Is Barefoot Running A Growing Trend Or A Passing Fad?

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Kevin A. Kirby, DPM

   Barefoot running has gained in popularity ever since last year’s publication of the book Born to Run. This book details the story of the Mexico-based Tarahumara Indians, who, for centuries, have regularly run barefoot at distances sometimes greater than a marathon.

   One of the book’s claims is that the Tarahumara Indians can run barefoot for many miles without getting injured. Another claim is that there is no proof that the expensive running shoes sold by the running shoe industry are actually doing their job of preventing running injuries. The book suggests that runners should go back to how our earliest ancestors ran: barefoot.

   The barefoot running advocates claim that running in shoes causes injuries. They also say that running barefoot is more natural and prevents injuries. One faction of the barefoot running community claims that the only way to reap the full benefits of barefoot running is by running shoeless while another faction says it is best to run in “minimalist shoes” that have thin soles and are lightweight. The barefoot advocates never talk about the thousands of runners who are able to run every day pain-free, without injury, because they are wearing running shoes.

   I have had plenty of personal experience with the effects of running shoes on injuries and performance. I began competing in distance running at the age of 12. Due to various running injuries I suffered from running between 70 to 100 miles per week in high school, I sought the help of a local podiatrist. He made a pair of custom foot orthoses for me. These orthoses solved my running injuries for many years. I would not have been able to run all those years, relatively injury-free, without foot orthoses inside my running shoes.

   My experimentation with barefoot running began over three decades ago when I was a distance runner at the University of California at Davis. Our coach would often have us do mile intervals on a grassy baseball field, which allowed many of us to run without shoes.

   Rather than the near pound in weight that I carried on each foot with my size 12 training flats, the change to barefoot running allowed me to run about five seconds faster per mile than an equivalent effort while running in shoes. Barefoot running was a nice supplement to our training. However, it was not practical nor safe for all the hard miles and irregular surfaces we ran on during our training.

   For years, runners have raced in lightweight shoes since they “felt faster” when doing so. Numerous scientific studies have confirmed that the metabolic economy of running is indeed improved when running with reduced mass on the feet. However, there have been very few serious distance runners who have actually raced while barefoot. The most notable exception was Abebe Bikila from Ethiopia, who won the Olympic marathon in Rome 50 years ago while running without shoes.

   If running barefoot is a better and more natural way to run, as the barefoot running advocates claim, then why aren’t there more barefoot runners breaking the finishing tape at races? Are these talented runners worried they might injure themselves if they trained and raced barefoot? I think so.

   As physicians, we must all be very careful of what we tell our patients to do. From a medicolegal standpoint, we are responsible for any recommendations we make regarding the types of shoes our patients should wear or whether they should wear shoes at all. Experienced runners know that the lightweight racing flats that have been available to train and race in ever since the early 1970s are just as light and thin as the “minimalist shoes” that the barefoot runners tout as being the “newest thing.”

   If runners ask me whether running barefoot might be beneficial for them, I tell them they would be safer running in a lightweight racing flat. However, if they decide to run barefoot, they should do so at their own risk and on a safe surface to avoid injury. I also inform them that there is no scientific evidence that barefoot running produces any fewer injuries than running in shoes.

   Barefoot running is just another passing fad within the running community that I continue to educate my patients about so they can run with less pain and fewer injuries. I plan to continue running for many more years … in shoes.

Dr. Kirby is an Adjunct Associate Professor within the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt University in Oakland, Calif. He is in private practice in Sacramento, Calif.

Dr. McCord recently retired from practice at the Centralia Medical Center in Centralia, Wash.


"I also inform them that there is no scientific evidence that barefoot running produces any fewer injuries than running in shoes."

This is unfortunately just not the case. As detailed in "Footwear Science" in June 2009, shoes leave our feet "deformed". Do you really think that this effect only occurs when people are not running? Most runners I know have horrible feet.

The article is "The effects of habitual footwear use: foot shape and function in native barefoot walkers"

This article repeats the old saw that footwear is necessary, but presents no evidence to support the claim. Of course it's published in "Footwear Science", so I guess that is to be expected.

The US Military is also discovering that we've been ill-served by the running shoe. After determining that the classic "wet foot print" test method of determining "foot type" and therefore running shoe type just doesn't work, they're also exploring barefoot running as a training technique, and report that they are indeed lowering injury rates. At Fort Sill, running-related injuries are the number one injury in basic training.

For those of you not familiar with it, Pose is a running technique that uses barefoot running extensively in training, to teach barefoot-style technique for use when shod. Soldiers aren't going into battle barefoot.

And even a cursory examination of racing flats vs. a truly minimalist shoe like the Vibram FiveFingers or the VivoBarefoot Evo will reveal that they're dramatically different. All racing flats currently on the market have a raised heel and cushioning underfoot.

Dr. Kirby, As an active and thoughtful contributor to your field, you could have done better than this. If you've got a real, well-reasoned argument for supportive, motion control shoes with elevated, cushioned heels, I've yet to hear it. As it stands, you appear to be making the case that the preferred option for running should be a lightweight racing flat. What is barefoot or minimalist running but that logic taken a bit further? The principle remains to not interfere with the normal function of the human foot. Barefoot runners would add that altering one's natural functioning by encasing and controling the foot can make one prone to injury. This appears a rather intuitive concept, and one that you haven't in the slightest refuted or even really addressed. The only direct argument you make is related to performance: "...why aren’t there more barefoot runners breaking the finishing tape at races?" Is anyone really buying this? The East Africans that have been breaking the tape at races for years all grew up running barefoot, have strong, well developed feet, and train and race in relatively minimal shoes that have been handed to them by a major shoe company along with a paycheck that has more zeros on it than they've ever seen before. They run in shoes because they're fast, not the other way around. There may well be something substantial to be said for supportive running shoes, and you are right to attempt to address the issue. A dismissal with a "DPM" at the end of one's name is not sufficient. I'm still waiting for a line of reasoning that goes beyond "Watch out for those rusty nails!" Regards, Andy Southerland

Sounds just like every pro-barefoot article. Anecdotal references with no evidence to support/refute either side.

Murrieta, CA

"I also inform them that there is no scientific evidence that barefoot running produces any fewer injuries than running in shoes."

There is also no evidence supporting that running shoes reduce injury.

"If running barefoot is a better and more natural way to run, as the barefoot running advocates claim, then why aren’t there more barefoot runners breaking the finishing tape at races?"

They are, as you agree, running in racing flats, which is very similar to the new "minimalist" running shoes. The point is being missed. The idea of "barefoot running" is to change the gait to avoid heel contact with the ground at impact and shock absorb the way our foot was designed to absorb shock.

"These orthoses solved my running injuries for many years..." Was it the orthoses or was it the fact that they enabled to you "change the way you ran?"

There is no literature that "supports" what Root taught us about pronation etc. It only was used as a basis for what normal should be or is it normal? If we jump off a ladder, we would all agree that we would land on our toes? Why do we as podiatrists advocate landing on our heels then for 26.2. miles?

Nick Campitelli, DPM, FACFAS

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