Is Barefoot Running Good or Bad for You?

barefoot runningThe concept of barefoot running is getting a lot of interest lately, as well as a lot of debate on running and medical forums, with the question “is barefoot running good or bad for you?” It is certainly not a new concept and running shoe companies have been catering for the so called minimalist runners for many years. The recent publication of the book, Born to Run ignited a lot of interest in it.  In this post, Craig Payne shares some thoughts on the advantages and disadvantages of barefoot running.  What do you think?

The Barefoot Running Controversy

The benefits that are claimed for barefoot running include increased foot strength, which is based on the claim that running shoes weaken muscles, that no research has shown; improved running biomechanics, which the research has not shown despite claims by barefoot runners (all the research has shown is that barefoot running is different to shoe running, not better); reduced injuries, which has not been shown by the research and a quick look at barefoot running blogs and running forums show a lot of runners seeking advice for the inquires they got while running barefoot.

barefoot running Particularly common in barefoot runners is what has become known as ‘top of foot pain’ and metatarsal stress fractures. None of this means that barefoot running is not good, it’s just the claims made for it are not supported by the research in the way that those who make the claims like to think.

Many in the barefoot running community also claim that running shoes are evil and are the cause of many of the running overuse injuries that occur. Again, there is no evidence that this is actually the case, yet you can often see research quoted that they claim shows this. On closer inspection, the research does not actually show what is claimed. There is no research that running shoes help either. That does not mean they are bad, it just means that no one has yet done the research.

Elite runners and elite triathletes look for every edge that they can get and none of them run barefoot. Some do incorporate barefoot drills into their training, but do distance themselves from many of the claims for barefoot running. Even the elite African runners who grow up barefoot, choose to use running shoes. You often see statements about Abebe Bikala winning the 1960 Olympic marathon barefoot, but he went on to break a world record wearing running shoes in the 1964 Olympics. You often see statements about Zola Budd competing in the Olympic 1500 meter barefoot, but she started to get a number of injuries and had to resort to running shoes to prevent the injuries.

Bottom Line is that We Need More Research on Barefoot Running

Personally, I don’t have a problem with the concept of barefoot running. What I have a problem with is the somewhat religious fanaticism that some in the barefoot running go about with the claims they make and the misuse, misquoting and misrepresentation of the research that they make use of to claim to support their cause. Barefoot runners are not unique in this approach and others such as Pose and Chi runners make similar nonsensical claims.

My belief is that there is not one running style, technique or method that suits all runners and it’s up to the individual. Claims for the benefits of any running approach need to be carefully evaluated and not taken at face value and the research checked to see if it actually show what is being claimed. There is even an anti-barefoot running website that critically analyses all the claims made by barefoot runners.

PayneAbout the author: Craig Payne is Senior Lecturer in the Department of Podiatry at LaTrobe University in Australia and a moderator on Podiatry Arena where a lot of barefoot running topics get discussed.

Photos from istockphoto and wikipedia

vibram fivefinger barefoot running

Comments from Mike: Sounds like there are definitely pros and cons to barefoot running, but until the evidence shows us otherwise, I’d lean towards running shoes.  Especially if this is something you are not used to doing and you run for long distances, your foot may not be ready for it!  What do you think?  Have you had an experience with barefoot running, either good or bad?  I know that I have seen a large increase in the amount of barefoot runners wearing the Vibram FiveFinger product, any experience with this product or others for barefoot running?

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42 Responses to “Is Barefoot Running Good or Bad for You?”

  1. I just bought some Vibram five fingers and I love them. However, I am not a distance runner. I wear them around casually, for weight lifting, and for occasional sprints. I think it is fairly widely accepted that deadlifting is better performed without shoes or with shoes that have little support. The vibrams allow me to do my lower body weight training without breaking any rules at my gym. Also, I simply like the feel of the Vibrams. Most of us have weak feet and I think good posture and body mechanics start at the ground up. I say cross-training barefoot is a positive move. Going 100%? I don't know. It will be interesting to see the results of some of the studies that are underway.

  2. As a former long distance runner I know from personal experience there is a lot going on during the dynamic gait cycle of running. As a clinician who did his doctoral studies focused on running injuries and running economy I know there is no evidence as Mr. Payne correctly points out, to support the notion that barefoot running is better than running with shoes.

    Increased forces from varying types of surfaces (think concrete vs. grass) and even increased body mass (difference between a 110 lb runner and 210 lb runner)will all have an effect on the ground reaction forces experienced by the body. Quite often the shoes are what reduce this force and dampen the impact that otherwise would be experienced by the body through the repetition of long distance running. Even those blessed with bio mechanically perfect joint alignment (I am not) can still benefit from the dampening of these forces when training at 70 to 150 miles a week (level which elite runners will train consistently.)

    On an anecdotal level, I know a lot of runners, including myself, who can tell when it is time to change shoes based on lower extremity symptoms. I would experience diffuse left knee joint pain while running between 450 and 500 miles in a pair of shoes, just about the time when stress lines would start to show in the EVA. Get a new pair of shoes and I would notice an immediate relief of symptoms while running.

    That being said there are some bio mechanically gifted individuals who will do fine running barefoot. These individuals are few and far between and will generally do best by keeping their mileage low while running on soft surfaces; will have perfect or near perfect mechanics; and generally will have a small body frame and low body mass. Not exactly the average runner.

    Brian J. Boyle, PT, DPT

    • I weigh 235lbs and run on concrete. In padded trainers can’t do more than 5 miles before knee or back pain. Since switching to minimalist shoes I can comfortably do 1/2marathons under 2hrs. Not great times but carrying that extra weight it’s not too shabby. Perfect biomechanics isn’t realistic but my biomechanics are much better barefoot. Saying that I wear minimal shoes or no shoes all the time, transitioned to barefoot slowly and do feet strengthening exercises. When people get injuries barefooting it tends to be because they didn’t do one of those. For me personally I run minimalist because it feels good and got rid of my back pain – but I’m just one (of a growing number of) anecdote(s).

  3. Going points JP and very well said Brain, thanks!

  4. Christie Downing, PT, DPT, Dip. MDT Reply August 30, 2010 at 3:22 pm

    Barefoot sensationalism is just that…at this point its based on ideology, theory and personal opinion. It goes back to the mantra that "natural" things are good and "non-natural" things are bad. Yet, there are countless examples in nature where "natural things" do not always benefit us. We don't naturally get iodine in our diet, so we got goiters, we don't have flouride in natural drinking water and our teeth all rotted. There are still many essential amino acids our body does not produce and we need to get them from other sources. Our body was never meant to be self sustaining. I believe we were given brains for a reason…so we can learn how to adapt to our environment, build tools, etc to help us.

    Thanks for this post…although I am not one myself, I have close ties to the ultra running community and it's commonly discussed amongst them. I agree completely that while there many be some benefits from barefoot running, at this point, it's speculation and idealism, not science. Until we know the "for whom" and "to what extent" and for what benefit (if any), there is, in my mind, no reason to run barefoot.

    As you said, at this point we just know that barefoot running is different, not that it's better.

  5. Trevor Winnegge DPT,MS,OCS,CSCS Reply August 30, 2010 at 4:23 pm

    Funny that this post was posted today, as we had a runner come to our clinic with a stress fracture of the second and third metatarsals. He was a barefoot runner and the surgeon told him he should wear shoes and it started a newar brawl. This barefoot runner was telling the orthopod whome he sought out his opinion on how to treat his foot, that he was wrong. he packed up and left the building. Was definitely a funny moment in the clinic and frankly I think there will be many metatarsal problems coming in with the rise of barefoot running. I also think there will be a rise in stress reactions and fractures throughout the lower chain. An interesting study would be to take teenage runners and xray their feet, ankles, knees and hips at age fifteen and again at age 30, then compare joint destruction in the barefoot and sneaker groups. I realize this would be a hard study and would have a lot of external factors involved but my guess is there would be a bit more joint damage throughout the lower chain with the lack of shock absorption provided by sneakers.

  6. Christie Downing, PT, DPT, Dip. MDT Reply August 30, 2010 at 5:00 pm

    That's funny Trevor…yet just another example of how patients can get the wrong idea or be wrongly impressioned by an unreliable source, website or an idea. Forget the guy that went to 8 years of medical school…I know better because I read it on the internet! Parents are guilty of this too…I know what's best for my kids because "I'm a mom!"

  7. I think we need more barefoot exposure/to get out of shoes when the option presents itself, but I definitely don't feel barefoot running necessarily merits a place in this mix. There are a host of reasons why running barefoot is likely not the smartest idea in our modern world, but if it is done, you need a proper progression and a willingness to be very conservative with volume and surface choice out of the gate.

    As a strength coach, I personally prefer to leave barefoot for warm-ups, and various forms of static training provided I don't see any undue compensations going on (in which case it is likely back to the drawing board to figure out what the limiting factors may be).

    At the end of the day, I'd still favor shod running, but with a preference towards a more minimalist shoe (or, more precisely avoidance of anything with a ridiculous heel on it). But as with all things, each approach certainly needs to be customized based upon myriad factors.

    I'd also like to add that I am a mere dolt compared to you and the many excellent PT's who stop by your site, Mike. As such, I know my place and my limitations, and I'd prefer to send someone to consult with quality professionals like you if I am ever in the slightest position of doubt. The major rule I play by is that I can always get a bit more aggressive if the current modalities, intensity, and volume are able to be handled by the person in question, but once you go to far, I've just ended up creating more work for the PT crowd and made my own profession look bad on account of my foolishness.

    ~Stan Rigoletti

  8. My opinion:
    The foot was devolped and refined to run on grass and dirt. There is nothing natural about concrete. The foot was not designed to run on concrete.

    -Mat Failla MSPT

  9. I love this post and like what everyone has to say. Just to add, our generation is much different than that of the Neanderthal era (caveman; where they were actually barefoot!). Comparing the two generation; our generation is extremely overweight compared to Neanderthal's. Neanderthal's don't have Wendy's, McDonald's, BK, or just simply easy access to food. They actually had to work hard and burn calories to hunt for food. On another note, they didn't walk on CONCRETE!

    I think it was during a conversation with Charlie Weingroff when he came to visit NU, he proposed a question that if people were truly flat foot/pes planus, wouldn't they be as well when lying supine? If FWB, they have pes planus, but supine they somewhat have an arch….does this mean we can actually train the intrinsics muscles?

    Barefoot training: clearly if someone is pes planus or weak that their foot is in pronation, it wouldn't be smart to train them through movement, however, it's possible to train them stationary. What about other factors? Weak glute med to help control the greater Q angle, IR of the tib/fig?

    Subtalar pronation causes the talus to adduct and plantarflex, therefore, when there is LE dysfunction shock absorption suffers and any joint in the kinetic chain can suffer. Stance phase forces equal 70-80% of the body weight. During running, forces exceed 200 percent of body weight. Not only LE extremity joints, but lumbar spine facets may also be irritated by faulty mechanics. For instance, hyperpronation leads to internal lower extremity rotation, which causes anterior pelvic tilting, and finally repetitive overstress to the lumbar spine in extension. (Liebenson)

    The following chart shows how a failure to achieve resupination impacts a number of different conditions. (Liebenson)

    • Medial overstress of the Achilles' tendon >> Achilles' tendinitis;

    • Tibial torsion (internal) >> iliotibial band friction syndrome due to overstretch of insertion on medial tibial plateau;

    • Tibial torsion (internal) >> extensor mechanism disorders due to increased lateralization forces of the patellae;

    • Internal hip rotation >> anterior pelvic tilt >>facet overload and/or hamstring traction strain.

    The gluteus medius muscle is primarily responsible for stance leg stability. Weakness results in an inability to maintain the body's muscle tightness inhibits its antagonist, the gluteus medius. Once the gluteus medius is weak or inhibited the tensor fascia lata (TFL) typically substitutes for it. This results in increased lateralization forces at the patella and a loss of hip extension mobility. This muscle imbalance can be easily assessed in the sidelying posture by seeing if the thigh flexes during abduction to 30 degrees. The only resistance is from gravity. (Janda)

    Another factor could be looking at Janda's
    tonic vs. phasic muscle. (Tonic: gastroc/soleus; Phasic: Tibialis Anterior). Alot of clinicians do calf raise just to throw exercises in there as oppose to training the phasic muslces. It would probably be a better avenue to think of muscles as pulleys; hence the muscle imbalance.

    Sorry for putting so much information, but there is no one single factor. Just think about how foot pronation really affects the entire kinetic chain. There are plenty of clinicians who may not actually research the pros/cons as well as putting the science together to create the "art" aspects (Arts&Science). We just need to be more smart and know more of the rationale behind this. I like this quote: "Don't run to get fit…….GET FIT TO RUN!"

  10. Ryan Shelton, DPT, OCS Reply August 31, 2010 at 7:23 pm

    I would agree with the notion that more research is needed. Some research is out there comparing barefoot running versus shod running, but (as has been said before) most is anecdotal. I have had many patients in our clinic that have had pain running and when I had them run on our treadmill without shoes, they could run pain free. Literally…pain free for up to 15 minutes (one particular woman had pain 3 minutes into a run, and without her shoes (at same speed/incline) stopped after 10-12 minutes because she was out of breath, with no pain. So I definitely think there is "something" to it. Do we need more research: yes. Do we have to wait for it to try and make our patients better, quicker? No.

    In regards to ground reaction forces. There are studies (sorry I can't think of the reference) out there that compare GRF's between heel strikers, midfoot strikers, and forefoot strikers. What it shows is that heel strikers have an impact peak during heel strike, whereas the curve of the midfoot/forefoot strikers (really the only comfortable way you can run barefoot) GRF is more bell shaped. It doesn't prove this argument, but there is evidence to support the idea that high impact forces and loadrates coincide with running related injuries. I also believe, however, that whether a person wears shoes or not, landing is less of a heel strike is probably better for your body.

    I'd also like to comment on what Brian said in an earlier comment:

    Increased forces from varying types of surfaces (think concrete vs. grass) and even increased body mass (difference between a 110 lb runner and 210 lb runner)will all have an effect on the ground reaction forces experienced by the body. Quite often the shoes are what reduce this force and dampen the impact that otherwise would be experienced by the body through the repetition of long distance running.

    Take a look at the article by Bishop, et al in the Journal of Athletic Training. (2006) "Athletic footwear, leg stiffnes, and running kinematics."

    They propose that leg stiffness is necessary, but too much may result in injury (overuse and stress fracture). We as therapists are trying to decrease the stiffness in the LE with patients who may have stress fractures/tendonitis,ect. by considering a more cushioned shoe or adding cushioning to the shoe to help "pad" the affected area. What the research suggests (I don't want to say "proves" as there are some limitations to the study) is that the more cushioning introduced, the higher the leg stiffness becomes. Seems kind of counterintuitive right? If your interested I would recommend the article, it's a pretty quick read.

    Brian, I promise I didn't set out to pick on you. My apologies for using another of your quotes:

    That being said there are some bio mechanically gifted individuals who will do fine running barefoot…generally do best by keeping their mileage low while running on soft surfaces; will have perfect or near perfect mechanics; and generally will have a small body frame and low body mass.

    I'm considered overweight: 5'9" 185-190 lbs. I run roughly 10-15 miles per week (continually trying to get more) and I run on concrete whenever I can…its more comfortable than grass. I have what we would consider pes planus and can say my mechanics aren't perfect.

  11. Ryan Shelton, DPT, OCS Reply August 31, 2010 at 7:27 pm

    I would agree with the notion that more research is needed. Some research is out there comparing barefoot running versus shod running, but (as has been said before) most is anecdotal. I have had many patients in our clinic that have had pain running and when I had them run on our treadmill without shoes, they could run pain free. Literally…pain free for up to 15 minutes (one particular woman had pain 3 minutes into a run, and without her shoes (at same speed/incline) stopped after 10-12 minutes because she was out of breath, with no pain. So I definitely think there is "something" to it. Do we need more research: yes. Do we have to wait for it to try and make our patients better, quicker? No.

    In regards to ground reaction forces. There are studies (sorry I can't think of the reference) out there that compare GRF's between heel strikers, midfoot strikers, and forefoot strikers. What it shows is that heel strikers have an impact peak during heel strike, whereas the curve of the midfoot/forefoot strikers (really the only comfortable way you can run barefoot) GRF is more bell shaped. It doesn't prove this argument, but there is evidence to support the idea that high impact forces and loadrates coincide with running related injuries. I also believe, however, that whether a person wears shoes or not, landing is less of a heel strike is probably better for your body.

    I'd also like to comment on two statements Brian said in an earlier comment:

    [Increased forces from varying types of surfaces (think concrete vs. grass) and even increased body mass (difference between a 110 lb runner and 210 lb runner)will all have an effect on the ground reaction forces experienced by the body. Quite often the shoes are what reduce this force and dampen the impact that otherwise would be experienced by the body through the repetition of long distance running.]

    Take a look at the article by Bishop, et al in the Journal of Athletic Training. (2006) "Athletic footwear, leg stiffnes, and running kinematics."
    They propose that leg stiffness is necessary, but too much may result in injury (overuse and stress fracture). We as therapists are trying to decrease the stiffness in the LE with patients who may have stress fractures/tendonitis,ect. by considering a more cushioned shoe or adding cushioning to the shoe to help "pad" the affected area. What the research suggests (I don't want to say "proves" as there are some limitations to the study) is that the more cushioning introduced, the higher the leg stiffness becomes. Seems kind of counterintuitive right? If your interested I would recommend the article, it's a pretty quick read.

    [That being said there are some bio mechanically gifted individuals who will do fine running barefoot...generally do best by keeping their mileage low while running on soft surfaces; will have perfect or near perfect mechanics; and generally will have a small body frame and low body mass.]

    I'm considered overweight: 5'9" 185-190 lbs. I run roughly 10-15 miles per week (continually trying to get more) and I run on concrete whenever I can…its more comfortable than grass. I have what we would consider pes planus and can say my mechanics aren't perfect.

  12. Ryan Shelton, DPT, OCS Reply August 31, 2010 at 7:30 pm

    The way I think about barefoot running is the same with muscle control of other joints. I wouldn't expect to see great results if I trained my patients to increase motor control, stability, and proprioception in the clinic and sent them home with a restrictive brace (you can apply this to most joints). I feel that the foot should behave the same way. If I want more control/proprioception/stability, why insert a rigid orthotic (or even semirigid, or OTC insert) to reduce the amount of input into those joints/muslces and potentially decrease carryover of gains?

    Whether you believe in it or not, I think the debate is important. It's going to spark more research which is always a good thing. I also think orthotics have there place as well. There are times when we don't want the foot to have as much motion, but I don't believe they should be a long term fix for everyone. I have had some discussions with other colleagues and researchers who tackle the biomechanics of the LE and at the end of the day we feel the types of people who should NOT go barefoot are those with insensate foots (DM, Neuropathies, ect). It's also a good idea to have some protection in cold weather as the protective sensation of the foot with gradually be lost, potentially causing injury.

    I hope I didn't offend anyone with this post, it wasn't my intention. I really hope I didn't come off as religious fanatic or misuse any information for the cause as the author says us barefooters do. But I do have a childlike urge to point out some differences of information used by the author. I looked long and hard for info about Zola Budd switching to shoes after she "started to get a number of injuries and had to resort to running shoes to prevent the injuries" and this is what I found instead.

    [When Budd finally did put on shoes to run on the roads growing up, they felt "so sluggish and uncomfortable. I had more injuries running with shoes than I ever did barefoot. I am so glad it (natural running) is being rediscovered."]
    http://www.dailycamera.com/ci_15870824?source=most_emailed#ixzz0yEbfpnho

  13. i love the vibrams. you claim that until we have more research, we should stick with running shoes, but i think it should be the other way around. since we evolved without running shoes, i think we should give barefoot running the benefit of the doubt and should not switch to running shoes until research has shown that it is superior.

  14. Kudos to Mat Failla with the most common sense comment! Running on cement is not natural… brilliant!

  15. I take the middle of the road approach. For some people, I might recommend Vibrams, and on the other end of the spectrum, I might make orthotics. Each has to be evaluated individually.
    I feel that it is more the "barefoot style" (not heal striking) that is superior, not so much the need to go barefoot.
    For many, the increased proprioception and strenghtening of intrisic muscles of the foot are great in running shorter distances. When you get into the people that put many miles in per day, the benefits may not be there.

    One thing I would ask about these people that did get stress fractures, what did their great toe and ankle ROM look like? Would they have gottten stress fractures in any shoe because their mechanics are so bad?

    Chris Leavy MS, ATC, CSCS, FMS/SFMA

  16. Great responses so far. Probably once a week I am asked what I think regarding barefoot running. I usually respond with " It is definitely not for everyone. If someone has a mechanical fault or injury they should not even try it until they are healed/fix their faults, and shouldn't people try barefoot walking first?"

    If someone has poor mechanics of the foot and ankle, including overpronation, and you have them RUN barefoot, chances are they do not possess the motor control of the foot intrinsics to magically form an arch at high velocities. As stated by Garrett and others, shouldn't we be training the intrinsics in a static position, and then advancing towards dynamics? This is kind of like training someone to have proper scapular/GH mechanics prior to having them start a throwing program.

    That being said, I have begun to implement barefoot WALKING (not running) into my planter fasciitis and ankle sprain programs with much success. My results are purely clinical and not backed by research, but I feel that once patients who exhibit poor walking mechanics can master static control of their arches, they need to implement it into motion. You can actually hear the difference in patients who land with a "thud" on their heel (pre-rehabilitation) and fall into poor gait patterning, versus the patients who end up landing midfoot and going through mid-stance nicely in supination. Once again, this is just what I have seen in my clinics, and I am looking forward to future research and discussion on the topic.

  17. Fredrik Gyllensten Reply September 6, 2010 at 4:51 am

    Good post, I guess it's important to not get carried away.

    However, after reading 'Born to Run', i started testing barefoot running, and I love it – I'm never going back! I've had pain in the left side of my lower leg/calf, and thats pretty much gone now after a few months of barefoot running. I'am also, without a doubt, experiencing less stress on my legs overall when running.

    The main reason for these affect, I think, is not because of barefoot running per say (and I don't always run barefoot, often I use Nike Free or Vibram FiveFingers – it depends on terrain and weather), but the change in technique that barefoot running ignited.

    Simply put; Barefoot running enables you to feel how you run much easier, and helped me improving my running technique a lot :-)

  18. I love this post. Great info provided by everyone.I know we have been talking about BAREFOOT training but what do you guys think about running in soccer shoes,rugby shoes, lacrosseshoes, track shoes, or any kind of cleats…?
    also you may find this interesting.
    http://www.barefootrunning.fas.harvard.edu/

  19. And what would you all say if someone were able to mimic the lower impact curves of the barefoot Africans from Lieberman's study but did so in running shoes? What would that say about shod running? What would it say about running technique?

    I posit that it's less about the shoes and more about the running economy as per technique. When the form improves the shoe selection can become less of a factor. But for some, reducing the heel to forefoot disparity can positively influence technique as well.

    Incidentally, on another blog there's an interesting Ex Phys discussion about the feasibility of a sub-2-hour marathon: http://www.tiny9.com/u/marathon

  20. Fredrik Gyllensten Reply September 8, 2010 at 1:41 am

    Exactly, Bob. That's my experience, however; it was the barefoot running that thought me ti improve my technique – without any trainer or anything. The thing is; when your feet are free, it's a lot easier to feel what you are running on (doh!), and adapt a technique that is more comfortable, and better and more efficient for your body.

  21. I wonder how many of the barefoot detractors are runners themselves. And I also wonder how many have TRIED some method to improve their running economy (Pose, ChiRunning, barefoot, etc.)

  22. The only scientific material Ive come across about barefoot running and barefoot running shoes

  23. so far The best article I've come across about barefoot running and barefoot running shoes

  24. My first thought upon reading this is "haven't you searched Pub Med?"

    Example: "Foot strike patterns and collision forces in habitually barefoot versus shod runners.

    Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D'Andrea S, Davis IS, Mang'eni RO, Pitsiladis Y.

    Department of Human Evolutionary Biology, 11 Divinity Avenue, Harvard University" from which I quote: "Kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers… …Fore and mid-foot strike gaits were probably more common when humans ran barefoot or in minimal shoes, and may protect the feet and lower limbs from some of the impact-related injuries now experienced by a high percentage of runners."

    There is a ton of research out there regarding impact forces (Biomechanical and physiological comparison of barefoot and two shod conditions in experienced barefoot runners.

    Squadrone R, Gallozzi C.

    Institute of Sport Medicine and Sport Science, Italian Olympic National Committee, Rome, Italy), and there is quite a bit of evidence to support two assertions:
    1) fore or midfoot striking, shod or barefoot, results in lower impact forces on all joints involved.

    2) Running shoes give more mechanical advantage during the push off phase of the stride.

    The biggest research gap lies in comparison of bone thickness, bone density, and muscular and tendon development between lifelong barefoot runners, barefoot runners running for several years with no injuries, lifelong shod runners who use a fore or midfoot strike and lifelong shod runners who use heel strikes.

    This research will tell us a lot. Basic physiology dictates that the very small forces generate by children and the naturally slow progression of force increases as the children mature allow for plenty of time for bone, muscle and tendon remodeling to occur and (hypothetically) create or maintain a foot structure that is both 'immune' to "overuse" injuries and better able to transfer force through the stride. Common sense tells us that the bones will be more dense and the muscles and tendons more well-developed in those who have a long history of forefoot striking, especially barefoot, but only research can give us a reliable, empirical answer.

    If there is a significant disparity between the shod heel-strikers and the other groups, especially the barefooters, there is a VERY high probability that this lack of development allows for the specific cited injuries when starting to run barefoot.

    I have had personal first-hand experience with bone hardening in the hands due to so-called Iron Fist training, and these effects have been verified by the researchers on "Fight Science" and other Discovery Channel shows. It takes several years to build the bone density necessary to perform the more advanced breaks without injury, and the steps along the way are small and many in number. Switching from shod running to barefoot running should be handled in much the same way.

    On another note, I think that the available research I have cited, and there are 90 results on a "barefoot running" search at Pub Med FYI, can be used to propose that for absolute maximal race performance a mid or forefoot strike in shoes is the best. However, knowing the potential advantages of the barefoot running, sub-maximal training should probably be slowly transferred into running in five fingers or perhaps even truly barefoot. This would allow for the foot to become stronger and more capable of force transfer, while maximal training in shoes trains the nervous system to take advantage of the increased mechanical advantage during push off. This allows for the benefits of both methods to be maximized in terms of athletic performance and injury prevention.

    I will be posting an article on my site as soon as it is off the ground.

  25. Barefoot running is awesome. I've always been a barefoot person so when I started running it just came naturally. At first your feet hurt, but so does pretty much every other muscle that's getting used so much. Your feet harden (and yes, they will be dirty). I couldn't picture myself running in shoes. But whatever floats you boat. Except if you use the five-finger product that doesn't count as running barefoot.

  26. I began running in the Vibrum five fingers last spring, and sadly fell into the category of having a complete fracture of my 2nd metatarsal. You may think that I would now hate the shoes, but in fact I still believe highly in barefoot running. Yes, there is risk involved, and I could have avoided it all if I was a little more careful. After running in sneakers for my entire life on concrete, my foot muscles and bones are weak, and not well prepared for the change in running form. I have since progressed at a much slower rate, and listened more to my body, and am doing very well in them. Why do I continue to try to make this barefoot thing work? Because, although there is not a lot of research on it, as a Physical Therapist, the concept makes a great deal of sense.

    Barefoot running and mid-foot striking essentially go hand in hand. It is the way your body naturally strikes the ground while barefoot, and it has been thought to be completely abnormal for a human to run with a heel strike. The mid-foot strike allows for decreased stride length, reduced joint stress, and a continuous forward momentum as you run (where running with a heel strike causes a brief, but abrupt, complete stopping of the body upon contact).

    An important point, as stated above, is to remember that "barefoot running" is just that, having nothing on your feet. "Minimalist running", a similar concept, is having a shoe with reduced heel cushioning and minimal material between your foot and the ground (this included the vibrum five fingers). In true barefoot running, you gain important sensory feedback from your feet, which can enhance muscle activation and reaction to change in ground surfaces. In minimal shoe running, you can still benefit from most of the other benefit of barefoot running. You are able to adopt a mid-foot stike pattern (the high heel cushion of a typical running shoe makes it nearly impossible to strike with the mid-foot first), which has been shown to reduce joint stress and allows the foot to interact more naturally with the ground. You are also able to use and strengthen the same muscles that are used with a barefoot style of running. It does provide a little bit of padding from the ground, and may be a good place to start for the majority of us who run on concrete. This would likely reduce the chance of a metatarsal stress fracture.

    Again, I understand that there are no randomized controlled trials out there supporting barefoot running. However, there is a lot of anecdotal evidence and emerging research, and if you think it though, the concept makes a great deal of sense.

    "Until we know the "for whom" and "to what extent" and for what benefit (if any), there is, in my mind, no reason to run barefoot."
    Humans have been running barefoot for thousands of years. Maybe we should wait for some evidence to support the use of shoes before we start recommending those to patients.

  27. I have been a long distance runner for years and recently was introduced barefoot running when I was having pain in my foot after long runs. My problem was an excessive heel strike at initial contact that was causing me to transfer excess force through my first MTPJ. The joint would get painful, red, and swollen after long runs. I consulted a physical therapist about the injury who had me perform peroneal muscle exercises to strengthen my arch, as well as begin barefoot running to strengthen the intrinsic muscles of the feet.

    I have experienced a lot of success with both interventions. I started running in socks on the treadmill for a minute or two and gradually built up the duration. I went and bought a pair of Vibram KSO Trek shoes when I was convinced that barefoot running was helping me. It has not only built up the strength of my foot, but it has also changed my gait. During barefoot running you concentrate on landing midfoot/forefoot and only allowing a graze of the heel on the ground. This has taught me to not excessively heel strike, resulting in a more even transfer forces across my forefoot.

    I use the KSO shoes at the gym to run shorter distances (around 2-3 miles) and while lifting. I consider the barefoot running as “exercise for the feet” and still wear Asics running shoes when doing longer runs (5+ miles). I am fearful of injuries if I run too long barefoot, but I’m told that if you build up the milage (duration) gradually they’re great for distance running.

    • Brian, well said – I like the concept of using this as an exercise, and using shoes for long distance. Makes sense. Personally, I just dont think we can all of a sudden go barefoot cold turkey and not expect to cause some stress injuries, but your progression looks good. Thanks for sharing!

  28. I’ve been running both barefoot and with the Vibram five-finger KSOs for about a year now, after having long-term issues with my hip joints as a distance runner. I had to basically start over, running no more a mile at a time the first week and slowly building up. I did struggle with some top-of-foot-pain early on because I was running too far too soon (a common problem with the five-fingers) but thankfully no stress fractures. I backed off a bit until the pain went away, then slowly eased back in. This last fall I ran a 10-mile hilly trail race up in Wyoming in my five-fingers, and although I wasn’t fast I finished injury free.
    I think if you’re careful and patient, barefoot and minimal shoe running can be a very enjoyable sport, but it can cause some problems if you are impatient. You really have to pay attention to the feedback from your body.
    Just my .02…

  29. READ THE BOOK BORN TO RUN
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  30. Hi Mike,

    I am little late posting to this article but its a favourite topic. I have a post on my site evaluating the kinematics and kinetics of barefoot and shod running. I also look at the different ways that we foot strike and how this mimics some barefoot mechanics.

    It is here:

    Further , there is one interesting research finding that none of the other commenters have mentioned that I think has is relevant.

    The research on injuries and impact forces is relatively sparse. There does not appear to be a link between the amount of the peak ground reaction force (the active peak during push off) nor the peak impact peak (i.e. the collision force). What does appear to related to some injuries (stress fractures) is the rate of the loading during the impact phase of the ground reaction force (Zadpoor 2011).

    What is so interesting about this is that the rate of loading of the collision/impact force is the SAME when running barefoot and when running shod with the dreaded heelstriking. This is a finding of both the beautiful Lieberman paper and Squadronne’s paper. This little tidbit never seems to get any press.

    All the best,

    Greg

  31. “There is even an anti-barefoot running website that critically analyses all the claims made by barefoot runners.”

    …Using lies, such as that Abebe Bikila didn’t beat the world record until he started competing in shoes. That is objectively false. Abebe succeeded Sergei Popov, the former record holder, in the 1960 Olympic Games in Rome. That WR was achieved running barefoot and wasn’t beaten until 1963. That was an easy one to catch, I bet there’re many other lies used when he needs to support his claims.

  32. The thing is, to get useful data the ramp up for barefoot running has to be long and controlled. I feel like I’ve seen too many stats and studies where population injury rates are cited with no evidence of whether these people transitioned slowly over several months or if they read Born To Run and immediately ran a 10k barefoot the next day. I feel like this is never taken into account and makes every barefoot research account I’ve read useless. Of course most docs/therapists will disproportionately see the overzealous transitioners and less of the gradual ones and get a bad sample of barefoot running effects.

    I think barefoot should be looked at similar to lifting with a belt vs raw lifting. For some reason shoes are a lot more polarizing than belts, probably because wearing shoes is the norm in our culture while the belt is the exception in day to day life. Yes, a belt is going to let you squeeze out more performance. Yes, you’re going to get injured if you suddenly take it off and go raw right away. And yes, you’re going to get a ton of benefits if you slowly build up your raw lifts and your natural ‘belt’/abs.

    A final thought, I think we’re approaching this question backwards. We never ask ‘Is lifting without a belt good/bad for you’ and I find it odd we do with shoes. I mean modern structured/padded running shoes are a recent invention. At what point did natural anatomical human running become a special kind of running that we have to debate it’s validity?

    I posit the way we should be asking the question is “Do shoes actually add any benefit compared to someone who either transitioned very slowly to barefoot or has always run barefoot”

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