Running Barefoot

As I mention in my article on Being Barefoot, there is growing interest in tapping into the power of our feet to reduce injury and improve overall fitness. In that article, I speak at length about the muscles within our feet and the benefits that come with strengthening them and being barefoot. But I only briefly mention barefoot running. Throughout the millions of years of our evolution, we, humans, have developed the unique ability amongst primates to be endurance runners. And as such, our bodies and in turn the way we move had to adapt. (Bramble & Lieberman 2004) Despite much research, there is still more to learn about how our feet are meant to move during this key human activity. (Hatala et al. 2013) People are even curious if barefoot running is good for you at all.

This article will attempt to address (as well as is possible with the available information) 2 main questions…

1. Is barefoot running good for us?

2. If we want to take up barefoot or minimalist running, how should we be moving?

Before we dive in, it is important to define some terms. This will hopefully make the article more digestible but also if you want to do more research you will have some knowledge to work with in your searches…

Firstly, there are different parts of the foot musculature that are important to be aware of. There are local stabilizers (muscles that function within the foot), which are referred to as intrinsic foot muscles (IFMs) (there are 19 IFMs). Then there are the global movers (muscles that connect to the region and support foot movement) which are referred to as extrinsic foot muscles (EFMs) (there are 10 EFMs) (Card & Bordoni 2021). Lastly, there is a term which you have likely already heard: the arch of the foot. There are actually 3 arches, not 1. But when someone says “the arch” they are typically referring to one in particular (the medial arch). The medial arch, held firm by the IFMs, are responsible for movement, and creating a stable, healthy foot. (Card & Bordoni 2021; McKeon et al. 2015)

Then there are ways to describe what kind of footwear (if any) someone is wearing. If I say minimalist runner, it refers to someone wearing footwear that is flexible, has minimal support/cushioning and typically no difference in built in elevation between the heel and toe. That is opposed to conventionally shod runner which refers to someone wearing what would be considered “normal shoes” to run. They typically have cushioning, arch support, an elevated heel, and are made of inflexible material.

Finally, there are the 3 striking patterns. A striking pattern is the way our feet touch the ground during stride. We have toe or forefoot striking (FFS), midfoot striking (MFS), and heel or rearfoot striking (RFS).

One way to assess how we ought to be running is by looking into what conditions would be the most likely for injury to occur. If we want to continue to exercise and live healthy lives then injury prevention is a priority.

We can start with how conventional shoes can cause injury…

Despite sneaker companies releasing new shoe models all the time with claims like “increased comfort” or “increased foot support”, injury rates related to running haven’t changed. (Murphy, Curry, Matzkin 2013) Running shoes were only widely used starting around 1970 (Lieberman et al. 2010) and a quick internet search says the first running shoe was invented in the mid to late 1800s. So, if we are evolutionarily endurance runners, you would think our bodies are surely capable of running without injury. What were we doing until then? An article written by Harvard professors and medical professionals, claims that people wore sandals or moccasins with minimal cushioning, or were barefoot. (Lieberman et al. 2010)

Cushioning and arch support (via elevated soles and insoles) are the primary culprits of increasing the risk of injury in runners wearing conventional shoes. With increased amounts of cushioning comes less of a need for our IFMs to work. Weak IFMs can be responsible for a variety of problems such as plantar fasciitis, bunions, hammer toe, claw toe and even problems further up the leg such as shin splints and general knee pain (Miller et al. 2014; Soysa et al. 2012; Garth & Miller 1989; Murphy, Curry, Matzkin 2013).

Additionally, when we run in conventional shoes, many people are more likely to land heel to toe (RFS) which can be responsible for an impact force 3X greater than our body weight and what would happen while landing toe to heel (FFS). (Lieberman et al. 2010; Murphy, Curry, Matzkin 2013) This is problematic because cushioning can lead to decreased tissue tolerance, making the lower body completely reliant on footwear for protection and more susceptible to injury from variables such as high impact from running and jumping. (Murphy, Curry, Matzkin 2013; Webber, J. T., & Raichlen, D. A. 2016; Robbins & Hanna 1987)

One final problem associated with the added space between our feet and the ground is that the material decreases the sensory feedback we are able to receive, which therefore limits the neuro-muscular control of our IFMs and EFMs during activity, which can lead to injury. (Robbins & Hanna 1987; Rothschild 2012)

So now let's see what the risks are with running barefoot…

The first one is obvious. If you are barefoot, particularly in the beginning, before your feet have been able to build calluses you are at a high risk of stepping on something that pierces your skin and causes an infection or more serious injury. (Murphy, Curry, Matzkin 2013) If you are wearing sneakers this scenario is much less likely.

We saw that the impact with RFS is a problem, but there is also a good reason to be skeptical of forefoot striking. If you are an FFS barefoot runner there is an increased risk of having stress fractures in your toes. (Murphy, Curry, Matzkin 2013) But this problem likely remains true for barefoot rearfoot striking as well. If you continue to RFS without shoes, your body is still receiving 3X body weight impact with each stride, and that is without padding. For this problem, durability of the feet is a variable to consider, if you are gradually well adapted to barefoot running, you may have more resilient feet, and the impact may not be as serious of a problem. But if you are not well adapted and continuously run barefoot this is most likely where problems arise.

Now that we have a better understanding of the pros and cons of shod vs barefoot running we can take a look at the question:

Is barefoot running in general good for us?

The simple answer seems to be yes. BUT it is more complex than that. Firstly, everyone is unique so there are plenty of people who already have existing conditions that might preclude them from even considering running barefoot. There are also people who run fine, without injury in conventional running shoes, and they might not feel it is worth the effort to switch, and that is fine. Remember, all we can do is make the best decisions with the information we have available to us.

But if you are someone who can, and does want to explore barefoot running, your main barrier is the adaptation period. If you took your shoes off right now and decided to go for a run, chances are you would get hurt. (Murphy, Curry, Matzkin 2013; Daumer et al. 2014) You likely do not have the muscular support, tissue resiliency, or neural control to not damage yourself. Making the switch can require a long transition period to avoid injury, and the duration can depend on a variety of factors. If you do decide to make the transition you will need to do a few things. Firstly, you will need to gradually build up the musculature in your foot (I have some tips for this in my other article). You will also need to teach your nervous system what it means to be barefoot, by walking around and doing more tasks with no footwear. (Rothschild 2012) When you do begin running, do very short distances at slow paces and pick the places you are going to run, so you avoid having foreign objects piercing through your skin. You will also need to be very conscious of the sensations in your body to avoid stress fractures. If you start to feel pain or discomfort it is very important that you consult a medical professional so that you don’t risk severe injury.

Minimalist footwear can be a great place to start this transition. It seems to resolve many of the issues with wearing conventional shoes and being barefoot. It removes the cushioning that prevents the activation of your IFMs, and increases the sensory feedback relative to conventional sneakers. (Miller et al. 2014; Warne et al. 2014) It also can protect your otherwise bare feet from sharp objects, and the slight padding has the potential to reduce the risk of stress fractures (but probably not to the degree of conventional running shoes). But, don’t think that once you have minimalist shoes there is no adaptation period, and jump right in because with minimalist footwear you will still be using your feet in ways your body has not become used to. Your feet still have to build up strength and neural control. But if you do want to incorporate minimalist footwear, it could be helpful to get a pair you can use to walk around with during the day so your feet begin to adapt even when you aren’t running.

Now we have arrived at another nuanced question:

How should we be moving? Should we be FFS or RFS?

A note for context: Researchers typically point to mechanical efficiency and injury reduction as two determining variables in their studies, but they are often linked to one another. If one motion is not as mechanically efficient it can lead to more pressure added to a part of the body causing injury.

75-95% of runners are thought to run with an RFS pattern. (Stearne et al. 2014; Davis, Rice, Wearing 2017) Unfortunately, this hasn’t stopped between 19-79% of runners from experiencing lower limb injuries every year, and knee injuries make up a large chunk of that. Also, 52% of runners experience some form of achilles injury throughout their life. (Stearne et al. 2014; Davis, Rice, Wearing 2017) The statistics are to provide context, but there could be other factors that result in those rates of injury besides the way we run (such as warm-up routines or even diet and sleep). So why is it thought that the striking pattern could be a cause of those injury rates?

When we land with our heel on the ground first, there is a loss of kinetic energy in our stride, so we may lose momentum. This effect actually makes the impact our body has on the ground harder, increasing the potential for injury. (Murphy, Curry, Matzkin 2013) As I mentioned before, heel striking can actually create an impact force 2-3X as much the weight of the human body, whereas FFS can be about 3 times less (this is also partly due to reduced stride lengths, which can further decrease impact force). (Murphy, Curry, Matzkin 2013)

While the FFS pattern alleviates pressure on the body by reducing stride length and ankle stiffness, it is thought that the pressure when you change from an RFS to an FFS pattern may go from the knee to the ankle, increasing the potential for injury there. (Murphy, Curry, Matzkin 2013; Stearne et al. 2014) The study that had that finding is worth discussing a bit further. They found no advantage from one striking pattern over another. (Stearne et al. 2014) They even found that runners struggling with ankle injury may even benefit from switching from an FFS to an RFS pattern (because of the reduction in impact force against the ankle). Furthermore they found that if people switched from an RFS to FFS pattern they would experience significant calf fatigue which would prevent the runners from performing as well (the first time I went for a run I started using an FFS pattern and I got real tired, real fast). While this is invaluable information in the debate between RFS and FFS, this study was conducted in one day and all the participants were wearing the same non-minimalist running shoes. This prevented them from seeing the long term impact of FFS, where the calf and foot musculature would adapt to the new striking pattern. Another study phased their participants into minimalist running over a 6-week period. (Khowailed et al 2015) They found significant reductions in impact force and a change in muscle activation that would lead to further injury reduction.

While there is no consensus in the literature surrounding which type of foot strike is best. It does seem like an FFS pattern has more support. If you are looking to make the switch to minimalist/barefoot running and you are concerned about having to relearn the mechanics of running, I am going to attach some resources below for you to use to help you along. But, you may find that you automatically switch to FFS or MFS patterns. (Miller et al. 2014; Wit, Clercq, Aerts 2000) The extra cushioning in conventional shoes makes RFS more comfortable for many runners, but when you switch and keep the same pattern you may automatically change or feel you want to change because of the newfound impact force on your heels. (Murphy, Curry, Matzkin 2013)

One study observed the foot striking patterns of participants of the New York City Barefoot Run in 2011. They observed that out of the 169 athletes running barefoot 59% were FFS, 20% MFS and 21% RFS. Out of the 42 athletes wearing minimalist footwear 33% FFS, 20% MFS, and 47.6% rearfoot. (Larson 2014) While we should not draw any serious conclusions out of this for a variety of reasons (we don’t know sample size + we don't know the extent to which these athletes train barefoot + we don’t know the rates of injury for those that were running with different striking patterns), it does show changes in a minimalist/barefoot population from the statistic mentioned earlier about the general population that 75-95% of runners are thought to run with an RFS pattern. (Stearne et al. 2014; Davis, Rice, Wearing 2017)

It is important to repeat that people are unique, so what may work for one person is not necessarily the best thing for someone else. It is important to safely and gradually experiment with what works for you. If you are not switching to minimalist shoes or barefoot running, and you have not experienced running injuries then staying with your current strike pattern may not be problematic. But if you do want to make the switch it is very important that you build up the strength of your feet gradually and begin to adapt to being barefoot before running. Finding a barefoot running training program or trainer could also be beneficial so you can be sure you are doing things properly. (Khowailed et al 2015)

Before I provide some resources to help you along your journey I want to address one more question. Which is...

Does foot striking pattern matter for walking?

The answer is yes and it is surprisingly different from the answer for running. It seems we are actually designed to run with an FFS pattern but walk with an RFS pattern. One study found that the RFS pattern in walking increased mechanical efficiency and lowered the force of impact particularly on the ankle (it would be interesting to see a study on force of impact from walking on the knee with an RFS pattern, as that was one of the downsides of this pattern discussed for running). (Cunningham et al. 2010) Another study looked at the mechanics of movement of the Daasanach people in Kenya who typically do not wear shoes and found that the slower they moved, the more likely they were to use a RFS pattern, and the quicker they moved the more they would switch to an FFS pattern. (Hatala et al. 2013) We are the only primates that are endurance runners despite sharing commonalities in foot anatomy with other primates. (Bramble & Lieberman 2004; Cunningham et al. 2010) So while we may have developed an evolutionary advantage running with FFS, we still walk more efficiently with an RFS pattern, which we probably developed before we became specialized endurance runners. (Cunningham et al. 2010)

Resources

Great educational YouTube Channel talking about being barefoot

• • Very informative video to explain most of the concepts I go over in this article

  • Video about transitioning to being barefoot

This paper emphasizing the very unique ability for humans to run long distances

MINIMALIST SHOE INFO

Anya’s Reviews

Anya has been through her own barefoot journey and uses this website to recommend shoes for you depending on what you are searching for (i.e. style, season, vegan, running, sandals etc.)

She also has a discount section!

Vivobarefoot

Vivobarefoot is one of the more popular minimalist shoe brands. They even have a repair service if something is wrong so you do not have to buy new sneakers.

Xero shoes

My first pair of minimalist shoes were from Xero and I found them to be really comfortable, and a good starter shoe. But they did not last long, so I would not recommend for people who are very active.

Vibram

Vibram is famous for their toe shoes. There was even a study done on minimalist running that used Vibram’s shoes for the treatment group.

Instagram Accounts

HealthyFeetAlliance

They make informative posts about feet and share content from other experts.

MyFootFunction

They explain a lot of concepts surrounding foot health and post a ton of exercises and tips for what you can do for your feet.

The Barefoot Sprinter

Graham Tuttle has 288k followers, discusses a lot about foot and general bodily health, and even has a foot strengthening program which is available in his bio.

Vivobarefoot

On their Instagram, Vivobarefoot shows off their shoes and initiatives.

AndyBryan-Podiatrist

A podiatrist who explains barefooting concepts and goes over some ways to strengthen those IFMs.

Anya’s Reviews

Similar to her website, here Anya gives recommendations for shoes and even goes over some basic barefooting concepts.