Run-Training and Injury Prevention

Part 1:  Barefoot Basics

by Dr. Christopher Moran  

Should You Go Bare? The Barefoot running craze is quickly catching on in the running and endurance sporting world where injuries are generally considered to be “all a part of the game.” “It’s not IF you will get injured; it’s WHEN.” Is Barefoot Run-Training just a fad or is there more to it as a key to injury-free running?

In this series of articles, we will explore some of the latest information on this topic, beginning with the 1. Barefoot Basics, then analyzing the 2. Mechanisms of Common Running Injuries, 3. Running Technique to Prevent Injury, 4. Treatment of Common Running Injuries, and finally, 4. Nutritional Considerations for the Endurance Athlete.

Why Shoeless?  Over-striding, and therefore striking the heel of the foot first on each stride, is suspected to be a major cause of acute as well as chronic running injuries. It is also a huge limitation to fast running times in competition. Let’s look at the ‘heel strike’ a bit more closely. 

The heel bone, or calcaneus, is, well, a bone! Covered by some skin and small amount of fat and fascia and serving as an attachment point to anchor the powerful Achilles tendon, there is not much cushion or ‘give’ here while crashing your full body weight onto the heel bone upon each running stride at speed. With each stride, you are landing with an estimated three to three-and-a-half times your body weight (some estimates are much higher) onto the outstretched leg (and heel bone). This can and will, in time, cause either acute and/or chronic overuse injuries if the running this way is done regularly and with anything much more than a gentle slow jog.

Now imagine (or better yet, try for yourself) running barefoot in a soft field of lush grass. The body will not naturally allow landing on the heel bone, but rather will support the forward momentum of the body by placing the foot directly under the hips and strike the ground first with the outside of the mid-foot or forefoot (this slight to moderate pronation of the foot is normal), roll quickly onto the ball of the foot and push off on the big-toe side. You will notice that the stride will be light with quick ‘turn-over,’ defined as an increased number of foot strikes per unit time, and you will feel like you are gliding across the field. Just prior to contact with the ground, the toes will be pointing slightly downward upon impact instead of skyward, as is the case with a heel-strike-first stride. Impact will be absorbed by the body’s large muscle groups in the legs while strong tendons and connective tissue (fascia) quickly loaded, will return this energy to help propel the body forward without requiring muscle contraction for this extra ‘push.’ You will experience the natural human running mechanics that protects and propels the body forward efficiently with stability of the foot, ankle and knee while guarding against injury. The sensory (proprioceptive) nerves in the foot will be able to feel the ground surface and instantly adapt to any irregularity in the terrain, and in this way safeguards against injury.

No manicured lawn to traipse around on? Then calculate 10% to 15% of your body weight and place this amount of weight in a backpack or weight vest (better choice if available) and go out for an easy ‘Zone I’ aerobic jog. The foot strike will be where it needs to be naturally with a quick turn-over to match. Running up a fairly steep hill without the temporary extra weight will also nicely serve the same purpose. It is virtually impossible to overstride and heel strike on up hill runs if the hill is of sufficient inclination.

Try to match the feel of this natural stride and foot strike when strapping on your running shoes, and running efficiency will improve while protecting your foot from the hazards of road and trail running such as stones, sticks, glass, gnomes and other assorted potential foot-munching debris. If your shoes have cushioning that is too thick, then achieving this natural and efficient stride and foot strike will be nearly impossible as the nerves (proprioceptors and mechanoreceptors primarily) of the foot and those within related joints will not be able to sense the stability of the ground underfoot, actually increasing foot strike pressure on each stride. A shoe with a large padded heel will encourage landing on the calcaneus (bone, remember?). Biomechanically, this will also necessarily lead to ‘putting on the brakes’ and effectively will stop forward movement and momentum with each stride while forcing the muscles to contract harder on push-off to make up for this braking action (more on the biomechanics and consequences later). Injuries are created when landing on the heel bone, transferring the stressful forces to ankles, Achilles tendon, shins, knees, hips, sacroiliac joints and lower lumbar spine.

Next time we will explore common biomechanical faults which cause the injuries most associated with running, learn how to correct these faults with proper technique for peak efficiency and enjoy the result of faster and easier, pain-free, injury-free running.

Dr. Chris Moran

Dr. Chris Moran is in private practice at Traverse City Knee and Shoulder Solutions in Traverse City, Michigan and can be reached by calling (231) 943-2100 or by e-mail at drcamoran@gmail.com.

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