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Barefoot Running Part I: Back to Basics

Barefoot Running in the mountains

In part I of this two part article, I discuss some key points on the rage of the minimalist  shoe and barefoot running.

With all the hype of late on barefoot running due largely from the popularity of the book  “Born To Run” by Christopher McDougall, I thought it appropriate to weigh in on this  issue. The concept of barefoot running has been around for many years in many cultures  all over the world, as McDougall describes in his book. The key concepts to recognize for t  the modern day runner is that most of us have been raised to walk on man-made  surfaces(roads and sidewalks) that have been evenly paved and smoothed out. Adding to which, we have spent our entire lives in built up shoes with cushioned soles and even arch supports. Contrast this with tribes like the Tarahumara that McDougall highlights in his book, who have spent their entire lives walking and running barefoot on natural, uneven terrain, and do so injury free well into the later years of their lives. How can they do that? Why do we suffer so many running injuries despite expensive running shoes and years of engineering making these shoes better?

A lifetime of barefoot running and walking has led the Tarahumara people to develop a wider foot structure, with much stronger foot intrinsic muscles and much better balance and coordination of the foot, ankle and lower leg muscles. As such, we cannot expect someone who has spent their life walking and running on smooth surfaces and in shoes to just go cold turkey and hang up their running shoes.

The problem for modern day runners is that they do not possess enough strength, balance and coordination of the lower leg and foot intrinsic muscles that control the foot and ankle. From age 6-12 are the most critical developmental years for structure and development of the arch. Therefore minimalist activity may be best done at these times.

A lifetime of wearing shoes can result in dysafferentation (a fancy neurological term which simply means that nerve receptors in the joints, tendons, muscles etc. are not properly stimulated and do not send proper impulses to the brain). Dysafferentation can weaken reflex muscle activity, affect joint and muscle function, and result in pain. A lifetime of wearing shoes can also impair the proper balance and coordination required for us to adjust to the ground as the foot strikes the ground during running. Therefore, if barefoot running is a goal, you must approach it in a way that slowly trains these muscles to adapt gradually to be able to run barefoot.

Before we detail some guidelines for safe and proper usage of minimalist shoes, lets look at a few key points:

1. The theory behind the minimalist shoe is that by allowing the bottom of the foot to sense suface irregularities, cutaneous receptors in the sole of the foot will initiate a reflex that causes the flexors of the foot to engage, distributing pressure over a larger surface area. This is known as “positive support reaction”.
2. During the positive support reaction, a stimulus is applied via the ground to pressure receptors in the sole of the foot, the longitudinal arch, and the intrinsic foot muscles. This triggers the extensor thrust mechanism, and facilitates posture by engaging the lower extremity extensor muscles and spinal erector muscles. This reflex often becomes dysfunctional in cases of flat feet (pes planus) or high arched feet (pes cavus).
3. With regular use of minimalist shoes, such as the Vibram Fiver Finger, Vibrum Komodo Sport or New Balance Minimus Zero, the arch of the foot can strengthen. Minimalist shoes also lesson vertical forces traveling through the lower extremity because of the shift to a more forefoot or midfoot strike during gait. This allows the gastrocnemius/ soleus muscles to dampen ground impact forces.
4. Several studies have shown minimalist shoes/barefoot running can reduce retropatellar pressure by up to 50%. 1,2
5. The reduced impact of barefoot or minimalist shoe running can cause other compensatory issues such as increased ankle dorsiflexion and rearfoot eversion (turning outward) which can greatly increase tension in the Achilles tendon and the medial posterior compartment of the lower leg. This can lead to overuse injury.
6. If the flexor digitorum muscle (on the bottom of the foot) is not strong enough to decelerate digital dorsiflexion of the toes, too much tensile strain may be transferred to the plantar fascia resulting in plantar fasciitis.
7. Longterm use of minimalist running has been shown to deform the calcaneal heel pad, leaving the heel vulnerable to injury. Therfore, it is recommended minimialist shoes or barefoot running be done on grass, trails, or sand and avoid asphallt or concrete.
8. Remember, early hominids had different foot architecture than that of the average shod wearing human of today. The noteworthy differences are wider forefoot, and higher arch.
9. People with lower arches may be predisposed to abductor hallicus(plantar fasciitis) and posterior tibialis(shin splints) muscular injuries. This is because use of minimalist shoes and barefoot running place more stress on the medial musculature structures of the foot and lower extremity.

In Part II of this article will detail proper break in guidelines for minimalist shoes.

A special thanks to Dr. Thomas Michaud for all his efforts in his latest book, Human Locomotion. Dr, Michaud has provided a very comprehensive look in detail at not only foot and ankle biomechanics, but in overall movement and how the foot and ankle affects the entire kinematic chain. He has provided the practitioner of manual medicine invaluable information and into many troubling chronic and complex pathologies and offered us biomechanical explanations as to their etiology as well as conservative management treatment protocols.

References

1. Cavanagh PR. Ground reaction forces in distance running. J Biomech. 1980;13:397-406
2. McClay I. “Lower Extremity Kinematiic Comparisons between Forefoot and Rearfoot Strikers,” in Proceedings of the American Society of Biomechanics, p. 211, 213, Stanford, CA, 1995.
3. Michaud, T. Human Locomotion: The Conservative Management of Gait Related Disorders. 2011

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