Barefoot running: an evaluation of current hypothesis, future research and clinical applications

Abstract

Barefoot running has become a popular research topic, driven by the increasing prescription of barefoot running as a means of reducing injury risk. Proponents of barefoot running cite evolutionary theories that longdistance running ability was crucial for human survival, and proof of the benefits of natural running. Subsequently, runners have been advised to run barefoot as a treatment mode for injuries, strength and conditioning. The body of literature examining the mechanical, structural, clinical and performance implications of barefoot running is still in its infancy. Recent research has found significant differences associated with barefoot running relative to shod running, and these differences have been associated with factors that are thought to contribute to injury and performance. Crucially, long-term prospective studies have yet to be conducted and the link between barefoot running and injury or performance remains tenuous and speculative. The injury prevention potential of barefoot running is further complicated by the complexity of injury aetiology, with no single factor having been identified as causative for the most common running injuries. The aim of the present review was to critically evaluate the theory and evidence for barefoot running, drawing on both collected evidence as well as literature that have been used to argue in favour of barefoot running. We describe the factors driving the prescription of barefoot running, examine which of these factors may have merit, what the collected evidence suggests about the suitability of barefoot running for its purported uses and describe the necessary future research to confirm or refute the barefoot running hypotheses.

A comparative biomechanical analysis of habitually unshod and shod runners based on a foot morphological difference

“…8). These results are consistent with previous studies that have reported that RFS unshod running of habitually shod runners have higher VALR (Paquette et al, 2013); more specifically, the medial forefoot (first and second metatarsal) bears more loading compared with other conditions, which is linked with calluses observed in plantar skin (Grouios, 2004), forefoot pain (Keijsers, Stolwijk, Louwerens, & Duysens, 2013) or even metatarsal stress fracture (Nagel, Fernholz, Kibele, & Rosenbaum, 2008;Tam et al, 2014). Further, the RFS unshod running of habitually shod runners and FFS unshod running of habitually unshod runners show greater pressure time integral than RFS and FFS shod running.…”

“…The different FFS styles between shod and unshod running of habitually unshod runners is plausible when considering the proprioceptive ability of humans, which is believed to adjust body function according to running surface or environment (Gu, Lu, Mei, Li, & Ren, 2014;Lieberman, 2012;Sousa & Tavares, 2013;Sousa et al, 2012;Tam et al, 2014). RFS shod running of habitually shod runners has larger passive impact peak and active impact peak compared with RFS unshod running (Fig.…”

“…Importantly, RFS unshod running of habitually shod runners shows a higher VALR than RFS shod running (Fig. 6), which is a predictive factor of metatarsal and tibial stress fractures and plantar fasciitis (Lieberman et al, 2010;Tam et al, 2014;Van Gent et al, 2007). The presented differences in spatiotemporal parameters and kinematics between RFS shod and unshod running of habitually shod runners, suggests that habitually shod runners cannot transit into FFS (forefoot strike) running immediately while trying barefoot running at their first attempt, which is correlated with an increase in running-related injuries.…”

“…This was thought to contribute to high incidences of stress injuries to the feet and lower limb, especially the metatarsals, tibial stress fracture, patellofemoral pain, Achilles tendinopathy, and plantar fasciitis (Nunns, House, Fallowfield, Allsopp, & Dixon, 2013;Revill, Perry, Edwards, & Dickey, 2008;Tam, Wilson, Noakes, & Tucker, 2014;Willson et al, 2014). Studies concerning barefoot running concluded that barefoot running could minimize impact peaks through a FFS pattern (Lieberman et al, 2010), increased proprioception via direct contact with the running surface and increased foot and leg muscle strength (Sousa, Silva, Macedo, Santos, & Tavares, 2014;Sousa, Tavares, Macedo, Rodrigues, & Santos, 2012;Tam et al, 2014), thus reducing injury regardless of the choice of footwear (Lieberman, 2012;. Considering the benefits of barefoot running, the public media, runners, sports community and footwear companies have shown increasing interest in barefoot running technology.…”

Long-term adaptations of habitual barefoot locomotion on foot morphology and biomechanics during childhood and adolescence (PhD Academy Award)

“…Proposed benefits include injury prevention, enhanced proprioception, foot muscle strength and running economy, as well as superior running biomechanics 1. The few reports of long-term barefoot locomotion investigated mainly adult populations.…”