Wednesday, June 12, 2013

Barefoot Running Can Cause Injuries

When barefoot running and barefoot running shoes became the latest fad to hit the running market, podiatrists everywhere were skeptical. Running barefoot? No shoes? No support for our feet?
It turns out we were right to be skeptical to some degree. I blogged about a month ago how minimalist shoes can help strengthen toe muscles, which is one good point. But one good point shouldn't overwhelm all the information out there that suggests that barefoot running and minimalist shoes are not right for every person.
Dr. Douglas Brown, a radiologist in Orem, Utah noticed a drastic increase in the number of patients he was seeing with heel and foot problems and he wondered if there was a connection between their injuries and barefoot running. At the time, there were no scientific studies for him to read. So he contacted Sarah Ridge, a professor of exercise science at Brigham Young University in Provo, who studies impact injuries in sports and suggested that she next study this topic.
The resulting study, which was published in February in the Medicine & Science in Sports & Exercise adds fuels to the debate over whether barefoot running is truly better for your bodies, especially our feet. Dr. Ridge studied 36 experienced runners, both men and women, who ran on average between 15 and 30 miles a week while wearing normal running shoes. She sent them to Dr. Brown for baseline MRI scans of their feet and lower legs to make sure they had no injuries or problems. All of her volunteers had normal feet and lower legs.
Half of the runners were randomly assigned to continue running like they had, with the same mileage and shoes. The other half were given a pair of Vibram Five Fingers barefoot-style shoes and told to start incorporating barefoot running techniques into their running, gradually. During the first week they were to wear the minimalist shoes for the first mile, two miles the second, three miles the third, and then as often as they liked.
After 10 weeks the runners had a follow-up MRI. None of the runners had injuries to their lower legs, like to their Achilles. However, more than half of the runners wearing minimalist shoes showed the early signs of bone injuries in their feet.
Most had developed bone marrow edema, which is an accumulation of fluid, like what happens during bruising, in the bones of their feet. The radiologists rated the edema from 0 to 4 with 0 being no edema and 1 being slight bone damage caused by simply moving around on and loading the foot. This level of edema is considered healthy because it's a sign that the body is responding to the changes in training and adapting.
Runners in the control group, who wore their normal shoes, had level 1 edema in their feet. However, a majority of the runners in the minimalist group had at least a level 2 edema "which indicates early bone injury," says Dr. Ridge, and three had level 3 edema, "which constitutes an actual injury." Two runners had full stress fractures in their feet or level 4 edema, one in the heel bone and the other in the metatarsals.
Overall, runners in the minimalist group were running fewer miles at the end of the 10 weeks than they had been at the beginning, "probably because their feet hurt," said Dr. Ridge.
Why some runners developed serious foot problems and others did not is not clear, and Dr. Ridge is currently analyzing information about the runner's mileage, running form, body weight, and other variables.
"What we hope to see is whether there are some runners who, because of their biomechanics or other factors" and why they are predisposed to injuries during the transition from shoe running to minimalist running and if they should even transition.
These results don't mean that every one who switches from shoe running to minimalist or barefoot running will have foot injuries. What is important to note is that you need to take the transition slowly and not over do it. You may not be able to run your average amount of miles to start with. Follow your podiatrist's recommendations and the shoe manufacturer's instructions.
Reference: New York Times
If you are a runner and have a foot problem, call our Newington, Kensington, or Middletown office to make an appointment.
Craig M. Kaufman, DPM
Connecticut Foot Care Centers
Sports Medicine Podiatrist in CT
Podiatrist in Newington
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