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
Visit our website, like our page on Facebook, and follow our tweets on Twitter. 

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• Going Minimal All It's Cracked Up To Be?

Minimalist Shoe Strengthen Toe Muscles

A new study supports the idea that minimalist shoes strengthens small muscles in the foot better then traditional running shoes. However, it adds another dimension: large gains in toe flexor muscles were found in those who wore minimalist shoes for short duration athletic movements.
The study was published in Footwear Science and conducted by German researchers, who divided 47 women into three groups. Two groups did 30 minutes of "high-intensity athletic training" five times a week for three weeks. Half of them wore their regular running shoes, while the other half wore Nike Free 3.0 shoes. The third group did not train.
This is how the researchers describe the training:

Exercises consisted of strength and agility tasks chosen to increase the number of push-offs per week and therefore the mechanical loading on the forefoot. In total, athletes executed approximately 5,000-6,000 intensive push-offs within three weeks (15 training sessions). The training program consisted of running, sprinting, and jumping drills (e.g. zig-zag run, the direction changes, sprinter-ABC, one-and-two legged rope skipping, cutting maneuvers  one-and-two-legged standing vertical and horizontal jumps, running upstairs and downstairs, and slalom racing). The exercises were performed on an indoor artificial surface. All exercises were accomplished with the highest possible intensity.

Before and after the three week training program, the researchers measured the subject's toe flexor strength with several tests. The toe flexors are crucial during push-off and when stronger, they are able to give a better push-off and be less inclined to injury. 

For those who wore the Nike Free 3.0, toe flexor strength increased 13-20%, while those who wore traditional sneakers saw an increase of 7-16%. 

This study is important because it shows that even when not used for running specifically, minimalist shoes can strengthen other parts of your body. 

Reference: Runner's World 

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
Visit our website, like our page on Facebook, and follow our tweets on Twitter.