Should You Be Barefoot Running?

Forget everything you know about barefoot running. That is hard, I know. You may have read Born to Run, and, inspired by your prehistoric ancestors, taken off your dress shoes and run laps around the conference room screaming, “I am an untamed, wild beast roaming the prairie!”

Or, you might have tried running barefoot, only to step on a piece of glass. Or gotten a stress fracture. Or gotten called a mean name by a passerby. “J.R.R. Tolkien called and he wants his main character back!”

The problem with a reasoned discussion about barefoot running is the same problem facing discussions about religion or politics or the Kardashians. All those topics have become belief systems in some cases. And belief systems are not likely to be swayed.

So imagine you are an alien beaming down to Earth for the first time. Should you put shoes on your appendages most resembling feet? Or should you go bare-appendage?

I won’t hide the ball—the answer is unsatisfying. Barefoot may work for some, especially in moderation, and may be terrible for others, especially in excess. Let’s break it down.

Anecdotes

Any discussion of barefoot running needs to talk about the elephant in the room. Some people credit barefoot running as their salvation from long-term injuries. Here, we’re not talking about shoe drop, but about extreme minimalism—actually running barefoot or in some sort of minimal foot covering like a sock or sandal.

There are numerous stories of runners dealing with many years of knee, IT band, hip and other issues transitioning to barefoot running and becoming healthy for the first time. Born to Run was full of them. Sometimes, it seems like the old saying about Crossfit and triathlons applies. How do you know someone that was saved by barefoot running? Don’t worry, they’ll probably tell you.

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On the other side, there are stories of people trying barefoot running and getting injured. Aylin Woodward wrote an opinion piece in Scientific American about her shin splints after wearing minimal shoes. As a coach, I have seen some pretty nasty achilles and foot injuries in minimalist runners (but not just barefoot runners, of course).

At the Stanford Invitational track meet last week, I saw a number of top pro and collegiate runners doing barefoot cool-downs on grass fields. However, very few top runners actually train barefoot.

Full disclosure: running barefoot on grass seemed to help me get over a persistent knee injury after I first started running. Whenever I fail to do some barefoot easy miles occasionally after runs, I think that my form gets sloppy over time, falling back into the bad habits that made me constantly injured when I first started out. But I do almost all of my training (and all of my racing) in protective shoes.

All that said, anecdata is the fake news of the science world. What do the studies say?

Summary of the Science

Born to Run came out in 2010, and is arguably one of the most influential running books ever. It wasn’t just a great piece of storytelling, it presented an anthropological argument for barefoot running—our species ran and ran well long before shoes were invented, so are we sure we should be running in shoes today?

The book had some scientific backing, headlined by the ultimate in science sex appeal—a cover article in Nature. That 2010 article can be summed up simply: “Fore-foot- and mid-foot-strike gaits were probably more common when humans ran barefoot or in minimal shoes, and may protect the feet and lower limbs from some of the impact-related injuries now experienced by a high percentage of runners.”

The case for barefoot was sexy and intuitive. And it was launched into a vacuum. As recently as 2009, a review article in the British Journal of Sports Medicine found no studies on elevated-cushion heels or pronation-control systems.

A sexy topic with little research … you can guess what happened next. Tons of studies! Here’s a tiny sampling.

Running economy: A 2016 review article in the Journal of Science and Medicine in Sport on running economy found that barefoot running may reduce oxygen needed to run a given pace a small amount, but it cautioned high risk of bias and that it didn’t apply to runners actively making the transition. Similarly, a 2015 review article in Sports Medicine found small beneficial effects on running economy in some runners.

Impact forces: A 2015 study in Medicine and Science in Sports and Exercise found that 23 female runners ran with higher cadence and reduced excessive hip adduction, hip internal rotation and contralateral pelvic drop when barefoot. No need to know what those things are (they sound like great dance moves), just that they have been suggested as knee-injury causes in female runners. However, there seemed to be more loading at the ankle, though that was not the focus of the study. A 2013 study in Human Movement Science found more loading in the tibia (shin bone) in 18 runners making the transition to barefoot. (A 2017 article in the Journal of Sport and Health Science summed up how it all fits together in the context of footfall.)

The general takeaway seems to be that barefoot running alters biomechanics and transfers load down the kinetic chain, from hips and knees to shins and feet/Achilles.

What causes these changes? Running barefoot causes a change in form for many runners, with increases in stride rate and shifted ground interaction (usually towards mid- or fore-foot landing), and as one 2015 study in Human Movement Science found, these changes can happen in as little as 30 seconds. While there are more studies than you can shake a stick at, the general takeaway seems to be that barefoot running alters biomechanics and transfers load down the kinetic chain, from hips and knees to shins and feet/Achilles. However, like all things, it’s complicated and heavily dependent on the background of the study population.

All this gobbly gook is well-and-good, but how does it translate to injuries? A 2016 study in the American Journal of Sports Medicine of 1332 Army soldiers found no differences in injury rates. In a similar 2016 study in the British Journal of Sports Medicine (I like to think those journals bonded while watching the hit musical Hamilton), there was no statistically significant injury difference between 107 barefoot and 94 shoe-wearing runners when equalizing training distance. Notably, the injuries in the barefoot group were generally in the lower legs, as opposed to the knees and hips.

But wait, there’s more! A 2017 study in the American Journal of Sports Medicine took 61 runners and randomly assigned about half of them to barefoot running with a gradual increase of training volume over 26 weeks. Of the minimalist group, 16 of 30 got injured during the study period (compared to 11 out of 31 in the shoe-wearing group). The study conclusion? “Runners should limit weekly training distance in minimalist shoes to avoid running-related pain. Heavier runners are at greater risk of injury when running in minimalist shoes.” (While I am not an exercise scientist and did not even stay at a Holiday Inn Express last night, that seems like a tough-to-draw universal conclusion from the data.)

There are tons more studies out there, with some varying findings. The details aren’t so important unless you are doing your dissertation on it; what matters is the general finding that barefoot is not a panacea for every runner. For some, though, it could be. But for others, it could be a ticket to a stress fracture. Gray areas are annoying!

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Other considerations are distance/speed run (most studies aren’t measuring longer races, high-volume training or elite athletes), gender, injury background, current form and even body shape/composition. There is no one-size-fits-all answer, just like there is no one-size-fits-all shoe.

Takeaways

Barefoot or minimal running may be good because it could reinforce proper biomechanics and strengthen parts of the kinetic chain (primarily in the lower legs). Those benefits may be less pronounced in runners that already have good form. It could be bad because it may be riskier for those same parts of the kinetic chain, plus it’s probably not a good idea on rocks or at very high training volumes. On top of that, there’s probably a reason pro runners don’t do it for their training. Given the extremely narrow margins at the top end of running, any significant (and obvious) universal advantages would have already been seized.

So the unsatisfying-as-heck answer: the efficacy of barefoot running probably depends on your background and goals. Those runners at the Stanford track meet may have the best of both worlds—they train in shoes, but do some barefoot running (and sometimes strides) every once in a while. I have many of my athletes do five to 10 minutes of barefoot/socks running after runs and will often have them use it to reinforce proper biomechanics when returning to running after a layoff, but haven’t noticed a substantial difference either way.

One thing is certain—freshly cut grass does feel good on your toes.

David Roche partners with runners of all abilities through his coaching service, Some Work, All Play. With Megan Roche, M.D., he hosts the Some Work, All Play podcast on running (and other things), and they wrote a book called The Happy Runner.