Barefoot Running - Is it just hype?
There has been a lot about over the past few years on the benefits and injury risks of minimalist shoes and barefoot running. It has an almost cult-like following with a lot of supporters saying 'normal' shoes are ruining your feet and people who go barefoot or wear minimalist footwear don't develop the same foot problems as others.
It's hard to dig around in there and separate out the marketing hype from the actual benefits and injury risks to then make a decision on whether you should give it a go. Hopefully, I will try to address some of these points with some decent peer-reviewed scientific studies and allow you to make up your own mind on whether minimalist footwear is right for you. I will also include my own personal experience with barefoot shoes albeit I am not running in minimalist footwear yet!
TL;DR - barefoot running is a complex topic. There are many advantages to running in barefoot or minimalist footwear but there are risks to be considered. Most of the risks can be mitigated by a good understanding of transitioning to barefoot running and having a good plan in place for this. The pure performance benefits appear to be limited
Terminology
Let's first discuss what is meant by the terms that are commonly used for 'barefoot' running:
- Barefoot - no footwear
- Minimalist footwear - footwear that has a lot of flexibility, minimal/no cushioning but some protection in the form of a sole. It will also have a 'zero drop'.
- Zero drop - basically flat footwear - no change from the heel to toes
- Barefoot running - usually actually refers to running in minimalist footwear (confusing I know)
- Barefoot shoes - refer to minimalist shoes
Generally, barefoot and minimalist footwear are used (rightly or wrongly) very interchangeably and in fact, both can often be used together to mean the same thing. Generally barefoot running refers to running in minimalist shoes however and that is how it is going to be used in this article.
What is minimalist footwear?
Generally, it's a minimal construction of footwear aimed to allow sensory and proprioceptive (feeling and connection with the ground) feedback whilst providing some protection for your delicate feet!
Features that make it minimalist rather than 'normal':
- Zero drop - essentially flat footwear where your feet can move, and your muscles do the stability work rather than relying on moulded padding in the shoe
- Minimal padding - to allow the feedback from the ground to be as strong as possible
- Wide toe box - allowing the toes to splay out and provide stability
- Sole with some puncture protection - there to protect the feet but still allow sensory feedback
- Generally minimal construction - most have no midsole, no foam cushioning layer and a limited tread pattern
- Flexibility - just look at the photo below from one of the minimalist shoe manufacturers. Flexibility means your foot can move and flex as it wants to with no hindrance from the footwear you are wearing
Benefits to minimalist footwear over barefoot
Protection!
The advocates for barefoot will cite that we were supposed to walk like this, and that footwear puts our feet in unnatural positions and desensitises them to the natural world and the sensory feedback they were designed for. I can see this to a certain extent, imagine when you are wearing your cushioned running trainers. How many small stones can you feel? How many slight dips and imperfections in the round can you notice? Now imagine walking barefoot (you probably do this on the beach). The sensory feedback is hugely different to wearing shoes in the same scenario.
There are however things out there, especially in the modern world that want to hurt our feet. Pieces of glass, sharp stones, thorns, nails and screws even. If you are looking to get more sensory feedback you don't really want your feet cut up and hurt on your first outing, plus your feet won't be 'hardened' to being barefoot when they have spent most of their life in a nice cushioned shoe.
This is where minimalist footwear comes in. It allows protection without sacrificing all the sensory feedback and studies have shown it does a good job of mimicking being barefoot without the drawback of impaling a piece of glass into your foot. We know this by participants in studies getting the same gait pattern changes if they are barefoot or in minimalist footwear. Sure, it's not exactly the same in terms of sensory feedback but it's a lot closer than normal shoes so provides a good 'middle ground'.
A little point on the evidence here...
A disclaimer here is that every one of us is slightly different and has different predisposing factors to benefits and injury risks associated with footwear choice when running.
Before we get on with the main benefits another caveat to this is the lack of reliable scientific studies on this topic. There are a lot of studies but many do not compare like with like (for example one study comparing any traditional running shoe with any barefoot shoe rather than standardised styles), or many have struggled to come to a statistically significant conclusion.
This has made it very difficult to come to valid conclusions myself and I find myself saying the obvious 'we need further quality research' line. However armed with a massive stack of studies and a highlighter, and applying some common sense I have pulled out the following conclusions below.
Benefits to running barefoot/with minimalist footwear?
- Stronger and more flexible feet
Studies have found that by being barefoot our intrinsic foot muscles (the little ones in the foot and around the toes) have to adapt and get stronger to cope with the increased forces placed on them. Similarly, the extrinsic muscles (ones into the ankle, calf and rest of the leg) also have to adapt and do the same. There has been found to be an increase in the cross-sectional area of the Achilles tendon and a study has even shown that simply walking barefoot produces similar strength gains to those experienced in a foot and ankle strengthening exercise program over 8 weeks.
It has also been found to significantly increase the strength of the medial arch through the activation and strengthening of the muscles that control this. This is thought to be mainly due to the activation of musculature that is usually dormant. Again this makes sense - in most footwear there is some level of arch support so why would these muscles be needed if your footwear does the job?
The feet also have been shown to become more flexible, however, this is less studied. Here common sense would tell us this is due to the feet themselves (rather than the shoe cushioning) having to adapt to changes in the ground surface. It was however found that in a habitually barefoot population, there was increased foot flexibility compared with a habitually shod population.
- Decreased running-related injuries
Now you will see this on here and also on the risks section below. This is because there is conflicting evidence about injuries and barefoot running.
The reason I think there is evidence for decreased injuries is the change in foot strike position. This simply means the bit of your foot that strikes the ground when you are landing a step. Usually in runners, this is the rear foot (heel). In barefoot running generally over time people transition to a forefoot strike. This is linked in many studies with lower injury prevalence. However, there are caveats to this which will be discussed below.
Another reason for decreased injuries appears to be the lower ground reaction forces. This means that less force goes through the foot and ankle when forefoot running and therefore in barefoot running this change appears to have a good impact on injury prevalence.
In a recent study, the majority of participants who had started barefoot running developed any new injuries and also experienced previous injuries resolving after transitioning to barefoot running
- Increased running economy
Training in minimalist shoes is shown to have a moderately beneficial impact on running economy. Running economy is (in basic terms) the energy demand of running at a constant defined speed. A good running economy means you use less oxygen to maintain this speed and therefore it is a good predictor of endurance running performance. For endurance running increased running economy is better.
However several studies have linked this more to shoe mass than the actual act of barefoot running. Each step means that mass has to be accelerated and lighter shoes have performance gains. Even a lighter cushioned shoe will have the same gains if it weighs the same.
- Greater foot and ankle stability
Again this goes back to the increase in muscle mass around the foot and ankle and increase in muscle strength. Due to this and the increased proprioceptive feedback to the foot from both the lack of cushioning and minimal sole it has been found that there is increased foot and ankle stability as these intrinsic and extrinsic muscles play a large role in this function.
This is not well studied but by applying common sense and biomechanics if we are reducing the support on the foot and ankle and demanding more from these muscles then, as proven, they will get stronger. If this training takes place on more uneven ground or incorporates more balance-challenging activities such as obstacles encountered when (for example) trail running then we are naturally working on balance training and thus will get an increase in this.
Risks to running barefoot/with minimalist footwear?
- Bony Injury Risk
Even common sense must tell you that if your feet are used to being cushioned, especially in a sport that is placing stresses on them such as running, then decreasing this cushioning must place higher forces on them? Yup.
The evidence here suggests that there is an increased risk of metatarsal stress fracture and bone bruising to the metatarsals (bones that connect your foot structure to your toes). Studies have found increased fractures of the metatarsals as a cause of injury in barefoot runners but the bone bruising was found to be asymptomatic
It is however unclear if this is part of a lack of transition process and the bone bruising was also thought to be part of the adaptation of the bones to the increased load.
Less trained runners will also have a higher initial loading of the foot when going to barefoot running than those who have a lot more running experience in general.
- Soft Tissue Injury Risk
The majority of participants in a survey about barefoot running experienced Achilles or general muscular foot pain when starting barefoot running. This is a lot higher than expected taking into account they were runners before the transition!
Increased loading of the plantar fascia will occur and it has been shown that this will take on average 3-4 weeks of 30-minute running to adapt to the increase in forces placed on it. There is also the risk of an increase in tissue-level strains at the metatarsals (the diaphysis to be exact), but only a single study reported this risk.
The knees were also found to experience higher loading when running barefoot increasing the forces on the patellofemoral joint (front of the knee) and also on the knee joint itself. This can lead to an increase in the incidence of knee injuries especially runners knee (patellofemoral pain syndrome).
- Running Performance
As we have seen above, barefoot running can increase running economy however it hasn't been shown to increase running performance.
At best in several studies including a Cochrane review running performance was found to be similar. At worst other studies have cited factors against barefoot shoes that have been shown to increase performance.
What do I mean by this? Well, increasing the stiffness of running shoes as opposed to decreasing it has been shown to give performance benefits. Similar is also true for energy return and here the midsole thickness plays an important role meaning that running efficiency is increased with a thicker midsole due to the energy returned by the spring action of the foam.
What does the literature suggest about transition?
This is a lot less controversial! Most if not every study states that some form of transition to barefoot running should be carried out and no one should go straight from running in cushioned shoes to barefoot running.
How you should do this is open to debate but based on the evidence I would recommend the following principles:
- Don't get carried away running in your barefoot shoes - build this up really gradually
- There is no evidence that continuing to run in your cushioned shoes whilst transitioning has a negative impact
- Foot and ankle training is key
- Look to strengthen your foot and ankle muscles gradually and progressively
- Single-leg balance work is important
- Ankle and foot flexibility exercises should also be incorporated
- There is no set time frame for this transition but the longer the better - gradual improvements
- Aim for at least 8-12 weeks
Personal Experience
My own experience is really limited so far. I have started to transition by wearing a pair of barefoot trainers. However, I am only wearing these when I would usually wear trainers in general daily life so this isn't all the time. For example, my work shoes and running shoes are all 'normal' and as these are not worn out I don't see any reason to change at the moment - why create more waste?
Why did I do it in the first place? Well, I have noted some changes to my feet in terms of toes getting closer together and reduced ankle strength so I thought I would try it mainly for this and see if by reducing the support and also gaining a wider toe box I could improve these two aspects. It's really early days but I definitely feel increased space between my toes. Given also no adverse effects I'm persevering and seeing if I can get some of the positive impacts I've talked about above.
I will say that largely it's been a fairly easy process. I felt a harsher ground feel on each step and also felt I adjusted my cadence when walking and decreased my stride length. Initially, I was getting a lot of rubbing on the skin of my feet even when wearing socks with my barefoot shoes, however, I switched to a different style and this went away.
Initially, I was getting some heel pain, I think this was from me being so used to heel-striking and this has largely gone since I have noted my gait pattern and cadence have changed. It's still early in my experience so I would love to hear from you especially if you have gone all the way and are barefoot running!
I'm quite excited to get into this more with trail running and more outdoor pursuits where I will be able to feel the ground more and get increased sensory feedback over more uneven terrain
Conclusions?
The main takeaway here should be the need for a robust and planned transition process if moving from cushioned running shoes to minimalist shoes or even barefoot entirely. This plan is really important and below I have added some resources that describe transitioning in more detail and it is something I plan to do a follow-up on so subscribe if that interests you (it's free!)
I feel overall that there is a lot of marketing hype over barefoot shoes (but then again probably less than cushioned running shoes and what they will do for you) but there is a lot of truth in it. The scientific evidence whilst not as robust as we might like shows a lot of benefits to barefoot running and whilst there are risks most of these appear to be short-lived (in terms of muscle soreness) and can be mitigated by transitioning rather than expecting to pop on the shoes and go for your normal run.
Why isn't it more widely adopted? Well, I think it's the patience element. People want to put their shoes on and go for a run. They don't want to be worrying about a transition process and the evidence shows that those who don't follow this process get injuries and pain. Wouldn't make you want to stick with it.
Is this for everyone? No. Plus I can't really fully recommend/dismiss it until I have fully tried it for myself. I feel the evidence however shows that if you want to try it and follow a transition plan then there is no reason not to! Let me know your experiences below
Transitioning Resources
- Vibram 5 Fingers (Free Guide)
- Vivobarefoot Courses (Paid but video guides)
- Zero Shoes Blog (free and lots of info)