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05/13/2013 Jefferson J. Mennuti, DPM
Biomechanics of Barefoot Running
I have been thumbing through some of the recent literature about the above subject. I think what the reality of this debate is not, in fact, barefoot running per se. I believe the real issue is biomechanics; specifically forefoot running vs. heel striking. So I would like to shift this thought process from "barefoot running" to "forefoot vs heel strike running".
In my vast history with running (5 weeks) I have converted from my new balance 1140 to the minimalist. The rationale was not for the sake of "feeling the ground under my feet", but rather to encourage a more natural running posture (forefoot strike). The 1140 emphasize the heel strike, and are great shock absorbing shoes. The minimalist, at its core is a zero drop shoe, offering minimal cushion upon heel strike.
Since the conversion, I have noticed a lot more tone in my legs, and mild to moderate anterior medial shin splints. This is what I had expected. Obviously, this was not a blind trial. From what I have gathered from my research (personal trial and literature review), the better running gait is the forefoot strike, shorter stride and a higher cadence. This is in contrast to the conventional heel strike, long stride gait. It makes more sense with sprinting, rather than jogging. However, with some training one can get used to it. It offers a higher level of shock absorption, more muscular expenditure, especially with eccentric contraction of the anterior crurals.
Also, if I may be so bold as to use a metaphor, like a boat, the motor is in the rear. If the feet were like the propellers of a boat, pushing the body forward, rather than the conventional. A long stride, heel strike, with the foot in front of the body, is more akin to pulling the body forward.
I like the idea of a minimalist shoes, not because of "ground feel"; but rather, because they are zero drop. The conventional shoe usually is about a 2mm heel rise, give or take, with plenty of technology for cushioning below the heel. The zero drop is the key. The bare foot does not offer a 2mm heel rise, and thus its would be unnatural to run as such. I think, in the very near future, the minimalist shoes are going to be replaced with the zero drop or minimal drop shoe.
I would like more opinions on the biomechanics of running.
Jefferson J. Mennuti, DPM, Orange City, FL, dr.mennuti@gmail.com
Other messages in this thread:
05/21/2013 Robert Scott Steinberg, DPM
Biomechanics of Barefoot Running (Brad Makimaa, DPM)
A few things are missing from Dr. Makimaa's rational. First, he does not mention that the runners "length of leg", which is of course determined by the runner's height, has to be taken into account.
Second, after we take into account the affects this has on stride length, we must then look at the runner's chosen stride length, and determine if the runner is under or over striding, for the speed they are running.
Third, is limited dorsiflexion of the hallux a factor in a runner's stride length? Heel strikers can have a longer stride. Forefoot runners must pull up short, unless they are sprinting. The thickness of the forefoot in the chosen shoe, affects limb length.
Dr. Makimaa referenced his "rigid" orthotics, which makes me want to know just how rigid; What material, in what thickness, for how much body weight? The Asics Tri Noosa 8 is not a stability shoe according to Asics, which lists the Gel- Noosa Tri 8 as a neutral shoe, i.e., cushioned, which might be okay for forefoot strikers, if they run the whole race only striking only their forefoot.
For my patients who are recreational runners, running to stay fit and feel good, I have a rule (Robert's Rule); Don't let ego allow you to do something stupid! Run in such a manner that you'll be able to continue to run for years to come. I explain that the "rubber" between their foot and the road, is insurance to protect from injury. For the elite runners, each and every one has very different needs that need to be addressed.
To be blunt, beyond ego, I see no rational reason to risk the injuries inherent in barefoot or minimalist running, unless you are one of those rare human being who has perfect biomechanics and perfect form.
Robert Scott Steinberg, DPM, Schaumburg. IL, Doc@FootSportDoc.com
05/20/2013 Brad Makimaa, DPM
Biomechanics of Barefoot Running (Jefferson J. Mennuti, DPM)
I would like to clarify some of the ideas of this principle. I would also like to call for someone in one of our "Podiatric educational institutions" to create a revolutionary road map for the prescription of the proper shoes based on speed and patient makeup. We are the shoe gurus and there should be no second place on this issue. If you want to run in any style, you must see a podiatrist first. Just like a school physical for sports is mandatory. This is not a black and white issue. Everyone will or can run on the forefoot. Just speed up. Therefore simply asking the patient how fast they run will set apart the majority of the shoe categories. Think of track spikes. There is literally nothing proximal to the rearfoot. Not needed because you are sprinting on the forefoot only. If your patient wants to run in that fashion and is at approx 8 min/ mile pace or lower then forefoot running is a viable option. At 10 min/ mile you will work much harder trying to forefoot run than a heel toe style. More effort goes into deceleration.
I have experimented with this many times and would love to see research done further. When running on a treadmill and same for the road, I alternate speed between intervals of 10,9,8,7,6, and 5 min/ mile pace (5 is a little tough). Then attempt forefoot for each speed and heel toe for each speed. A very clear delineation of effort is present. Very obvious at the extremes, i.e., 10 min/ mi on the toes and 5 min/ mi on the heel seems absurd and very difficult.
As you increase speed and transition closer to forefoot, then stability needs change as well. This reduces the importance of orthotics and stability shoes (not eliminate). As you decrease and have a heel toe gait then this support is critical for injury prevention (providing overpronation is present). This is just a basis for what category of shoe works. Obviously, pronation, equinus, weight, all biomechanical principles all come into play and variables change but this speed evaluation gets you started. If someone is a slower runner and wants to run barefoot. This is not ruled out, but they must understand that this is not just wearing or not wearing a different shoe. It is literally a new sport. It is not just new shoes. Every day, I see injuries from attempted barefoot or natural running shoes because the patient continued a heel toe gait with the new shoes. They were not fast enough and had no idea how to change their gait. Instead of buying new shoes, the concept is really buying a new running style. Bottom line- Research showing what shoes work at what speed and what running style will create a road map of where runners need to look. Or, more importantly not look. i.e., What is ruled out for them. Then we, the shoe gurus, can tweak the suggestion based on our biomechanical exam. Note- I overpronate (mod). I run/ train in rigid orthotics and Asics Kayano (stability shoe). 8-9 min/mi mid to FF gait. I race in orthotics and Asiscs Tri Noosa (a racing triathlon shoe with stability) 6-7 min mile 5k all FF and 8 min/ mi for half marathon, mostly FF gait. (Yes, I am afraid to give up orthotics for the 5k) mentally) Brad Makimaa, DPM, Key West, FL, drmak3@comcast.net
05/20/2013 Kevin A. Kirby, DPM
Biomechanics of Barefoot Running
First of all, let's set things straight. The scientific literature to date has found no decrease in injury rate with barefoot or with shod running. In other words, we simply don't know for sure whether barefoot running produces fewer injuries than running in minimalist shoes or than running in conventional training shoes. The prospective research has not been yet been done on this subject.
However, it is clear that running barefoot or running in minimalist shoes can cause injuries since there are plenty of anecdotal reports and studies in the literature that show that barefoot and minimalist shoe running does not protect a runner from injury.
Secondly, I hope that no one is ignorant enough among our profession to assume that "minimalist running shoes" are a new idea. Myself, and many other competitive distance runners from the 1970s and 1980s routinely ran in thin soled, lightweight and low heel height differential shoes that were called, during that era, racing flats. Therefore, minimalist running shoes are basically modified racing flats that have been continually available in running shoe stores over the past four decades.
Third, forefoot or midfoot striking is not the preferred method of running for very many runners. In fact, of all the studies that have looked at foot strike during long distance races, they show that runners overwhelmingly prefer to rearfoot strike (75-90%) versus midfoot or forefoot strike. Yes, as running velocity increases, runners will tend to foot strike at more anterior aspects of the shoe sole, but at the slower speeds of most recreational runners, rearfoot striking is the preferred, self-selected running style.
Please, let's discuss the science of running, not continue to spread the myths from the Internet by the uninformed evangelists for barefoot or minimalist shoe running.
Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net
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