefoot minimalist runner - this article is not accurate.
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2Paco
Vegan and loving it!
05:59 PM on 08/18/2012
Sorry Stephanie he is right. Take your shoes off and go outside and try it out. It is quite amazing.

I am a runner and also a physical therapist. I kept seeing this one man out early in the morning running barefoot on the roads. So I thought I needed to try that out. The most amazing thing was how I shifted completely onto the front of my foot. The other thing I noticed was how lighter I was with each step.

Also most runners aren't landing with a heelstrike. Or at least the good ones. They are landing midfoot and the wearing down of the shoes that you are seeing is from a shear force as the foot lands further forward.

You would be surprised how little published research we have on actual runners running. Recently (last 2 years?) I read a published study written by a researcher who placed a video camera along a marathon and once analyzed found the majority were actually landing midfoot.

Take those shoes off and give it a try. Also if you are a runner see what happens when you throw out that heal strike running style. You might even be faster!
06:47 PM on 08/26/2012
According to counts at races about 80% of runners land with a heel-strike. I'm pretty certain that is a majority. Of course these aren't "good" runners...

And my interest is NOT helping good runners become better runners (any more than I feel it important to help the extremely wealthy become even more disgustingly wealthy). After all, they're doing fine already.

I am more interested is in helping those who don't run well or who can't seem to run gracefully, or enjoyably in shoes, and especially those who quit running because they found it hurt too much.

To that end, I will continue spreading the word that the most beneficial aspect of barefoot running is NOT that it builds foot strength (that's merely a nice side effect).

The most important aspect of barefoot running is the ability to TEACH us to avoid injurious stresses (long before we get injured) - all of those stresses pass through our sensitive soles (our quality control inspectors, or first-alert warning systems) letting us know, immediately, emphatically, with each and every step, when we're subjecting our foot, and the rest of our body, to excess stress. And you thought soles were sensitive just so your sibling could torture you by tickling your feet!

Research is great, and eventually, maybe some will show us scientifically what our ancestors knew long before shoes began disabling modern human feet.
04:46 AM on 08/17/2012
I can sort of get behind the basic message of the article which boils down to: Avoid "Too Much Too Soon" (TMTS - an acronym that developed staight out of the BF community) and "we are all an experiment of one" (ie doctors generally have no idea, but they have to publish things anyway). The author is clearly not a barefoot runner or even a runner who has put some time and effort into trying barefoot running. There are forums out there where those curious about this "fad" can get good, solid info and advice from highly experienced runners who have been at it for many years. The Barefoot Runners Society and the Barefoot Running forum at Runner's World Online are good places to start. There are also good books available now - Amazon's got them, and be sure to read the reviews.

One tip for anyone wanting to try it out: The riskiest thing to do is simply replacing your running shoes with VFFs or other super-minimal footwear, without cutting your mileage. That'll put you in the highest risk group (and if you get hurt, don't blame the "fad"). You should alternate *barefoot* (not *minimal*) sessions with your usual runs in your usual shoes for quite a while. A really great method is simply taking your shoes off toward the end of a run, maybe the last few hundred meters, and running home barefoot. Don't be afraid of hard surfaces, either. They're actually safer than people generally think.
01:45 AM on 08/17/2012
Thankfully, those aren't just edited pictures. That's actual barefoot runners on the right striking a $10,000+ force plate which measures GRF, with photosensors at each of the joints. The skeleton you're seeing is a computer generated image based on said photosensors. This equipment, and the image you see, are using the latest in biomechanics data collection, researched at one of the most prestigious universities in the field, with some of the most accomplished and published professors regarding this topic in the world. As mentioned in the article, this is using preliminary data collection and is demonstrating trends found so far. Awheewall, mate556, where does YOUR evidence come from to refute this? Are you just arguing because you read, "Born to Run" and maybe another Barnes and Noble bestseller and think you're the expert?
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Stephanie Eaton Agosta
are you talkin' to me?
02:29 PM on 08/18/2012
Then you found a runner who is running incorrectly, because with barefoot running theory and practice, the foot never lands in front of the hips - that would be an injury waiting to happen barefoot or shod. It is incorrect running form.
08:22 PM on 08/26/2012
Where does MY evidence come from? You want me to demonstrate that there is NO evidence to prove padded running shoes prevent injuries? The burden of proof would be with me if I was trying to argue that there WAS some evidence. I pointed out that the author's comment was misleading, which it is. I never argued with any findings, I merely pointed out that the whole article was lazy recycled rubbish, typical of someone who've never tried this style of running for themselves.
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11:27 PM on 08/16/2012
I had trouble with running in sneakers for years. It wasn't enjoyable, but I did it believing it was an important aspect to being healthyl. After a few bouts with shin splints and hip pain, I was never sorry putting it on hold for a while. Decided to give barefoot/Vibrams a try in the last month or so, and it's been incredibly fun. No sign of the old injuries yet, and it's generally just been more enjoyable to run without sneakers.

The warnings are true though: Ease in. Seriously. Switch between normal shoes and barefoot/minimalist at first. Walk barefoot or in minimalists for a week, preferably on grass. Then, start walking with a couple of minutes of jogging. Jog ten minutes the next week, twenty after that. Focus on the forefoot strike, legs under hips, back straight, heels almost to your butt. Don't be afraid to take a week off if your calves or ankles hurt. Walk barefoot at home and wear minimalists out as often as possible (not every workplace or social event is accepting, but do what you can) and practice the forefoot strike consciously when walking or running. You'll be using dormant muscles, so they'll take time, but the advantages can be marvelous.

Most importantly, if you like shod-running, and you don't have injuries, keep it up! Don't fix what ain't broken. The minimalist style's working for me and a number of others right now, but if it isn't for you, enjoy!
06:22 PM on 08/16/2012
If you've ever been running on the beach just think how nice that is. Barefoot running should be like that. I would still wear shoes while running on pavement, much harder than soil. You can get a cheap pair of wrestling shoes instead of buying finger shoes.
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Lonnie Taylor
01:11 PM on 08/16/2012
I wore Vibram Five Fingers casually for a few weeks and spent a lot of time in agony. I have very flat feet. After a few hours I would feel shooting pains through my muscles. It's definitely a workout to wear these shoes, especially for someone that is used to a lot of cushion and underfoot support. I suspect that if wore them for just a few hours a day over time my foot would be more toned, but lacking patience I just decided to stop wearing them and opted for a more comfortable shoe.
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Stephanie Eaton Agosta
are you talkin' to me?
02:20 PM on 08/18/2012
The best transition would have been a couple of hours a day in them for the first 2 weeks, then gradually increase.
06:59 PM on 08/26/2012
The most unfortunate part of this is that almost every one of the poor soles I hear from, who said that "barefoot didn't work for them", or "injured them" thought they would get the same benefit as being barefoot (running or walking) by using "barefoot shoes". After all that is what the "helpful" sales person told them before they laid out the $$$ for "Barefoot shoes"...

Try going literally barefoot occasionally on a variety of terrains, of course be careful - being careful IS the reason gong barefoot works. Going literally barefoot allows us to benefit from the good senses we are blessed with, to provide immediate and emphatic feedback, with each and every step, from our sensitive bare soles, teaching us to move more gracefully and safely.
03:35 PM on 08/31/2012
Thanks for your great contributions, Ken. Talk about patience, Lonnie, you are correct.

I have walked well over 100 miles BAREFOOT this summer on all surfaces in preparation for running. Three weeks into the walks, I tried to run a 1/2 mile and bruised my heel. Don't do it. Walk at least 50 miles with the fore/midfoot first.

I have managed to walk a strong arch into my feet where none was before. Old ankle pains from chronic sprains? Gone. I can now run a few miles, soft and silent, but my calfs and/or form still need some more work. I'm starting to see major results. Heck, I ran 2 miles this week on rough woods trails and crushed acorn topped asphalt!

I have yet to buy a minimal shoe except the Invisible Huarche, which I have not worn. Doesn't feel right now that I'm getting better with bare feet. I'll also say that I have never been a regular runner, I'm more of a general recreational athlete/hiker.
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Lisa Arends
Author, wellness coach, and teacher
05:31 AM on 08/16/2012
I started using Vibrams almost two years ago. After a loooong, slow transition, I now use them for my shorter runs (
12:00 AM on 08/16/2012
I switched to barefoot or minimalist running two years ago. Following duel surgeries on my feet. I couldn't be happier. My feet calves and legs are stronger and I have had less injuries. Now I have had injuries but in general they didn't occur whilst running. What I did was take one of these nice couch to 5k apps, despite easily being able to do a 5k and followed the very deliberate instructions on the app despite the boredom and the tedium I continued.

The majority of injuries are due to jumping into it too fast. Heck even if you take a couple weeks off you need to slow back into it. And also realize that you are fighting your natural tendency of a lifetime of heel striking.

You need to be methodical about it. I know people that switched to minimalist shoes that simply can't transition to a forefoot strike. They stubbornly continue despite warnings from others and injured themselves.

Oh and your picture is ridiculous. You don't run on your toes and certainly not that far out in front from under your body. I hope this article doesn't get submitted in regards to your PhD
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Stephanie Eaton Agosta
are you talkin' to me?
02:27 PM on 08/18/2012
amen
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04:08 PM on 08/15/2012
"From an injury perspective, does the forefoot strike and reduction in loading rate now synonymous with (conditioned) barefoot running counteract the increase in demand to the calf, Achilles, and ankle-joint complex? Will this increase in energy absorption induce muscle tears or tendonitis? And does the reduction in knee-joint loading warrant a lengthy and strict adherence to a barefoot running transition protocol?"

Translation: Ease into it. If it hurts, ease off. If you like it, keep doing it!
03:34 PM on 08/15/2012
Thsi might be a little off topic, but...
What were people thinking when they chased streakers in the 70's?
If they had caught them, what next?
Did the streakers experience calf fatigue in greater numbers than their pursuers with shoes?
Science is cool!
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HUFFPOST SUPER USER
AlwaysCanadian
Lifelong Pacifist
09:56 AM on 08/16/2012
"If they had caught them, what next?"

Brilliant! Never thought of that.....
12:48 PM on 08/20/2012
As a past streaker who was never caught, I was lucky. A number of my friends (all of us wore ski masks and sneakers) were caught, however. Teachers had gone into the woods around the school and taken our clothes - forcing them to identify who they were in order to get their clothes back. As a plan B, I had stashed a second set away from the group's and made it back to class with no repurcussions.
02:27 PM on 08/15/2012
Whoever created your foot strike graphic knows nothing about barefoot running vs shod running. You have lazily taken the graphic on the right and changed the foot angle to an unnatural angle to try and make a point you don't understand. With barefoot running the foot lands under the body's centre of gravity and never forward of the knee or hip. It would be impossible to run in the manner to which your graphic demonstrates.

Your article also makes the lazy point that there is no evidence that barefoot running causes less injuries. Whilst true, this is misleading as there is also no evidence to show that shod running helps prevent injuries - none! Isn't that a bit odd considering all the money that has been pumped into the technology contained within those shoes that there is no evidence to say that they do anything for us?

Please research your articles in the future. This is just recycled misleading rubbish.
07:08 PM on 08/26/2012
The graphic shows accurately the position of a typical heel-striker who just took off their shoes and their first instinct is to avoid heel contact by tensing the calves.

Experienced barefoot runners, instead of pointing the toes toward the ground by tensing the calves, simply bend the knee a bit more before landing. High-speed video analysis of experienced barefoot runners shows that as the fore-foot lands (gently, not striking), the heel is barely (a millimeter or two) off the ground, and soon touches to save the calves from excess strain.

The foot will land slightly in front of the body, but, because the knee is bending at this point, and the body is moving forward, the foot lands at the same speed as the ground beneath it, and is soon under and behind the body.

This experience comes from playing (experimenting) while actually barefoot (not in "Barefoot Shoes") on a variety of terrains. Pretty much the same conditions under which the best runners in the world grow up.
01:24 PM on 08/15/2012
While the rest of the world awaits sufficient prospective data, I will continue to enjoy my stronger knees, calves, ankles and feet, the long-sought-after absence of plantar fasciitis & shin splints, and increased proprioperception. I didn't spend 2.5 million years evolving just so I could cram my feet into casts every day, turning them into deadened stumps. See you off the trail!
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aliceandthecat
the most curious thing I ever saw
02:54 AM on 08/15/2012
I have always wondered whether shoes, and specifically coverings for the bottom of the feet don't constitute one of mankind's oldest technologies. Old, like fire, and spear tips. Protecting the bottom of our feet lessens injuries to the one area of our bodies that remained in contact with the ground one we evolved an upright posture. Altering our traction and our sensory input would have had as profound an impact on our evolution as hand axes, and cooking. We can toughen our feet to a certain extent, but a shoe clad individual can accomplish things no barefoot primate can.

As we evolved our tools became more complex and then influenced our evolution. H. Sapiens sapiens, may have evolved to be a shoe, and clothing, wearer. If this argument is the case, running barefoot would unnatural for us, under many of the most common terrestrial conditions. We may have evolved in shoes.
11:25 AM on 08/15/2012
Considering that approximately 40% of the world population still goes barefoot everyday (healthfully), the idea that humans have evolved to wearing shoes is certainly preposterous. Evolution acts much slower and more subtle than our minds can comprehend.
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aliceandthecat
the most curious thing I ever saw
01:56 AM on 08/16/2012
Healthy is debatable, there are any number of parasites that occur more frequently among unshod populations. Worms, fungi, and ticks. Necator americanus and Ancylostoma duodenale both enter the human populations through the skin, principally the feet, and can penetrate intact epidermis.

The people in this world who most frequently go barefoot don't have the money to buy on a regular basis. Bare feet in America are possible due to our proclivity to sanitize our environment and eliminate parasites, not to mention our resolution to practice allopathy so frequently.
01:47 PM on 08/16/2012
I'd say geographic location certainly influences proclivity toward coevolution with the "shoe".
12:58 PM on 08/15/2012
Supposing that humans have evolved adaptations to footware, modern running shoes would still be a radically different approach. High levels of padding (and the materials science required to produce them) didn't become prevalent until the mid-20th century. A thin strip of leather or other material might of allowed primitive man to cross jagged rocks more easily, but it wouldn't have made landing on the heel while running comfortable.

As a completely anecdotal report: I always hated running as an activity unto itself and especially loathed distance running. However, I enjoyed activities that involved running (e.g. soccer) and would often run around the house or sprint short distances to get somewhere faster. After finishing college, I read enough about 'barefoot' running to psych myself up, got a pair of Vibrams, and gave it a whirl. I eased into it by wearing them around on the weekends, then every day, then finally going on short runs.

Regardless of any structural benefits or risks, running 'barefoot' reminded me of how it felt to play as a kid. I ended up not hating it. I still don't run much or very far, but a couple of nagging issues I'd had with running were resolved by structure-less footwear (most importantly, my left toe stopped going numb mid-run).
07:15 PM on 08/26/2012
Oh yes, and we do have some adaptations to wearing footwear, even a year of habitual shoe-wearing will increase the sensitivity in our soles, as well as how hard we "hit" the ground. I suspect this is because our feet really do want to feel the surface as we walk and run.