Are Your Running Shoes Actually Hurting You?

I just thought I would post a research paper I recently did for an English Composition course. For those that care, it is a Rogerian essay with MLA citation format. I received a 100%.


Are Your Running Shoes Actually Hurting You?
In the last thirty to forty years, running-related injuries have been on the rise. According to Donald Goss, a doctoral student in the study of Human Movement Science, injury rates in active runners has varied between 19 and 79 percent (62). These same statistics were not collected before the 1970s. Does this mean that running-related injuries did not exist, or that the rates of injury were so low that it was not worth recording? Possibly, however, the data just does not exist. Did anything significant happen in the 1970s that would possibly have warranted the collection of this information? How about a radical new design in athletic shoes by Nike? Before this renovation, people simply ran in racing flats; in other words, their shoes had very little, if any, cushioning or support. So is there an alternative to using a modern running shoe with lots of cushioning and support, or are we all consigned to the norm when it comes to running? There is a new, although some would say old, style of running that is gaining popularity: barefoot, or minimalist, running. Could this be the answer?
After running my entire life, and suffering periodically with incapacitating knee pain, and hearing about this barefoot, or minimalist, running movement about three years ago, I decided to educate myself on the positive and negative sides of both styles of running. The consensus of most runners that I either discussed this question with, or that I personally had myself, were as follows: running barefoot puts an undo amount of strain on the ankle and calf muscles, which leads to injury; I could step on something I do not want to, such as stones, glass, or even worse, dog dirt; going barefoot is generally dirty and unsanitary; I cannot possibly be competitive, in terms of speed or endurance; running on the beach in soft sand might be acceptable, but never on a hard, unforgiving road; and almost every podiatrist says that feet need the support and cushioning a quality pair of shoes provides. Although these are all valid concerns, most are just a preconceived notion of reality without legitimate support to back up the claims. I will be looking at the legitimate claims, though.
Running barefoot absolutely puts more strain on the ankle and calf muscles compared to running with a shoe. Goss explains this increase strain is due to the transfer of impact energy from the knee to the ankle, which could result in injury (68). As far as stepping on something, there is a risk of puncture, abrasion, or messiness that a running shoe would undeniably prevent. The last major argument for keeping shoes on is the amount of support and cushioning they provide. Daniel Lieberman, a professor of human evolutionary biology, stated that “About 75 percent of runners today are predominantly heel strikers…Running shoes make it comfortable to heel strike” (qtd. in Nearman 5). Lacking an abundance of supportive data for running shoes, I felt that the only way to objectively evaluate the other style of running, was to try it.
Since transitioning, I have logged more than two thousand barefoot miles while running on roads, and have even completed a half and whole marathon, entirely barefoot. Since there are no accepted studies that state that any one technique is the only way to run, I want to look at the factual data that does exist, that disputes the reasons why someone should not run barefoot. The strongest argument against running barefoot is the strain that it can introduce to the ankle, so I am going to start there. However, to fully understand the impact of running on the feet and legs, I need to explain the differences in the mechanics of both traditional and barefoot running. Goss explains that in the more traditional running form there are long strides with a heel strike that then rolls forward on the foot and pushes off with the toes. This heel strike has two effects: it creates a peak impact force at the moment of impact that travels into the knee, and it creates a braking action by having the heel in front of the runner’s center of mass, thereby losing some forward momentum (63-64). When it comes to the barefoot form, despite several different styles, there are several common traits. The foot strike is no longer a heel, but a mid foot or forefoot strike. Basically, this is right behind the fifth metatarsal, or base of the little toe. Immediately after the forward portion of the foot makes contact with the ground, the heel is making contact and then rolling back onto the forefoot again. This forefoot strike forces the stride length to be drastically reduced. The foot is making contact with the ground below, to just behind, the runner’s center of mass. To compensate for this reduced stride length, the cadence is increased, normally to around 180 to 200 foot strikes per minute. By bringing the foot strike below the runner’s center of mass, two significant things are accomplished. One, the peak impact force is drastically reduced as well as transferred from the knee to the ankle as I already mentioned. Two, there is no longer a braking action. In fact, there is quite the opposite. By having the foot strike below the center of mass, the body is put into a sort of controlled fall, allowing gravity to carry the body forward. Runners World makes a beautiful insight about the barefoot running form being very natural and, therefore, almost subconscious (“Barefoot Running”). So, traditional or barefoot, there is going to be strain on some part of the body, but barefoot running generates a much lower impact force, and as Goss determined, the lower the level of forces generated, the less chance of developing an overuse injury (68).
Stepping on something rough or unpleasant is not as much of an issue as one might think. To understand this, it is necessary to understand two terms: proprioception, which is the ability to know where and how one’s body is positioned in space, and exteroception, which is the ability of the body to recognize and respond to external stimuli. Jodai Saremi, who is certified in group exercise and personal training, describes this concept when she discusses all the receptors that exist in the feet that provide feedback to tell the body what orientation it is in, how much pain and pressure it is feeling, and therefore how hard of a step the body can afford without injury (25). Ken Bob Saxton puts it best when he says, “‘Feeling discomfort and pain is a feedback system’ that helps runners realize they need to change how they're doing things” (qtd. in Saremi 27). A perfect example of this is, while I was walking across some construction debris barefoot, I stepped on an upturned nail. I did not even scratch my foot because my brain recognized the stimuli and stopped me from putting pressure on my foot. I have no doubt I would have been seeking a tetanus shot if I were in shoes. What this means is that by wearing shoes, the runner is dulling their feedback system, which could lead to an inefficient running form, that could then lead to a running-related injury.
No one can argue that being barefoot is not dirty, but being unsanitary is a different matter. Most disease is spread from hand to mouth, so there is little risk of spreading disease from being barefoot unless the foot is being put in places it is not meant to go (“Hygiene, Health and Bare Feet”). It can also be argued that less bacteria lives on a dry, bare foot. It is unlikely for shoes to be more sanitary than feet because most people wash their feet daily, and being barefoot keeps the feet dry. This prevents an environment conducive to bacterial or fungal growth. The American Academy of Dermatology agrees with this assessment when they determined that “Athlete’s foot does not occur among people who traditionally go barefoot” (qtd. in “Why Should You Go Barefoot?”).
I have no delusions of ever being a world class athlete, but have always considered myself a competitive distance runner, so I was very interested in how being barefoot would affect running speed and capable distance. The most notable barefoot race in history would have to be the 1960 Summer Olympics when “Ethiopia's Abebe Bikila, the greatest Olympic marathoner of all time, won the first of his consecutive gold medals sans shoes in a world record 2:15:17” (“Barefoot Running”). Even though 26.2 miles is a long distance, Chris McDougall, in his book Born to Run, makes reference that the most known tribe of barefoot runners, the Tarahumaras, have the “ability to run extremely long distances of over 100 miles at incredible speeds without undergoing the regular injuries of American runners” (qtd. in “Why Should You Go Barefoot?”). I imagine that should be fast and far enough for even the most critical among us.
Running is not limited to only some softer terrains. If fact, the harder the surface, the more efficient the running form becomes. Doctor James Stoxen, a chiropractor and trainer to several national and world championship teams, describes the body, and more importantly, the foot as a springlike mechanism that absorbs and releases energy while running. Drop a spring, or ball, on a soft surface and not much happens, but if you drop it on something hard there is a much better bounce. This concept can help explain not only how some chronic running injuries are caused, but how they can be helped: “When the supportive mechanism weakens it stiffens… By releasing this stiffness… we may be able to restore the ability to take impacts better (Stoxen).
The last argument against using shoes is that the cushion and support is not only unnecessary, but detrimental: A 1989 study of marathon runners by Dr. Bernard Marti, an expert in preventative medicine, concluded that “Runners in shoes costing $95 [for 1989] or more were twice as likely to get injured as runners in shoes which cost under $40 [for 1989]” (Nearman 6). I already mentioned how shoes can reduce the feedback from the foot, but the shoe will act as a brace: “Wearing shoes creates a need to wear shoes: People think their feet are weak and that they must wear shoes. When they do, the muscles in their feet don't have a chance to become stronger so they do become weak. It's like an arm after wearing a cast” (“Hygiene, Health and Bare Feet”). Muscles are supposed to be strengthened after a cast comes off, not left to atrophy by leaving the brace on.

As many positive aspects as there are for barefoot running, it is not the one-and-only way that anyone should run. There is going to be strain to one joint, muscle group, or another. Also, barefoot running can be dangerous for some people with certain medical conditions: It is “Best suited for people with healthy circulation and an intact sensory system” (Saremi 24). Oddly enough, the most important question is not shoes or barefoot, but rather running form. Since only about 25 percent of shod runners use a toe-heel-toe strike pattern, it would be very beneficial to incorporate some barefoot running into a training program to learn the technique that provides the least overall stress on the body. The fact that running barefoot has to be argued, and not the other way around is sad; after all, historically speaking, shoes are the new invention. It should be the shoe companies that have to prove the benefit of their invention.
Works Cited
“Barefoot Running.” Runnersworld.com Rodale, n.d. Web. 8 July 2014.
Goss, Donald L., and Michael T. Gross. "A Review of Mechanics and Injury Trends among Various Running Styles." U.S. Army Medical Department Journal (2012): 62-71. Academic Search Complete. Web. 8 July 2014.
“Hygiene, Health and Bare Feet.” barefootalliance.org The Barefoot Alliance, n.d. Web. 20 July 2014.
Nearman, Steve. "The Science of Barefoot Running." AMAA Journal 24.2 (2011): 5-6. Academic Search Complete. Web. 20 July 2014.
Saremi, Jodai. "Barefoot Running, A Revolution or Regression?” American Fitness 30.2 (2012): 24-28. Academic Search Complete. Web. 20 July 2014.
Stoxen, James. “Why do I Run Barefoot…” Teamdoctorsblog.com 21 Feb. 2012. Web. 20 July 2014.

“Why Should You Go Barefoot?” squidoo.com n.d. Web. 20 July 2014.

Comments

I participated in Dr. (MAJ) Don Goss's study at UNC Chapel Hill as one of the BF guys. He was extremely thorough in comparing joint loading impact, and is just a great guy besides.
 

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