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The benefits of barefoot running and exercise

The benefits of barefoot running and exercise.

Many of my patients are runners, and they have certain characteristic injuries that we treat on a daily basis at my clinic.  I am constantly asked the same questions by barefoot and shoe runners frequently.  I was asked to write an article by many of my patients to address many of the recurrent questions I am asked…..

While still in the vast minority, an increasing number of people are joining the barefoot running trend, throwing their shoes to the wind and letting their feet run free, literally.  From the research that I have done, I think it is a great idea.  The reasoning for this is based on evolution.  Humans have been barefoot or wore minimal shoes for millions of years.  It is only in the past quarter to half a century that modern technology has changed to way we walk and run.  Therefore, running with shoes is actually THE NEWER TREND, not barefoot running.  Evidence is still preliminary on which is better, but there are some interesting facts to consider.

Writing in the journal Nature, Harvard researchers explained:

“Humans have engaged in endurance running for millions of years, but the modern running shoe was not invented until the 1970s. For most of human evolutionary history, runners were either barefoot or wore minimal footwear such as sandals or moccasins with smaller heels and little cushioning relative to modern running shoes.”

Basically, your feet were designed to work without shoes. And while running barefoot does pose certain unique hazards, such as stepping on a sharp object or injuring your skin on abrasive pavement, there are reports that barefoot running is actually quite beneficial.  While the research is still limited and many of the reports anecdotal, running barefoot may actually decrease the likelihood of ankle sprains and chronic injuries.  Our feet have 26 bones, 33 joints, and over 120 muscles, ligaments and tendons that all have to work in synchronicity every time you take a step.  That is a pretty impressive feet (no pun intended) for to two extremity appendages furthest from the body.  They have a natural motion that has been developed through millions of years of evolution.  Fact, as modern technology increases in shoe design, so has the incidence of foot, ankle and knee injuries.  The more support we give our feet, the less the muscles and joint have to work which eventually leads to weakness, instability and dysfunction.  Barefoot running corrects this problem by forcing your feet to respond to different elevations and terrain while running bare foot which causes your feet muscles to work hard which results in the stabilization of the foot.  When the foot is stable, so is the ankle, knee, and even the hip and back .

Walking or running with shoes is quite a different experience than doing so without them. This is evidenced perhaps no more clearly than among children, who in the developed world are virtually the only ones who have not yet grown accustomed to wearing shoes, and as such their gait should be more or less the way nature intended.  Many professional runners write that if you want to learn proper running mechanics, watch children run bare foot.  It’s a very natural motion the way we were intended to run.  It’s funny how we spend millions of dollars a year on sneakers that make us run differently that our bodies were originally designed?

Research published in the Journal of Foot and Ankle Research revealed:

“Shoes affect the gait of children. With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity. Shoes reduce foot motion and increase the support phases of the gait cycle.

And therein lies the question: is footwear a boon or a bust to mankind? Surprising as it may sound, emerging research suggests modern running shoes, with their heavily cushioned, elevated heels, may actually encourage runners to strike the ground with their heel first.  When you strike with your heals first, there is a direct force which travels up through the straightened leg, through the knee and into the hip.  If you ever wondered why so many people used to run and cannot do it anymore do to repetitive overuse injury…..this is why!

The Harvard researchers continued in Nature:

“Here we show that habitually barefoot endurance runners often land on the fore-foot (fore-foot strike) before bringing down the heel, but they sometimes land with a flat foot (mid-foot strike) or, less often, on the heel (rear-foot strike). In contrast, habitually shod runners mostly rear-foot strike, facilitated by the elevated and cushioned heel of the modern running shoe.  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.

This difference results primarily from a more plantar flexed foot at landing and more ankle compliance during impact, decreasing the effective mass of the body that collides with the ground. Fore-foot- 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.”

This reasoning may explain how marathon runners in Kenya are able to run great distances barefoot with virtually no pain or injuries. Likewise, research reviewed by Michael Warburton, a physical therapist in Australia, revealed:

Running-related chronic injuries to bone and connective tissue in the legs are rare in developing countries, where most people are habitually barefooted

Where barefoot and shod populations co-exist, as in Haiti, injury rates of the lower extremity are substantially higher in the shod population

Wearing footwear actually increases the likelihood of ankle sprains, one of the most common sports injuries, because it either decreases your awareness of foot position or increases the twisting torque on your ankle during a stumble

One of the most common chronic injuries in runners, planter fasciitis (an inflammation of the ligament running along the sole of your foot), is rare in barefoot populations

If you research what evolutionists believe on the science of barefoot running, you will see that nature and innate ability give us all that we need to know how to run properly.  In order to learn how to run properly, watch a child run.  They are forwardly flexed at the waist, they land on their mid or fore foot, they compress into the stride and then push off as it to kick yourself in the buttocks.  The beauty of this natural, untrained motion is that by running this way, the force of impact is behind the knee and in front of the hips rather than being transferred straight up the leg and into the hips.  Also, this running motion allows you use your Achilles heel as it was intended, as a springboard.  Some of the best long distance runners in the world are from third world countries and have been running barefoot their entire lives and are much more efficient runners with less injuries than their shoed competitors.

In fact, most dominant division one running schools like Oregon and California schools have incorporated barefoot running as part of their overall training regimen.  In doing so, they have found that their runners have better balance, have fewer injuries, and have more overall lower body balance and stability just from running exercises several times a week.  There have even been numerous clinical cases of peoples’ shoe sizes decreasing because of a stronger lift in the arch which results in better running mechanics.

Just taking off your shoes, if you’ve been wearing them all your life, does not mean you’ll immediately attain proper barefoot running form. Many new barefoot runners continue to land heavily on their heels — and the result can be injury. So if you decide to give barefoot running a try, make sure you do it slowly, progressing gradually to more and more time spent without shoes. A good starting point is to first try walking barefoot and then begin with quarter-mile barefoot runs.

Keep in mind also that your gait will be different than it is with your shoes on — this is expected. Listen to your body and knowledge of how to run and walk barefoot, and allow your feet, ankles, knees and hips to naturally change position in response to the terrain.  When you start going barefoot it is best to initiate on naturally softer ground like grass, dirt paths and sand, not cement, asphalt or hardwood. When the muscles and joints of your foot become more stable and the skin on the bottom of your feet thickens, you will be able to handle progressively more time barefoot and on a wider variety of surfaces.

One final note, barefoot running or walking doesn’t have to be an “all or nothing” decision. You can incorporate as much barefoot time into your life as you feel comfortable with. Quite possibly, you’ll enjoy it so much that you will naturally find yourself kicking off your shoes as much as possible.  The only caveat to this is be careful if you are trying this for the first time over 50 years of age.  Over 50, there is a change in the types of cells called osteoclasts and osteoblasts.  Many older runner have a hard time making the transition and need to take it slower than most to get accustomed to barefoot running.

I also suggest reading a book called “Born to Run” by Christopher McDougall.  It was an interesting read to the world of barefoot running and gives a lot of insight from an evolutionary standpoint on why it is beneficial to run barefoot.

As always, do your homework before you engage on your barefoot venture.  You have most likely been running or walking with shoes most of your life so there will be an acclimation period until your body becomes accustomed to the running style it once knew as a child.

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