This is the 3rd part of the series of articles on running injuries by Dr Emily Splichal, DPM, MS, CES, and founder EBFA Fitness. In this article Dr. Splichal talks about barefoot running trends and whether it is worth the hype.
As trends come and go within the health and fitness industry, one trend that had probably the greatest controversy surrounding it was barefoot running.
More appropriately referred to as a midfoot strike pattern in either minimalist footwear or without shoes, barefoot running had everyone from Podiatrists to running coaches in a frenzy.
Does barefoot running actually have less injures compared to shod running?
And is a midfoot strike more efficient than a heel strike pattern?
As the trend to try barefoot running “because it’s hip” starts to fade, it is time to look past the hype and decipher which runners it may be most appropriate for.
The Anatomy of a Midfoot Strike
What makes barefoot running or a midfoot strike pattern unique is the position that the foot is in when it strikes the ground. When a barefoot runner strikes the ground the ankle is in a plantarflexed position, with the ball of the foot being the initial contact point.
As the body weight transfers across the foot, the heel lightly touches the ground before springing forward preparing for the next step. This is as opposed to shod running where the ankle is dorsiflexed at foot contact, and the heel is the initial contact point.
The Runner with Flat Feet
When we think of a runner with flat feet (aka over-pronation), we probably think of motion controlled shoes and custom-molded orthotics. Thought of as a hypermobile foot with poor stability, this foot type is often associated with shin splints, knee pain and low back pain.
So can a runner with a flat foot safely run barefoot?
Although many cringe at the thought of a runner with flat feet running barefoot, I take a different approach. For these runners it is actually the pronation-phase during a heel strike where these runners are getting injured.
So if we could alter the strike pattern so that the runner avoids pronation – they may have less injuries!
As a runner with flat feet transitions to barefoot running, foot strength is key. I recommend these runners focus on foot and hip strengthening exercises for 2 weeks before going for their first run.
Short foot is a great exercise that can be done throughout the day and at the gym (YouTube link to How to Short Foot). In addition doing glute bridges, single leg squats and single leg deadlifts should be integrated into the strength program.
The Runner with an Old Injury
Whether it is stress fractures, plantar fasciitis or shin splints, most runners with a history of an overuse injury are encouraged to get into orthotics and change their footwear into something more controlling.
Should this always be the case?
Again I make the argument that it is not the shoe that is to blame – but rather these runners are not reacting to the ground impact forces efficiently.
Would these runners benefit from a strike pattern that has different levels of ground reaction forces? I think so!
Although the research demonstrates that both the midfoot and heel strike pattern have essentially the same amount of impact forces, the forces encountered in a midfoot strike are spread over a greater amount of time.
If we look at the graphic, we can see that a heel strike pattern has two force peaks, while a midfoot strike has one peak that is broad. The broad peak pattern for a midfoot strike means that the foot has more time to absorb and dissipate these impact forces.
With the appropriate foot strength and an altered foot strike pattern, these runners may experience less overuse injuries. Because this type of runner has a history of an injury, I always encourage them to work with a barefoot running coach to ensure that the strike pattern is correct!
The New Runner
The final runner, I recommend or encourage to try barefoot running is the new runner. With no bad habits from years of shod running, this runner is like a blank canvas.
All new runners should work with a barefoot running coach who can assess their running gait, give them tips for perfecting the strike pattern and create a program to follow as the runner increases their mileage.
Remember that a balance of foot strength and foot mobility is key to injury-free barefoot running. Make barefoot strengthening a key component to your barefoot running program and end each run with myofascial release to the bottom of the foot and lower leg. A great product I recommend for daily use is the Foot Baller from TP Therapy. (www.tptherapy.com)
To find a barefoot running coach near you, I recommend visiting www.vivobarefoot.com
Dr Emily Splichal, DPM, MS, CES
About Dr Emily Splichal
Dr Emily Splichal, Podiatrist and Human Movement Specialist, is the Founder of the Evidence Based Fitness Academy and Creator of the Barefoot Training Specialist Certification for healh and wellness professionals. With over 11 years in the fitness industry, Dr Splichal has dedicated her medical career towards studying postural alignment and human movement as it relates to foot function and barefoot training.
Dr Splichal actively sees patients out of her office in Manhattan, NY with a speciality in sports medicine and biomechanics. Dr Splichal takes great pride in approaching all patients through a functional approach with the integration of full biomechanical assessments and movement screens. Dr Splichal is actively involved in the correction of movement dysfunctions as it relates to sports injury and frequently performs manual therapy techniques including joint mobilization and trigger point release.
Dr Splichal is actively involved in barefoot training research and barefoot education as it relates to athletic performance, injury prevention and human movement dysfunction. Dr Splichal has presented her research and barefoot eduction both nationally and internationally. As a frequent contributor on the EBFA Fitness blog (www.ebfafitness.com) and webinars, Dr Splichal readily makes her content accessible to therapists, coaches and runners.
Previous article: Preventing Overuse Injuries in Runners