06/24/2013 11:49 am ET Updated Aug 23, 2013

Running: Barefooted (Part 3)

What About Injury?

Over the last 40 or 50 years, as recreational running has enjoyed immense popularity in America, foot and leg ailments have become increasingly prevalent. Despite the claimed advances in running shoe technology, rehabilitation techniques, and training methods, there is still no real consensus on the actual cause of these injuries, and thus there has been no real remedy offered in the mainstream.

There is, however, the business model that treating the symptom is preferable to finding a cure because the revenue stream stops right there, with the cure. But, who would really believe such tacit collusion could exist in the modern, civilized, medical/shoe-industry complex? It can't happen here, right?

In any event, between about 20 percent and 80 percent of long distance runners will become injured by their sport. This necessarily indicates that the running shoe, and any other external fix has proven to be -- based on evidence -- an overall, abject failure. Instead of solving problems, our trusted shoes could very well be causing problems.

The running shoe has been shown to materially alter sensory perception, making it more difficult to respond in correct context to variations in surface firmness. Moreover, cushioning makes it near impossible to sense the additional impact transient of a heel strike, which tends to accompany shod running, but is normally absent in barefoot running. You don't feel the shock, but it's still there! Compounding this, shoes, because they insulate and "support" the foot, necessarily weaken it in the same way that helping a chick peck its way out of its shell prevents initial, natural strengthening.

I know some might bristle at such a conclusion in large part because it's unlikely many of us know a world without shoes. Most of us were forced into shoes before we were walking! So, such knee-jerk defensiveness of convention can be expected. The tenacious grip of belief can be hard to shake even in the face of irrefutable fact.

I might point out that through all the research that has sought the cause or causes of injury, running technique has taken a back seat. That's because running, unlike other sports, is considered to be a natural activity. It's argued humans already know how to run, which is true -- up to a certain point.

As a species we're more similar than we are different. We're hard-wired for (endurance) running. As children, before we know anything, most of us experience our three-dimensional world viscerally. From this most primal level, we begin running with a technique as fluid and efficient as that of any wild beast. Prescriptions of society -- restrictive shoes, and fearful or irritated early parental admonitions, "Stop! Don't run into the street!" -- negatively affect gait, and create a cognitive dissonance that can be recognized in the body language of most runners. A heel strike, common to, I'd estimate, about three-quarters of the running population, is a startling example of the conscious mind saying, "Go!" and the subconscious mind saying, "No!" Every step slams on the brakes. This running style is a gestalt that reveals just how far we've veered from our natural alignment with those physical forces that originally modeled our form to suit our function. Understand that running speed is irrelevant in this equation, and that endemic injury is the smoking gun. That leads right to running technique, because it's only through egregious misuse that we could so consistently be injuring the most resilient structures of our bodies, our feet, and legs.

I address this in lectures and in other more running-specific writings, but let me just offer a quick aside. There could hardly be a greater voluntary insult to the body, to the lungs especially, than smoking cigarettes. Anyone who can recall their first smoke probably remembers the physical effect: quite a bit of coughing, burning, watery eyes, and probably dizziness and nausea, too. That smoking provokes physiological responses akin to poisoning, or allergic reactions, would clearly seem to demonstrate that inhaling cigarette smoke, which contains carbon monoxide, among other toxins, presents a clear and present danger to the physical health of the human organism.

Yet, Memorial Sloan-Kettering Cancer Center and the Fred Hutchinson Cancer Research Center determined that the likelihood of getting lung cancer from smoking, which is said to kill about 130,000 people each year, can be accurately predicted by age, sex, and smoking history. For instance...

A 68-year-old man who smoked two packs a day for the past 50 years and continued to smoke had a 15 percent (less than 1 out of 7) chance of developing the disease in [the next 10 years].

That 15 percent is at the high end of the scale. Compare that with the estimates that between 20 percent and 80 percent of all long distance runners will be injured by their sport -- running! -- which is as natural to human beings as breathing fresh air. The issue here is not the severity of the ailments, say, lung cancer vs. shin splints, but their respective prevalence. How could the odds possibly favor smoking 40 cigarettes a day (more than two per waking hour), every day, for half a century? Let me say again: Only through egregious misuse are we able to so consistently injure the most resilient structures of our bodies!

Because the running shoe materially alters natural gait and simultaneously robs us of the feedback necessary to correct and adjust our faulty stride, this protective, supportive device creates and becomes itself a threatening environment. Sadly, with cushioned shoes, we don't even get the initial red flag that a drag on a cigarette provides.

Check out Running: Barefooted (Part 4): What's the Fix -- "Then, after purchased pain killers, hi-tech shoes, and orthotics fail, we still seek other passive remedies..."

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