When Patients Ask About Barefoot Running And Minimalist Shoes
Chances are that you have had a patient or two ask for your opinion on barefoot running or minimalist shoes. Accordingly, these panelists share their perspectives on the recent surge of interest in these topics, review pertinent keys to patient assessment and discuss common injuries they have seen.
In an intriguing roundtable discussion, these accomplished sports medicine podiatrists (including a couple of longtime runners) discuss various issues related to barefoot running and minimalist footwear. Does barefoot running have a role in the training regimen of elite athletes? What do you say to non-elite athletes or beginning runners who want to try minimalist shoes? How critical is a gradual transition to minimalist shoes? Is there sufficient research to validate the hype or do common injuries like metatarsal fractures suggest otherwise? Without further delay, here is what the panelists have to say.
When patients ask about your opinion on barefoot running and whether or not it may be appropriate for them, what do you tell them?
The majority of the panelists agree that this depends on several factors. Bill Johncock, DPM, says it depends on the type of injuries runners have had in the past, whether they have any current injuries, the types of surfaces they run on, their age, etc. Jenny Sanders, DPM, and Nicholas Romansky, DPM, also ask these patients if they have already tried barefoot running, and whether they had a favorable or unfavorable response. Drs. Johncock, Romansky and Sanders all concur that it is important to determine the patient’s motivation for wanting to run barefoot. Is it fueled by hype, a history of chronic injury or some other factor?
“Understanding a runner’s motivation to want to run barefoot is key to making an informed decision,” points out Dr. Sanders. “Many runners don’t know why they think they should run barefoot and have no plan whatsoever as to how or why to adapt to a new form.”
Richard Blake, DPM, assesses the patient’s biomechanics in order to determine if his or her feet are stable enough to handle barefoot running. However, he notes that “many feet are so unstable that it is hard to recommend such an activity.”
Dr. Romansky says he rarely recommends barefoot running or minimalist shoes for patients or athletes starting to exercise or restarting an exercise program after a layoff. Similarly, Kevin Kirby, DPM, is not likely to recommend barefoot running to beginning runners as he believes it may increase their risk of injury at a time when their body is not quite ready for the extra stress that it will place on their feet and lower extremities.
However, as a sports medicine podiatrist and longtime distance runner, Dr. Kirby does tell runners that barefoot running is “certainly a reasonable way to train for running on a part-time basis as long as it is performed on a safe surface.” He reminds patients there is an extra risk of stepping on sharp objects with barefoot running. Dr. Kirby also notes that he is “more likely” to recommend occasional barefoot running to more experienced runners to allow more training variety and as a method to help them refine their running form.