When Patients Ask About Barefoot Running And Minimalist Shoes
Dr. Richie says the biggest problem he has seen with the barefoot/minimalist shoe movement is the use of “flimsy lightweight shoes” by overweight, untrained athletes who are taking fitness classes such as Cross Fit and Zumba, or who are exercising at home to videos such as Insanity Workout or P90X.
“This trend has sent a large number of patients to my office with stress fractures, Achilles tendinopathy and plantar heel pain in numbers like I have never seen in 32 years of running a sports medicine practice,” notes Dr. Richie.
Dr. Richie says many novice athletes have good intentions when starting a fitness program but they can be swayed when going to an athletic shoe store or department store. Given that minimalist shoes are softer and lighter with the initial fitting in comparison to standard shoes, minimalist shoes are an easy sell for the shoe salesman, notes Dr. Richie.
“The victim is the unsuspecting future patient who succumbs to the cool look and ultra lightweight feel of the minimalist shoe,” says Dr. Richie.
Describing himself as a 170-pound moderate overpronator who had typically worn stability shoes with custom orthotics, Dr. Johncock attempted his own “study of one” two years ago with a six-month transition to less supportive shoes and ceasing to use his orthotics. He wound up with an Achilles injury. He is 48 years old, has been running for 35 years and has a past history of Achilles injuries. However, as a result of his “experiment,” Dr. Johncock has moved into a more “neutral shoe” and wears lighter weight shoes for his speedwork and races just as he did during his younger days. Dr. Johncock notes that he returned to wearing his orthotics.
“I did not feel the risk of total transition to minimalist shoes was worth the potential benefit for me,” notes Dr. Johncock. “If I wake with knee pain tomorrow, I may change my mind.”
Are you seeing more runners or fewer runners interested in barefoot running?
The majority of the panelists say patient interest in barefoot running has significantly declined. Dr. Johncock still has a number of patients asking about barefoot running but notes that it has “tapered off from the exponential increase of one to two years ago.”
“Most runners are starting to realize that the poorly designed research studies that come from those who received monetary compensation from minimalist shoe companies were biased toward selling more five-toed shoes and not toward allowing runners to train more, run faster and have fewer injuries,” asserts Dr. Kirby.
However, Drs. Sanders, Richie and Blake are still seeing curiosity and interest in minimalist shoes. Dr. Sanders says the new questions from runner patients tend to be on minimalist shoes versus structured running shoes and ascertaining the ideal, heel-to-toe differential. When it comes to his runner patients, Dr. Richie says there is growing interest in trying minimalist shoes and changing their foot strike pattern in running in the hopes of improving their performance.
“This trend is definitely growing and so is my practice,” claims Dr. Richie.
“Runners will always want to try to reduce injury and improve performance. Podiatrists will always be part of this conversation. This is a good thing,” asserts Dr. Sanders.
Dr. Johncock says it is “ill-advised” for podiatrists to vilify barefoot runners just as he feels it is wrong for barefoot running advocates to attempt to make podiatrists villains for prescribing orthoses that they feel will benefit their patients. Dr. Romansky concurs, noting that many individuals have blamed current injury patterns on a shoe type or a shoe company. He feels answers will come through ongoing research on the subject.
“With time, we will (and have already begun) to build a new injury database noting the pattern, type and severity of injuries associated with barefoot running and/or the minimalist shoe movement,” notes Dr. Romansky. “We would be shortsighted or narrow-minded not to think so.”
Drs. Kirby, Romansky and Johncock says there are other silver linings to the recent barefoot running/minimalist shoe movement.