I see quite a few runners in my practice. In the last few years, I’ve been getting more questions about the possible benefits of barefoot running. Many of these runners have heard some of the claimed benefits.

Does barefoot running prevent injuries compared to running in traditional shoes? Does it improve running speed or endurance? And are minimalist shoes – shoes that replicate the benefits of barefoot running but offer some foot protection – just as beneficial (or harmful) as barefoot running?

In a study published online this month in Sports Health: A Multidisciplinary Journal, Kyle P. Perkins and others reviewed the available literature on this topic. They found 23 appropriate studies on the topic and tried to find evidence for any risks or benefits.

To be perfectly clear, I’ll quote the authors’ conclusion. “No definitive conclusions can be drawn on the risks or benefits to running barefoot, shod, or in minimalist shoes.”

There were some observations from the study worth noting:

• Barefoot running tends to create a faster cadence or increased stride frequency. It is also associated with a shorter stride and shorter ground contact time. What affect these changes have on the distribution of running stress or long-term wear and tear is unclear.
• Runners wearing traditional shoes usually make contact with the ground through their heel. Barefoot runners more often land on the midfoot or forefoot, which might help avoid repetitive stress on the heel.
• It appears that barefoot running and wearing minimalist shoes might cause higher degrees of knee flexion when the foot hits the ground and less flexion during stance phase. These positions might reduce the forces on the patellofemoral joint (kneecap and front of the thigh bone). In theory, barefoot running and wearing minimalist shoes might be beneficial for patients with patellofemoral pain syndrome or prior knee injuries.

• The downside to potentially less extension of the knee could be that increased force is placed through the ankle with barefoot running and minimalist shoes. Theoretically, these forces could cause overuse injuries like Achilles
tendinopathy.

It is important to remember that no definitive evidence that barefoot running or wearing minimalist shoes offer definitive benefits – or risks – compared to shod running. Running injuries are caused by all kinds of risk factors, and shoes are only one of those factors.

Having said that, if a runner wants to try barefoot running or minimalist shoes due to knee pain or to improve running performance, she can try it for a short period. If she is concerned about her foot anatomy or a previous injury, she should talk to an orthopaedic surgeon and discuss barefoot running or minimalist shoes.

Also listen to these podcast discussions from The Dr. David Geier Show:
Episode 149: How can you select an appropriate running shoe for your foot? (starts at 5:22)
Episode 96: Who is most likely to suffer injuries when starting a running program? (starts at 4:10)
Episode 8: Is barefoot running better for your feet than running with shoes? (starts at 2:44)

Have you tried barefoot running, or do you wear minimalist shoes? Did you notice any benefits – less pain or better performance? Or did you have more problems? Please share your experiences below!

Reference:
Kyle P. Perkins, William J. Hanney and Carey E. Rothschild. The Risks and Benefits of Running Barefoot or in Minimalist Shoes: A Systematic Review. Sports Health: A Multidisciplinary Approach. Published online August 8, 2014.