Barefoot running: reduced or increased risk of injury?

  • 26th May 2019
  • Physiotherapy, Running, Tips

Earlier in the month, the SPEAR physiotherapy team had a CPD session in the Aberdeen Sports Village Clinic; subject? Barefoot running. Our physiotherapy student, Eilidh, hosted the session as we discussed the pros and cons of barefoot running; and most importantly, the science and research behind this. Eilidh wrote this blog for us after the CPD session.

Barefoot running has long been a subject of the avid runner’s curiosity with the above question being the forefront of discussion and research surrounding the subject. It is easy to see how interest arose, after world record performances from Zola Budd in the mid 1980’s, a long-distance athlete who trained and raced barefoot, provoked research into the concept.

The studies and conclusions.

Various studies have compared the differences between shod and barefoot running with similar conclusions drawn from each.

  • Barefoot running increases the pressure going through your forefoot/midfoot on foot strike
  • Barefoot running has been shown to decrease your stride length (however these studies often use runners who have never run barefoot before, which might suggest that hesitancy is the reason for this)
  • Barefoot running increases proprioception (the body’s spatial awareness of the joint) compared with shod running
  • Barefoot running changes the position of the ankle on foot strike compared with shod running

If you were considering transitioning to barefoot running for any reason, several of this list may put you off, particularly if you are an elite runner with little margin for error and looking to run as economically as possible. However, barefoot locomotion appears to be beneficial for optimal foot development and partially preventative in some foot pathologies, depending on the individual biomechanics of each runner. In the injury debate, there is just not enough evidence provided to draw clear conclusions on whether barefoot running is injury preventative.

Running and injury. 

Running in general exposes you to a variety of factors that can cause niggles and injuries to arise, but this doesn’t mean running is in any way detrimental to your body’s fitness. The body continually adapts to cope any with new and increasing loads, such as increasing mileage during running sessions, but as with any system, overloaded it can start to break down.

In the same way, this applies to transitioning to barefoot running, an acute transition causes changes in gait biomechanics and if your foot is unused to this and not strong enough to cope with these biomechanical changes, a niggle will likely arise.

An example of this may be someone who would run comfortably in shoes with a strong arch support and lots of cushioning, compared with someone who dislikes a cushioned, strongly supported shoe in favour of a more neutral running shoe style. However, this does not mean that someone with a very cushioned shoe has weak feet musculature, as again it depends on the biomechanics of the individual and habitual preference.

Injury patterns. 

Particular injury patterns that may not benefit from barefoot running are suggested to include bone stress injuries due to the increase in pressure through the forefoot/midfoot on foot strike, while in contrast, runners suffering with patellofemoral pain may find barefoot running beneficial, as shod runners have decreased peak knee flexion which can increase patellofemoral joint pressures.

Other injury patterns that may benefit from barefoot running are ITB syndrome, glute and hamstring strains/tendinitis and plantar fasciitis, while shod running is said to benefit those with Achilles tendinitis and calf strains/tendinitis.

It is important to note that these are suggestions made by researchers evaluating a particular group of study participants, therefore factors such as footwear should be made in consideration with the various running styles and foot strike patterns that are present in the individual and not based purely on the conclusions drawn by a study.

What’s the answer then?

General advice which may be of benefit to runners trialling barefoot running or barefoot shoes would be to transition gradually to reduce the risk of overloading your foot’s muscular capacity and in doing so allow time to adjust to new footwear. The majority of major brands such as Nike and Adidas have a variety of types of running shoes, ranging from neutral support to very supported.

Brands such as Vivobarefoot are on the extreme end of the running shoe spectrum and an immediate transition from a highly cushioned shoe to one of their barefoot styles should be carefully considered, dependant on factors discussed within this article.

As always, introducing anything new into your training can come with risks and/or benefits and it completely depends on the individual as to whether the use of barefoot shoes or barefoot running will suit your training. Listening to your body as it adapts to footwear changes will allow you to decide on whether barefoot running is for you, if you decide to see what the hype is about for yourself.

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