Running Barefoot Could Cause Serious Problems

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By ALICIA CHANG, Associated Press

LOS ANGELES (AP) — Swept by the barefoot running craze, ultramarathoner Ryan Carter ditched his sneakers for footwear that mimics the experience of striding unshod.

The first time he tried it two years ago, he ran a third of a mile on grass. Within three weeks of switching over, he was clocking six miles on the road.

During a training run with a friend along a picturesque bike path near downtown Minneapolis, Carter suddenly stopped, unable to take another step. His right foot seared in pain.

[Health Tip: Use Proper Form When Running.]

"It was as though someone had taken a hammer and hit me with it," he recalled.

Carter convinced his friend to run on without him. He hobbled home and rested his foot. When the throbbing became unbearable days later, he went to the doctor. The diagnosis: a stress fracture.

As more avid runners and casual athletes experiment with barefoot running, doctors say they are treating injuries ranging from pulled calf muscles to Achilles tendinitis to metatarsal stress fractures, mainly in people who ramped up too fast. In serious cases, they are laid up for several months.

Many converts were inspired by Christopher McDougall's 2009 best-seller "Born To Run," widely credited with sparking the barefoot running trend in the Western world. The book focuses on an Indian tribe in Mexico whose members run long distances without pain in little more than sandals.

While the ranks of people running barefoot or in "barefoot running shoes" have grown in recent years, they still represent the minority of runners. Some devotees swear they are less prone to injuries after kicking off their athletic shoes though there's no evidence that barefoot runners suffer fewer problems.

In some cases, foot specialists are noticing injuries arising from the switch to barefoot, which uses different muscles. Shod runners tend to have a longer stride and land on their heel compared with barefoot runners, who are more likely to have a shorter stride and land on the midfoot or forefoot. Injuries can occur when people transition too fast and put too much pressure on their calf and foot muscles, or don't shorten their stride and end up landing on their heel with no padding.

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Podiatrist Paul Langer used to see one or two barefoot running injuries a month at his Twin Cities Orthopedics practice in Minneapolis. Now he treats between three and four a week.

"Most just jumped in a little too enthusiastically," said Langer, an experienced runner and triathlete who trains in his barefoot running shoes part of the week.

Bob Baravarian, chief of podiatry at the UCLA Medical Center in Santa Monica, Calif., said he's seen "a fair number" of heel injuries and stress fractures among first-timers who are not used to the different forces of a forefoot strike.

"All of a sudden, the strain going through your foot is multiplied manifold" and problems occur when people don't ease into it, he said.

Running injuries are quite common. Between 30 to 70 percent of runners suffer from repetitive stress injuries every year and experts can't agree on how to prevent them. Some runners with chronic problems have seized on barefoot running as an antidote, claiming it's more natural. Others have gone so far as to demonize sneakers for their injuries.

Pre-human ancestors have walked and run in bare feet for millions of years often on rough surfaces, yet researchers surprisingly know very little about the science of barefoot running. The modern running shoe with its cushioned heel and stiff sole was not invented until the 1970s. And in parts of Africa and other places today, running barefoot is still a lifestyle.

The surging interest has researchers racing for answers. Does barefoot running result in fewer injuries? What kinds of runners will benefit most from switching over? What types of injuries do transitioning barefoot runners suffer and how to prevent them?

While some runners completely lose the shoes, others opt for minimal coverage. The oxymoron "barefoot running shoes" is like a glove for the feet designed to protect from glass and other hazards on the ground. Superlight minimalist shoes are a cross between barefoot shoes and traditional sneakers — there's little to no arch support and they're lower profile.