Subscribe
As an orthopedic physical therapist who builds custom orthotics and provides custom orthotic therapy, one might be surprised that I am also an advocate of barefoot running.
I believe that running around barefoot forces the foot into an ideal posture for running unlike the sophisticated running shoes on the market today that allow and even encourage running.
The runner who is a “heavy striker” is a great candidate for barefoot running. While there have not been many studies examining the benefits of barefoot running compared to shod running, the fact is that there is a lower incidence of chronic injuries associated with barefoot running. In fact, an article in Sports Science notes that “running barefoot is associated with a substantially lower prevalence of acute injuries of the ankle and chronic injuries of the lower leg in developing countries”.
The heel strike is a normal part of the normal gait cycle in walking, but in running, it is preferable to be a mid-foot striker rather than a rear foot striker. Heel strikers are “puling themselves along” while mid foot and fore foot strikers are “pushing themselves along”. I encourage heavy plodders to try to run on their toes in order to move the strike toward the forefoot. In contrast, look at this image and see both the body posture of the runner and how by leaning forward his strike is naturally more underneath him, and as such, is naturally more of a forefoot or even mid foot strike. 
I have found that one of the best ways to do this is to run barefoot. By running barefoot, there is a tendency to stay off the heel because excessive heel strike is actually painful, which should tell us something about the way the foot is designed. Remember, there is good evidence from at least a couple of world class runners, that barefoot running does not interfere with performance and, it may be argued, that barefoot running might even enhance performance.
I also want to promote a great new shoe to assist one in their barefoot running efforts. The Vibram Five Finger Classic Water Shoe, shown below is a really useful way to get into barefoot running so that as one does so the risk of injury to the sole of the foot is minimized.
Vibram Five Finger Classic Water Shoe
The shoe is available at REI for example, and costs about $75.00. Pretty good value. The people I know who are wearing the shoe are very impressed with the feeling they have about the shoe and how it gets them onto their toes during their runs.
So the take away is this: If you are having trouble as a runner with chronic injuries, or if you are a really heavy striker and you can hear your self running, or if you describe yourself as a really “heavy” runner, then you might be a really good candidate for barefoot running to help you re-educate yourself to be more of a forefoot or even a mid-foot striker. If you go in this direction, then the Vibram Five Finger Classic Water Shoe might be a good solution for you.
[...] The Case for Barefoot Running [...]
Pingback by One Persons Case for Orthotics « SRCPT at Sports Reaction Center — October 13, 2009 @ 5:30 pm
I ran for 5-1/2 years, from age 35 to age 40, but then had to give it up because of my work schedule. I was at 6 miles, 6 days weekly. I never lost the desire, and in Jan. 2009 I began running again after a 15 year interlude. I was only running 3 days a week, and I was wearing custom orthotics and good Asics shoes.
I noticed that I still had the stiff legs & hips, so I immediately started stretching. That helped a little. Then I decided to incorporate forefoot running into my runs. I started out while running only about 2-1/2 miles total. I would run about 1-1/4 mile with a heel strike, then I could convert to forefoot running while going up a hill, and would finish the rest of the run w/a forefoot landing.
I gradually began increasing my mileage, staying well within the 10% rule. I experienced occasional bouts of tender pads on the balls of my feet, but never true pain. My feet would be better by the next morning.
I was doing great – no stiff legs or hips, no strange knee pains, no calf or Achilles Tendon problems – just the occasional tenderness on the balls of the feet (which seemed to be improving).
One evening in very early October ’09 I felt so good that I increased my mileage (still within the 10%), and increased my speed. I felt some actual pain underneath the 4th metatarsal of my left foot near the end of my run. I stopped running for a week, then went back at it again.
The pain held off for about a mile, then it came back. I decided to try to run through it – bad idea. I got about 3-1/2 miles into my nearly 5 mile run, and had to walk back home, limping all the way.
I went to a podiatrist, briefly telling hm about my experience above. When I got to the part about the forefoot strike, he said, “Why did you do that? Where did you get that idea?” Let’s just say he had never heard of the forefoot running strike, and I don’t think he’s too conducive to a paradigm shift.
He said it sounds like a stress fracture, so he took X-rays. He showed me the X-rays and said the shape of my foot sets me up for metatarsal injuries (using the heel strike). He said I have Metatarsus Adductus. He said no running or fast walking for 8 weeks minimum, and had me in an aircast for 4 weeks. I’m okay with that, because I don’t want to do permanent damage.
I’ve been doing some looking on the Internet, and I believe I have a mild case of Metatarsus Adductus. The bones are somewhat curved, but not skewed or twisted drastically.
Should I try a newer, better pair of orthotics & go back to heel strike? Or should I continue with working on the forefoot strike and just back off a little, but this time do it without the orthotics? Is a foot with mild Metatarsus Adductus one that should never, EVER be subjected to forefoot running?
I know this has been a long post, but I’m at my wit’s end trying to figure out what to do. I loved running without the leg/knee/hip issues when I was running with the forefoot strike, but at least I was able to stretch after running & keep on going 3X a week with the mild/moderate aches/pains. Please – HELP!
Rich
Comment by Rich Shawver — November 13, 2009 @ 7:23 pm
Hi Rich, sounds like a challenge. The Metatarsus Adductus is typically associated with a plantar flexed first ray. In the event that the first ray is also rigid, then you would be better off with an orthotic device with a forefoot post and a first ray cut out. Often, because the drop off is too big, I refill the first ray cut out with a light foam like poron. You might also need a metatarsal arch pad to increase the available “range” of the first ray. With this type of orthotic device, you should be able to execute a forefoot strike without much difficulty. Another suggested accommodation is the 2-5 bar post to further accentuate the well for the first ray to drop into. I also like to use a deep heel seat and some mid foot posting as well to spread the wealth as it were. With such a device, you should also make sure to use a neutral shoe because you don’t want correction on top of correction if that makes sense. Let me know if this helps.
Comment by Neil Chasan, PT, MMT — November 16, 2009 @ 12:15 pm
Neil,
Thank you for the detailed suggestions. I will relay them to my podiatrist.
So you don’t think I’m a good candidate for going to a shoe with a less elevated heel (like a Nike Free, for ex.) and getting rid of my orthotics altogether as I continue to work on the forefoot/midfoot landing?
Of course, I’m not talking about going out & doing 4 or 5 miles w/o the orthotics. I’m thinking of dropping back to 1.5 miles & sort of “starting over.”
Thanks…..Rich
Comment by Rich Shawver — November 16, 2009 @ 7:42 pm
You are welcome Rich, and no, not at all. I think that you sound like a person with a forefoot dysfunction that with a forefoot post properly constructed it should allow you to run in a neutral shoe
Comment by Neil Chasan, PT, MMT — November 16, 2009 @ 7:48 pm