05/09/2013    Amol Saxena, DPM

Outside Magazine’s Article by Andrew Tilin on Barefoot Running

I am sure the article was designed to fuel the
debate between minimalist/barefoot running and
traditional shoes. Unfortunately, it isn’t that
clear cut. By printing McDougall’s inflammatory
comments towards podiatrists, specifically saying
they aren’t research scientists (either is he
last I checked), actually weakened his argument.
(He should also note Dr. Kevin Kirby has
published extensively in many high-level
biomechanics journals before he casts stones.)
In general, podiatrists see only people with
injuries so they will be biased in that regard.
Back in the 1970’s runners wore minimalist shoes
and got injured. Shoes got more supportive and
cushioned, and people still got injured.
Generally speaking runners will get injured,
often from increasing their training volume or
intensity or running on an unfamiliar surface.
Also in general there is bias when “research
scientists” study non-injured runners in a secure
environment at a “snap shot” of their
running “life”. Research on runners using
treadmills have shown gait is different than
running outside, and yes, when they use shoes,
pronation (which had been previously thought to
be the root of all evil) is increased. They
haven’t done longitudinal studies on any of the
subjects in the studies they quote. Eventually,
almost all runners seeking improvement will get
injured, regardless of shoes and surface. The
other thing to keep in mind is that often just
time, not a treatment nor a shoe change, that may
heal an injury.

In cultures which are touted to run barefoot,
they develop their strength and cadence over many
years. Interestingly, you almost never see a
Kenyan running barefoot on concrete. Ethiopian
Abebe Bikila, whom the barefoot proponents
constantly remind us that he won an Olympic
marathon unshod, subsequently won a gold medal in
record time in the next Olympiad with running
shoes.

What is known, and perhaps the only real
scientific take home point from McDougall’s book
is on page 205 of his book: an athlete
significantly increased his cadence to180
steps/minute and ran faster. That is the crux of
any type of running, regardless of shoe type; the
faster the cadence, the less contact time and
less time for force to affect the body. The best
US 10K runner increased his cadence 5
steps/minute which equates to one second/minute
gained. In a race taking 27 minutes, his time
improved 27 seconds!

Criticizing shoe companies from making profits on
running shoes and podiatrists from orthoses is
really no different than authors making profits
by hyping a book or researchers promoting their
findings without having the complete picture.
There is some science behind using minimalist
shoes, specifically less heel contact and less
stress on the knee’s patello-femoral joint.
Longer study of whom these shoes and techniques
will benefit is needed.

Amol Saxena, DPM, Palo Alto, CA, Heysax@aol.com

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