Are Those Barefoot Running Shoes Just a Gimic?
Joanmarie Pellegrini, MD
Tuesday, October 25, 2011
You have probably seen these new shoes around town. They are the ones that are very thin and have toes. Why are people wearing them? If you stop and ask them, they will tell you that it is a more natural way to walk or run. The belief is that we were born as humans to run and we started out in pre-historic times without any shoes. So, let’s look at that statement.
For several decades the running shoe companies have been making a fortune by successfully convincing us that their shoe will help us run better, faster, and with less injury. But, they do not provide us with the randomized studies or data. Every year about 40-60% of runners are sidelined with an injury. This number has remained constant over the decades despite the “improving” technology in running shoes. Do we conclude that the newer and better shoes are not better? Perhaps that is not the correct conclusion. It might be good news that our injury rate has remained the same despite the fact that runners are now older, fatter, and more out of shape (suggesting our injury rate should be increasing). There are other studies that show that runners who buy more expensive shoes are more likely to be injured (even when corrected for mileage and amount of training). This may be for several reasons. It may be that the runner who is more prone to injury is willing to spend more on the “miracle” running shoe. It may be that runners believe the marketing statements and therefore run less cautiously (because their “miracle” show will protect them). Or, it could be that the shoe is actually inherently bad. Since there is little data, we will not really know.
So, if the fancy shoes haven’t decreased our injury rates, then what about running barefoot or in one of those “minimalist” shoes? This is such a new trend that there are not much data. Orthopedic and podiatric surgeons are convinced that as this trend increases, they will begin to see new injury patterns. Runners who run in highly cushioned shoes tend to have knee, thigh, and hip injuries (the highly cushioned shoes protect their feet and ankles). Running in minimalist shoes will increase foot and ankle injuries (but may lessen knee/thigh/hip injuries). We have been wearing shoes our entire lives and so our feet are not in shape for barefootedness. And, let’s face it, who wants to run barefoot in Maine most of the year?
I’ve been a runner for several decades and I have a lot of running colleagues. I think there are several reasons runners are injured so often. These least of these reasons is the shoes. That said though, most people do not bother to have their gait evaluated and they buy shoes based on the looks or the price and not on how well they fit the type of runner. Most runners forget to cross-train and so they suffer injury from repetitive stress. When we run, we affect our entire body and if part of our body (think spine and pelvis and hips) is out of alignment or tight, that will affect our gait. Very few runners pay any attention this. Also, many people run on the roads (hard surface and slanted) or on treadmills (also hard surface but with an unnatural gait). We forget that what we eat may affect our bones, joints, and ligaments. Also, obesity puts more stress on our joints. Diabetes affects our sensation in our soles and this can also affect our gait.
What do the experts say about the new trend? Certainly, they do not recommend that you run out and buy the new trendy minimalist shoes and start running in them. They do recommend that we consider incorporating barefoot running into our training. Because we have “wimpy” feet we should start slowly. This will allow the muscles in the feet to get stronger. Also, barefoot running has different ergonomics and will boost our “push off” power. Because the gait is altered, it may help to reduce the repetitive stress on our joints. It will also help to increase your time barefoot at home. You probably should not do all your walking or running in minimalist shoes.
Dr. Pellegrini’s recommendations for lessening your injury rate: cross train, incorporate yoga at least once a week into your program, find a reputable massage therapist for deep tissue massage for those problem areas, get a professional gait analysis by a shoe technician next time you are in a “running store”, eat a healthy diet, change up your running routine and running surface. I have not personally tried the “barefoot” shoes but I think it might be worth a try if introduced slowly. I recommend each runner do their own research. If you are already nursing an injury, then you really need to talk to your therapist or doctor about your exercise program.