By: Jeff Strojny, C.Ped.
The barefoot running movement has been growing in popularity with claims of natural movement and gait. There is debate among runners and physicians alike as to whether this new footwear is beneficial to the long distance runner and, if so, if it is beneficial for everyone. While there have been no studies investigating injury occurrence in barefoot versus shod situations, many studies have shown difference in gait, muscle engagement and proprioception in barefoot shoes (Robbins, 1987; Robbins, 1994; Kadambande, 2006; Divert, 2005; Bruggeman, 2005) . This could be due to a vast array of variables introduced when a runner is switched into a barefoot condition. Any results may not be indicative of a more barefoot change but rather general change in footwear. Therefore, it seems appropriate to test one variable at a time.
The major differences shown between barefoot and shod conditions need to be further investigated to determine which, if any, could lead to injury reduction. These include shock attenuation, peak forces, proprioception level, psychological effects and gait changes.
An increase in proprioception has been shown in barefoot conditions (Robbins, 1995). Further, this increases lateral ankle stability and prevents ankle sprains. Ankle sprains own a small proportion of total running injuries so this variable seems unlikely to be a large factor (van Gent, 2007). However, increased ground feel may help runners take more care in their stride since they are able to feel the ground reaction forces. This deals with the psychological aspects of barefoot running as well and could be an important factor.
Many major shoe brands market shoes to be soft, supportive and protective. This allows runners to believe their feet are less prone to injury and can result in careless gaits which can lead to overuse injury. The multitude of running shoes available now may cause a “what if” factor instilling a sense of uncertainty that the runner purchased the perfect shoe for their foot.
Most running injuries stem from overuse and manifest as musculoskeleton problems such as shin splints, stress fractures and muscle strains (Hreljac 2004). Lieberman showed that peak forces were decreased with a more forefoot landing in runners. This would lessen the total peak forces on the body over the total course of a run. Other studies suggest a link between barefoot running and strike patterns (Maiwald, 2008; Lieberman, 2010; Robbins, 1994). Shod conditions showed a higher tendency to land more on the heel than the unshod condition.