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yay-5089418 pond5As a podiatrist, my teachers, professors and peers, espoused that feet need help, specifically they need good support, cushioning, and padding. But, more and more, I started reading about people and cultures that go barefoot and not only do they have fewer foot, ankle, knee and even back problems. Now, I am re-thinking everything I learned.

Was The Human Foot Designed to Walk and Run Barefoot?

The human foot is incredible, strong, dynamic and adaptable. For thousands of years our feet survived and functioned fine (maybe even better?) without elaborately padded, supported $100 Nikes. Further, persons without their hands can learn to drive and paint with their feet. Take a look at the masterpieces created by the Mouth and Foot Painter Artists association. Why can’t a runner learn to run barefoot?

Recently, Christopher McDougall has reinvigorated the barefoot running debate with his book Born To Run. Previously, some runners have had great success barefoot, including the late, great Abebe Bikila from Ethiopia.

Runners have been plagued with foot, ankle and knee problems. It comes with the territory: two to three times the weight of the runner’s body coming down on each foot with each stride. The advocates of barefoot running claim they can literally feel the ground and as a result, the biomechanics of their running gait changes to lessen the force of your foot landing.

Advocates of barefoot running contend that shoes worsen the chance of injury.

The scientific literature on barefoot running (and barefoot walking) is scarce, but at this point the published research leans toward running and walking barefoot, and I would have to agree—barefoot is better!

I just may be the first podiatrist to advocate running barefoot, but let me clarify this statement: I don’t believe barefoot running  is for everyone. I will discuss who and who shouldn’t run (or walk) barefoot in just a moment. First, let me talk briefly about the medical and scientific literature.

The scientific literature on barefoot running is sparse. But, what is out there supports more foot and ankle injuries in people wearing running shoes than in persons going barefoot. This is also true of plantar fasciitis, some knee problems, and other injuries. It appears that running shoes decrease sensory feedback, interfering with the body’s natural shock absorbing tendencies. Further, running shoes may actually decrease the runner’s awareness of their foot and the foot’s position, increasing the risk of injury.

Our feet have many muscles within each foot and many that attach to our feet that originate in the leg. Wearing running shoes may lessen or diminish the “firing” of some of these muscles. When the foot is not in shoes, it adapts—rapidly—to uneven surfaces, and in theory, forcing us to “use” all the muscles in our foot.

Who Should Run Barefoot (and who should not!)

Reasonably experienced runners in good condition with healthy feet should try barefoot running (when conditions and terrain warrant it). By “healthy feet” I mean their foot has a good, stable structure, and good sensation. Their foot does not have an excessively high arch or low arch and they are not diabetic. Further, their foot should be free of any significant deformities—no bunions, hammertoes, or other bone problems. Persons who are diabetic, have decreased sensation, or a foot that is not healthy or flat or high arched etcetera, likely needs corrective support, such as good running shoes and/or orthotics.

Learning to Run Barefoot

Barefoot runners have a different gait than shoe-wearing runners. Learning to run barefoot takes time and training. I imagine not everyone will be able to teach themselves and their feet to adapt to barefoot running. Remember, some of the superstar athletes who run barefoot may have grown up in cultures where shoes were not the norm and as result, you have someone whose foot is more use to being bare than in a shoe. Further, persons who are in these “barefoot” communities may have a foot with genetic adaptations geared toward barefoot running—meaning, generations of going barefoot have essentially bred a foot that works better when bare.

What to Watch Out For When Running Barefoot

Barefoot running isn’t without risks. Start slow and build up gradually. Research the right way to build up proprioception reflexes in your feet, ankles and legs, and build up the muscles. Don’t run where you can injure your feet—avoid nails, rocks, broken glass etcetera.. (Part of the reason the medical community has strongly advocated shoes is because of the risk of puncture wonds. Every podiatrist has seen his or her share of glass and nails inside their patients’ feet. Further, cold weather can cause frostbite on unprotected feet.)

Vibram makes a shoe that increases the ability to feel the ground, as does Terra Plana and Nike Free (see links below). One scientific study does support that Vibram’s Five Finger’s reasonably simulates barefoot conditions.

I would be interested to hear about your experiences running barefoot. Specifically, I am curious if there are any successful barefoot runners who have a poor foot structure (i.e. flat foot, bunions, pronation etc.)

Resources for Barefoot Running

The point of this article is to get people thinking about barefoot running and decide for themselves if it is right for them. Here are some resources to help you learn more about barefoot running (and I would recommend reading Chris McDouball’s book Born To Run):

Running Barefoot

Society for Barefoot Living 

Wikipedia on Barefoot Running

Barefoot Runner

Living Barefoot

Vibram Five Fingers

Terra Plana

Go Barefoot

Enjoy Going Barefoot

Review of Nike Free

Nate Luzod – A barefoot runner’s journal

Barefoot Ted’s Adventures

Barefoot Running in Seattle

How to Begin Barefoot Running

Freeing the Captives… 2 Barefoot Soles at a Time

Image Credit – man’s feet running on the grass Photos by Pond5

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  • nick

    Dr. Nirengberg,
    If you could just shelve out a few minutes to respond to my post it would be much appreciated! I am a freshman in high school who has run track and cross country. I had plenty of success and no injuries throughout the fall and winter running seasons, but upon the start of spring track started having a load of problems, primarily with my knees. The diagnosis was runner's knee, nothing “out of the ordinary”. I did a month of physical therapy and got inserts for my shoes. It seemed to help somewhat, and I have been making a slow recovery. I don't know much about barefoot running, but I have heard a world of good about how it prevents injuries. The thing is, I have extremely flat feet, something that my PT says probably contributed to my knee problems considerably. Would you still recommend barefoot running to someone like me? Besides my flat feet, and by extension my knees, I am otherwise in great health. Thanks in advance!

  • Kasia

    Dr. Nirenberg, 
    I am glad to see that health care professionals, and especially podiatrists are starting to promote “going back to the basics”.  I just recently read “Born to Run” and it was not only an inspiring book, but also provided great analysis of why we (humans) should run barefoot.  I have been a runner for about 20 years now and I am also a physical therapist and even though I learned the anatomy and biokinetics I wonder why did I ever thought that the arch in our foot needs any extra help (cushioning i.e.).  What I am learning now is all new to me.  I was never a heel runner, but to not strike with the heel first seemed to be a conscious effort.  I ran a few times barefooted and it was just natural to strike with the ball of the foot first, then let the heel touch the ground, to then let the Achilles fire and assist in the push off.  My feet also felt nice even hours after the run – a pleasant tingling (foot receptors had a party :)
    You mentioned that people with high/low arches may need running shoes/orthotics.  I would, however, advocate for everyone to give it a try for barefoot running first with keeping in mind that the length of the stride as well as running style (staying low – with minimal pelvic drop on the unsupported side and keeping the knees slightly bent at all times) may play a very important role.  This may require some time to practice and pelvic/core muscle stabilization.  But it is worth the effort!
    Thank you,
    Dr. Kasia Hefflefinger

  • beenrunningforever

    I don’t run barefoot, but have been running on a forefoot running style for the last 6 months. I transitioned recently from a traditional padded running shoe to a recommended nb790 shoe. It is a middle of the toad shoe that is not padded or barefoot. I had a fallen metatarsal for 10+ years under the second toe before changing running styles. I now have no fallen metatarsal. The fist day I ran this forefoot running style, I felt immediate lack of any pain in knees and hips. My running times have increased and I can feel my body using less energy to run the faster times. I don’t need a doctor to tell me that this is the way to go because it just is. I am a lifetime runner that ran on my heels prior to this and it was obvious from the first step of forefoot running that this was it. I will eventually get a barefoot type shoe, but the trick is to run with a mid or forefoot style of running and to slightly lean forward with good posture.

  • Asim

    I’m 36. I had runner’s knee for 15 years. Every time I played football, squash or ran my knees would hurt slightly for one or two days, particularly when going down stairs, so I limited sport to once a week. I had been to a top physio who gave me customised arch supports but they didn’t help much. I heard about barefoot running 2 years ago, gave it a try and was shocked that after a run by knees didn’t hurt. I also tried squash barefoot – my knees didn’t hurt after playing but only if I consciously ensured I did not land on my heel. After several months it became natural to play squash landing on the front part of my foot. The transition to barefoot (I use aqua socks with normal socks most of the time rather than actually do anything barefoot) has not been easy. I initially suffered from achilles tendonisis and then knee tendonosis. Once diagnosed I did the appropriate stretches and they went away pretty quickly. I’ve also had lots of blisters. Today I’m playing sport almost every day, running 5k on a regular basis, and have no pain in my knees at all.

  • Dan

    The question isn’t barefoot or shoes… If you learn how to run properly, i.e. forefoot landing (hate the word strike, you should never strike) and display correct posture, it doesn’t matter what you have on your feet.

  • Guest

    I have been a runner for years and started feeling the effects of arthritis at a very young age. When I heard that barefoot running is supposed to help with joint issues, I decided to give it a shot. Let it be known that I have extremely flat feet!
    I bought the vibram fivefingers and did the recommended training schedule on their website. I didn’t have any issues starting out, except sore foot and calf muscles (the good kind of sore). The more I ran in them though, the more problems started to arise. I have never had ankle problems in my life, even though 5 years of volleyball and 5 marathons. I sprained my ankle for the first time, and I believe it is in part to the muscles used in running barefoot as compared to running shoes. I believe they weakened or became too strained.
    Since then, I only use my Vibrams for the gym and I run with running shoes with a smaller sole (like Nike Free). I believe it is better to have lighter shoes, but I don’t think I will ever return to barefoot.