Risks, rewards, and a really dumb, although poignant, analogy
Vibram, the company that makes the thin, Five Fingers minimalist running shoe, was recently sued for making deceptive claims about their minimalist running shoes. The basis of the lawsuit was that Vibram is inflating the benefits of barefoot and minimalist running with no scientific evidence to support the claim.
Sportsscientists.com recently published the most well balanced, insightful, common-sense blog on the topic of barefoot running that I’ve ever read. As the authors point out, the problem is not so much that barefoot running in and of itself is risky, (although as a foot and ankle specialist, I’ll still argue that), but that the “deceptive and misleading statements about the benefits of barefoot running”, the lack of proper training, and the corporate and media hype to sell minimalist running shoes is what is leading to the increase in barefoot running injuries.
The benefits touted by the barefoot running ‘experts’ include better shock absorption by running on the balls of your feet and strengthening the muscles in your feet and lower legs. I’ve even heard such unsubstantiated claims that by improving the muscle strength in your feet, you can create a better arch if you’re flat footed, eliminating such conditions as plantar fasciitis and making the need for foot appliances such as orthotics and arch supports obsolete. That’s simply untrue. Most flatfoot deformities are hereditary. We can accommodate for the overly flexible foot with custom orthotics, but we cannot fix the problem by running barefoot. That would be like doing exercises to eliminate your nearsightedness. You can’t do it. You’ll always need appliances to accommodate for your hereditary misfortune; glasses or contacts.
It’s not the few hardcore barefoot runners that are having the problems. They’ve been at it awhile and got there gradually. It’s the runners that jump on the bandwagon without being truly educated on the risks involved with progressing toward this new running technique. They may do so too quickly, leaving them vulnerable to a variety of overuse injuries such as stress fractures and tendonitis. They may run barefoot or in minimalist shoes such as Vibrams, but continue to run the way they always have, with full heel strike, increasing loading forces on the heel by up to seven times higher than in well-cushioned running shoes.
Aside from the risks, barefoot running can have rewards, if you take your time to get it right. Just like running a mile on your hands can improve muscle strength in your arms, shoulders, back, chest and abs. That doesn’t mean you should do it. Well, you can if you’re really, really want to, and in that case do your research, and make sure you learn the right technique, engage in appropriate training over time to gradually improve your strength and technique, thus reducing your risk of injury. So in the case of hand running, you wouldn’t think about “running” a mile on day one. You’d need to start slowly; first training your body to balance better with a few handstands. Maybe you’ll be able to do a few more each day, graduating to “walking” across the room, then a little further each day. It would certainly take some time to get your hands used to the rough sidewalks and streets that they’re not used to “running” on, but after a few weeks your calluses might offer you some protection. After weeks, maybe months of improving your muscle strength, you might be able to run a mile on your hands, reaping the benefits of your newfound technique.
Now, I know that sounds absurd. But so does barefoot running to a medical professional who spends the better part of his day treating tendonitis, stress fractures, and pulling stones, splinters and shards of glass out of people’s feet, amongst other types of foot and ankle injuries.
If you are really inclined to run barefoot, educate yourself regarding the risks vs. rewards. If you are going to run barefoot, then go about it in a very controlled, systematic way in order to minimize the risks of getting hurt. Get the right coaching, have the right mindset and a very cautious approach to this new technique; very slowly letting your body adapt to the different biomechanics involved in this new way of running.
I also suggest closely monitoring your feet and legs for any abnormal pain, tenderness, and/or swelling. Call your Kansas City podiatrist if the pain continues or worsens even after you’ve stopped running.
Mark A. Green, DPM