Bob Tank, Doctor of Physical Therapy and orthotic specialist at ProRehab, PC discusses both the facts and his opinions of barefoot running.
The arguments for barefoot running are that it is more efficient energy wise and that it leads to fewer injuries.
I do not believe either of these statements have been scientifically proven and in fact, it can be argued that it may be less efficient since the energy absorbed in barefoot running is an additional load to the calf muscles. In regards to less injury risk, the premise is that barefoot running results in landing more on the forefoot or midfoot as opposed to having the impact at the rearfoot or heel. Heel striking generally results from a longer stride (step length) and results in the foot landing more out in front of the body. This is thought to then result in the body having to exert a “braking” force to maintain our balance and this force is then transferred and ultimately absorbed up to the knees and hips. If in barefoot running the foot lands more on the front part of the foot, it is argued that the foot placement will be more directly under the body (knees) and therefore the impact will be decreased and absorbed by the muscles more than the bones and joints. None of this has been conclusively proven. One of the drawbacks to barefoot running is this can shift the impact stresses to areas that are not accustomed to those types of loads and therefore may result in increased injuries to the Achilles Tendons, Plantar fascia (arch strut) and metatarsals. Because of this, if a runner chooses to change their running style to involve barefoot running, they need slowly transition to this over an extended period of time (months). Greater tension is placed upon the Achilles tendon and arch structures in unshod running simply due to the fact that running shoes keep the heels from dropping down to the normal 12mm heel lift built into the midsole of a running shoe. Minimalist shoes are somewhat of a compromise as they have 0-5mm heel lifts built in (depending on the model) and allow the runner to more comfortably land on their forefoot. They are also more flexible, lighter weight, and have more cushioning that the standard running shoe but, this results in less control over excessive movement or rolling of the foot. They also wear out quicker due to the less durable materials used in manufacturing them.
My opinion is that if a runner is considering transitioning to barefoot running, that they first try to shorten their stride in their regular shoes, which should alter the landing point to more toward the forefoot (away from the heel). They can practice this on a treadmill first with emphasis on quicker turnover, at a set speed, and they should focus on running tall, landing soft and with less noise at impact.
It should be mentioned that foot strike position at initial impact is not solely related to type or absence of shoes but is also related to fatigue, speed, joint flexibility, previous injuries and body structure. Those runners with a foot type that is either extremely flat (pronated) or extremely high arched (supinated) should be especially cautious about trying to run barefoot. In my experience, these runners would decrease their chance of injuries by wearing a shoe designed for their excessive pronation movement (more stability built into the shoe) or one designed for additional cushioning in the case of the high arched foot type. Further protection can be provided through the appropriate use of custom molded foot orthotics which are designed for total contact with the sole of the foot and built with a deep heel cup to not only help absorb impact forces but also to control excessive side to side rolling of the foot (side note, not all custom orthotics are built with these features included). This type of running orthotic is designed to accommodate for faulty foot or leg structure and cannot be used during barefoot running and is less effective in minimalist shoes.
For clarification, in my mind I would classify minimalist shoes as Nike Frees, other light weight shoes with minimal structure but nonetheless they have a full outersole, just minimal heel lift built into the sole. The Vibram 5 toed shoes I would classify as more of a barefoot shoe.
