Should We All Run Barefoot?

Now this has been a popular topic for several years! Immediate answers to that question include “Well, maybe,” or “It depends.”

Let’s first delve into the theory behind the practice of barefoot running. Supporters of barefoot running contend that years of wearing shoes have led to our feet becoming weakened, atrophied, and delicate. This is probably true to some extent. It is also possible that several dozen generations of this practice may be accelerating this change in the human to a more shoe-dependent foot.

When running barefoot, we tend to land more forward on the foot (midfoot/forefoot versus heel) and also to land with a more flexed knee. These two components help to reduce impact forces and more optimally align the lower limb during our stance phase of gait (stance is when the foot is on the ground, the swing phase is when the leg is in the air). Barefoot running contributes to a more ideal stride and strike pattern for most people. This proper form is more artistic in the runner and may lead to decreased injury risk and/or potential performance improvements.

However, the musculoskeletal “work” done by all those tendons, ligaments, muscles, bones, and other tissues in the foot and lower leg when running barefoot is quite high. It takes a long time, actually a number of months, for these connective tissues to adapt to the forces of barefoot running. Therefore, we should “dose” our barefoot running (among those for whom it is appropriate) very gradually. The best way to do this is to run barefoot on a well-manicured grass field such as a golf course, a high-quality track, or a beach where available. Of course these venues are not always accessible, but they are ideal for at least three reasons: 1.) the surface is consistent, allowing you to look at the horizon instead of down where you are placing each step, 2.) the surface will usually be safe with respect to such hazards as broken glass, etc., and 3.) the surface will be more forgiving (soft) and will be easier on the body. A good way to introduce barefoot running into your routine would be to add 4-6 x 75-meter strides (acceleration runs at about 75% max speed, not quite sprinting) at the end of a few runs per week, or perhaps doing one or two short recovery runs of 2-4 miles each week, all on the surfaces mentioned above.

One of the challenges we have seen in the physical therapy clinic with barefoot running is that most runners don’t want to run less. They come in with all sorts of goals, ideas, or assignments for us, but nobody ever says “Hey, I want to run less mileage than I currently am doing.” It’s just one of those runner things. However, when a runner introduces a new physiologic stressor as powerful as barefoot running can be, it is imperative that the barefoot running be a small and very gradually increased dose, and overall mileage is slightly reduced to allow the tissues to adapt and compensate. This is where most runners make errors and get injured.

Is there any runner for whom barefoot running is not such a great idea? Absolutely. If we have a runner who is both heavy and hypermobile in the foot/lower extremity, he/she may not be the best candidate for going barefoot. Why? Well, even though it is true that you can strengthen the leg and train the neuromotor system to use a certain technique, the ability to effect change through training is still somewhat small in most people. That heavy, hypermobile person is only going to be able to strengthen so much. Their relatively high bodyweight-induced ground reaction forces, coupled with their intrinsic skeletal instability make them vulnerable to tissue overload and breakdown. “At-risk” individuals should approach the shoeless condition with caution.

What about shoes? Well, I think shoes are a wonderful invention, and for most of us, most of the time, most of our running should be in shoes. They protect the feet from a lot of the surfaces modern runners train and race on. If we all lived where there was nothing but grass or beach that may be different, but most runners train on a mix of trails, roads, and other surfaces. A shoe sure comes in handy when running down a gravel road. But I won’t go too far here because that is another topic, i.e. “what kind of shoes should runners use”, and I’ll address that soon.

In summary, barefoot running can be a liberating experience , and it can help improve our form and technique. Like anything, we just have to be thoughtful about how we apply it and “one size does not fit all” with respect to running barefoot.

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