Barefoot running… is less really more?

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Durban - People have been running barefoot for centuries and as sculpted running shoes have flooded the sports shoe market, only a few die-hard runners have resisted the tide of advice to cushion their feet from the impact of foot on hard ground.

South Africa’s barefoot running sensation, Zola Budd, was noticeable at the 1984 Olympics, not just for her talent and the controversial collision with US athlete Mary Decker, but also because she was running without shoes.

Over the years, several athletes have shone without shoes, but overwhelmingly, runners have followed the advice of the experts that when running, feet need motion control, cushioning and support.

But voices questioning the value of hi-tech support, have got louder, fuelled by the popularity in 2009 of Christopher McDougall’s book, Born to Run, which promotes barefoot running.

In the US, The Barefoot Runners Society www.TheBarefootRunners.org), founded in November 2009, has 88 chapters and 4 500 members in various countries, including South Africa, which has a small membership.

Barefoot events, like the US Naked Foot Runs, have sprung up in many countries, with runners participating barefoot or in minimalist shoes (lightweight and with flexible soles).

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Adidas's Gazelle shoe helps in transition to minimalist shoes, say manufacturers.

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Advocates of barefoot running claim that modern running shoes cause injuries by preventing the natural movement of feet and legs and argue that running without shoes can actually help to strengthen feet, ankles and lower legs, while also improving balance.

Sceptics argue that many runners have high arches and other foot types that need the cushioned support of a standard running shoe.

The theory behind barefoot running is that the soft raised heel of running shoes encourages you to land on the rear part of your foot, which was not designed to take the kind of force running generates, leading to injuries. By ridding yourself of supports in your shoes, you are forced on to your mid- or forefoot and you begin to run as people have for thousands of years.

McDougall found that becoming a barefoot runner was the answer to his injuries.

“I’d spent years struggling with a variety of running-related injuries, each time trading up to more expensive shoes, which seemed to make no difference,” he wrote in an article in the Daily Mail. “I’d lost count of the amount of money I’d handed over at shops and sports-injury clinics – eventually ending with advice from my doctor to give it up and ‘buy a bike’.”

McDougall’s quest for answers, as documented in his book, took him to the Tarahumara tribe in Mexico, the “best long-distance runners in the world”, who do two-day ultra marathons with old tyres or leather thongs strapped to their feet – and who suffer virtually no injuries.

He points to the studies of Dr Daniel Lieberman, professor of biological anthropology at Harvard University, who has been studying the “growing injury crisis” in the developed world and who says: “A lot of foot and knee injuries currently plaguing us are caused by people running with shoes that actually make our feet weak, cause us to over-pronate (ankle rotation) and give us knee problems.

“Until 1972, when the modern athletic shoe was invented, people ran in very thin-soled shoes, had strong feet and had a much lower incidence of knee injuries.”

As more people questioned whether less support would be better, sports shoe manufacturers stepped up to the plate and the first minimalist running shoes entered the market. They are thought by many to be the next best thing to barefoot running.

Vibram Fivefingers is one such shoe.

“Running barefoot is different,” says Alex Hawkins, brand manager for the distributors for Vibram FiveFingers in southern Africa.

“It means landing on your forefoot as opposed to landing on your heel when running in conventional footwear. A good landing should feel gentle, relaxed and compliant. Minimalist footwear encourages a more healthy and more natural forefoot strike which provides the body with its own natural cushioning to run all distances. It is very important to follow a gradual transition training programme from conventional shoes to minimalist shoes.”

Durban sports stores say most of the big brands have introduced minimalist shoes.

Inov-8’s Bare XF claims to promote a natural running style. adidas says its adipure range progressively takes the heel down to avoid injuries and help develop the runner’s ability to transition to “barefoot” running. Nike has brought out Nike Free, contoured to emulate the shape of a bare foot, New Balance has its Minimus shoe – and there are others, too.

Not surprisingly, experts warn against over-simplifying the issue of switching from running with support to barefoot running.

Wayne Holroyd, a physiotherapist at the Centre for Sports Medicine, uMhlanga, has a cautious approach.

“The improvement in running efficiency of barefoot running is due to the fact that barefoot running demands a forefoot or midfoot (flat foot) strike as the uncushioned heel cannot tolerate the impact forces of repetitive heel strikes. This is as opposed to running with shoes where more than 75 percent of runners will run with a heel strike.

“What we are seeing clinically now, is that there is a high incidence of plantar fasciitis, Achilles tendonosis and calf strains in those who have adopted a forefoot strike running technique. These are the very injuries that barefoot running was meant to reduce.

“People with foot deformities that affect gait mechanics should avoid barefooting or running in minimal shoes. If you want to change, start off slowly and progress gradually. The vast majority of running injuries that we see, regardless of running style, are as a result of the inability to accurately control the position of the pelvis and hip which then affects the loads on the entire leg and foot. Leg stability training is generally a very good idea for anyone who has suffered a lower limb running injury.

“There have been very few good quality studies investigating the claims of barefoot running. Much of the information in the public domain is purely anecdotal.”

Dr Ross Tucker, a research associate in the department of sports medicine at the University of Cape Town, has researched and written about the pros and cons of barefoot running.

“As yet, there is no conclusive evidence that either proves or disproves the benefits of shoes or barefoot running, or links the mechanical characteristics of barefoot running to a reduced risk of injury,” he says. “For all the work showing how impact forces and loading rates are reduced when barefoot, it remains to be proven that this leads to lower injury rates.

“There are plenty of theories and some are sound, but we await the real evidence for the injury and performance side of the debate, which will come from long-term prospective studies.

“The evidence so far suggests that barefoot running produces some potentially beneficial changes, mostly related to how running form and kinetics are altered without shoes.

“However, it also points to a potentially large group of people who, when running barefoot, may have increased risk of injury, especially early on – these are people who continue to heel strike when barefoot and who may “force” a forefoot landing, leading to huge strain on the calf muscle and Achilles tendons.”

Tucker says the key point is that barefoot running should be recognised as a skill and people do not have the ability to acquire skills equally. Those who do not may be substantially worse off and require much longer to make the adjustments. Whether they should even try is questionable.

“The issue is not necessarily whether barefoot running is ‘good for you’, but rather whether barefoot running helps us understand anything about how we run that might help us reduce injury risk,” he says.

There are big differences between individuals, too. Some adapt quickly to minimalist shoes or barefoot running, and others battle to run without “traditional shoes”.

“We have to be careful about generalising the ‘extreme’ observation – that is the mistake shoe companies made when telling everyone they needed all manner of gadgets in their shoes and it is a mistake people are making now when advocating barefoot running.

“I believe barefoot running will help most runners.

“It may be as part of a training programme where barefoot running helps with the adaptation because it loads differently, activates muscles in different patterns and therefore provides a good training impulse.

“For some, barefoot running, or running in minimalist shoes, will go on to become the ‘only way’.

“For others it will remain a training technique and that’s fine too. But I would look at incorporating it, just for the training adaptations it provides. Adapting to barefoot running or running in minimalist shoes should take up to 12 weeks to build up to 40 minutes of solid running, plus two to four weeks of preparation.

“It is a long-term investment and if you continue your normal training barefoot, you are pretty much guaranteed to get injured,” Tucker says. - Daily News

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