Day 66 - Bare Feet

66 down, 299 to go!

I promised in a prior post to review some of the literature on barefoot and minimalist running.

Barefooting is a hot topic in the running world right now. 

It wasn't long ago that Vibram's FiveFinger shoes began to gain a real foothold (see what I did there?) in the popular market. One consequence is that what used to be a relatively unknown niche in the North American running community has become accessible to neophytes and experts alike. Books like Born to Run by Christopher McDougall encourage recreational runners, either implicitly or explicitly, to doff their structured shoes in favour of FiveFingers, sandals, or even their bare soles, suggesting that the best runners run without shoes, accumulating better finishing times and fewer injuries than their more sturdily-shod peers.

Contrary to what many barefoot fanatics would have you believe, the evidence for these claims is pretty mixed.

Is barefoot always best?

This study found that running economy improved over time when shod runners transitioned to simulated barefoot running. Of course, the young men studied were given proper training in transitioning to minimalist running and were experienced runners prior to transitioning. There was no initial difference in running economy; differences developed over a 4-week habituation period. This study - though not particularly strong, as it relied on self-report - suggests that barefoot runners report fewer lower extremity injuries than their shod counterparts. The authors of this systematic review, however, found that impact attenuation (i.e., how hard (or not) you hit the ground with your feet) varied for bare feet vs. athletic shoes depending on a number of factors, including the type of shoe and the type of activity. They conclude with the supposition that different profiles of attenuation could be beneficial or harmful, depending on a wide array of activity- and form-related factors.

Some argue that foot-strike has more to do with staying injury-free than does your choice of footwear. 

Along with the surge in barefoot popularity has come the edict that "correct" form entails a forefoot or midfoot strike, and that this was probably the foot-strike that our ancestors used to run long distances and stay injury-free. This study of a traditionally barefoot population in Kenya found, to the contrary, that many of these runners adopted a heel-strike pattern when running at endurance speeds. This study of runners with self-selected foot-strike patterns showed greater shock attenuation and reported greater comforted with a rear-foot strike, which I'd argue is the most demonised striking pattern in the recreational running world at the moment.

The argument that many proponents of barefoot and minimalist shoes make is that these unstructured shoes make it nearly impossible for you to land with a potentially-damaging foot-strike. 

I'd argue that the pain that results from a poor foot-strike in an unstructured shoe might deter you from hitting the ground with a lot of damaging force, but that the shoe (or lack thereof) isn't likely to solve the entire problem if you're running with uncomfortable or damaging form.

Oh no! The dreaded heel-strike...you will become paralysed for life or excommunicated from the Church of Running.

My personal experience with shod, minimalist, and unshod running has been mixed. 

I started running in the heavily-structured Nike Moto8, and suffered some pretty annoying off-and-on knee pain, including a recurrent pes anserine bursitis that probably had its origins somewhere in a long career of eggbeater and whip kicks but seems to have been badly aggravated by running. I switched to FiveFingers and completely-unshod running (exactly what it sounds like...bare soles on the grass, dirt, or pavement), following a pretty conservative program that facilitated a slow transition from structured shoes. In noticed an immediate decrease in knee pain, but soon experienced gnawing shin splints that took weeks of rest to abate. 

Eventually, I abandoned both the naked soles of my feet and my FiveFingers, and began running full time in Nike Free Runs, which are among the less-structured shoes available at most big-box and running stores. I found a good middle ground with these shoes; I only get occasional twinges in my knees, and I don't get any shin pain. Indeed, this study supports my own belief that barefoot running and running in a minimalist shoe are not the same and do not produce the same mechanics; whether that is a good or a bad thing depends on your level of commitment to barefoot running, I suppose - for me, it seems to be a good thing.

I do notice that my arches get sore and feel worn out on mid- to long-distance runs. I have pretty (read: really) high arches and I'd suggest that the relative lack of support probably has a lot to do with that sensation. It's not unbearable, and has improved with time and training.

I also have changed and tweaked my running style. 

I have spent some time watching videos that describe so-called natural running, particularly this one, and find that they have been helpful in developing a foot strike and overall running style that feels comfortable instead of painful. I have also attended Good Form Running at Runner's Choice, and found the clinic helpful for fine-tuning aspects of my form; in particular, I learned that I needed to dorsiflex a bit more, which I think may have been at the root of my shin pain while wearing FiveFingers. Overall, I've been striving for a comfortable stride with a midfoot strike and relaxed upper body, and I think that this probably has a lot more to do with my relative lack of current injury than does wearing an unstructured shoe. I do agree that wearing a minimalist shoe has allowed me to feel my own form and the ground, and consequently better understand what my body is doing when running.

Fact: Bare foot running = dirty feet.

If you're interested in the topic of barefoot running, you might like to check out this episode of CBC's The Nature of Things, entitled The Perfect Runner, for an overview. Born to Run offers a heavily-romanticised depiction of the Tarahumara tribe and their running practices, but you won't find much in the way of unbiased evidence within its pages. As I've mentioned in a previous entry, there is a barefoot and minimalist subreddit that provide support and advice for new recreational runners and more experienced competitors alike.

Just be careful - people have jumped on the barefoot "cause" with gusto and will provide a lot of pseudo-scientific evidence to support their claims that barefoot is best. Many take exception to the notion that minimalist shoes like FiveFingers or Frees even approximate barefoot running, and feel that the only way to run "properly" is completely barefoot. If you choose to go this route, please keep safety in mind, start slowly, and choose your terrain wisely. Runners with reduced sensation in their lower limbs would be unwise to attempt barefoot running without a doctor's supervision.

Ultimately, I'm of the opinion that the only "proper" way to run is the way that feels good and keeps injuries to a minimum - and I believe that form is highly individualised and has to take into account body habitus, injury status, distance and speed run, and personal preference. Your best bet is to play around with form, attend a clinic or do, read up, and talk to other runners.

PS, did you notice that I didn't say anything about physical activity today? That's because I haven't done any yet, but I will!