The publication of the popular book “Born to Run” by Christopher McDougall, has led to massive interest in and experimentation with barefoot running. Shoe manufacturing companies have taken advantage of this new phenomenon by developing minimalist shoes which gives the user a close to barefoot experience. The central theme driving the adoption from shod foot to barefoot is the hypothesis that it improves running economy thereby saving energy and injury risk reduction. However there is little high quality evidence to support this hypothesis.
The proposed difference between barefoot and shod biomechanics is focused on the mid/forefoot strike (barefoot) versus the heel strike (shod). Barefoot running is thought to encourage a mid/forefoot strike and hence reduce injury, through incurring less ground reaction force. Ground reaction force (GRF) is the force that results when landing with foot contact, and can be up to 3 times our body weight. Davis (2012), contends that adopting a mid foot strike can reduce the GRF by 30%.
It is this concept that drives sales for minimalist shoes and increasing the number of people participating in barefoot running. However it has been suggested that an athlete can adopt a variety of landing patterns whether shod or barefoot. Further to this, Hatala et al (2013) have shown that heel striking is common among a habitually barefoot population (75%), but when running speed increased a greater number adopted a forefoot strike (60%). Significantly 40% of people still adopted a heel strike regardless of running speed. This would imply that barefoot running does not lead to a forefoot strike. This finding was also reaffirmed by Lieberman (2012).
It is my belief that it is the athletes’ running style that dictates if they forefoot strike or heel strike, in spite of what they are wearing on their feet. The belief that barefoot running reduces injury is simplistic in its thinking as running related lower limb injuries are multi-factorial, (Murphy et al, 2003).
Although with a small sample size, Cheung et al, (2011) demonstrated that re-educating from a rear foot strike to a non rear foot strike reduced ground reaction force, reduced symptoms and was maintained after three months. This finding should dispel any misunderstanding that running styles/landing patterns can’t be modified and should support further research into landing patterns and lower limb injuries. Running re-education focused on a forefoot/midfoot strike, higher cadence, shorter stride length, centre of mass over the stance leg, and the recruitment of larger global muscle, is more important than what is on your feet.
In conclusion, there is little evidence that barefoot running is better for you. This does not mean that it is not better for you but the reality is, without high quality RCT, we have no concrete evidence either for or against it. With this in mind, people wanting to try barefoot running should do so gradually, allowing their body to adapt to possibly a different way of running.
Bibliography
Altman A, Davis I. (2012). Barefoot Running: Biomechanics and Implications for Running Injuries. American College of Sports Medicine, 11, (5), 244-250.
Cheung R, Davis I. (2011). Landing Pattern Modification to Improve Patellofemoral Pain in Runners: A Case Series. Journal of Orthopaedic & Sports Physical Therapy, 41 (12), 914-919.
Hatala K, dingwall HL, Wunderlich RE. (2013). Variations in Foot Strike Patterns During Running Among Habitually Barefoot Populations. PL0S ONE, 8(1): e52548
Lieberman DE. (2012). What We Can Learn About Running from Barefoot Running: An Evolutionary Medical Perspective. Exercise and Sports Sciences Reviews, 40, (2), 63-72.
Lieberman DE. (2014). Strike Type Variations Among Tarahumara Indians in Minimal Sandals Versus Conventional Running Shoes. Journal of Sport and Health Science, 3, 86-94.
McDougall C. (2009). Born To Run: the hidden tribe, the ultra-runners and the greatest race the world has ever seen. 1st edn. New York: Random Houce Inc.
Murphy FD, Connelly DAJ, Beynnon BD. (2003). Risk Factors for Lower Extermity Injury: A Review of the Literature, British Journal of Sports Medicine, 37, 13-29.
Tam N, Astephen Wilson JL, Noakes TD, Tucker R. (2014). Barefoot Running: An Evaluation of Current Hypothesis, Future Research and Clinical Applications. British Journal of Sports Medicine, 48: 349-355.
