When Patients Ask About Barefoot Running And Minimalist Shoes
Doug Richie, Jr., DPM, says the vast majority of his patients have “no interest in running barefoot and look at the movement as a silly fad with potential dangers.” Alternately, he has had many patients ask him about possibly switching from stability running shoes to minimalist running shoes. Dr. Richie says these inquiries are fueled by one of the following reasons: boredom with their current level of training; boredom with their current running shoe; getting swayed by advertising; getting swayed by Internet chatter about the barefoot/minimalist craze; an interest in improving performance; or a nagging injury that isn’t getting better.
Dr. Sanders cautions her patients that definitive scientific evidence (via prospective, randomized, controlled studies) either for or against barefoot running “is still lacking.”1
“Barefoot or minimalist running is neither the savior nor the apocalypse to running injuries,” maintains Dr. Johncock. “The late, great George Sheehan, MD, (a running philosopher and accomplished runner himself) was frequently quoted as saying, ‘We are all a study of one.’ I feel barefoot running is absolutely a subject where this is true.”
How do you evaluate a runner to determine whether he or she is a candidate for barefoot/minimalist running?
Dr. Kirby has observed that runners who are more experienced in distance running, younger, of normal body weight and are frequently barefoot while walking are “much more likely” to tolerate barefoot running than those who are beginners, older, heavier or habitually shod. Dr. Kirby feels that any runner can run barefoot or in minimalist shoes on an intermittent basis. He believes that the main question for the podiatric physician is whether the runner will derive benefit or possibly become injured from running barefoot or in minimalist shoes on a regular basis. Dr. Richie counters that when it comes to giving advice to runners on what biomechanics or characteristics of the feet are better suited for barefoot running, there is insufficient evidence from which to make such recommendations.
When patients ask Dr. Richie about switching to minimalist shoes, he points out that the origin of the movement was among elite runners who sought new methods of improving performance and that running barefoot was proposed as a training technique used once a week to supposedly strengthen the feet in elite runners. Then Dr. Richie will ask inquiring patients if they consider themselves to be truly elite runners and whether they have a specific goal of dropping a few seconds off their 10K time. He also asks these patients if their body frame is similar to the Kenyan runners leading the pack at the New York City or Boston marathons. Dr. Richie then reminds them that the Nike Free (Nike) shoe was designed for elite runners.
Dr. Romansky also emphasizes candor about fitness level. He says many patients are not as fit, functional or efficient in using their bodies as they think they are in multiple forms of exercise including running, cycling, Zumba, gym workouts, spin class, etc. Accordingly, Dr. Romansky emphasizes performing a quick but in-depth functional movement screen to evaluate the athletic patient. This evaluation should focus on the patient’s core, balance, proprioception and single leg raise exercise, and compare the right side to the left side. He also asks patients if they’re going to use the minimalist shoes only for running or for other activities such as gym workouts, daily errands or housework. Dr. Romansky also tries to find out what shoes patients have worn in the past.