Barefoot running, which typically involves the use of barefoot running shoes, appears to cause injuries to the foot, including a range of injuries that are precursors to more significant fractures in the foot.
While some firms tout products such as the Vibram Five Fingers barefoot-style shoes for running, asserting that running barefoot is closer to how our ancestors ran, the practice has long been suspected of being related to mounting reports of heel and foot problems. Advocates say that this type of footwear creates less constriction and inhibition of natural movement, reducing injury, pain, and posture issues, said The Daily Mail. The barefoot shoes are meant to work like a glove, protecting feet from glass and other road debris.
Radiologist Dr. Douglas Brown said he has seen an increase in heel and foot problems in barefoot runners, according to The New York Times. Unable to locate scientific studies that looked into the matter, he suggested that Dr. Sarah Ridge, a professor of exercise science at Brigham Young University, look into the matter. Dr. Ridge studies impact injuries in sports.
The study, published in February in Medicine and Science in Sports and Exercise, looked at the risks and benefits of wearing so-called minimalist or barefoot shoes. Proponents of the practice say that this style of running shoe minimizes risks for pain and injury; however, others believe the practice can lead to other injuries. According to the researchers, said The Daily Mail, barefoot shoes comprise some 15 percent of the running shoe market.
For her study, Dr. Ridge recruited 36 adult, experienced runners; male and female; who ran 15-30 miles weekly; and who ran in traditional running shoes, explained The Times. The participants underwent a baseline MRI with Dr. Brown, who scanned their feet and lower legs to check for injuries and other problems.
The participants tested with normal feet and lower legs; MRI scans were reviewed by a number of radiologists. Half the group was randomly selected to run as usual, maintaining the same mileage and using the same running shoes, said The Times. The remaining half were given a pair of the Vibram barefoot-style shoes and were asked to begin gradually including these shoes in their runs: One mile in the first study week, two in the second, and so on until their fourth week, when they were free to use the Vibram shoes as often as they chose, said The Times. This schedule mimics what the Vibram website recommended at the time of the study, in 2011.
Ten weeks later, the participants received a follow-up MRI, which revealed no evidence of injuries or changes in the runner’s lower legs; however, more than half of the minimalist shoe runners revealed early signs of foot bone injuries, said The Times. According to The Daily Mail, female runners were at greater risk than male runners. Testing revealed that most runners developed bone marrow edema in their foot bones. Edema, or fluid accumulation, is similar to what is seen in bruising and was rated on a scale of 0 to 4: 0 signified no edema, 1 signified that slight bone damage, caused by moving on and loading the foot, occurred, The Times explained. Level 1, considered in the healthy range, means the bone is strengthening and responding well to training. In the control group, most runners had edema levels of 1 throughout their feet.
Most of the minimalist shoe runners developed level 2 edema, “which indicates early bone injury,” said Dr. Ridge; three tested with level 3, which is more extensive and, “which constitutes an actual injury.” Two suffered from level 4 edema, which means they had full stress fractures, The Times pointed out, one had a stress fracture in her heel bone and one had a stress fracture in his metatarsal. Most in this group were running less miles by the end of the 10-week study, “probably,” Dr. Ridge said, “because their feet hurt,” wrote The Times.
Advocates of barefoot running say that humans ran and walked with no shoes for thousands of years before the advent of footwear and claim that walking barefoot is not only more normal for humans, but should reverse prior and future injures caused by footwear, said The Times. Anecdotal—typically received from physicians who treat runners—reveals that in some barefoot runners, new injuries are being seen, said The Times.
“Transitioning to minimalist shoes is definitely stressful to the bones,’ Dr. Ridge said, adding, “You have to be careful in how you transition and most people don’t think about that; they just want to put the shoes on and go,” according to The Daily Mail. Yet, despite following the suggested shoemaker’s guidelines, the barefoot runner group still suffered injuries, some serious and to the bones of the foot.
In 2012, researchers warned, noted The Daily Mail, that barefoot running shoes were associated with an increase in injuries including pulled calf muscles and Achilles tendonitis, with some patients unable to walk for months.