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Minimalist running shoes: Do they really prevent injuries?

Barefoot-style running and minimalist running shoes are growing in popularity, but some new research now shows there are risks.

Barefoot-style, or minimalist, running shoes are still growing in popularity in the military, and the debate continues over whether this style of running prevents injuries or just causes different injuries. There is new research on minimalist running shoes (MRS) and their impact on lower leg and foot injury. After a 10-week study, runners who transitioned to Vibram FiveFinger minimalist running shoes showed signs of injury to their foot bones, while the runners who used traditional running shoes showed none. The types of injuries the MRS runners demonstrated were early signs of inflammation, which may or may not be associated with pain or joint dysfunction. If they are, it might be difficult for the runner to know he/she is actually injured until it is too late and the injury has progressed. More research is needed to determine if other factors (weight, running form/style, mileage, running surface) contribute to injuries associated with barefoot-style running. At least one recent study suggests running style may be a factor. For more in-depth information, read HPRC’s InfoReveal.

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The barefoot running question

The book Born to Run by Christopher McDougall has been a primary catalyst for the rapid expansion of the population of “barefoot runners” over the past year.

The book Born to Run by Christopher McDougall has been a primary catalyst for the rapid expansion of the population of “barefoot runners” over the past year.  Most barefoot running advocates are in reality minimalist runners – they wear as little on their feet as possible.  In most cases they wear just enough to provide a little cushion on concrete or other hard surfaces or to provide a thin layer of protection from glass or other sharp objects. Minimalist footwear is referred to as “barefoot technology,” which, at some level, seems to be an oxymoron.  The cynical side of me says the term was coined by those expecting to make money off a new trend.

It is important to first note that there is no evidence-based information to support either side of the debate on the efficacy of being either shod or unshod.  The most interesting research pointing toward the possible advantages of the minimalist approach is outlined by a Harvard professor and his colleagues in a January 2010 edition of the journal “Nature.” A counter to the assertion that barefoot running is beneficial can be found on a website titled “Barefoot Running is Bad.” The pro barefoot running community points to initial research that indicates there is more force absorbed by the body by a runner wearing shoes than by barefoot runners.  The greatest difference is that barefoot runners have a forefoot strike, while runners wearing modern running shoes tend to have a heel strike. The opposition community points to anecdotal information that there has been a rapid rise in the incidence of stress fractures in the feet of barefoot or minimalist runners.

For me, the jury is still out.  I find the concept that we should allow our feet to function as designed intriguing. My advice to those in the military interested in transitioning to a barefoot regimen is to first consult their local provider for advice. In addition, anyone starting a barefoot running program should increase the barefoot component of their normal workout routine gradually. A good rule of thumb is to increase the barefoot part of the program by no more than 10 percent each week.  Barefoot adherents should also listen to their bodies and stop any activity that leads to joint or soft tissue pain.

My closing concern: warriors, regardless of where they are assigned, will spend a considerable amount of time in some sort of boot technology while training or deployed.  As the sports medicine community debates the value of being barefoot in contrast to lacing up the latest Nike technology, we need to determine if there is any advantage for warriors adopting a partial or full barefoot workout program.  This research should include an assessment of the positive or negative effects of frequently transitioning between minimalist footwear and boots.  As more warriors get the minimalist footwear bug, it is important that we provide them the best evidence-based information that supports or argues against the practice.

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