When Patients Ask About Barefoot Running And Minimalist Shoes
Have any of your elite running patients switched to barefoot or minimalist running? If so, what was the outcome?
Dr. Richie notes that one patient, a veteran Ironman triathlete, decided to switch to total barefoot running last year so he could “run faster.” He had bilateral cavus feet and had run injury-free for over four years in traditional shoes. Within three months, the patient developed a calcaneal stress fracture, according to Dr. Richie. He notes that this was not just a stress reaction but a complete fracture through the tuber of the calcaneus that was visible on computed tomography (CT) and magnetic resonance imaging (MRI). Dr. Richie says two other patients switched to barefoot running over the past year and have had no problems, but they both mix barefoot running with shod running during their weekly training.
Dr. Johncock notes he has only had one elite athlete who attempted to make the jump to total barefoot running and extreme minimalist shoes (Vibram). He ended up in Dr. Johncock’s office with a metatarsal stress fracture. He does note that a number of his college runners and high-level athletes do a portion of their training on grass barefoot or in minimalist shoes, but this “typically accounts for 10 percent or less of their total training.” Dr. Johncock adds that he has seen a general trend of more elite athletes going with a lighter, less supportive shoe for their training.
Dr. Romansky reports that many of his patients have switched but very few exclusively use minimalist shoes. He says they may alternate with a zero drop shoe type or a lower profile shoe. He adds that some may use minimalist shoes for gym use, daily use around the house, daily errands and light trail walking. Regardless, Dr. Romansky says the use of minimalist shoes or barefoot running “must be a progressive and well thought out plan.”
Over the past 28 years of being a sports medicine podiatrist, Dr. Kirby says all of his elite running patients were already running in “minimalist shoes” as these shoes were called “racing flats” up until a few years ago when the barefoot running fad began. He adds that during his collegiate long-distance running days in the late 1970s, “many of us occasionally ran barefoot as a way to vary the stresses on our feet and lower extremities.
“Therefore, the notion that running in ‘minimalist shoes’ or running barefoot is a new idea is not only false but frankly is comical to anyone who is knowledgeable of the long history of distance running in the United States and other countries around the world,” says Dr. Kirby.
He notes that currently, no barefoot runners hold world records in any track events or long distance running events. Dr. Kirby says elite runners don’t want to increase their risk of injury by running barefoot so they instead wear thin-soled, lightweight racing flats to run their races in, just as they have done so for at least the past half-century.
Dr. Sanders says none of the elite runners she treats have changed from shod running to a minimalist shoe or barefoot running style. If Dr. Blake is treating an elite runner, it is usually due to a foot, ankle or leg injury and “the last thing we are thinking about is changing shoes and technique.”
While Dr. Johncock says he is far from an elite runner, he runs two to four ultra-marathons a year and has seen more of his friends in these ultra-marathons run barefoot or in true minimalist shoes. He notes that has yet to be beaten by any of his barefoot friends in distances over a marathon.