Barefoot Running – Who can benefit and should you try it? The other day a young patient who had been having some problems with shin and ankle pain talked her mom into purchasing her the new Vibram five fingers style running shoes. If you are not familiar with these, they look like a glove for the feet and slip on like one too. They are one of the many styles of shoes designed for those who are now going minimalist or barefoot in their running style. Recently, I joined an advisory board for the barefoot runners society, a group dedicated to running barefoot or minimalist. Running barefoot changes your running gait, and I have seen video’s of people running on freshly paved country roads barefoot. True, many tribes in Africa grew up and aged shoeless, and those who were most able lived long lives and would run from village to village barefoot. Some of those same runners due to genetic adaptation win the NY marathon each year. Running in shoes or shod running tends to allow a larger stride and those that do have a harder heel strike. The argument for this is that there is a spring mechanism that allows for better absorption of forced while running barefoot, partially because barefoot running has you running into mid foot strike rather than heel strike with a longer stride. While those who now advocate for the barefoot approach state that their legs feel better, most who decide to run barefoot develop other issues, such as damage to the tissues on the bottom of the feet, or they continue to have problems in their calves or heels even barefoot. Can you run and hide from your body mechanics by changing from shod (shoe) to barefoot? Many runners who decide to go barefoot or minimalist do so believing it has made them feel better. Is it possible that they feel better because their gait is different barefoot, but this induces other mechanical issues? Shouldn’t we be more objective. The way we feel while running is quite subjective, and we base the way we feel on what we believe is normal. For most of us, symptoms is not normal and a lack of symptoms is normal or is it. Thought of another way, the way we walk is determined by our genetic make-up and by the age of 6, we typically stand and walk the way we will as an adult would, with the exceptions of height and width (women develop wider hips). If you are built asymmetrically, you are likely to be inflexible and if you have flat feet or low arches, you are likely to be even more inflexible. Those who have severe foot overpronation (foot flare, with flat feet) may even experience pain from the time they are in their teens. Relating this to running, running shod will give you a larger stride and you are likely to have a heavier heel strike, with a secondary stride in the upper body for compensation. If you run barefoot, the stride will be shorter, but the body dynamics for shock absorbtion will be different as well. If you are asymmetrical and run shod, we will see over and under striding in both the lower and upper back. If you run barefoot, we will see the same. In this doctors experience, running either way will be affected by body mechanics and when you are built asymmetrically, it will distort your core as you try to push it with higher mileage, causing a harder heel strike, shod or not, resulting in problems such as shin, heel, knee and other complaints. The advantage of shod running, even if we go more minimal in the shoe is that we can help offset the disadvantages of body mechanics that are less than ideal for running. The goal is to keep you on the road, so being open to alittle gait help is a good thing, not a bad one. Those who are asymmetrical will benefit from a minimally invasive orthotic shell such as the black superfeet which are small, and are a tiny shell that will fit in the shoe. On a treadmill, you will see immediate improvements in stride length and shoulder movement. Since runners are different, doctors need to be flexible in their approach to how we help them so they can run better, with improved mechanics and less pain. On the other hand, runners who prefer a total non shod approach and are symmetrically built, may do quite well without an insert in their shoe. They are the ones that ran in regular shoes, and decided to switch and likely had few problems running one way or the other. One other thing that can help both types of runners is to relax the shoulders. Runners who are built asymmetrically tend to compensate by hunching their shoulders which limits upper body movement and exacerbates foot strike, over and under striding and actually slows your pace down while increasing your pulse (makes you work harder, try it with a heart monitor). As a final thought, shod and barefoot running are two different mechanisms with differences in the way we use our bodies. We as runners must not be dogmatic blinded by a belief system that can leave us injured and off the road. Those who are asymmetrical need to be willing to try minimalist shoes with mild correction. While it may not work for everyone, it works for most and is based on sound engineering principals. Happy running. Let me know what you think. As always, I value your opinion.