Shoes Versus Skins
Monday February 15, 2010
Print This- Select Text Size:
advertisement
To the average person, the idea of running long distances barefoot may seem detrimental to good foot health. And yet, a growing body of research, including a recently released study by Harvard scientists, suggests otherwise.
The bottom line is quite clear, say advocates: Running in shoes can cause more problems than it prevents.
Barefoot running is not new — man ran barefoot for millions of years until the invention of protective footwear, observes Irene Davis, PT, PhD, FACSM, a professor in the Department of Physical Therapy at the University of Delaware and director of the school’s running research laboratory.
A growing number of recreational and competitive runners are reviving the concept of barefoot running, encouraged by advocates such as Ken Bob Saxton and Chris McDougall, and supported by major shoe manufacturers such as Nike, which sells a minimalist shoe called the Nike Free that is designed to mimic barefoot running.
The theory behind barefoot running is that it allows the foot to function more naturally, notes Davis, who runs 20 miles a week barefoot. “The sole of the foot provides important sensory input that is used to determine how to adjust the leg stiffness according to the surfaces it meets,” she says.
“If you provide additional cushioning in a shoe, it has been shown that the leg will actually stiffen. If you provide arch support and rear foot control, the demand on the muscles of the arch and ankle will decrease and they will weaken. It has been shown in two studies that when individuals go barefoot or run with minimalist footwear, their muscles get stronger.”
Shoes also influence how a foot lands when running, notes Lisa Ann McCall, PT, BS, a physical therapist in private practice in Dallas and the author of “The McCall Body Balance Method.” “When you put something underneath your foot, it’s like running in a box and it causes you to land with a heel strike, which is anatomically incorrect,” she explains. “The human body is designed to land more midfoot. That’s just the human design.”
Damien Howell, PT, MS, OCS, a physical therapist with Physiotherapy Associates in Richmond, Va., often uses barefoot running as an intervention for patients experiencing foot and leg problems such as shin splints. “I tell them, ‘Don’t strike the ground heel first,’ and within one session they can run without shin pain,” he says. “But then they struggle with the new form, so while they’re on the treadmill I will have them run barefoot, which helps them to make that correction and run without a heel strike.”
Though an advocate of barefoot running, Howell says that it’s not for everyone. The ideal candidate, he says, is a young runner with no history of injury. Older runners, especially if they have a history of foot or leg problems, should consult their physicians before attempting barefoot running.
“There are distinct advantages to barefoot running, and there is good equipment out there,” Howell says. “The challenge is figuring out how to [transition] someone from a traditional shoe into [a minimalist shoe]. It involves coaching and figuring out how to progress so that you get appropriate strength without getting an overuse injury.”
Physical therapists can help runners segue from shoes to barefoot running by emphasizing the need to proceed slowly and cautiously. As with any new exercise or movement, the connective tissue and muscles must be given sufficient time to adapt.
“When people become excited about barefoot running, they think, ‘I’m just going to run barefoot,’” McCall says. “But their feet are weak. The skin on the bottoms of their feet is tender and hasn’t had a chance to thicken, so they set themselves up for stress fractures and other injuries.”
Before tossing away their shoes, runners should honestly assess their level of achievement, McCall says. Runners with a lot of “mileage” can probably start running barefoot a little more quickly than those who are not quite as conditioned.
“The most critical thing is to listen to your body,” McCall says. “If you begin to feel even the slightest pain in your foot, then you must stop. This can be a challenge for many runners because they are oriented toward time, distance and speed.”
McCall also encourages novice barefoot runners to walk around barefoot for a while before they actually start running. This improves foot-eye coordination and thickens the skin on the bottoms of the feet.
“I can’t see any runner not benefitting from barefoot running to some degree,” McCall says. “The key factor is dosage. We should dose barefooting to the right degree for each individual based on their level and whether they have an injury. Most importantly, they should take their time.” •
Don Vaughan is a contributing writer for Today in PT.
To comment, e-mail pteditor@gannetthg.com.
