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

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

---

05/13/2013    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