IN THE REHAB ZONE

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Barefoot Running Part II: Proper Guidelines

In part two of this two part article I will detail some recommended guidelines for implementing a safe progression from running in sneakers to minimalist shoe or barefoot running. Keep in mind, there are different foot types, some of which may be better suited for barefoot running.

At Capitol Rehab of Arlington, we utilize the Functional Movement Screen™ that was developed by Physical Therapist Gray Cook.

• Cook states with looking into barefoot running it is important to clear up the Big 3 movements: Deep squat, In line lunge, and Hurdle step. These three movements look at mobility, stability and balance of the foot and ankle, knee, hip, lumbar spine and pelvis in relation to each other during the movement.

• We then must evaluate single leg balance. We can also evaluate the effect of an orthotic or running shoe on balance. If balance is better with an orthotic or sneaker, then we may need to use a corrective orthotic or specific sneaker type(neutral, motion control, or stability) for a few months to re-pattern the arch of the foot.

• After a few months in the orthotic, we have re-patterned the arch, but you do not possess the motor control to own that new arch, the orthotic does.

• Now we can progress to one day a week training in a minimalist shoe like the Vibram Fiver Finger, Vibrum Komodo Sport or New Balance Minimus Zero.

• Jumping rope will foster correct posture and gluteal activation and hip extension, as opposed to running on treadmill which is hip flexion dominant.

• Calf muscles and outer hip muscles (abductors) will hurt due to intrinsic activation from jumping rope and wearing a minimalist shoe. After one month, you can progress to twice a week barefoot training. That may consist of wearing the minimalist shooes during a strength training workout in the gym, or a 20 minute tempo run on soft surface.

Bottom line is barefoot running does result in a shorter stride and cause runners to land on the mid foot/ball of foot which is preferred to heel striking for more efficient running. The problem with making the change from running shoes to minimalist shoes like the Vibram or even barefoot entirely, is that most runners will need to progressively transition to less shoe over time and maybe eventually barefoot. There are many runners who have foot types that are too rigid and high arched, or even too flexible to be able to safely barefoot run. That being said, these individuals can benefit from wearing these shoes to walk around while strength training at the gym, or walking around in general. Overtime they may be able to build up to jogging.

The bottom line is recreational use of a minimalist shoe while walking or jogging does stimulate the digital flexors of the toes and can strengthen the arch of the foot and increase arch height.

Having your foot type and biomechanics evaluated by a sports medicine professional is recommended before attempting to go barefoot.

Here are some basic guidelines if you are interested in barefoot running or just want to get into wearing a minimalist shoe during exercise or walking:

• Start with walking 1-2 times per week for 30 minutes and then gradually progress to running(see the protocol above).
• Start with short tempo runs (15-20 minutes). Do not go out and run a 5K the first time you wear a minimalist shoe or go barefoot.
• Stop barefoot running or training at the first site of pain, and consult your physician.

Some Key Points Concerning the Minimalist Shoe or Barefoot Runner

• Foot biomechanics can vary among individuals causing a need for different shoes for different foot types. Runners need one of three basic shoe types-neutral, stability, or motion control.
• The human foot can be best described as a mobile adaptor. The foot is rigid at heel strike, then becomes flexible through midstance, and becomes rigid again at toe off. Running mechanics whereby the runner lands midfoot can slightly change biomechanics of pronation, supination, inversion and eversion, but the foot still must be a “mobile adaptor”, adapting to ground reaction forces.
• Our feet are designed to traverse the natural varying terrain of the earth, which places three dimensional forces into the foot, and subsequently into the body. The foot is designed to continually adapt to the ground surface.
• The earth gives natural shock absorption in a natural setting.
• Manmade surfaces like roads and sidewalks, boardwalks etc. are relatively flat and two dimensional. Thus the combination of two dimensional road surface and the enclosing shoe somewhat limits the mobility of the foot.
• Any covering on the foot will alter the foots natural biomechanics. Shoes like the MTB rocker restrict the biomechanics to a relatively sagittal plane (front to back) and eliminate a lot of the three dimensional forces the foot is designed to utilize.
• Much research has been done in the field of foot biomechanics and shoe design over the past decade.
• Newton’s Action/Reaction technology helps assist runners to utilize a mid foot or forefoot strike and the lugs on the sole of the shoe help to store potential energy at foot strike. These lugs spring back assisting in lift off during toe off.
• Most runners would be better suited to use the minimalist shoe on a limited or part time basis as part
of their training regimen.
• Despite many advances in sports medicine and performance, like corrective exercise, kinesiotape and
orthotics, runners and walkers continue to sustain injuries at an escalating rate.
• Injuries such as plantar fasciitis, runners knee, shin splints, stress fractures, neuromas etc. are often due to faulty biomechanics, overtraining/ overuse, and improper footwear.
• A strong core with good hip strength and mobility, along with proper foot biomechanics are essential to injury free optimal sports performance.
• Stretching is vital to maintain good flexibility of soft tissues to allow for proper joint motion, and
better contraction capability for force production.
• Yoga, frequent foam roller use, stretching, soft tissue release such as Active Release Techniques and chiropractic manipulation are essential elements to
staying healthy.

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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