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Minimalist Shoes and Barefoot Training

The topic of barefoot running is one that will draw mixed opinions from any health care professional.  All shoe companies are now in a race to capture this part of the market, and many of these companies have their own ‘minimalist’ shoe.  This post is not to necessarily promote or advocate ‘minimalist’ shoes or barefoot running; we write to provide information about the basics, and some of the common issues that we see arise from this as physical therapists.

 

What is barefoot running?

The idea of barefoot running  has been studied for many years, but much of the mainstream popularity was created by the bestseller,  Born to Run, by Christopher McDougall.  In the book, McDougall, a journalist and avid runner, traveled to Mexico to run with a local tribe that has been competing and running for generations barefoot.  McDougall proposed that everyone should be running barefoot because this alters your gait cycle and promotes a more efficient gait.  In addition, this tribe, as well as humans, have run and walked for thousuands of years barefoot.

The biggest change is that barefoot running forces the individual to land on their mid and fore-foot rather then on their heel and rear foot (as most traditional running shoes now promote).  This, in theory, should reduce the forces through the lower extremity in body at impact.  Check out these great videos showing impact forces, courtesy of the Harvard University Skeletal Biology Lab:

 

Barefoot Running

Running in Shoes With Heel Strike

Why has barefoot running and minimalist training become so popular?

Much of the popularity is attributed to McDougall’s book, and now you can hardly go a day without seeing someone training, walking or running in Vibram Five Fingers.  One can argue whether this is just another ‘fitness fad’, while others may say that this trend is here to stay.  Many in the weightlifting community have been training barefoot or with minimal shoe wear for years.  Only in the last forty years has shoe design changed to promote more of a heel strike.

Evolutionary history suggests that the human foot was designed to be adaptable and durable without shoes.   Proponents of barefoot training and running will tell you that this promotes a more efficient and greater shock absorbing gait pattern. Other added benefits include less expenditure of energy, and a stronger foot!

 

What does a ‘minimalist’ shoe look like?

Almost every shoe company now has a minimalist shoe, with the most popular being the Vibram Five FingersNew Balance Minimus, and Nike Free Run.  Essentially, these shoes provide protection to the foot, but allow you to run as if you were running barefoot.  They tend to be very lightweight, flexible, have a very wide toe box (front of the shoe), and have a ‘zero-drop sole’.   This means the heel of the shoe is the same thickness of the rest of the sole.  Each shoe company has put their own style and trademark on the ‘minimalist shoe.

 

What are common problems that you see from people wearing these shoes?

1) Do NOT think that wearing a minimalist shoe will cure for all orthopedic injuries and maladies!  Training barefoot or wearing minimalist shoes will not cure your injuries!  Most individuals have worn shoes with support and cushioning since a very young age.  This support often causes a relative weakness in the intrinsic muscles of the foot.   We strongly advise individuals to consult with a physical therapist or health professional if you are dealing with an injury before wearing this shoe.

2)  Not allowing yourself enough time to transition and get use to the shoe.  Because the shoe does not have a raised heel, many individuals have difficulty because their calf muscles are constantly on stretch.  This is why many people feel sore when first wearing these shoes.  In many instances, if you don’t allow enough time to transition into this shoe, we see individuals with plantar fasciitis, achilles tendonitis, or other lower body injuries.

 

What do you suggest if I’m interested in wearing a minimalist shoe?

1) Make sure that you are injury free.

2)  Start by wearing your new shoe for errands, household chores, or walking.  If you start to feel sore (and you likely will), switch back to your regular shoes.  Continue with this progression, until you feel like you can comfortably wear a minimalist shoe.  This sometimes takes a day, a few weeks or even a few MONTHS.

3) Make sure you are regularly stretching your calves and plantar fascia.  The Stick’, foam rollers, spikey ball or other self-myofascial release tools work wonders in these areas.

4) Don’t jump right to running in these shoes.  If you were running a marathon, you wouldn’t run 26.2 miles without training first.  The same rationale applies for minimalist shoes.

 

Should I run in a barefoot or minimalist shoe?

If you choose to run in this type of shoe, we suggest you build up VERY slowly.  Start with walking, then progress to quarter or half mile intervals.  Slowly increase your time running in them by no more then 10% a week of total time or volume.  Be patient with your progression.  This should take several weeks.

 

Do you ever recommend someone not wear this type of shoe?

We advise those that are dealing with a lower body injury or have recently had surgery to avoid use of this shoe in the short-term.    If you have very flat feet,  consult with your PT or health care professional first before beginning this transition.  Exercise prescription and manual therapy can often help make this transition better.

 

Where can I find more information on this topic?

Runners World has some quality information about how to transition.  The barefoot running group at Harvard University has studied barefoot running in a lab for years, and has a wealth of information of videos and topics on this topic (Disclaimer: they are funded by Vibram) .  Irene Davis, a physical therapist and professor at the University of Delaware, has written a lot on this topic as well.

We encourage you to become educated before making a decision of transitioning to this shoe for exercise.  A little bit of knowledge, will save you time, money and injury!

Check out Dr. Tamer Issa's book, Freedom From Neck & Back Pain- Learn to Live an Active Life Without Fear of Pain
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