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Health & Exercise Forum

The Naked Truth About Barefoot Running

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Aug 29, 2011

Dr. Mackarey's Health & Exercise ForumLast year’s Steamtown Marathon saw the influence of the new “barefoot running” fad, with R. J. Stiltenpole of Scranton Running Co. as one runner who sported the barefoot look and plans to do so again in October 2011. He, like many other “barefoot runners,” sported minimalist shoes to prevent cuts and blisters from the pavement. Stiltenpole wore Vibram FiveFingers Shoes, which he sells in his store. (The truth is that few barefoot runners actually run barefoot, thus the oxymoron, “barefoot running shoes!” Most runners use “minimalist footwear” such as Vibram FiveFingers Shoes or Nike Free Shoes to protect their feet from glass and other dangerous debris.  You can find information on shoes at

In essence, running is a minimalist sport—just lace up your shoes and go! Now some runners are making it even simpler by running barefoot. While it is not new, barefoot running has become extremely popular in the last few years, due in large part to the popularity of the book, Born to Run, by Christopher McDougall, which recently made the New York Times’s best-seller list.

History of Barefoot Running

Who runs barefoot? The Tarahumara people of Mexico, the Kenyen tribesmen, and the Kalahari hunters all run barefoot. But what sets these people apart is the fact that they have been running barefoot all their lives! For Zola Budd from South Africa, who set world-records running barefoot, this style of running was one he had practiced from childhood.

Rationale Behind Barefoot Running

So, why does the Average Joe Runner think that he should abandon his running shoes and race in the buff? The first reason is that some scientific evidence suggests that contemporary running shoes contribute to running injuries. As shoe manufacturers pour money into the development of new shoes, their technology may actually allow runners to exceed their anatomical and physiological limitations, thereby contributing to repetitive stress (i.e. overuse) injuries.

A second explanation for the popularity of barefoot running is that novice runners want to imitate elite runners. They do this by adding variation to their routines to achieve balance and prevent injury.

Third, barefoot running may reduce impact forces, offering a softer landing than running in shoes. According to runners like Stiltenpole, running barefoot changes the way the foot strikes the ground, causing a runner to land more gently and lightly. Proponents of barefoot running say that this emphasis on a “soft landing” of the forefoot—or ball of the foot—causes barefoot runners to suffer less impact than hard heel-striking shoe-runners.

Effectiveness of Barefoot Running

Research performed in 2007 revealed that most runners (75-percent of those studied) strike the ground with their heel. 24-percent struck the ground with their mid-foot, and only 1.4-percent of runners struck the ground with their forefoot. All runners were wearing footwear.

Dr. Daniel Lieberman from Harvard University contends that barefoot runners are more likely to strike the ground with their forefoot or mid-foot rather than their heel, which generates lower impact forces. Dr. Lieberman says that this running style is observed primarily in those who had been running barefoot from childhood, and he maintains that the “world’s best natural runners are forefoot strikers.”

The Pose Method of running may offer the best of both worlds, as it promotes soft running in a running shoe, on the ball of the foot. Dr. Romanov (INSERT FIRST NAME) proposed this theory after observing the running style of animals such as the cheetah. He recommends keeping your center gravity over your base of support and using gravity and momentum to propel you forward. When a runner uses the heel-strike method, his center of gravity falls behind his base of support, and he must use excessive muscular effort to advance his body forward. Dr. Romanov believes that the heel-strike method is an inefficient way to run, but he also admits that his Pose Method is hard to master. I have seen encouraging results after using the Pose Method in both my own running and in the rehabilitation of patients with running injuries. For more information on this method, visit

The Downside of Barefoot Running

Not all experts agree on the merits of barefoot running. First, it may not prevent the majority of running injuries. As Dr. Lieberman discussed, even though people who run barefoot experience lower impact because they are less likely to strike with their heel, research does not correlate the amount of impact with the severity of injury. Dr. Lieberman concedes that the most common running injuries are not the result of impact, and evidence does not reveal that “shod running” (running with shoes) weakens the muscles of the foot.

Second, barefoot running may actually increase the incidence of Achilles problems, plantar fasciitis, patello-femoral (i.e. anterior knee) pain, and iliotibial band syndrome according to Dr. Ferber from the University of Calgary. Running barefoot can also lead to overuse syndromes and osteoarthritis.

Third, barefoot beginners may underestimate the training that is required to lose the shoes. Stiltenpole finds that barefoot runners think more is better, and they attempt to run barefoot too much too soon. This causes many barefoot beginners to suffer from painful calf muscles and Achilles tendons.  Stiltenpole recommends running 3-5 minutes upon the first use of minimalist shoes, and gradually adding a few minutes at a time as the foot muscles get stronger. Consider starting with 5 minutes at a slow pace, and run on soft surfaces such as grass or sand. Advance slowly (5 minutes per week), and use it as a training method on off-days. Before changing your running style or footwear, consult with a professional who specializes in this sport. Stiltenpole stresses that technique is important, and he recommends taking a mechanical running class, such as the free class that is offered at the Scranton Running Co. on Tuesday and Thursday nights at 6 pm.

A fourth drawback of barefoot running is that your feet are more vulnerable to injury from sharp foreign objects and infectious matter. Those with diabetes, peripheral vascular disease, or a compromised immune system—like those with HIV or rheumatoid arthritis—should avoid barefoot running.


While barefoot running has caught a great deal of attention in the current professional and consumer literature, current scientific studies do not favor barefoot running over running in footwear. Consider using barefoot running as a training method on off-days for 5 to 10 minutes. This can help you learn the concept of “soft running” to lessen impact, develop other muscles of forefoot and calf more effectively, and possibly prevent injury. Then, add a few minutes each week until you reach 20 to 30 minutes. Until a sufficient amount of quality evidence is available, common sense must prevail when it comes to barefoot running.

CONTRIBUTING AUTHOR: Janet Caputo, DPT, OCS is clinical director of physical therapy at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she practices orthopedic, neurological and sports physical therapy.

Read “Health and Exercise Forum” by Dr. Paul J. Mackarey every Monday in The Scranton Times-Tribune. Dr. Mackarey is a doctor of orthopedic and sports physical therapy with offices in downtown Scranton. He is an affiliated faculty member at the University of Scranton, Department of Physical Therapy.