Barefoot running – cause or prevention of injuries?
June 13, 2010
Now that I’ve started my great barefoot running experiment, as mentioned Yesterday, I thought I’d assess the initial risk with running barefoot. It’s an interesting dichotomy – running barefoot is seen as both a source of injury and a means of preventing it. This depends on who you talk to, and there are certainly biases on either side of the issue.
Of course, in the past year or so, with the release of Born to Run, and the Harvard Study on barefoot running: http://www.barefootrunning.fas.harvard.edu/index.html barefoot running has developed into a fast-growing movement. So we’ve had a large number of people quickly adopting it. More recently, this has resulted in an uptick in barefoot running related injuries, according to Matt Fitzgerald’s article in Competitor Magazine. As the article points out, it’s hard to say whether barefoot running causes more injuries or if it causes a proportionate number of injuries, but there’s just more people running barefoot now.
I do think starting to run barefoot poses some unique challenges that elevate injury risk. Muscles, tendons, and bones that have been greatly underused for most of your life are inevitably weak and vulnerable to overuse. Overprotected skin is soft and vulnerable to puncture. Using a different running form can also cause adjustment problems elsewhere in the body. The recent barefoot running movement, and the rash of injuries that have come with it, have afforded me the opportunity to step back and take a look at the challenges and injuries that others have incurred on their attempts to transition to barefoot running. The Huraches/minimalist/barefoot running Google group has been an excellent resource. Here’s a list of possible barefoot-running related injuries that I’m going to bear in mind as I make the transition:
- Skin puncture – This is an obvious one, and something the scares most people away. By shedding the huge layer of protection, the skin of my feet will be vulnerable to puncture by sharp objects. To prevent this, I plan to start my running on grass in rather desolate areas where I’m less likely to encounter man-made sharp objects – glass from bottles, shards of metal, etc. I’ll also be keeping a keen eye out for objects as I’m starting. My skin will tough up over time, and be more puncture resistant. Ultimately, I will be transitioning to minimalist shoes, which will make this a non-issue.
- Ball of the foot (BOF) pain – running barefoot puts more direct pressure on the ball of the foot. This may result in some initial discomfort in the region, in particular if I step on a small rock directly in the middle of the BOF. This is definitely something to watch out for, as it’s rather difficult to run with good form if the BOF is hurting.
- Calf/Achilles’s tendon pain, inflammation – barefoot running also utilizes these groups more. I think this tends to be more of an over-use kind of issue, so taking it slowly and gradually should help me steer clear of this.
- Plantar Fasciitis (PF) – Similar to calf and Achilles’s pain, I think this is more of an over-use issue for barefooters. It’s interesting because barefoot running is typically recommended as treatment/rehab for PF because it will strengthen the tendons long term.
- Top of the foot (TOF) pain – this seems to be a big one. Obviously, you’re not directly contacting the ground with the top of the foot, so top of the foot pain is usually indicative of something more internal – perhaps a stress fracture. If I feel this kind of pain, I’ll definitely hold back, maybe even take some time off.
- Toe fracture – This is what I’m most afraid of for trail running. You’re moving along pretty well on a rocky trail, and then you slam your bare foot into a rock, fracturing one or many of your toes. I’m going to hold off on trail running for a while because of this one. I’ve heard of some trail runners being able to run through mountains barefoot, but I’ve also heard of people really messing up their toes. I might just stick to using shoes on the trail, though I’ll be looking for minimalist trail shoes that offer adequate protection (I find right now there are few choices).
I hope to mitigate these problems by taking a very gradual approach, and listening to my body. I won’t increase distance, speed, or change surfaces until I’ve given it a couple of days rest to see how my body responds. So far, after running barefoot for 20 minutes Yesterday, which was actually more than I intended to run, I’ve had some mild soreness Today in the expected regions – calf/Achilles’s, hips, feet muscles. Seems like I have it just right, but will probably ease off a bit this week. I’m hoping that I can get past the initial hurdles unscathed and reap the long-term benefits of injury prevention and efficiency.