Born to Run (McDougall 2009) is a fascinating book that is often credited with popularizing the barefoot running movement. It tells the story of the Tarahumara tribe specifically their unique running style and footwear. The Tarahumara actually wear a type of shoe—the Huarache sandal—fashioned out of old tires with leather laces that would be closer to a minimal support shoe. Either way it appears to be highly effective at running long distances frequently without injuries.
While the story of the Tarahumara is very compelling. I was very interested in McDougall’s telling of the history of running shoes and running shoe companies as I don’t believe this is very well known. The narrative states that running injuries used to be relatively rare. Running shoes at this time were very basic with minimal cushion and neutral arch support. As the sport became more popular in the 1970’s injury rates began to rise. A note of caution with this story is that the incidence of running injuries wasn’t studied much if at all prior to the this time.
The sport becoming more popular also correlates with new running shoes from new companies such as Nike and Asics beginning to hit the market. Over the following decades, the running shoe market continued to grow with additional companies and innovations becoming popular. These shoes grew increasingly specialized with more cushion and more arch support. Surprisingly with all the money, research and innovation poured into the running shoe arena no shoes have been proven to reduce injuries.
McDougall himself adopts the barefoot running style and tells his story throughout the book. He details his transition from a broken down former runner to a pain free runner by switching to a barefoot style. He also relates the stories of other ultramarathoners who have been successful with this style. It is a very interesting and absorbing read for anyone with an interest in running.
The rise of barefoot running is in part a response to the high frequency of injury rates. Commonly, it is reported that up to 79% of runners per year can expect to hurt themselves. The knee is the most often injured area and there is a significant connection to knee demand and the heel strike running pattern. The purpose of barefoot running is to encourage a forefoot or flat foot strike rather than a heel strike. It also promotes foot/ankle strength by putting more demand on this area of the body.
There are a few caveats to all of this information. Practical Physical Therapy advice is to not switch from a successful style or shoe. If you are a fully cushioned heel striker without injury, I would stick with the style that has worked for you. Biomechanical changes to running form are tricky and the group that benefits the most are those with a history of recurring injuries especially of the knee. One of the biggest problems that novice barefoot or minimal shoe runners have is they switch their shoe but not their running style. That often means they take the cushion away from their heel but still pound on it with every stride which is a recipe for injury.
Most important is to allow a great deal of time to accommodate to a new running style or shoe. A walk to run program with limited mileage will reduce the incidence of injury. The most common injuries seen from switching to a minimal shoe are stress fractures, plantar fasciitis, and achilles tendinitis among others. If you would like to be proactive, I highly recommend talking to a PT to get instruction and technique advice to appropriately strengthen the areas of your body that will be involved with your new running style.