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Barefoot running presentation: Overview of the science
So last night, at the Sports Science Institute of South Africa where I'm based, I gave a presentation on barefoot running, aimed at the public. A big topic, obviously, always guaranteed to pull a good crowd and generate lively debate. Which it did.
It's a topic I've covered in great detail before on this site, with approaches ranging from a look at the evidence for shoes, to the findings of the latest barefoot running research. I fly to London tonight for the UKSEM conference, where I'll be chairing a debate on running injuries (among other talks), and which will probably be one of the highlights of the meeting, since it includes Daniel Lieberman and Benno Nigg, both of whom have done research on this subject. So there'll be more to come from that, no doubt.
But for today, I just wanted to share with you the presentation that I did last night. It will lack the sound and my explanations, of course, but most of it should be fairly self-explanatory. For those who want to read through a more detailed description, you can read the article I wrote after the ACSM meeting earlier this year - most of the concepts covered in the presentation below are also described in that article.
I would say that the three key points about this whole debate are:
Evidence linking the mechanics to the injury outcome still lacking
There is as yet no conclusive evidence that either proves or disproves the benefits of shoes or barefoot running, or links the mechanical characteristics of barefoot running to a reduced risk of injury. That is, for all the work showing how impact forces and loading rates are reduced when barefoot, it remains to be proven that this leads to lower injury rates. I began last night's talk by saying that this was the first time a "scientific" presentation would be given with so little conclusive scientific evidence! There are plenty of theories, of course, and some are sound, but we await the real evidence for the injury and performance side of the debate, which will come from long-term, prospective studies.
Recognize that running barefoot may be a skill and that people acquire skills at different rates (or not at all)
The evidence so far suggests that barefoot running produces some potentially beneficial changes, mostly related to how running form and kinetics are altered without shoes. However, it also points to a potentially large group of people who, when running barefoot, may have increased risk of injury, especially early on - these are the people who continue to heel-strike when barefoot, and who may "force" a forefoot landing, leading to huge strain on the calf muscle and Achilles tendons.
The key point is that barefoot running (and thus running in general) should be recognized as a SKILL, and it is clear that we do not all have the ability to acquire skills equally. Those who do not may be substantially worse off, and require much longer to make the adjustments. Whether they should even try is a good question.
The issue however is not necessarily whether barefoot running is "good for you", but rather whether barefoot running helps us understand anything about how we run that might help us reduce injury risk. If barefoot running provides these answers for a given runner, then of course it would be enormously beneficial. But it may be that simply learning about barefoot running helps runners in shoes just as much!
It's also vital to recognize that huge differences may exist between individuals: some adapt very quickly to minimalist shoes or barefoot running - these people are the "responders" and they tend to go on to become "evangelists" who tell everyone to throw away their shoes! At the other extreme, however, are non-responders, who, for reasons unknown, will battle to run without "traditional shoes". In both cases, we have to be careful about generalizing the "extreme" observation to the general population. That's the mistake shoe companies made when telling everyone they needed all manner of gadgets in their shoe, and it's a mistake that people now make when advocating barefoot running.
We do not fully understand why some people adapt faster than others. The studies required in the future need to assess how biomechanical and neuromuscular changes are learned and relearned when running barefoot, and then to establish whether this impacts on injury risk. Those will come, in time.
Worth a try, or inclusion into training. But respect the length of the investment: Change management
In terms of advocacy, I believe that barefoot running will help most runners. It may be as part of a training programme where barefoot running helps with adaptation because it loads the joints differently, activates muscles in different patterns and therefore provides a good training impulse. For some, barefoot running (or minimalist shoes) will go on to become the "only way". For others, it will remain a training technique, and that's fine too. But I'd certainly look at incorporating it, just for the training adaptations it provides.
The key, as mentioned in #2 above, is to recognize that going from shoes to either minimalist shoes or barefoot is a skill and involves a significant change. Therefore, it's essential to respect the time that it will take to fully adapt to the different loading stresses associated with running either barefoot or in minimalist shoes. I've given an illustration of a programme in the presentation, where I've 'budgeted' 12 weeks to build up to 40 minutes of solid running (plus 2 to 4 weeks of preparation). Some people may take even longer than this - the question that has to be asked then is whether it's worth it? Is a 6-month intervention worth the benefit, when the benefit hasn't yet been clearly established? I doubt it.
Nevertheless, if you're sold on the idea of giving it a try, recognize that you're making a long-term investment, and that if you simply continue your normal training barefoot, you're pretty much guaranteed to get injured!
Evidence linking the mechanics to the injury outcome still lacking
There is as yet no conclusive evidence that either proves or disproves the benefits of shoes or barefoot running, or links the mechanical characteristics of barefoot running to a reduced risk of injury. That is, for all the work showing how impact forces and loading rates are reduced when barefoot, it remains to be proven that this leads to lower injury rates. I began last night's talk by saying that this was the first time a "scientific" presentation would be given with so little conclusive scientific evidence! There are plenty of theories, of course, and some are sound, but we await the real evidence for the injury and performance side of the debate, which will come from long-term, prospective studies.
Recognize that running barefoot may be a skill and that people acquire skills at different rates (or not at all)
The evidence so far suggests that barefoot running produces some potentially beneficial changes, mostly related to how running form and kinetics are altered without shoes. However, it also points to a potentially large group of people who, when running barefoot, may have increased risk of injury, especially early on - these are the people who continue to heel-strike when barefoot, and who may "force" a forefoot landing, leading to huge strain on the calf muscle and Achilles tendons.
The key point is that barefoot running (and thus running in general) should be recognized as a SKILL, and it is clear that we do not all have the ability to acquire skills equally. Those who do not may be substantially worse off, and require much longer to make the adjustments. Whether they should even try is a good question.
The issue however is not necessarily whether barefoot running is "good for you", but rather whether barefoot running helps us understand anything about how we run that might help us reduce injury risk. If barefoot running provides these answers for a given runner, then of course it would be enormously beneficial. But it may be that simply learning about barefoot running helps runners in shoes just as much!
It's also vital to recognize that huge differences may exist between individuals: some adapt very quickly to minimalist shoes or barefoot running - these people are the "responders" and they tend to go on to become "evangelists" who tell everyone to throw away their shoes! At the other extreme, however, are non-responders, who, for reasons unknown, will battle to run without "traditional shoes". In both cases, we have to be careful about generalizing the "extreme" observation to the general population. That's the mistake shoe companies made when telling everyone they needed all manner of gadgets in their shoe, and it's a mistake that people now make when advocating barefoot running.
We do not fully understand why some people adapt faster than others. The studies required in the future need to assess how biomechanical and neuromuscular changes are learned and relearned when running barefoot, and then to establish whether this impacts on injury risk. Those will come, in time.
Worth a try, or inclusion into training. But respect the length of the investment: Change management
In terms of advocacy, I believe that barefoot running will help most runners. It may be as part of a training programme where barefoot running helps with adaptation because it loads the joints differently, activates muscles in different patterns and therefore provides a good training impulse. For some, barefoot running (or minimalist shoes) will go on to become the "only way". For others, it will remain a training technique, and that's fine too. But I'd certainly look at incorporating it, just for the training adaptations it provides.
The key, as mentioned in #2 above, is to recognize that going from shoes to either minimalist shoes or barefoot is a skill and involves a significant change. Therefore, it's essential to respect the time that it will take to fully adapt to the different loading stresses associated with running either barefoot or in minimalist shoes. I've given an illustration of a programme in the presentation, where I've 'budgeted' 12 weeks to build up to 40 minutes of solid running (plus 2 to 4 weeks of preparation). Some people may take even longer than this - the question that has to be asked then is whether it's worth it? Is a 6-month intervention worth the benefit, when the benefit hasn't yet been clearly established? I doubt it.
Nevertheless, if you're sold on the idea of giving it a try, recognize that you're making a long-term investment, and that if you simply continue your normal training barefoot, you're pretty much guaranteed to get injured!
More to come in the future, I am sure. Looking forward to meeting Lieberman for a few runs along the Thames, and we will be discussing the future research that needs to be done!
Until then, enjoy the presentation below! Again, click the grey arrow, hover over "More" and click "Fullscreen". Email subscribers click here to visit the site to view presentation
Ross
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