Since the release of Christopher McDougall’s book “Born to Run” (published 2009) there has been a significant increase in the hype of barefoot running and minimalist shoes.
When I am confronted by a patient inquiring on my thoughts of them trying barefoot running or minimalist shoes, I first ask the patient their underlying motivation for doing so. Most common responses are fueled by the hype, a history of chronic injury, or the desire to run faster and more efficiently.
Whether or not I recommend barefoot running depends on several factors. Initially I begin by taking a thorough running history of the patient. Pertinent questions include:
- What types of running-related injuries the patient has sustained in the past?
- Whether the patient has any current injuries?
- What types of surfaces the patient runs on?
- The patient’s age?
- What types of shoes the patient currently runs in, and types of shoes worn in the past?
- Whether the patient has attempted barefoot/minimalist running in the past?
I will then assess the patient’s running biomechanics to judge whether the runner has feet stable enough to handle barefoot running. I am unlikely to recommend barefoot running to the following categories of runners who are predisposed to running-related injuries:
- Older runners
- Heavier runners
- Those that are habitually shod
Contrast the following categories of runners that may well tolerate barefoot running and reap some of its benefits:
- Experienced long distance runners
- Younger runners
- Normal body weight
- Frequently barefoot
One of the key differences between barefoot/minimalist running and the “traditional” running shoes is that you land more on the forefoot in barefoot/minimalist shoes. Though this acts to decrease the stress placed on the knees, it shifts a greater amount of stress to the ankle and foot, especially in the Achilles and the metatarsals.
It is of utmost importance to emphasize to patient’s interested in trying barefoot/minimalist running that this should be a very gradual transition. The transition will alter a runner’s form and function, which necessarily causes previously dormant muscles and joints to fire. These muscles and joints need time to strengthen gradually so it is imperative those runners making the barefoot/minimalist transition ramp up their mileage slowly to avoid overstress and injury.
This trend is on the rise and therefore much of the definitive scientific evidence on the subject is still out for debate. The sports medicine podiatrist is a perfect place to begin when considering transitioning to barefoot/minimalist running.
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