Fads come and go. In my practice, one of the most frequent questions asked is about the effectiveness of barefoot running shoes. My answer? We are in the midst of another passing fad of products, this time designed to mimic or support “nature.” And who doesn’t want to be more natural these days?
Barefoot running shoes are designed to re-create a “natural,” barefoot running dynamic on “unnatural” surfaces like concrete, asphalt, red top, black top, etc. How can we have a barefoot running shoe? Doesn’t barefoot denote without shoes?
Choosing to run on non-yielding surfaces without the protection afforded by proper running shoes can be harmful to the foot and ankle and cause even more problems downstream from compensation patterns. So what really are these pedal marvels and why is everyone running to take their shoes off?
Barefoot running shoe manufacturers believe that the human foot, unimpeded by synthetic surfaces and restrictive running shoes, should function at its best. That is a correct assumption, save for the fact that the human foot was designed long before the paving of roads. In fact, uneven, grassy surfaces are the most natural surface for the human foot because it helps the body navigate and respond to uneven terrain, while at the same time absorbs shock, stabilizes weight and propels the body forward. In order for this to occur successfully, most of us are born with a flexible forefoot and a rigid or stable rearfoot. In other words, at heel strike — when your heel hits the ground — your leg from the hip down is aligned for optimal function and is stabilized during normal walking.
As weight passes forward over the forefoot, on the natural yielding surfaces of grass, the foot is flexible enough to respond to the stress of uneven terrain yet stable enough for the rearfoot musculature to propel the body forward. In fact, because the rearfoot houses the Achilles’ tendon, the posterior tibial tendon and the peroneal tendons (the powerhouses of propulsion), the actual heel strike against the ground becomes much less necessary when running on natural surfaces like grass and soil.
It is this dynamic — the decrease in heel strike — barefoot running shoes seeks to achieve. This is precisely why this technology is failing its mission. The lack of heel strike on unnatural surfaces is not mimicking the way the foot would perform barefoot on natural surfaces. For this very reason, these shoes will eventually come up short, as the foot requires either cushioned heel strike on an unnatural surface or minimal heel strike on natural surfaces.
Since the majority of body weight passes through the first metatarsal bone and big toe — the first ray — during the process of forefoot propulsion, it becomes obvious that any abnormalities in this part of the foot spell disaster. Since we find that the greater majority of humans have a flexible first metatarsal bone, and since we know the greater majority of runners are running on non-yielding surfaces like asphalt and concrete, we find that a flexible first metatarsal will meet the non-yielding surface and will be pushed hard, up away from the ground surface upon contact. This dynamic then creates a decreased range of motion in the first metatarso-phalangeal joint (what we know as the bunion joint).
Try this. Hold your first metatarsal and pull it up as hard as you can, then with your other hand try to pull your big toe upward toward your ankle. You will find the joint will jam up and feel restricted. Now, hold your first metatarsal and apply pressure down toward the floor, then with your other hand, pull your big toe up toward your ankle. You will find a dramatic increase in the upward range of motion of the big toe — this is normalized function.
Runners wearing barefoot running shoes will experience the first dynamic: decreased power of propulsion afforded by the big toe because the muscle contraction is now restricted and less efficient. This in turn causes the rearfoot powerhouse muscles to compensate for this decreased propulsion power. If this dynamic happens over and over with every step, and our barefoot running shoes are depending upon forefoot stability for propulsion power, can you begin to see the pathology that eventually occurs?
We will see things like first metatarsal phalangeal joint pain, pain under the second metatarsal head, Achilles’ tendinitis, plantar fasciitis, posterior tibial tendinitis and/or peroneal tendinitis. Eventual stress fractures of the metatarsals may occur in addition to knee, hip and back problems.
So who should be using barefoot running shoes? The answer is very few people should. Only those people with stable (not flexible) first metatarsals will do well with these shoes, as well as those with very powerful lower leg musculature (although even those with powerful lower leg function will ultimately go on to some type of pathology).
So let’s get real. If you are a serious runner, you need to see a podiatrist who is also trained in functional foot typing, as developed by Dr. Dennis Shavelson to find out if barefoot running shoes are for you. If not, you can safely wear conventional running shoes manufactured by companies who have spent years on research and technology with the addition of a proper running orthotic.