Barefoot Running Debate

Just a word of caution for those of you who are being asked about "barefoot running" by the media. I have been interviewed about barefoot running many times now and some writers/reporters seem to think that running in Vibram FiveFingers or other minimalist shoes should be included under the category of "barefoot running".

As an example, while we were at the iFAB meeting in Seattle last month, Craig Payne, Bruce Williams and I were being interviewed on barefoot running. The reporter's first question was what we thought of "barefoot running shoes". I spoke up saying that "barefoot running shoes" did not exist any more than "naked clothes" existed! Barefoot means "no shoes, no socks", not thin-soled shoes with five separate toe pockets! I said that I have no problem with the term "minimalist shoes", but that the term "barefoot running shoes" is simply wrong and misleading since any shoe will greatly alter the mechanical interaction between the foot and ground, no matter how thin the sole is.

As another example, in an interview I did with a large east coast newspaper a few weeks ago on the subject of Vibram FiveFinger shoe and metatarsal stress fractures, I said that there were very few people actually running barefoot , when compared to those that run in shoes. The reporter disagreed with me saying that that many people are buying Vibram FiveFinger shoes so that meant there were quite a few people "running barefoot". I corrected him saying that running barefoot means "no shoes, no socks". not running in thin soled shoes.

The reason I bring these points up is that I believe that those of us who are being asked about these points about the difference between running barefoot versus running in minimalist shoes versus running in more standardly designed running shoes should make sure that the person interviewing you understands that when you say "barefoot running", this means "no shoes, no socks", and does not mean wearing thin soled running shoes. I don't want to see someone make statements that are misinterpreted by the reporter and then put into an article on barefoot running that not only confuses the public but also misstates the true opinions of the podiatrist being interviewed.:drinks

 

Kevin ... someone posted something earlier in this thread, or I read it elsewhere ... on the Runners World forum, there is a barefoot subforum and apparently there is a large amount of discussion on the forum about minimalist/barefoot running shoes. If I recall what I read correctly, there is a lot of angst on that forum from the 'purist' barefooters that they even discussing these shoes in the 'barefoot' forum.

 

Craig:

When I did the Barefoot Running Debate with Ken Bob Saxton for Runner's World back in January 2010, he made the comment during the phone debate (which wasn't printed in the RW debate) that he thought it was better to run barefoot than run with minimalist shoes such as the Vibram FiveFingers. He thought that any shoe will reduce the ability of the feet to sense impact forces appropriately and, for that reason, he thought that barefoot running was probably safer than running in minimalist shoes.

Of course, Ken Bob also grew up barefoot and was able to transition into barefoot running fairly rapidly, probably because his feet were already preconditioned to the barefoot state. Ken Bob seems to be one of the barefoot advocates who are most reasonable in their assessment of barefoot running, and seems to be interested in barefoot running for its perceived health benefits, and not be into barefoot running just to make a buck. Because of this, I respect his opinion, but would have to disagree with him as to whether barefoot running (i.e. no shoes, no socks) is the best way for the the habitually shod population of modern society to be doing all of their training and racing mileage.

In fact, many of the true barefoot runners, such as Ken Bob Saxton, don't like the minimalist shoe movement since they think that this is not truly barefoot running and think that these types of shoes will cause more injuries than simply running barefoot. I would have to agree with Ken Bob on this one. However, I would add that the types of injuries and anatomical components of the foot and lower extremity that will be most frequently injured with barefoot running vs minimalist shoe vs traditional shoe running will likely be quite specific for each shoe/unshod condition chosen by the runner due to the unique loading forces that each shoe/unshod condition places on their feet and/or lower extremities.

 

Excuse my delay in replying to this, I've been overseas teaching. That's the key isn't it, the surface stiffness? How similar to concrete do we need to be? How stiff is the surface when running over a force plate or on "hard surfaces" as was reported here: http://tsaklis.com.p6.hostingprod.com/yahoo_site_admin/assets/docs/ARICLE-NATURE2.13221323.pdf
?
Which led to the conclusion:
"Here we show that habitually barefoot endurance runners
often land on the fore-foot (fore-foot strike) before bringing down
the heel, but they sometimes land with a flat foot (mid-foot strike)
or, less often, on the heel (rear-foot strike)." Which isn't quite the same as your contention that "ALL" will forefoot strike when running "on concrete or similar". May I ask what data you can put forward to support your conjecture? I'm assuming you have measured "ALL", to make such an all inclusive statement?

When I get chance later this week, I'll upload some stills for running on concrete which show that you are wrong with your "ALL" inclusive conjecture.

Hint: when writing up your PhD, I'd avoid the term "all".

P.S. I'm inclined to agree with Dana regarding the gravitas of your "paper".

All aboard the bandwagon...

 

Hi Simon
I do not disagree with what you say Simon and I look forward to your videos. This article was written whilst lying on a sun lounger in Crete whilst watching my little play in the pool with an inflatable whale. It was written from my experience and passion for running, but mainly for a Tri magazine, when I get round to condensing it down to about 500 words. It was meant for consumers and not written as a scientific article. To be honest I'm really pleased that some good people have read and commented on it.

 

Simon, I've been thinking (dangerous concept) about another variable that effects leg stiffness and how it comes in to play with respect to the relationship between surface stiffness and leg stiffness. On natural surfaces, specifically mountain trails, there can be considerable variation in surface stiffness but as a whole, more compliant than what you might find with respect to asphalt or concrete. Not only is asphalt or concrete more consistent with respect to stiffness/compliance but it is also more consistent with respect to its relief. In other words, it tends to be completely smooth.

On natural surfaces, not only is there variation between stiffness/compliance but the surface is never really that smooth. The example I'm thinking about which minimal shoes or no shoes work really poorly on is a surface covered with unavoidable rocks that are 1/2 inch in diameter. I don't care if the person is a fore foot, mid foot or rear foot striker, running over these things with minimal or no shoes are not fun.

While the surface may be quite compliant calling for increased leg stiffness, if your feet are not protected from marble sized rocks, regardless of the stiffness/compliance dimension of the surface, your legs will become extremely compliant in order to protect your feet from inevitable pain. Forcing you to look like you are tip toeing through the tulips.

Of course, there is an answer for everything. Many trail running shoes are made with a pliable plastic "rock plate" that runs the length of the shoe often located between the mid sole and outer sole of the shoe. The rock plate enables a more direct relationship between surface and leg stiffness.

My point is that while surface stiffness might be the key, add in some small rocks and the whole equation is quickly changed.

Dana

 

Or a thumb tack, this is the spike orthotic effect that we have discussed previously, i.e. withdrawing from a painful stimulus. The point being variation in the pain threshold; is this the same between individuals? No. Hence some people will continue to heel strike barefoot on concrete, while others might not. Lets take the extreme example of a subject with sensory neuropathy who heel strikes while running in shoes on concrete- would this subject continue to heel strike while running barefoot on concrete? If sensory input is key, then the answer is probably yes?

Yet I suspect that as the body senses a painful stimulus, it will try to reduce the rate of acceleration toward the stimulus by firing muscles, which will ultimately result in modulation of leg stiffness.

 

For those interested, the 'Born to Run Fan site' has been conceived: http://www.borntorun.org/

 

Would be great to have a quick summation of this debate/conversation. There is well over 880 posts here. In my dreams hey?

 

Thats easy.

In general, the barefoot running community misrepresent, misuse, misinterpret, misquote (and some even lie) about the research. When they post here talking about the science, we ask them to show us the science, they never come back to post on it.

 

My summation would be:-

- some small studies suggest that barefoot running may be beneficial in some circumstances but more research is needed
- people regularly manipulate studies to produce the "evidence" they desired to get from said study (not just in this case either) especially the media
- increasing research is suggesting that the current method of prescribing running shoes may be flawed, but again more research is needed
- no definitive studies have shown that shod or unshod running is better or worse for reducing injury rates (I'm not including the use of orthotics here as I don't know enough about them)
- anecdotal evidence suggests that it's possible to wear shoes and still be barefoot providing you wear the right shoe
- Traditional running in shoes contributes to traditional running injuries
- barefoot running has a new set of injuries to contribute to
- neither will prevent injury in any case as most injuries are due to training patterns and overuse

any good?

 

Yes very good summation, however I would like to see the evidence that traditional running shoes contribute to running injuries. Generally good well fitted running shoes reduce the risk, however some poorly chosen running shoes can contribute to running injuries.

 

Funny thing B Nigg concluded that shock absorption in shoes made no difference and the control aspect had some, but very little effect. So how can we say that well fitted running shoes reduce the risk of injury - stick injury yes, but we don´t know all the facts yet. Take the understanding of leg stiffness as an example

and then this is this.

 

I like mine better:

1. Running research shows that runners take shorter strides and tend to strike more toward the forefoot while barefoot than when running in traditional running shoes.

2. There is no evidence that barefoot running produces a lower rate of injury than running in shoes.

3. Nearly 100% of all elite runners race in shoes, not barefoot. Less than 0.01% of the running population runs more than half of their running mileage while barefoot.

4. The true barefoot running community, those that run without shoes, thinks that running in minimalist shoes, such as the Vibram FiveFinger shoe, is more likely to cause injury than running barefoot.

5. Running injuries are caused by the increased magnitudes of loading forces and increased magnitudes of loading rates on the structural components of the foot and lower extremity that are mechanically inherent to the activity of running. Because of this fact, running injuries will tend to occur at a higher frequency than walking injuries regardless of what shoe is worn or whether the runner is barefoot while running.

6. Barefoot running and Vibram FiveFingers shoes are simply another passing fad that will eventually die away within the next five years, only to be replaced by another fad.

 

You misunderstand what I was saying, my point was that running has a set of injuries associated with it that are well documented, not that running shoes cause the injuries but merely the act of running itself. Traditionally most runners are shod which is why I mentioned shoes. I was merely trying to show that neither running in shoes or running without shoes will prevent injury but each has different injuries associated with it (although obviously there is a large overlap).

As far as I know there isn't any definitive evidence that running shoes, well fitted or otherwise, actually reduce injury. There's plenty of anecdotal evidence (which incidently there is for barefoot running too) but anecdotal evidence isn't really relevant. That seems to be the big problem with this subject, the research just doesn't exist and there's that much misinformation floating about that it becomes very hard to take a subjective view. I don't honestly see that there will be a definitive answer on this subject ever to be honest. I think there's too many variables that could influence a study and conducting a study large enough to be meaningful will be very difficult.

 

I agree with all you say obviously it makes sense. I just want to make this point: that at some point anecdotal evidence can be more valuable than a university research project with audited and assessed research data collected in a controlled setting: in some cases! I am now taking my research very seriously to satisfy the criteria to obtain a PhD, however I feel that my 35 years as a runner (Sub-4 minute miler 1985), my 22 years in MSK and thousands of assessments give me greater judgment in a clinical setting than any research paper ever has. Your thoughts?

 

I appreciate what you're saying, but remember anecdotal evidence can be wildly inaccurate. Often a person will form an opinion about something and it clouds their judgement. For example if I said to you that I bought a motion control shoe and that wrecked my knees and stopped me running, you could easily say that motion control shoes are bad as a result of this information. However it might be that I also increased my mileage at that point, or my quality work, or even that I started doing more off road/road sessions then I used to so the picture is not complete. Often you see in the barefoot running world people that suffered with PF and it's got better since running barefoot and therefore shoes are evil. When in actual fact that person may have been wearing the wrong type of shoe and doing too much mileage, so cutting the mileage significantly and gently easing into barefoot running has given the PF a rest and allowed it to heal. Maybe if they'd got a better shoe and trained accordingly the result would've been the same. Who's to know.

It's not that anecdotal evidence is useless but it's often influenced by a persons opinion rather than actual fact and that makes it hard to evaluate it. I agree that in a clinical setting anecdotal evidence is valuable because you are one to one with a person and if you change something small and have them report back it gives a reasonably accurate picture of the result of that change (assuming they tell you the truth) but getting that approach to work on a large scale and trying to control so many variables is extremely difficult.

 

There is something that strange to me:

In November Issue of Runners World Irene Davies is quoted (or missquoted?? - anyone of you have good contact with her?). This is what "she says":

What you'll likely notice is that with barefoot running, you tend to land on the whole foot instead of the heel (the more likely scenario when running on the road in a traditional running shoe). And without that well-cushioned shoe inducing you to extend your stride, you'll take shorter, more frequent steps and land much more softly. And you're less likely to develop tibial stress fractures, plantar fasciitis, and other injuries common to runners. Or so says Irene Davis.

Isn't it obvious that there is much more preassure on plantar fasciitis when landing on forefoot ?

 

Fredzio,

My advice is to never believe a single word Runners World print. I fell out with the one of the writers for the UK version several months ago when I wrote something for her and she completely changed it, yet structured it very cleverly to appear as if they were my words. When I confronted her about it over email we had 3-4 exchanges (with the Editor cc'd into all of them) and she didn't even apologise - just weasled out of it. The Editor didn't even respond to me. Journalists = scum.

That said, it was merely my experience with Runners World. I refuse to read it now. Not sure the exact story regarding the above quote with Irene though.

 

Quote: It's not that anecdotal evidence is useless but it's often influenced by a persons opinion rather than actual fact and that makes it hard to evaluate it. I agree that in a clinical setting anecdotal evidence is valuable because you are one to one with a person and if you change something small and have them report back it gives a reasonably accurate picture of the result of that change (assuming they tell you the truth) but getting that approach to work on a large scale and trying to control so many variables is extremely difficult.

Again I agree with you, however the anecdotes of an experienced practitioner passing on clinical skills can have very useful outcomes. Often much more useful than any research paper. I have never picked up a clinical skill from a research paper, but I have from many years at the coalface.

 

Agreed, they are still offering advice that has been since proven inaccurate as well as lots of other gibberish to appeal to new runners from the "fast fix" brigade along the lines of "lose 10 lbs in 10 days" or "perfect abs in 2 weeks" for example. It's now more of a lifestyle magazine then a running magazine imho

Fair point Clifton, I hadn't thought about it in that way. Obviously experience does count in a clinical setting. Just out of curiosity, have you treated many barefoot runners in the past? what problems have you come across as a result, and has there been any positive aspects to barefootedness (not really a word but I liked the sound of it )

 

I was brought barefoot in Australia until I came to the UK with my family at seven. I started running on kings beach Caloundra, Queensland and discovered I could run. I then made the England and GB senior team as a teenager and broke the British record for the indoor mile in 1985. Apologies for the 'brag' but this is on my website and so I get a few barefoot/Newton converts with issues, that come to me. In the very informal non-scientific article I wrote above it tells you how barefoot running suits a very small group of people, and I see this regularly in the very focal injuries that I see now in the sagittal plane. I had a female international middle distance runner come to me a few weeks ago, with a LLI (long right). She had previous used my orthotics with no problems for many years. She went to a Tri shop and they sold her a pair of Newton's and said "you are a forefoot runner, you do not need orthotics" (she has a 3mm platform on the forefoot of her left orthotic so that she had some forefoot raise as well as the rearfoot. The rearfoot heel raise on a forefoot runner is so that the heel has something to drop to, without eccentrically loading the calf. She took their advice and within three runs snapped her left 2nd met. With a short left leg she would experience a more rapid heel lift on the left to lift the pelvis on the short side (Common cause of plantar fasciitis actually) loading the forefoot. She is now back in orthotics and will never change again without talking through with the experts. Forcing yourself to run barefoot or in supposedly forefoot running shoes will increase the eccentric load forces on the gastrosoleal complex increasing the risk of very focal injuries in the sagittal plane. It might negate some lower back pain with LLI, but the risk of Achilles tendinosis etc massively increases.

 

Barefoot running for conditioned barefoot runners from child hood is normal and has less problems, however from my own personal experience and from what I have seen in older forefoot runners, it does eventually over stretch the connective tissue (sarcomeres) in the Achilles. Once this happens you have to do regular eccentric load exercises for the calves and run in wedged orthotics. I still run forefoot, I can' change it. Its a pain! I have an 11mm heel raise on my right orthotic and 13mm on my left (longer right leg). My walking orthotics have less depth but more raise (5mm) on the left because at 4km/hr I heel strike. Running, I forefoot run as said, negating the need for the 5mm raise.

 

When I went to school, sarcomeres were within muscles not tendons such as the Achilles, as you state above. http://en.wikipedia.org/wiki/Sarcomere Honestly Clifton, the more you write, the less I believe you understand.

 

Thank you Simon, I stand corrected.

 

Attention barefoot runners! The University of Delaware Running Laboratory would like to invite you to take part in a web based running survey in order to better understand the habits of the barefoot runner. Your participation will involve 15 minutes of your time each month to fill out an online survey. You will fill out one survey a month for a year, upon which your name will be entered into a raffle to win a GPS! To qualify for this opportunity you must be relatively healthy, between the ages of 18 and 50 and run more than 10 miles/week. You also must have been running barefoot for more than 6 months, and at least 50% of your mileage must be done completely barefoot. Please contact Allison Altman at 302-831-4646, or coordinator.runsurvey@gmail.com for more information.

 

2a. There is no evidence that running in shoes produces a lower rate of injury than running barefoot.

3a. While it is not common for elite runners to race barefoot, it is a common practice for elite runners to complete a portion of their training running barefoot.

4a. The "True Barefoot" community is easily identified by the placement of "Barefoot" preceeding their first name. (eg. Barefoot Kevin) The "True Barefoot" community has no clue about likelyhood of injuries caused by wearing VFF or minimalist shoes.

6a. Vibram FiveFingers have been on the market since 2006 or roughly 5 yrs so far. Another 5 yrs will put them on the market for a total of 10 yrs. If you consider the modern running shoe market starting in the early 1970's, it is less than 40 yrs old. 10 yrs represents 25% of the entire life of the modern running shoe market. This assumes that VFF will be gone in 5 yrs. Given that the demand for these shoes is still growing exponentially after a 5 yr life, it's a stretch to predict they will be gone in 5 yrs. It could be speculated that it will take Vibram that long just to catch up with the demand. The future will tell us if VFF are a fad or a trend in the running shoe industry.

Dana

 

This has been an a fairly passionate debate here guys. Both sides are certainly lining up here.
I tend to think that in a few years time this will be seen as a fad. Unfortunately it's a fad which may lead to short and long term injuries.
I do , however, get a couple of questions a week from patients about this new thing called barefoot running. Maybe when i get sick of talking abut it I'll direct them to this thread.

 

Let's see if we can get this baby to a thousand. It will be like getting 10 wickets in a match

 

There are the two sides and then there are people like me who do not belong to either side but feel the more vocal people on both sides are full of Bovine Excrement. Both sides don't have much to stand on other than their own unsupported opinions filled with emotional hot air. I don't see many of the self proclaimed "medical professionals" who contribute to this forum any more credible than the barefoot advocate when it comes to this debate. Both spew out loads of unsubstantiated crap about what they think or guess is best.

Dana, Senior Non Medical Professional and non barefoot runner (SNMPNBR)

 

Here is a recently published article from Lower Extremity Review on barefoot running where Craig and I were both qouted: The Truth About Barefoot Running: It's Complicated.

I wonder why they didn't interview Dana???

 

Dana, well put mate.
There is a lot of passion from everyone. I grew up in the country and it's been awhile since I've been exposed to bovine excrement. You do have a point about the fact that little has been proven here. I do find that with podiatry bbecause of the sparcity of research we tend tojoin the dots a bit to make a qualified assumption. Anecdotal experience can give you a good feel for something. Surely based on your experience you must have some opinion with regard to this.
I reckon you're partly right about the hot air.

 

Thanks Kevin, I'm interested in this statement from the article:
"Scientists in France reported in 2005 that barefoot runners had lower contact and flight time, lower passive impact peak, higher braking and pushing impulses, and higher preactivation of the triceps surae.11 The same researchers reported in 2008 that stride frequency, anterior-posterior impulse, vertical stiffness, leg stiffness, and mechanical work were significantly higher in barefoot running.12"

Does anyone have the full papers:
11. Divert C, Mornieux G, Baur H, et al. Mechanical comparison of barefoot and shod running. Int J Sports Med 2005;26(7):593-598.

12. Divert C, Mornieux G, Freychat P, et al. Barefoot-shod running differences: shoe or mass effect? Int J Sports Med 2008;29(6):512-518.

 

Yep. Check your email.

 

Ian:

Could you send those papers my way also....promise I'll invite you to my birthday party.

 

In your inbox Kevin. I'll wait for my invite

 

From todays paper: http://www.telegraph.co.uk/health/wellbeing/8146500/Fitness-Workshop-Barefoot-Running.html

Barefoot running still going strong in the UK media...

By the way - £120 an hour to tell people to keep their feet under their CoM? Not bad work if you can get it...

 

Kevin, thanks for sharing the link to the article. I found it well balanced, unemotional and objective in it's approach to covering several good aspects of the discussion. It would be great if the discussion on the Podiatry Arena followed it's example.

They would have no need to interview me. Even though I've figured out a formula that has kept me injury free in spite of running high mileage and competing for the past 38 years, anything I would have to say would only involve common sense, experience, intuition and insight. Unfortunately it is anecdotal and a formula only proven to work for me.

The panacea to running success is having fun and good health, figure that out and you have cracked the code.

Dana, who continues to learn for the purpose of refining his formula for the benefit of his own happiness and good health.

 

This is a little bit off topic as it's not related specifically to barefoot running, but the local tv station ran a story last week about a guy who is living a completely barefoot lifestyle. In the winter here it can get as low as -40, not including the windchill, which adds a whole new set of concerns.