Ask the c.Ped – Medical Perspective on Minimalist Running and Walking Shoes

Helen Russell

Helen Russell is the owner of Metro Run and Walk with her husband Mark. She is a certified pedorthist and has completed several marathons!

With the introduction of a host of “minimal” shoe collections from vendors such as Brooks, Asics, New Balance, Nike, and others, I feel that I have a responsibility to share thoughts and current findings from the medical community on barefoot and barefoot-style running and minimalist shoes.

There are tons of “studies” that proliferate the internet.  Some will prove that:

  • barefoot running is the only way to go; it strengthens the foot and muscles and allows us run faster, more efficiently, and ultimately with fewer injuries
  • others will prove that the incidence of stress fractures and plantar fasciitis have increased dramatically in the population of people attempting to run barefoot or minimal
  • some will show that increasing the cushioning and support in shoes and going for a maximalist experience is the answer

As in political reporting, articles and web postings about barefoot running often present only a fraction of the findings from studies. One must read the entire study to understand the findings and often the language in the studies is difficult for the average person to understand — impact forces, heel drop, lower extremity torque forces, planes of movement, collision forces, ground reaction force, etc. One must also be well versed and educated in the plethora of injuries discussed in the studies.

The majority of studies, however, conducted by professional “sport scientists” with backgrounds in biology, biodynamics, evolution, engineering, and medicine (even in conjunction with shoe companies) admit that it’s not so much what you put on your feet, it’s how you land on your feet that is important. Also, they all say that there is more work to be done to really get to a definitive answer about barefoot and minimalist running and shoes.

So, although I’ve read a number of studies and position papers, I’m no closer to understanding the “right answer” about barefoot running and minimalist shoes except to say that “it depends” and together we’ll find a solution that works for you.  I believe that shoes are but one of the tools in your toolbox for staying active.  Proper running form is another.

American Academy of Podiatric Sports Medicine, Barefoot Running Position:

Barefoot running has become increasingly popular as an alternative to running with shoes. While anecdotal evidence and testimonials proliferate on the internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects.

Barefoot running has been touted as improving strength, balance, and proprioception as well as promoting a more natural running style while reducing the risk of injury. Risks of barefoot running include puncture wounds, lack of protection from hard objects and increased strain to the lower extremity. Running in shoes, some argue, promotes muscle atrophy, decreases balance and proprioception and promotes an “unnatural” running style thereby increasing the risk of injury.  Currently there is a lack of well-designed studies regarding the benefits and/or risks of barefoot running. The American Academy of Podiatric Sports Medicine serves to advance the understanding, prevention and management of lower extremity injuries and so until credible research has been published which documents the benefits and risks of barefoot running the Academy encourages the public to work with their sports medicine podiatrists from the AAPSM and other sports medicine professionals in making an informed decision on whether or not to incorporate barefoot running into their training program.

Studies and Websites of Interest:

Should you wish to explore this topic further:

American Academy of Podiatric Sports Medicine, Advising Your Patients on “Barefoot” Running http://aapsm.org/pdf/articles/barefoot-running.pdf

Harvard Biology Lab, Skeletal Biology Lab, Biomechanics of Foot Strikes and Applications to Running Barefoot or in Minimal Footwear: http://www.barefootrunning.fas.harvard.edu/index.html

Runners World, Barefoot and Minimalist Shoe Resources http://www.runnersworld.com/community/forums/runner-communities/barefoot-running/barefoot-minimalist-shoe-resources-research-articles-videos-websites

So, although I’ve read a number of studies and position papers, I’m no closer to understanding the “right answer” about barefoot running and minimalist shoes except to say that “it depends” and together we’ll find a solution that works for you.  We believe that shoes are but one of the tools.

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