In my last article, “Barefoot Running: Evolution or Revolution”, I gave a somewhat in-depth review of the research on barefoot running versus running in heel-cushioned shoes. In this article, I would like to follow up with the latest information on barefoot running and review the guidelines and considerations for starting a barefoot running program. This article is, in part, written in reaction to the increasing reports of lower leg injuries in recent articles as well as trying to convey my own suggestions to developing a more comprehensive barefoot running program based on my experience as a corrective/sports massage therapist who sees many injured runners and as a personal trainer/running coach who has gained insight as to what these injured runners are lacking in their training programs as well as their running form.
Ross Tucker, Doctor of Exercise Physiology at the Sports Science Institute of South Africa and a leading expert on barefoot running, made three key points on barefoot running research in a public presentation in Africa, late last year. A week after the presentation, Dr. Tucker chaired a roundtable discussion at the UKSEM (Europe’s largest Sport and Exercise Medicine conference) in London featuring a session called, “Natural Running - Advantages and Disadvantages” which included the following world’s leading researchers on barefoot running:
*Professor Daniel Howell, Anatomy Professor at Liberty University (USA).
*Dr. Simon Barthold, a podiatrist who is now Asics’ global research consultant.
*Professor Benno Nigg, one of the world’s leading biomechanists.
*Professor Daniel Liebermann, a Harvard evolutionary biologist.
*Dr. Mathias Marquard, a clinician and running coach.
All of these experts agreed and supported Dr. Tucker’s following three points:
For all the running research showing how impact forces and loading rates are reduced when barefoot, it remains to be scientifically proven that this leads to lower injury rates. Although Dr. Lieberman’s research shows that the impact transient (the force at ground impact) is 700% higher for heel-striking than forefoot striking while running barefoot and Irene Davis’ research has linked these higher impact forces to injuries like shin-splints and potentially knee problems, only long-term, prospective studies will show the real evidence for injury and performance rates.
As a side-note: The entire panel agreed that running shoes have NO NEED for:
massive cushioning, stability devices, motion control devices, built-up medial arch supports nor rigidity! As we learned in my last article, Barefoot Running: Evolution or Revolution, there is not one shred of evidence to support these features. (Fortunately, the shoe industry has already started to cut-down on these features).
Barefoot running is a SKILL. Evidence suggests that barefoot running produces potentially beneficial changes in running form and kinetics; However, it may lead to injury especially during the initial transition from running shoes for those who continue to heel-strike when barefoot or ‘slam’ their forefoot landing which leads to great strain on the calf and soleus muscles, Achilles tendons and muscles of the foot. We must recognize that going from heel-cushioned shoes to minimalist shoes or barefoot is, in fact, a skill and involves a significant change, and therefore, a consideration for patience and time.
Barefoot running will help most runners, in some degree, either as a minimal training technique (since it provides a good training modality by loading the joints differently and activating different neuromuscular patterns that may have benefit for running performance... even when wearing shoes) to be incorporated into an existing program OR as a fully developed skill and way of running.
Whether you decide to use barefoot running as a training modality or as a fully developed form of running, we can all heed the advice of Dr. Tucker when he suggests that the key concept to remember is ‘that you have to manage the change as though you were doing a training regime for the very first time’. Although it may be considered a ‘natural’ way to run, runners need to patiently learn the ‘new’ form and allow time for the body and brain to adapt.
Keeping these three points in mind, Dr. Tucker suggests considering the following practical approaches to barefoot running:
If you are injured...give barefoot running a try. It will switch the load and add a new stimulus to your training and injury recovery. ( As in any rehabilitation, your goal is to get out of pain first. Consult your physical therapist as to how you might integrate going barefoot in your rehab as well as post-rehab conditioning program).
If you are NOT injured...give barefoot running a try but be careful and add it as just a training modality. If it is not broken, do not try to fix it! However, use it as a training modality to gain the added benefits it has to offer. (Follow the Pre-Conditioning Guidelines and establish a “proper” running form first, then you will be in a better position to decide if you want to transition into barefoot running fully).
If you are a High Mileage runner... use barefoot running ONLY as a training modality! You are too ‘competitive’ (...as Dr. Tucker puts it mildly...) and will injure yourself because you will over-do it and guarantee yourself injury! (Follow the Pre-Conditioning Guidelines and establish “proper” running form first and then progress to using it as a Modality).
If you are constantly battling calf, hamstring, foot and ankle problems... consider barefoot running as treatment but be ultra-conservative. Use it as a strengthening treatment and start with only 5 minutes of walking (not running) first. (Consult a physical therapist to help assess your problems and prescribe stretches and exercises).
Guidelines for Barefoot Running:
[ Preface: As a personal trainer, I am very reluctant to suggest specific exercises for anyone without having first analyzed posture, range-of-motion and muscle activation and strength as well as having interviewed for personal history and goals. I consider it irresponsible for any trainer or writer to make any suggestions without such assessments simply for the fact that there are too many personal variables and levels of progressions to accurately prescribe exercises. With that said, I would still like to suggest some general guidelines for progressive conditioning and the transition into barefoot running.]
(1 to 3 months).
Walk Before You Run. Cushioned heel shoes condition a person to strike more forcefully to collect information about the terrain and to seek stability. Therefore, you must consciously land ‘lightly’ when first going barefoot. Dropping the heels down to the ground after they have been riding high in heel-cushioned running shoes (not to mention high-heels) will force a stretch in the calves, soleus, Achilles tendons and foot muscles for most runners. So, again, respect the transition and allow time for the muscles to lengthen and activate through walking. As Dr. Irene Davis suggests, work up to at least 30 minutes (I recommend an hour) of walking regularly (3 to 5 times per week) first before running. [Tips for walking barefoot: Shorten your stride, land lightly on the heel and stride smoothly. Try landing on the outside heel and blade of the foot before rolling across the ball of foot towards the big toe for an even smoother stride].
Stretch and Massage Legs and Feet (if not the whole body). While you are in your walking phase getting used to barefoot walking, or minimalist shoes like the Vibram FiveFingers, be sure to concentrate on gaining proper flexibility through a proper stretching routine, especially about the joints of your ankles, knees and hips. Most people will find that taking away the shoes and having to drop the heel that much closer to the ground will put added stretch and stress on the calf and soleus muscles , Achilles tendons and fascia of the foot. Massaging will accelerate this process, not to mention that it will help rid the soreness you most likely will encounter during the transition. The rest of the body will benefit from stretching and massage as well. In addition, if you are not stretching and massaging regularly, it will be a beneficial behavioral modification to help balance out your training routine.
Strengthen Your Tendons. Any proper exercise program must first address strengthening the tendons before strengthening the muscles. Tendons take longer to gain their tensile strength than muscles. If tendon strength is not addressed first before developing muscle strength, the stronger muscles are likely to overstress the lesser developed tendons and cause tendonitis or even worse, strains or tears! [ Strengthening the tendons can be done concurrently as proper range-of-motion and flexibility are being gained: A complete circuit training working all major muscle groups with 20 repetitions per muscle group will emphasize strengthening tendons (and emphasize activating muscles rather than strengthening them). For example, start with 1 set of the circuit and work your way up to 2 sets 3 times per week.]
* Strengthen Your Core and Stabilizer muscles. Core strength must be developed before the rest of the body since all sheering forces in most movements will stress the lower back, thus risking injury, possibly compromising or causing irreversible damage to the vertebral discs. The stronger and more flexible the core muscles (transverse abdominis, rectus abdominis, internal and external obliques of the abdominal region and the erector spinae, multifidus of the lower back) , the stronger the lower back, and the more space available between the vertebrae, and the less likely the lumbar/sacral discs will be subjected to bulging, herniating or rupturing! Stabilizers must be strengthened before the large mover muscles they compliment since the larger muscles are only as strong as those stabilizers. Squat too much weight in the gym with weak leg abductors or adductors, for example, and run the risk of having the knees buckle in or out causing injury. Run too much with tight and weak abductors and run the risk of developing I.T. band syndrome characterized by lateral knee pain and if severe enough inhibition of movement about the knee and thus performance (not to mention taking you out of your training routine). Stretch and strengthen the abductors and adductors Equally or run the risk of one overpowering the other and consequently pulling the knee out of alignment. ...Getting the picture yet?! [ Strengthening the Core and Stabilizer muscles could start about midway (after 4 to 6 weeks) through an 8 to 12 week flexibility and circuit training program, for example, (...since you still want to build up their tendons first, right??!!). While working through the flexibility and circuit training progressions, just change the resistance to the existing core and stabilizer muscle exercises to more of a strength training regimen that would involve, for example, 2-4 sets of 12 repetitions in the beginning progressing later to 6 repetitions.]
Strengthen All Major Muscle Groups. Once your muscles have reached proper range-of-motion and tendons, core and stabilizers have been given a head-start, the training program would advance from the circuit training routine of 20 repetitions to lower repetitions and heavier weight for sport-specific muscle groups; First in isolation progressing towards complex sport-specific movement patterns.
However, once the major muscle groups are ready to be strengthened, the training program becomes too dependent on the goals of each individual athlete to be specific for our purposes here. [ Consult a Personal Trainer, physical therapist or Qualified Running Coach for a detailed strength training program. ]
Practice (holistic) running drills. What I mean by holistic is to build up each component or phase of your running stride and running form independently first through isolated standing drills (along with appropriate stretching and strengthening exercises for proper balance, posture and alignment) and then let them slowly integrate into a strong and efficient overall stride through the progression of running drills and later running. Each phase of your running stride will become stronger leaving you with no weak links. Later, when an acute awareness of proper form has been established, these component drills can be emphasized individually during long runs in an effort to integrate them into a complete and cohesive stride. And, a proper running form will decrease the risk of injury and the consequent time away from training that may result from existing faulty recruitment patterns. I would suggest at least one month of stretching and massage (or more, if you are in pain or injured) before developing proper running form since it is easier and more time efficient to erase the faulty muscle memory of your old stride before developing a proper new one. Otherwise, you are basically laying down a new muscle memory over the old one and creating twice as much work to erase the old, faulty recruitment pattern. Once you are able to walk barefoot for 30 minutes to an hour 3 to 5 times per week and have erased old muscle memory and regained acceptable ranges of motions through stretching and massage, you could, for example, schedule out the progressions of the running form drills (standing, standing and short runs, and rotating them during runs) with the progressions of your Pre-Barefoot Conditioning Guidelines and Transition Management period.
[ To learn these running drills and develop proper running form attend one of my Running Clinics or schedule a personal coaching session. Visit my website at johndodsonmassage.com ...or contact me directly.]
All of the expert participants in the UKSEM roundtable discussion agreed that there is no right way to approach the transition from running in shoes to running barefoot. Since these experts are still in the midst of studying the best way to make the transition, it should be sound advice to “listen to your body!”. If, in your transition, you are still sore more than 2 days after your barefoot run then you probably did too much! Let yourself recover and then tone down on the barefoot running to where you are not sore more than 2 days after the run.
Once a runner has worked up to 30 minutes to one hour of walking barefoot 3 to 5 times per week (and optionally followed the above Conditioning Guidelines and Running Form Drills) the feet and legs will be much more prepared to make the transition towards running barefoot and the neuromuscular system is more apt to run efficiently.
However, for the 75% of runners who heel-strike, the forefoot (or mid-foot) striking will require a slow and gradual transition. Dr. Barthold takes a gradual transition approach to mid-foot striking by suggesting to run in lightweight training shoes and then racing flats before going fully barefoot or wearing a minimalist shoe. Again, he is making this suggestion to allow the lower legs and feet to stretch and strengthen, the neuromuscular system to coordinate a more gentle foot strike and develop a more efficient stride.
Transition from walking to running:
Dr. Irene Davis suggests to build a runner up to 30 minutes of barefoot walking first. After that, build up to 30 minutes of running by starting out with 1 minute of running and 9 minutes of walking (for 30 minutes) progressing towards 9 minutes of running and 1 minute of walking (for 30 minutes).
Similarly, Dr. Lieberman himself suggests to start in your existing running shoes and to then take them off (or replace them with minimalist shoes) within sight of your house to run the remaining distance barefoot. Do this every second run but from a slightly further distance from your destination in building up to 40 minutes in 3 months (as an example).
Again, based on my experience, I strongly recommend following the above Conditioning Guidelines as well as the Proper Running Form Development in addition to the suggestions being made here to properly facilitate a successful transition to barefoot running. By going through the proper development and progressions you will be building a strong foundation for later training in a time-efficient manner and you are decreasing your overall chance of injury.
Using Barefoot Running as a Modality:
As a modality to add to your running training, it is still a good idea to build up a good amount of barefoot walking time to stretch, strengthen and activate the muscles and connective tissues in your lower legs and feet before attempting using barefoot running as a modality. After which, you can simply walk/jog barefoot or in minimalist shoes (for better protection) for a few minutes after your warmup and/or workout. Keep it simple: Start with 3 to 5 intervals of walking and jogging for a few minutes 2 to 3 times per week. You can then progress the jogging to running and running to sprinting as your program necessitates. Again, listen to your body!
Land on the ball of your foot. As mentioned earlier, Dr. Lieberman’s research indicates that when you take the shoes off and continue to heel-strike the impact force is 700% higher than when landing on your forefoot. Taking into consideration that 75% of runners who run with shoes land on their heels, their is a huge potential for injury during the transition phase of going from running shoes to barefoot running. In addition, landing on the ball of your foot will develop better momentum in your overall stride compared to a heel-strike that not only slows the stride pattern but adds greater impact forces to the ankles, knees and hips (whether you wear shoes or not). Running barefoot has also been shown to increase efficiency by 5% over shoe wearing (or shod) runners.
Develop a light foot-strike. If you have been wearing heel-cushioned shoes, you have developed a running stride that forces the foot-strike. Since there is a wedge of cushioning between you and the ground, your foot is striking even harder to find stability. Remove the shoes and continue to run like you were and you would be beating your feet into injury. So, tread lightly. Your sensory feedback from your feet and legs will let you know what is comfortable and what is too much. Listen to your body!
Avoid over-striding. Taking too long a stride will force the hips to arc higher in mid-stride and subsequently cause a more forceful landing. Taking shorter strides will minimize the impact force at foot strike since the hips will not make such a dramatic arc upward. This will also increase your running efficiency; The less bounce you have up and down, the more streamline your movement forward will become.
Dr. Tucker states: “Nobody knows what “perfect running form” is just yet, and the problem is that it may be individualized based on a set of say 50 different inputs. ...
However, [he does] think it wise to at least consider HOW you run. ...barefoot running is not by itself the answer. It’s a means to discover the answer, perhaps, and for some people, it may go on to become the solution. But for most, it’s a good way to accelerate the discovery of better running, to strengthen and condition differently, and then to benefit from that later on”.
Until we have more research to begin to indicate what “perfect running form” might be, we can still heed Dr. Tucker’s advice to accelerate the discovery process by investigating proper running form with a coach or trainer and discovering sound ways to approach conditioning, strengthening and recovering for the means of preparation, performance and maintenance.
And, as you go about your discovery, listen to your body!