Bare foot running

Barefooting – what and why? YMCA, LTR 2011

When I first started this piece on barefoot running several years ago, there was just a bit of material in the popular media about natural running style. I even had a handout from Ultrarunner magazine about adopting some barefoot running, because this was an article that was fresh and addressed the topic in the mainstream. I am happy to say that the world has changed a bit, and now the terms barefoot and natural running have achieved almost “Kleenex” status in the common vernacular and I now only need to give you the basics while pointing you to dozens of great resources on the topic, including an entire book written by Dr. Daniel Howell, about all of the health benefits of not wearing shoes.

While the book Born To Run and the recently published research of Dr. Dan Leiberman seems to have energized the term barefooting – running barefoot did not start in 2009 or even in this century. While I would encourage you to read the work of both of these guys – I’ll take a minute to point out some highlights of how we got to running shoes in the 20^th century. I hope to also spark a bit of thought about what things looked like before shoes and how that factors into where we are at today. I kept my shoes through this fervor about bare feet, but I can tell you that my thinking, as well as my shoe choices, continues to evolve over time on this subject. I think that every runner should look at the history of our sport and can take a lesson from what shoeless or minimal shoe training can do for your running.

The feet have 26 bones, 33 joints, 12 tendons, 18 muscles; each foot is an amazing piece of machinery and while it has many things it does not have others – so why it is made this way and what was it for in the first place?

Science has made a great case for a theory that the current form of humans evolved and succeeded as a species due to 26 different, running specific, adaptations. These adaptations allowed us to pursue quarry on the move, at a rate just fast enough to tire that animal out, while we have the innate endurance to finish the hunt and gain groceries. Again, Dr. Dan Leiberman offers a much more through explanation of this theory and it is solidly based in the science of biology and comparative biology. We were able to travel, pretty fast, and fast enough to win food and cross great distances. Clearly, we did this without shoes and anthropologists have not found any evidence of Nikes from this critical time period. 

Until Bill Bowerman, the famous University of Oregon track coach, created the running shoe in America in 1972, just 39 years ago, we all ran in very thin light shoes that offered little in the way of a heel cushion or padding from the ground. I have read that he designed the shoe to accommodate what he felt would be a longer and more competitive stride for his athletes. He could teach them to lead with the heel and the longer stride length would out run the competition. Bowerman was NOT a physical therapist, medical doctor or biologist who may have asked, “what might this lead to, other than winning races?”

Currently in Africa and many parts of the developing world, children are raised without transportation and also without footwear. It is estimated that the average Kenyan child has about 1,800 miles on their legs and feet by the time they graduate from primary school and all of these miles, for the majority of kids, are without shoes of any kind. It has been argued that this contributes to the number of victories for great Kenyan runners at the international level and on the Olympic podium. Early leg development and natural foot strength (at altitude, Kenya is a mountainous region with an altitude similar to Flagstaff, AZ) allow these kids to develop all the capabilities of their legs before serious training ever begins for competition.

Many cultures are able to train and run well without shoes or with minimal shoes. The Tarahumara Indians of Mexico are featured in Born To Run for their great ability and running in very simple sandals – a slab of rubber strapped to their feet for protection from sharp objects. This is a similar style of shoe to many early Nations of the American Southwest and the pre Spanish cultures in South America such as the Maya and Inca who had thousands of miles of roads and very little in the way of shoes to traverse them. In those days a severe running injury would cause you to drop lower on the food chain – a deadly prospect. So it might be safe (or humorous) to assume that if running injuries did occur in Inca runners – these runners did not pass on the genes for any fragile lower legs and knees.

According to Christopher McDougall’s book Born to Run, Alan Webb’s feet where flat and three sizes larger when he started working with his high school coach to become America’s new top miler. In 2007 Alan set the world’s best 1,500 meter time and broke Jim Ryun’s American record for the mile. But his quest began with flat, weak, de-conditioned feet that were in need of rebuilding. McDougall writes about an interview with Alan Webb on page 175 of his book and Webb says “ I had injury problems early on, … so we did foot strengthening drills and special walks in bare feet” McDougall writes that Alan’s feet changed and his arches became higher as muscles strengthened – his shoe size decreased and his injuries abated.

McDougall writes of an Irish Ph.D, Gerard Hartman who is considered an expert in physical therapy and works with professional runners from around the globe to improve their running. He has been a proponent of barefoot running for many years and cites that “the deconditioned musculature of the foot is the greatest issue leading to running injury, and we’ve allowed our feet to become badly deconditioned over the past twenty-five years”. Many folks have advocated that slowly and gently strengthening our feet over time will allow us to run better and with less injury. We may even find that we can run in lighter footwear. Lighter footwear means less effort and perhaps faster or the sensation of faster as the weight on the end of your leg from a heavy shoe creates a pendulum that takes effort in order to keep moving. 

What do shoes do for me? While all seem to agree that having a sole cover your tender skin provides some protection – many experts are currently reexamining what shoes do well and do not do so well. The good news about this controversy is that in the past 38 years, very little substantive research has been done on how shoes truly affect feet and that is beginning to change now. The United States Military is greatly invested in physical conditioning of its personnel and in the past has seen very high rates of injury in basic training and its share of running related injuries. A recent study on determining the appropriate footwear has shown that the type of running shoe had no correlation on injury prevention for the military personnel in the study. This leads us to “well what can I use to control the movement of my foot, for the least chance of injury?” Your gait, how your foot hits the ground and your running technique becomes more important than the type of running shoe that you might wear according to this study. Manufacturers have succeeded in creating footwear that controls movements of the foot and offers important padding from the ground as you begin running. However, seeking to control the movement of the foot by using a shoe will not ultimately be successful in preventing injury, in the long run, according to new studies. Technique will carry the day and great technique; sensitive feet that are aware of what they hit (and strong feet) may lead to using a much lighter shoe down the road. 

So why do we not teach barefoot running in the Learn to Run class? There are three big reasons in my mind, about why we cover this content as a lesson rather than a focus. First is that the process must be very gradual, even more gradual than learning to run, so we do not really have time in class to retrain what 30 or more years of wearing shoes has done with your feet. Second is that all of us have deconditioned feet similar to what Dr. Hartman discusses above – and this means that we have to slowly build up foot strength, even before we start running in minimalist footwear. I think that if you have already come from a culture of shoes that you will want to learn running first and then learn to reduce how much shoe you use. Third is that the only examples of people being injured with natural running come from runners who, in their enthusiasm, progress too quickly in bare feet or minimal shoes. One of my stated objectives for the class is to introduce you to a new lifelong activity, injury free. Therefore I do that with what your feet are already used to, and provide resources, and hopefully a strong dose of caution to you, while encouraging those who want to move their running to the next level to try strengthening their feet.

In the current day a larger percentage of runners are now dedicated to running entirely without shoes. They have run marathons, ultra marathons and farther in bare feet, and a second subgroup simply enjoys being barefoot full time, so they carry flip-flops with them to get into Wal-Mart or a restaurant. You can read their websites and their ideas about what shoes do and do not do for the wearer and how they feel more free with naked feet. There are as many reasons to consider shoeless as there are folks not wearing shoes. I would challenge you to consider the common thinking on this matter and both accept those who forgo footwear, as well as reconsider what you may gain from simply being barefoot at home or in the yard.

Before you assume that the “barefoot guys” are off the deep end in their “foot yogi-mysticism”, take a good look at the number of people from the medical community that advocate the sale of moccasins to children and preach “barefoot is best” for toddlers. The reason for this, they advocate, is that kids walk sooner when they learn to interpret the ground with their feet (proprioception) and build foot strength naturally. They do not want kids to cut their feet and thus sell a light flexible protective moc- type shoe to achieve this. Many parents have subscribed to this idea with the pediatricians blessing and I’ve seen it work for my own kid. (As I was buying lots of shoes for my running, at $80/pair…)

Arthur Lydiard was a cobbler and made shoes before he was a coach. A coach who was very focused on the success of his athletes. He had his runners in the most basic of footwear and preached against anything “more” for his entire career, which extended well into the era of modern shoes. Internationally sought after coach and physician, Dr. Phil Maffetone was suggesting more than a decade ago that minimal footwear was preferable for similar reasons. Even Stanford University’s world class track and cross country coach (the program gets Nike’s for free) has had his athletes running barefoot in the grass, two afternoons a week, for decades. He said to Nike that his guys got hurt less when they subscribed to this method. (This is what drove Nike to work with Dr. Gerard Hartman to create the Nike Free.) Long before the birth of the very popular Vibram Five Fingers shoe – many companies across the country have made a living manufacturing simple moccasins and unstructured footwear that allow the foot to move and muscles to work. Inuit people, north of the Arctic Circle knew that this is what kept their feet warm in winter – that the boot would flex and allow better circulation. 

So before you ever consider running barefoot, simply walking around without shoes at home is a good place to start and walking farther progressively is another. You may choose to try the new Vibram Five Fingers Shoes as well, which offer that slight amount of protection for your tender skin and not much else for padding. I have started using theses on very short runs (by time) and adding minutes each week very slowly. I spent a year reworking my stride before I ran with these shoes so that I am not landing on my heel much at all but using the mid-foot and most of my foot to absorb the impact of each step. To acquire a lighter step you can practice this technique while walking – you need not run in order to learn how to walk more gently and with a light step. Recall what I have said in many in stride analysis sessions – that cadence, how often your feet hit the ground, has everything to do with a light step. Walking or running, your step must be smaller and faster to achieve lower impact forces. 

For two years now the Outdoor Retailer Trade show saw scores of outdoor footwear manufacturers gunning for a piece of the barefoot pie, gearing up to make “thneeds”, or feather weight running shoes for everyone who wants to run barefoot. The marketplace is now flooded with these new shoes, some of them are untested, un-researched shoes as well. You may choose to try them or go barefoot, grab some moccasins, run in cheaper “race flats” or just try your old Chuck Taylor’s like Lydiard ran in for decades. One key criterion for choosing these shoes is that they should not have an elevated heel. Your foot should be neutral from front to back, just as if you were barefoot on the floor. Most of us can adapt to this well if asked to do so slowly – because you have never seen a baby or an east African in high heels.

But think about a deliberate program of gentle foot strengthening for yourself as a possible next step in your program and add it gradually, just like you started running. A foot that “knows the ground” and is most sensitive, may be less likely to sprain an ankle, will run trails better and may run slower at first but that is OK, you’re in shape and will not “de-train” as a part of this process. Your lower legs will continue to develop in a way that may reduce your injuries over time and your stride will adapt to something that is more powerful in the long run. That is what I want for your running – long running for the long run. So run gently out there.

Read an article about the study here http://well.blogs.nytimes.com/2010/07/21/phys-ed-do-certain-types-of-sneakers-prevent-injuries/?emc=eta1

The study here http://www.ncbi.nlm.nih.gov/pubmed/20576837

Danny Dryers list of preferred light weight shoes
http://chirunning.com/blogs/danny/2010/02/07/chirunning-recommendations-for-minimal-shoes/comment-page-2/#comment-1330

Interesting article on shoes from a rehab perspective

http://www.chirunning.com/shop/pages.php?tab=r&pageid=18&id=575

I have also added several new links on the toolbar here to assist you in learning more about natural running style. If you ever plan to increase your training volume, or wish to develop further as an injury free runner, you owe it to yourself to look over the current research in this area.

Feet & Footcare

“Your feet are your friends” unknown, but this sage wisdom has been handed down for a long time...

You need to start looking at your feet each day to better understand their needs and how they are taking care of you. Understanding the way your feet work will keep you running many happy miles. Dr. Tim Noakes states “Treat the cause, not the effect. Because each running injury has a cause, it follows that the injury can never be cured until the causative factors are eliminated.” Would you ever think of treating your hands with the casual disrespect we give our feet? Probably not, because you and everyone else takes notice of them – yet we often forget our most prized running instrument. The tool that contains 26 bones, 33 joints, 12 tendons, and 18 muscles is a terrific and something DaVinci called a wonder of engineering.

I should say upfront that most of what I know about foot care has come from years as a distance hiker and leading groups afield. But what I know (and share today) about running foot care comes from the 300+ page, definitive tome of foot care called Fixing Your Feet by John Vonhof. He has a blog as well but this book is so well thought out that it is in its 4th edition with Wilderness Press and I highly recommend this book.

So here is the nice thing about reading a blog – nobody will see what you do next.
Take off your shoes and we’ll have a brief foot tutorial and review - with you “kicking the tires” to see how these things work and if you are properly caring for them. Go ahead, your privacy is assured – but your running future is at risk if you do not take a look at these things…
Look for changes:
Redness, cracks in the skin, nails are OK, any itching or scaling? Blisters or sore spots, callus buildup, plantar warts or corns etc – should be things you are looking out for & aware of in the developing health of your feet. Our noses, ears and feet with continue to change over the course of our lives and this program, and your new pastime will impact your feet - so get a baseline look now and watch what happen over time.

Keep them smooth and clean.
Brush off the feet before going into socks and ensure nothing is in your shoes that should not be there. Use of lotion on your feet helps skin remain soft and then that skin is less likely to thicken – think about applying before bedtime and sleeping in clean socks to keep moisturizer close to the skin. Callus is generally accepted in the medical community to be a sign of abnormality, high friction, biomechanical issues or poor fitting foot gear. These should be sanded down, smoothed and reduced by gradual filing as often as possible. Failure to take care of this may cause the callus to dry and crack (producing a painful, tender injury to skin below) or deep blisters beneath the callus material which heals much more slowly than regular blisters. Soak feet in warm water or shower prior to filing/sanding with a pumice stone for best results.

Stop “hot spots” or blister right away.
If you feel friction inside the shoe stop and immediately examine the problem. Carry tape or mole foam when you anticipate trouble and apply as needed to stop friction. Even duct tape will work; trim edges to prevent “rolling” while you run as tape peeling up will make blisters worse. I love the Engo patches and have shown these to classes before – they are a Teflon type sticker that you can adhere anywhere inside the shoe as needed.

I will tell you that many of the above issues; dry skin, cracking, callus, even athlete's foot - can be reduced or eliminated by having your home and yard be a barefoot zone. Where your skin can breathe and both heat and friction that can come from shoes is reduced. I never teach anything I have not tried myself, and besides having stronger feet - many of these issues went away for me. I can honestly say that my occasional blister heals faster as well, when I leave my shoes off at home.

Trim your toenails before you need to – straight across to prevent ingrown nails. The failure to trim nails flush with the toe causes snagging on socks or shoes and can lift the nail off the nail bed. Long nails can cause “black toe” bruising and bleeding in the shoe! Yuck. During exertion feet will swell. Feet are largest in the afternoon, which is why it is the best time of day to buy shoes. Feet, running at days end will be very large, and so it is critical that nails be kept at the proper length to avoid impact injury.

Feet age – like we do they change over time. 1) They continue to enlarge and change in size. 2) The toenails often thicken. 3) The padding on the bottom of your feet thins and we lose some of the spring in our step as a result. 4) Feet stiffen and some range of motion is lost over time. 5) Balance sensitivity changes over time with some losses expected. 6) Arches flatten slightly. Again, I should tell you that research by Dr. Dan Lieberman and Dr. Daniel Howell show that cultures that live without modern footwear, do not see these changes over time, with the possible exception of increase in foot size. In other words; five of the 6 changes listed above (by Vonhof) do not occur in cultures that do not wear modern shoes. Take your shoes off at home first and enjoy the health benefits of doing so.

Proper shoe sizing, foot pedicures, stretching and strengthening exercises can also offset these changes to your feet and keep you happily running.

Troublesome toes: Many folks have a condition called Morton’s toe (named for the doctor who discovered the condition). The second metatarsal bone being longer than the first, the second toe is the longest one on the foot and shoe sizing must accommodate this difference. Estimates range from 15-60% of the population having this condition. The second toe length can affect gait and shoe fit. Poor fitting shoes can cause callus formation where the toe bears additional weight. Simply being aware of the condition can allow for accommodations such as sizing, or additional padding.

Little toes can develop what Vonhof calls the little toe triangle. Check your little toes (or nested toes) to see if they are round and smooth on the bottom or if they have a small hardened triangle of skin developing. This triangle is very vulnerable to blisters and even tearing and so it should be soaked, reduced and moisturized to remain trouble free for long runs.

Feet can produce a pint of fluid in perspiration each day! This has to me managed for the runner.
Blisters and foot pain are most often caused by a triad of elements; friction, moisture and heat. Eliminate or effectively manage at least one of the triad and you’ll run with comfortable feet. Complex foot issues can be mitigated using socks, powders, and lubricants in your primary care plan. Additional preventive support can be found with; taping, skin conditioners, antiperspirants, orthotics, specialized lacing, shoe and sock changes, nutrition and hydration, and gaiters.

Socks are as important as your shoes and they need to match up with your shoes well. Your socks assist in injury prevention if they provide cushioning, protection and temperature management. Some of the best socks for running are now made as Right and Left in each pair. Socks do not have a break in period but you should test your socks for 3+ miles or more in your shoes prior to race day to ensure; they feel great, will do what they are supposed to, and do not give you blisters. Synthetic fibers are best and keep feet dry. Feet that are too wet or dry and grabbing something in the shoe/sock are the ones that blister.

Women’s fitted socks, toe socks, anatomically fitted (right & left) socks, anti microbial fibers, seamless socks, double layer socks, compression socks, Teflon enhanced socks to reduce friction are all currently available. There are even waterproof socks called Sealskinz but my experience has shown that these get so sweaty inside that they may be unmanageable for many runners.
Pay attention to the size of the socks as the number on the package may be “sock size” which fits a range of shoe sizes and may not numerically correspond to your foot size. Remember you are buying socks to fit your feet and not the shoe size, which may be larger to accommodate your foot swelling while you run.
Popular fabrics that review well include; Coolmax, polyester, acrylic, olefin, merino wool, bamboo, drymax, x-static, blister guard, are all great fibers currently being used in running socks.

Many running shoe companies make a sock that works well. Other names include: Balega, Bridgedale, Thorlo, Drymax, Under Armour, Injinji, Wigwam, Teko, Wrightsock, Defeet, Fox River, Goldtoe, InGenius, and Smartwool. These are available at Zombierunner.com, Zappos.com, Roadrunnersports.com, REI.com and other retailers.

Lacing can change the fit of your shoe and take pressure off of trouble areas in many cases – refer to the book “fixing your feet” by John Vonhof or Runnersworld.com, or Ian’s link, posted here on the blog, for lacing suggestions and diagrams. There are products that offer micro tensioning for laces; stretch laces that look like springs, lock laces with tension adjustments, and sausage style laces that offer tension adjustments. These may help you micro fit the shoe and unlike the “garden weasel” seen on TV many of these lacing gizmos work.

Footbeds are available for a number of foot types and gaits. Over the counter insole products are shapeable and trim to fit for your shoes. When sizing these tools at home follow directions closely! Many of these products are expected to last about a year under normal use and are often superior to the insoles that come with your shoes. SOLE, Spenco, Superfeet, Hapad, and Sorbothane all make a reputable footbed product. These are not orthotics as a podiatrist would make for you and cannot correct gait issues. They may provide additional support, prevent injury and reduce chafing in footwear. If I reveal my bias here though – many PT’s who are running experts, feel that using a footbed or advanced support works at the pain or problem but not the source of the issue - which may be feet in need of balancing (in terms of strengthening and flexibility) - therefore footbeds may only treat a symptom. I mention these tools because they can enhance the fit of a pair of shoes that are working well for you. But I do not recommend them - rather I suggest that you use them sparingly if need to enhance shoe fit and as we started off with - treat the cause of the problem

Self massage devices, floor rollers or tennis balls can be used to massage and rejuvenate feet with great results. Many ultra runners swear by the monthly pedicure which includes some foot massage and foot maintenance.

A foot soak you can do at home which will deodorize, soothe and soften feet (while being antibacterial/antifungal) is Pedifix FungaSoap. Contains tea-tree oil, Epsom salt, & peppermint, costs about $11.00 at pedifix.com. I have had good success with this product as a way to prep my feet for nail trimming and sanding off callus material. It smells great and leaves feet very clean and soft. Let me know if you have another trick and I’ll post it here.

Ankle strengthening and balance exercises to increase proprioception aid in having stronger healthier feet and serve to offset aging and prevent injury. These need not be complicated – standing on one leg and remaining balanced, for progressively longer intervals, is one simple method and there are many others. Walking barefoot around the house a bit is another.

A great web resource - from the man who wrote 350 pages on footcare is http://fixingyourfeet.com/blog/
Read up, incorporate a few tips each week for your amazing feet, and remember that “Your feet are your friends”