(08/16/2013)


A few years ago, I wrote about barefoot, or minimalist running, as I made the switch myself from shod (shoe) running to the minimalist style. While it’s been two years since I gave all my padded shoes to Goodwill, there has been a lot more controversy regarding this style of running (and walking), and more studies trying to explain why running without shoes could possibly be better for us. After all, how could anyone give up fancy, cushy shoes for, well, very little between the foot and harsh pavement? I still believe there are beneficial reasons to do so.

 

minimalist footwearNow that I’ve experienced my own trial of running in minimal shoes – and I do emphasize trial – I feel I’m in a pretty good position to comment on this topic, both as an athlete and a health care professional. Not only do I have a physical running base in this style, I have also treated many runners and folks that began wearing the minimalist style shoes.

The New York Times has been a consistent provocateur on this topic since it first discussed Daniel Lieberman’s study back in 2010, and it was quick to pounce on two recent studies that made me scratch my head. This one, which took 36 shod runners and suddenly made half of them run in minimalist shoes, then compared MRI scans to the shod half, found the minimalist half had evidence of bone injury in the foot. My issue with this study is its true lacking of what I call “instinct research.” As any shod runner who has transitioned to minimalist shoes will inform you, that transition is delicate and must be constantly fine tuned. You cannot ask lifetime shod runners to suddenly slip on Vibram 5 finger shoes and say “run!” As I said when I last wrote about this, transitioning must be taught, because the forefoot strike is completely different than a heal strike (that’s why there are books written about it). So my “instinct research” would be to interview runners who made the transition, understand the process of bio-mechanics in making that change, then teach it to the study group so the actual study can be more accurate.

In another study, doomfully titled “Is Barefoot-Style Running Best? New Studies Cast Doubt,” again 37 or so runners, some heal strikers and some forefoot, were asked to don minimalist shoes and run like hell on a treadmill. While this study looked at performance and not injuries, its conclusion was that the minimalist running style showed no benefit, either to foot strengthening or economy. Again, the participants were not instructed on running style changes when running in minimalist shoes, and they were asked to run on a treadmill. Treadmills are not the same as running on pavement or even grass; they are padded and offer a much more spongy environment for the foot strike, and it is not an accurate measurement of foot strike in the real world of most minimalist runners.

From a professional standpoint, and from someone who has now treated the minimalist athlete (and grandmas that are wearing minimalist shoes for walking), another thing that bugs me about these studies is the lack of consideration to human bio-mechanics. Every single runner (or walker) has a different gait, with different sets of mitigating bio-mechanical circumstances. Even if you teach folks how to run or walk in minimalist shoes, they will ultimately have to fine tune their own style, whether they realize it or not. There are some hardcore athletes who will run in minimalist shoes and never have issues, while others will have to strengthen the anterior and posterior compartment of the foot and ankle to avoid injuries. Truthfully, and this is something that is not mentioned in the studies, minimalist running puts a tremendous strain on the flexor compartment of the ankle and foot. One of the many injuries I see in minimalist runners – including myself- are soleus (the muscle pancaked under the calf muscle) strains. It does not mean you should not run in minimalist shoes, but that you may have to prepare for the change.

The question I still get asked the most is the same one I wrote about two years ago. Should you transition to minimalist-style shoes? My answer is still the same. Yes and no and maybe. Runners and walkers with a solid base of exercise that are instructed correctly and shown preventive measures, absolutely. Folks with issues such and plantar fasciitis maybe- again, with the proper guidance. Folks with no exercise background, that are overweight, have bunions and irregular gait- still maybe but probably no until they complete a solid rehabilitation program that sets goals for minimalist shoes. If you take away padding and support for the foot, the muscles of this region are forced to develop to help support the forces of foot strike – and bio-mechanically, it’s a no brainer- muscle’s hypertrophy when they are challenged with resistance. I am still in agreement with Lieberman’s initial study.

Do I still believe in the merits of a forefoot strike? Yes. As someone who switched from a heal strike, I can tell you I run better, faster, and all of my original issues have vanished. Yet until studies take into account the enormous personal differences in running and walking style, these studies will always result in biased negative results.