To Run With or Without Shoes…That is The Question!

In recent years, much discussion has surrounded the topic of Barefoot Running.  The benefits versus the risks of running barefoot have the medical community divided on which is “best” and for which running populations.  International athletes suck as Abebe Bikila of Ethiopia have successfully competed in long-distance running events without the aid of shoes; if he can run without shoes, why can’t the rest of us?

It is not so much that you can’t become a “barefoot runner,” but the more important question becomes, is it safe?  What are the risks and benefits of running without shoes? 

Running barefoot has come into favor in recent years because runners and sports science researchers alike believe that running barefoot allows a runner to expend less energy in addition to decreasing their risk of acute injuries, such as ankle sprains.  Proponents believe that the risk of injury increases with shoe-wear due to slowed proprioceptive feedback from the foot to the brain.  Proprioceptive feedback is a message sent from the foot up to the brain that tells your foot that it is on the ground and in which position.  Without shoes, there is no interference from the material of the shoe and the feedback from the foot to the brain is faster and more efficient, thus your body can adjust to uneven surfaces quicker, preventing injury. 

The theory behind a decrease in energy expenditure in the athletes running barefoot has no substantial research behind it, but theorists believe it may have something to do with proprioceptive feedback in addition to the simultaneous use of foot and leg muscles.  It is believed that when running barefoot an athlete must use all the muscles in their foot and leg to run, thus no one muscle must work harder than it was intended, as they believe is the case in those running with shoes.  They say that shoes and “high-tech” athletic sneakers prohibit certain muscles in the legs from working at their maximum capacity, forcing other muscles to work harder, which could lead to an increase in energy expenditure. 

Proponents of running with shoes believe that without the use of supportive shoes and/or orthotic devices during running, the musculature of the foot and leg is incorrectly aligned or stretched.  Muscles function at their maximum capacity, with the least energy expenditure while in their correct anatomical alignment, so unless a person has a “perfect” foot, chances are their muscles are not functioning at the top of their game!  Orthotics and shoes to some extent, place the foot and leg in their “neutral position,” aligning the muscles, tendons, and ligaments correctly so as to allow them to exert their maximum benefit. 

In terms of injury, it remains to be seen whether more acute injuries are suffered with or without shoes because there simply isn’t enough research to support one side or the other.  However, it has been proven that the skin on the soles of the feet is 20 times thicker than any other skin on the body.  This may make the sole of the foot more resistant to injury over other areas of the body, but it certainly doesn’t make it immune to injury!  Those against barefoot running can show clear evidence to support an increase in puncture wounds to the soles of the feet in athletes running without shoes. Objects that could be encountered while running without shoes, such as rocks, glass, and nails still have the potential to cause serious injury and debilitation to the soles.

Certainly, if you suffer from peripheral neuropathy, as a complication of diabetes, alcoholism, or other inducing factors, shoes should be worn at all times.  In patients with neuropathy, infarct on the plantar aspects of the foot may go undetected due to lack of sensation, and further complications such as infection and non-healing wounds are imminent! 

Adjusting to barefoot running, should you bravely attempt it, may take up to 4 weeks, at which time the skin on the plantar surfaces of your feet with becoming thicker and more adept to handling new terrain.  You should begin by walking barefoot as much as possible, and slowly work your way into jogging, and eventually running when you feel comfortable.

No matter which thought process you follow, exhibit safety.  Carefully weigh the options, know which is best for you, and get running! 

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