rev*o*lu*tion n. 1. An abrupt overthrow of a government or group of
rulers. 2. A sudden or radical change in a system or state of affairs.
There seems to be a revolution taking place today in the running shoe industry. More and more Americans are running barefoot or running in those funny-looking glove-like shoes with five individual toes called FiveFingers. The maker of those shoes is Vibram, an Italian company that originally designed them to be deck shoes for boating. However, with recent research suggesting that modern running shoes do not improve performance nor prevent injuries and the inspirational 2009 book Born to Run by Christopher McDougall, waves of modern runners are going barefoot or taking a protective approach by wearing the Vibram FiveFingers (pictured below) or other similar ‘minimalist’ footwear from companies like Merrill, Feelmax and Terra Plana.
With the North American running shoe sales at 2.3 billion (2008) and the broader sports shoe market at $17 billion (2008), this new trend towards minimalism could have a large impact on the traditional running shoe giants like Nike, Reebok, Adidas and Asics. However, all of them have defended that their traditional “thick-heeled midsole” running shoes help runners perform better and protect feet from stress and strain.
Saucony and New Balance are the only running shoe makers to at least come out with shoes with a thinner midsole, a compromise, so far, between traditional thicker midsoles and the minimalist barefoot shoes with no midsole at all.
Asics and Adidas continue to ignore the barefoot movement and advertise more ‘supposedly’ technologically advanced “Heel-to-Toe” designs at ever-increasing prices: Asics sells the Kinsei 4 for $185.00 boasting they perform like “integrated accommodative orthotics” and Adidas has paired up with Porsche to sell the Adidas S running shoe, based on a car’s spring suspension system, starting at $199.00.
Nike and Reebok, on the other hand, tried to sidestep the barefoot movement with their thickly midsoled Free and Realflex models, respectively. Nike even tried to deceive the American public with a confusing TV advertisement in which they showed elite distance runners in a multitude of scenes, complete with motivational music and inspirational slogans that, at the end, told you to “Run Barefoot”. But, the confusing part was that every runner had on a pair of Nike Free... basically a light-weight running shoe with a thick midsole but without any outer sole or tread!?
Although the giant running shoe makers defend their marketing stance that their high tech, thick midsole shoes “improve performance and prevent injuries”, there is a growing number of medical and scientific researchers that disagree. Basically, there is a warring debate between the growing number of barefoot runners and scientific researchers on one side and big business on the other, comprised of the running shoe giants, podiatrists and sports-medicine experts.
The debate is over whether it is better for a human being to run in a thick, heel-cushioned running shoe striking on the heel and rolling towards the toes (as the running shoe giants would have you believe) or whether it is better to land with a bare forefoot or midfoot strike (as the researchers are proving and barefoot runners are attesting).
With an estimated 35.5 Million American participants in running annually (National Sporting Goods Association, 2010) and an estimated 75% of those runners striking on their heels as a form of running (Hasegawa et al., 2007) and with 30 to 75% of runners injured annually (Davis, 2011), this debate deserves critical attention.
History of Modern Running Shoe
The notion that runners should throw on a thick, heel-cushioned running shoes and run striking heel first originated with a man named Bill Bowerman, track and field coach at University of Oregon. As Christopher McDougall tells the story in his book, Born to Run, Bowerman was introduced to the concept ofby the ‘father of fitness and the most influential running coach of all-time’, Arthur Lydiard in New Zealand in 1962. An immediate convert to jogging and its health benefits, Bowerman returned home and started promoting “jogging” to Americans through running clubs and published a best-selling book in 1967 entitled: Jogging. Lydiard’s teachings and the research of that time on running supported a ‘flat foot’ (ball-of-foot) strike that Bowerman acknowledged and described as ‘easy on the body’. But Bowerman had an unresearched and unproven idea that a “heel-to-toe” stride would be better if you could put a piece of protective rubber under the heel and reach out and grab a little extra distance ahead of your center of gravity. The protective rubber came in the form of a running shoe that Bowerman himself designed and his runner-turned-entrepreneur Phil Knight would later turn into... Nike!
Evidence for Running Shoes
Now, many researchers are starting to challenge the giant shoemakers idea that “more cushioning” is a better safeguard. Dr. Craig Richards of the University of Newcastle in Australia revealed in an article in the British Journal of Sports Medicine (2008) that there are no evidence-based studies indicating that running shoes make you less prone to injury. Translation?.....Since Bowerman spawned the first heel-padded Nike running shoe back in 1972 there has not been one scientific study to substantiate the notion that padded-heel running shoes reduce the risk of injury!
Dr. Richards, on his huntersgate.com.au website has since challenged the running shoe manufacturers to a 12 month study in which they will need to prescribe which shoes from their line are best for a group of particular runners, donate those exact shoes to the runners and let the runners be tested for performance and injury rates. To date, not one manufacturer has accepted the challenge!
One would think that this would be a crucial part of research and development (and marketing integrity) for the running shoe companies... especially when 75% of runners wearing running shoes heel strike.
With all of the hyped ‘technology’ driving the running shoe industry, one would think that injury rates would have gone down over the years. However, in an article from the 2010 March Runners World, Amby Burfoot points out that a mid-1970s Runners World poll revealed that 60% reported chronic problems while a 2009 poll showed that 66% of runners had suffered an injury that year.
“Since the first real studies were done in the late 70s, Achilles complaints have actually increased by about 10%, while plantar fasciitis has remained the same” said Dr. Stephen Pribut, the former president of the American Academy of Podiatric Sports Medicine.
Dr. Joseph Froncioni, an orthopedic surgeon, in an article (2006) asked “Why is my office filled with runners who have injured knees (26% of running injuries), tibias (13%), Achilles tendons (6%) and plantar fascias (5%)?” And, then explained, ‘The cause of all these injuries is quite evident: cumulative micro-trauma caused by repetitive impact experienced during running”.
According to Dr. Irene Davis, director of the Running Injury Clinic at the University of Delaware, 30 to 75% of all runners are injured in an average year based on her literature review (2011). That would mean that of the 35.5 million runners in America, 10.5 to 26.6 million of them suffer injury each year.
There is no scientific evidence that heel-cushioned running shoes enhance performance or prevent injuries.
In fact, there is evidence that runners, as a group, who wear shoes are constantly injured!
Even within the running shoe design, there is evidence that the more a shoe is advertised as giving ‘better support’ in the form of cushioning gel, microproccesors, thrust enhancers and motion-control and consequently priced higher, the more a runner is injury-prone.
Robbins and Waked, in a 1997 research article in the British Journal of Sports Medicine indicate that advertising messages for running shoes that suggest superior impact absorbtion and protection are deceptive and create a false sense of security with users of expensive running shoes.
Dr. Bernard Marti at the University of Switzerland reported in the American Journal of Sports Medicine (1989) that runners wearing the more expensive running shoes were 123% more likely to get injured than those runners wearing cheap running shoes.
“The perception is that if you pay more, you will get better shoes” but “our research did not show that”, comments Professor Rami J. Abboud, director of the Institute of Motion Analysis and Research at the University of Dundee in Scotland.
In fact, there is evidence that worn-out shoes are actually safer than new ones. Dr. Barry Bates and colleagues (1988) reported in the Journal of Orthopaedic & Sports Physical Therapy that “foot control seems to improve as cushioning is lost and foot control accounts for at least half of running shoe related injuries”.
Researchers Steve Robbins and Edward Waked (1997) at McGill University in Montreal first discovered this relationship between balance and vertical impact studying gymnasts. The thicker the landing mat was used, the harder the gymnasts stuck their landings.
Runners with cushioned-heel shoes, like these gymnasts, are intuitively searching for stability upon striking the ground at the cost of the increased traumatic force being sent up the leg, hip and back.
In addition to running shoes forcing runners to pound the ground harder and consequently adding more shock force to the entire body, running shoes are associated to other detriments.
Rao and Joseph (1992), having examined 2300 indian children, found the incidence of flat feet three times more likely in those children who used footwear than those who did not and concluded that shoe-wearing in early childhood is detrimental to the development of the arch.
Dr. Irene Davis, in a lecture on running shoes, form and injuries (2011) said that, ‘I really think that the reason we have such an epidemic of plantar fascitis in this country...it’s the most common foot ailment...25% of foot injuries that we see is because we’ve taught our feet to be lazy”.
“The deconditioned musculature of the foot is the greatest issue leading to injury, and we’ve allowed our feet to become badly deconditioned” said Dr. Gerard Hartmann, Irish physical therapist, in the book, Born to Run (McDougall 2009). “Putting your feet in shoes is similar to putting them in a plaster cast. If I put your leg in plaster, we’ll find forty to sixty percent atrophy of the musculature within six weeks. Something similar happens to your feet when they’re encased in shoes”.
In addition to shoes, Dr. Hartmann also believes that orthodic devices also contribute to injury. “...once you block a natural movement you adversely affect the others. We’ve done studies, and only two to three percent of the population has real biomechanical problems. So who is getting all these orthodics? Every time we put someone in a corrective device, we’re creating new problems by treating ones that don’t exist.”
The barefoot revolution could not only have great ramifications in the running shoe industry but the orthodics industry as well. According to Transworldnews.com, the orthodics market in the United States in 2010 was an estimated $932 Million.
Dr. Hartmann is not the only one at odds with the prescription of orthodics. Benno Nigg (2011), professor of biomechanics and codirector of the Human Performance Laboratory at the University of Calgary, Alberta states that there is no conclusive evidence supporting the functionality of orthotic devices. “Orthotics can work and can have fantastic effects, but we don’t know how they work”... “we don’t really understand what we do.”
Nigg proposes a shift in the approach to skeletal alignment. “Maybe we should not think of pushing the skeleton around, but rather about finding ways to give signals to the body to do the right thing,” Nigg says.
Perhaps one way would be to go barefoot or to a minimalist pair of shoes to allow deconditioned musculature of the feet to activate and gain back their function, thus increasing balance and strengthening the foundation of postural alignment.
This was echoed almost 25 years ago. Robbins and Hanna (1987) showed evidence that the running shoe prevented the arches of runners to properly and naturally deflect the loading at ground impact and related this ‘foot rigidity’ in the shoe to the high injury frequency of runners with shoes; They suggested that running shoes should be designed to allow for the intrinsic function of the foot namely its shock absorbing function and sensory perception. Evidently, their suggestion went unheard.
Dr. Dan Liebermann, an evolutionary anthropologist at Harvard University, believes that “humans were running for millions of years, apparently safely, in running flats, in thin sandals, in moccasins or in no shoes at all” (www.barefootrunning.fas.harvard.edu/).
He hypothesizes from his research of early hominid fossils that a transition between two stages of the evolution of the human foot happened around two million years ago: Before then, Australopithecus, the first hominid to have a bipedal stature, had feet adapted to tree-grabbing and walking; After that time, Homo Erectus had a foot designed for walking and, for the first time in human evolution, running. He explains that as the thick woodlands in Africa started disappearing and savannahs started growing and hosting large populations of herd animals, Homo Erectus was able to transition out of the trees and feed himself on the savannahs through persistence hunting (Nature, 2011). Superiorly equipped with running feet and sweat glands to keep cool, Homo Erectus was able to chase herd animals, who could not gallop and pant at the same time to cool themselves, until they collapsed from overheating.
Michael Warburton in an article in Sportscience reports that laboratory studies show that running barefoot is about 4% more efficient than running with shoes. And, although Warburton points out the fact that in developing countries running barefoot is associated with a substantially lower prevalence of acute injuries of the ankle and chronic injuries of the lower leg, there is still a lack of well-designed studies of the effects of barefoot and ‘shod’ (shoe) running on injury nor are there any published controlled trials of the effects of running barefoot in simulated or real competitive performance.
Though while the evidence is lacking in both running shoe and barefoot running research in relationship to both injuries and performance, researchers have shown that midfoot striking while barefoot uses the foot’s natural force-dampening mechanisms to cushion and absorb the force of impact much more efficiently than while heel striking in shoes.
Despite the increasing evidence that a midfoot strike is easier on the body and a more biomechanically correct running form, the jury is still out on whether going barefoot is actually an improvement.
“The running shoe right now is doing nothing for preventing injuries,” said Reed Ferber, director of the Running Injury Clinic at the University of Calgary’s Faculty of Kinesiology. But, he adds, going barefoot has downsides too, and the research so far is still inconclusive. “It’s a total tradeoff.”
Matt Fitzgerald, author and runner, in an article for competitor.com (2011) reports that a few physical therapy and sports medicine facilities are seeing a rise (or “injury epidemic” as Fitzgerald describes it) in overuse injuries in barefoot runners especially in cases of plantar fascitis which accounts for about 90% of these injuries. Although it is not known through research whether barefoot runners are more likely to develop overuse injuries than shod (shoe) runners, he suggests that it is barefoot running specifically and not overuse in general that is causing these injuries.
And, although evolution may explain the shock-absorbing design of the human foot, Fitzgerald contends that not all humans are made for barefoot running. He explains that most other evolutionary biologists, other than Liebermann, would describe humans as ‘generalists’ rather than ‘specialist’ endurance runners. So, some humans are going to be better suited for running while others are not.
Dr. Mark Cucuzzella, a West Virginia University professor and 2:25 marathoner who has studied barefoot and minimalist runners in relation to running injuries, warns that only a few are actually barefoot endurance running specialists....“Throw your shoes away for good? Sure, if you have perfect mechanics and you’ve been living barefoot all of your life,” he says, “but that’s not the majority of runners. Most runners absolutely need to wear shoes when they run.”
Dr. Ross Tucker, on his website: www.sportsscientists.com, argues that without controlled studies we will not understand if the rise in barefoot running injuries is put into proper perspective. Whether barefoot running causes more injuries or whether running causes the same amount of injuries regardless of what is on the foot?
Tucker speculates that the rise in injury rates from barefoot running is similar to injury rates seen just after a new running technique workshop like the Pose Method, “Runners, armed with a new, injury-preventing running technique, were going away to implement what they had learned without due caution, and breaking down at either the calf, foot or Achilles tendons”.
He warns that ‘the same will happen for barefoot running, unless the runner is a) very, very careful to manage the transition slowly, and b) mechanically able to do it’. And, although he is convinced that there are some people who just cannot get away with barefoot running, he is still waiting for scientific studies to prove this point.
Indeed, until there are unbiased, independently researched studies detailing barefoot running, we need to take a cautious approach! Running shoe manufacturers are going to use their billions of dollars to persuade us to wear their shoes while minimalist shoe companies and runners who have successfully transitioned to running barefoot without any injuries are going to tell us that barefoot running is the only way to run!?
What we have seen up to now is that barefoot running can have positive muscular benefits by activating the dormant muscles in your feet as well as enhancing proprioception; And, it has positive mechanical benefits by reeducating different neuromuscular patterns and subsequently loading the joints differently through proper running form.
We have also seen that some runners are getting injured when they switch to barefoot running due to individual differences. And, many researchers are suggesting that most of these runners are violating the adaptation process in acquiring the barefoot running skill when they make the switch either continuing to heel-strike, still forcing a forefoot landing or still running the same distances as they did while wearing shoes. Other researchers are suggesting that some individuals were just not made to run barefoot.
Whether you just read McDougall’s book ‘Born to Run’ and are pumped up to throw on a pair of Vibram FiveFingers and start running the Copper Canyons with the Tarahumara indians in Mexico or you just want to reeducate your body and adapt to running more biomechanically correct and possibly reduce the risk of injury using barefoot running as a small part of training, the key to your transition is to respect the time it will take to fully adapt to barefoot running.
Until more studies can explain the nature of barefoot running, first consult your physician, physical therapist or personal trainer to understand if minimalist shoes and barefoot running is something that is appropriate for you. And, then, if you want to give it a try, take a very, very conservative approach to integrating it into your training. The laws of adaptation of the human body still apply: doing too little will not illicit a substantial adaptation response, while doing too much will lead to burnout and injury.
*In my NEXT ARTICLE..., I will summarize the Guidelines to Safely Getting Started in Barefoot Running.
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