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REHAB IN MOTION: Born to run barefoot?

I recently had a patient who is an avid runner ask me if he would be better off running barefoot.  He was intrigued by the premise of the best-selling book Born to Run: that barefoot running decreases injury risk.  My knee-jerk answer to this patient’s question was that barefoot running is a fad, and that he was better off in traditional, supportive running shoes.  A recent group of studies have forced me to revise my thinking on barefoot running.  When faced with the question, does barefoot running increase or decrease injury risk, the answer seems to be that it might do both!

A study published in Nature used a force platform to measure how the feet of Kenyan schoolchildren struck the ground. Those youngsters that ran in shoes landed on their heels, and generated a significant pounding. Those who ran barefoot landed closer to the front of their feet, generating less force at contact. Based on these findings, barefoot running seems to be the answer—less pounding should mean less wear and tear.

Not so fast—there are problems with this theory.  The vast majority of us learn to run in shoes. Shoes alter how we move. An article from The Journal of Foot and Ankle Research found that if you put young children in shoes their steps become longer and they land with more force on their heels. Just kicking off your shoes won’t make you run like a Kenyan.  Many newbie barefoot runners continue to stride as if they were in shoes—landing heavily on their heels. Most biomechanics experts agree that newbie barefoot runners do eventually adapt their stride, but that the pounding during this transition phase may actually increase risk of injury.

So, where does all this new science leave a runner who has been contemplating ditching their shoes? The evidence seems equivocal, but if you’re keen on giving it a try I advise you to start slowly. Try removing your shoes for the last two to five per cent of your normal run and ease into barefoot running by extending the barefoot portion by a few minutes every week.

Also, pay attention to your form. Don’t over stride when barefoot—your stride should be shorter than when shod.

You should also make a conscious effort to land lightly. Humans may have been built to run barefoot, but we did not evolve to run barefoot with bad form!

 

David Pechter is a physiotherapist at Rehab in Motion. For more information call Rehab in Motion clinics in Campbell River (250-923-3773), Courtenay (250-334-9670) and Port Alberni (250-723-9675) or visit www.rehabinmotion.com

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