Bare-ing It All-Minimalist Running Part Two

In our last discussion, we covered the basics of barefoot (BF) or minimalist running including the pros and cons.  Today I would like to cover how you may implement a minimalist program, the surface you run on, as well as today’s most popular equipment for BF running.

One of the first and most important things I tell patients is that they will need TIME in order to successfully implement a BF running program without having to worry about injury.  Matt Fitzgerald from competitor.com discusses several conversations with “running experts” that all claim to see a stark rise in plantar fascitis with the latest increase in BF running. (http://running.competitor.com/2010/05/features/the-barefoot-running-injury-epidemic_10118)  However, upon review in most or all of the examples, a slow and gradual break-in period was not discussed.  Even the author says he first tried one minute of BF running (implying that it should not hurt anyone) and surprisingly had immediate symptoms.  Although I do not have any way knowing, I would guess that he had been wearing a very supportive or even a posted shoe.  And much like the others, went straight to BF running or a minimalist shoe without taking the necessary time to allow his body to adapt and strengthen to its new demands.

To review from Part One, proprioception is “the sensations of body movements and awareness of posture, enabling the body to orient itself in space without visual clues.”  (http://medical-dictionary.thefreedictionary.com/proprioceptive   These types of nerves are important for many functions including balance and injury prevention in a running athlete.  The thick foam found in the bottom of a typical running shoe dampens the body’s nerves (proprioceptors).  This limits the normal feedback to and from the brain which compromises the foot.  By allowing the foot to “feel” and have more interaction with the ground (or surface you are running on), these nerves are able to better conduct and convey a message to the brain regarding its “surroundings”.  However, if you make a switch to a thin soled shoe too quickly, then the plantar fascia and/or the Achilles tendon could be stretched beyond it’s (present) normal range of motion.  When a tendon is stretched too far it leads to tendonitis (injury).  Therefore a slow implementation is needed to allow time for the tendons to stretch and learn to accommodate to the increased motion.

Below, I have found a basic 12 step plan that will help give your feet time to strengthen and adapt to your new workout. (http://runningquest.net/2009/10/16/12-step-program-to-run-shodless/)  As you can see, it starts off very (very) slow!  So take heed to the plan and its intention in order to minimize your chance at injury.

One other aspect of this chart that I find valuable is that it defines the surface on which you should train.  This is an overlooked aspect in most articles that I have found discussing the cons of BF running.  Like many of my patients, most people reading this article will assume that you should start training on grass or sand (or some other soft surface)  .  However, Steven Sashen states that the best surface to train on is a hard and smooth surface in his article. (http://www.invisibleshoe.com/297/surfaces/)  Why?  Well, the answer has to do with foot strike.  The website chart from Harvard University regarding the Biomechanics of Foot Strikes below illustrates the differences between the heel strike and mid-foot strike.  (http://www.barefootrunning.fas.harvard.edu/4BiomechanicsofFootStrike.html)

Running Kinematics Heel Striking Forefoot Striking Moment of Impact Hip and knee are flexed. Ankle is dorsiflexed (toes point up). Ankle is plantarflexed (toes point slightly down). Foot is usually slightly inverted (the sole is angled inwards). Land on the middle to outside of the heel just below the ankle joint. Land on outside of the forefoot (the ball of the foot, just below the 4th and 5th metatarsal heads). As you land, the ankle begins to plantarflex (toes move towards the ground). As you land, the ankle begins to dorsiflex (heel moves towards the groud). Arch of the foot is not loaded. Arch of the foot is loaded and begins tostretch/flatten.

By running on soft surfaces, we tend to revert back to a heel strike rather than a mid-foot strike.  This allows the foot’s tendons, muscles, and ligaments the proper time to strengthen and support the normal arches, rather than allowing the muscles to weaken over time.  In the FAQ section of this article, Lieberman and others explain more thoroughly not only the mechanics of BF running but also the surface to run on, how to get started, and many other popular questions (http://barefootrunning.fas.harvard.edu/6FAQ.html).

So what’s the newest and hottest equipment on the market today.  REI weighs in with their web article, “How to Choose Minimalist Shoes” (http://www.rei.com/expertadvice/articles/minimalist+shoes.html)  The Vibraam Five Finger shoe pioneers the pack as it is one of the first to market.

However, several others have come to become popular since then.  New Balance, Nike, and Merrell are all popular brands.  However, only Nike has “graded” their shoes with the intention of helping novices who have never tried BF or minimalist shoes.  I have recommended these to several patients as I feel like they allow a gradual progression which will allow the least amount stress to the foot and ankle.  Further, by “tapering” the amount of arch support and cushion, you allow the foot to increase in strength at a slow and gradual rate.  It might even be impossible for some individuals to ever be able to use a Vibraam Five Finger shoe because of previous ankle, knee, or hip problems.  For these people, the Nike Free 3.0 would improve foot strength but still provide a lighter and more stable arch than the true minimalist shoe.  Regardless of the brand of shoe you choose, make sure that you heed to the suggestions above.  I wish you all the best of luck and please let me know of your progress.

Dr. Charles Hecht is a chiropractor who practices at Partners in Health & Wellness in Chapel Hill, NC.  Partners in Health & Wellness offers chiropractic, acupuncture, massage, and personal training.  If you have questions, please feel free to add content to this blog or follow Dr. Hecht on Twitter, Facebook, or LinkedIn.

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