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Monday’s medical myth: run barefoot to prevent injuries

The human species is one of the most efficient terrestrial animals. We adapted to run on dry riverbeds and grasslands, but development of modern society has strained the evolutionary process. Footwear…

If you don’t change the way you run, ditching your sneakers is a recipe for injury. Steven at

The human species is one of the most efficient terrestrial animals. We adapted to run on dry riverbeds and grasslands, but development of modern society has strained the evolutionary process.

Footwear was initially introduced to protect the soles of the feet or provide traction or warmth. But as society has changed, footwear’s role has adapted to provide cushioning for the hard cobblestones or pavement, broad protection for industrial tasks, and more recently, as a fashion accessory and performance optimiser.

A return to barefoot running has emerged as a subculture in recreational running, its devotees pointing to reduced injury rates and a more “natural” running experience.

Perhaps the biggest impetus for the trend was Christopher McDougall’s 2010 best-selling book, Born to Run. While based on the story of Mexico’s Tarahumara Indians who run ultra-endurance distances barefoot or in tyre-tread sandals, McDougall also concludes that running shoes have done little to prevent injuries over the past 40 years.

The popularity of minimal shoes, such as the Nike Free and Vibram FiveFingers, has further fuelled the debate about whether we should ditch our old-school sneakers.

Apart from the aficionados writing in the popular literature, a key proponent of barefoot running is Harvard University evolutionary biologist Dr Daniel Leiberman. He argues that habitually barefoot runners land more on the mid-foot or forefoot, which reduces the transient shock on contact.

Want to run barefoot? Start out slowly on a safe surface such as grass or sand. Flickr/666isMONEY ☮♥&☠

Runners who wear shoes, on the other hand, land more on the heel and rely on the design of the shoe to absorb shock and control the foot during running.

But Leiberman suggests the issue is less about barefoot running being better than shod running and more about how we run.

Running barefoot encourages the runner to cushion the impact of landing by adjusting their running style to land with their toes down. The shock of landing is transmitted largely to the muscles at the back of the leg. As a result, barefoot and minimally shod running appears to reduce the risk of injury because they generate much lower collision forces.

But don’t throw your running shoes away just yet. Barefoot runners must learn to change the way they run: landing more on the mid-foot or forefoot, rather than on the heel. Then the elastic structures within the foot will do the job they were designed to do. And the Achilles tendon and calf muscles will contract eccentrically to cushion this extra load.

For those new to barefoot running, the unaccustomed strain on muscles and tendons can actually lead to injury – exactly what the change to barefoot running was supposed to prevent.

The solution? Start out slowly on a safe surface (grass or sand) to toughen the sole of the foot and allow the soft tissue of the foot and ankle to adapt to the new loading strategy. Alternating running barefoot one day and shod the next will also decrease the risk of injury.

We all have different abilities to learn and to adapt to new skills: some will make the adjustment and thrive as barefoot runners; others will struggle to make the change, particularly if they have irreversible structural problems with their tendons and muscles, caused by decades of wearing sneakers.

Unfortunately, ditching your sneakers isn’t the silver bullet to preventing running injuries.

Join the conversation

15 Comments sorted by

  1. jamie jardine

    Acupuncturist

    I changed my running style a year ago to avoid doing damage to my knees caused by running on your heels. Running on the front of my feet certainly reduced the impact on my knees, but after a few months of running this way both my achilles tendons become inflammed making running this way very painful. So I can attest to what is written here, running barefoot style is a great wat to run, but I think a fair deal of conditioning is required first to avoid injury.

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    1. Oliver Johnson

      Web Designer at Uncomfortablefoot

      In reply to jamie jardine

      I have a few colleagues who run barefoot every night and just by looking at them, I can already imagine how great the impact could be to their soles, as compared to having cushion to absorb it instead. However, they personally feel that running barefoot is more comfortable in constrast with wearing the wrong shoes. I have advised them to go seek professional help for the correct pair of shoes for their feet type not only to avoid injury from impact of running but also to avoid any sharp objects like glass fragments or stones. But some of them are still relentless to stay within their comfort zone.

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  2. Brian Stout

    Associate Professor of Social Work

    I've read 'Born to Run' and as a keen club runner one of the interesting aspects of the barefoot debate for me is how few club-standard runners have decided to 'ditch the sneakers'. At the Sydney Harbour 10k yesterday morning the MC noted that one of the lead runners was wearing fivefingers shoes; it is the rarity of the shoes in a race like this that makes them worth noting. Amongst the runners I know there is a general suspicion that barefoot running is just another marketing-led fad. We'll only be persuaded to go barefoot when we see the elite athletes doing so and then improving their times.

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    1. Jon Wilde

      logged in via Facebook

      In reply to Brian Stout

      I am unclear how taking off my shoes and not buying any gear can be a marketing led phase? From an anatomical standpoint it makes far more sense to me, to run this way. Sure it takes a while, our muscles have deteriorated through poor use, but when running correctly can maintain a good structure and stay in the aerobic zone, so in theory, could run far longer..
      I have zero pain now I train this way, going back just feel jarring.
      Take off those shoes and (start off slow but..) try it, only then can you know :)

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    2. Jon Wilde

      logged in via Facebook

      In reply to Jon Wilde

      Also, the lady in the photo... doing it wrong...
      Start on a hard surface, very short distances and your body will soon let you know the right way

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    3. Brian Stout

      Associate Professor of Social Work

      In reply to Jon Wilde

      The marketing element comes from all the shoe companies selling 'barefoot technology' shoes, the last thing that they want is for runners to actually run barefoot!

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    4. Jon Wilde

      logged in via Facebook

      In reply to Brian Stout

      Yeah, that part is definitely true. To be honest I do own 'barefoot' shoes too and although they encourage me to run with a barefoot style, they do remove most of the feedback and all of the feeling of freedom.
      I'm sticking with the end goal of a bare-barefoot marathon :)

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    5. James Stoxen

      logged in via Facebook

      In reply to Brian Stout

      Brian is right. These companies sell you a lot of BS that you have to FIRST transition into minimalist shoes then barefoot. Completely unnecessary

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    6. James Stoxen

      logged in via Facebook

      In reply to Brian Stout

      Brian, the powers that be make that impossible in the US It is illegal (against the rules) for high school runners to train or compete barefoot or without shoes. The rules need to be changed to reflect the new research

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  3. John May

    Software Developer

    Slow transition is exactly what I did and is definitely necessary. It took a year and a half to transition from wearing motion control/cushioning shoes to barefoot/minimal style. Before the transition, I could never manage more than about 15 km per week without breaking down with calf or achilles tendon injuries. Now I do 15 km training runs and have managed 80 km a week running to and from work using minimal style running shoes. I started with running 500 m and steadily building up the distance.

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  4. Chris Aitchison

    logged in via Twitter

    If the title of this article was: 'Monday’s medical myth: you need an inch of rubber between your feet and the ground when running' then I would have liked it twice as much :)

    I've been running with Vibrams for a few years now, and in my case I no longer get the niggling injuries I used to. I also have friends who have tried them and hate them, so horses for courses I guess...

    It is a good point you make about not striking with your heel, but it is much easier to do than it sounds when it hurts like hell because you don't have padding to cushion it :) The body adapts naturally without much conscious thought in my experience, but of course everyones mileage may vary.

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  5. Luke Flood

    creative director

    Whilst only being a casual runner myself, I was under the impression that the speed you run at is a major factor in this debate. ie. at jogging pace, it's really hard not to land on your heels, whereas at elite running pace it's very hard to not land on your forefoot, in either case because of the dynamics of the gait required to run at that pace. The opinion I've had from a couple of professionals who work with elite athletes is that the forefoot/barefoot technique has a potential place in the training regime of top level athletes, but is of no benefit to the park jogger. That's just what I've been told though.

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  6. James Stoxen

    logged in via Facebook

    No matter how difficult it is or how long it takes you, my recommendation is for you to learn how to run without braces on your body. For me it represents taking the patient out of the cast or brace as soon as possible so that the positive adaptation can be maximized without abnormal movement patterns causing arthritic changes for the long term. Try to think about training your feet the same way as any other joint of the body without BRACES!

    Here is an article that discusses how I decided to be a lifetime barefoot runner and strive to help my patients run barefoot again like they did in their youth

    http://teamdoctorsblog.com/2012/02/21/why-barefoot-the-story-of-why-i-run-barefoot-and-recommend-barefoot-training-and-running-to-my-patients-by-dr-james-stoxen-dc/

    Dr James Stoxen DC
    Barefoot Running Doctor

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  7. Jason McDonald

    Entrepreneur

    All right, surely there is a part of myth in all the fuss about barefoot running. I mean it just popped up as a revolutionary thing right after McDougall's book born to run best seller.

    My guess is that it is certainly not adapted to every individuals. Yes. And in anyway there a technique to learn and it takes times.

    However what lack in this article is also the Pros in injury prevention. I mean yes, barefoot running does avoid shoes running related injuries.

    In the article below you can clearly realize that you avoid a bunch of classical shoes running injuries:

    http://www.calendarofmarathons.com/barefoot-running-injuries/

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