How to Advise Patients Who Want to Run Barefoot

Laird Harrison


November 15, 2013

In This Article

Are Cushioned Shoes a Problem for Most Runners?

Out for a barefoot run in Delaware one day, physical therapist Irene Davis, PhD, noticed her husband, Darrell, accelerating to catch up with another runner. He seemed in fine form. Only when the Davises reached the end of their 4-mile course did they notice blood gushing from a hole the size of a quarter in the bottom of Darrell's foot.

How could he have run so far without noticing the injury? It was a cold day. Davis thinks her husband's foot got so numb that he didn't feel the pain as he literally wore through the sole.

To many people, the moral of the story would be obvious: Wear shoes when you run. But to Davis, director of the Spaulding National Running Center at Harvard University in Cambridge, Massachusetts, the point is that you should not muffle feedback flowing from the body to the brain.

And more often than cold, she believes, it's shoes that do the muffling. She hypothesizes that they have contributed to the injuries of muscle, tendon, and bone afflicting as many as 79% of runners.[1]

"I think you lose something when you cover the sole of the foot, because it's very rich in nerve endings," she says.

Running Barefoot Is Now the Rage

The notion that shoes contribute to runners' injuries has sparked a lively interest in barefoot running and in minimalist shoes. Many manufacturers have responded with footwear strikingly different from the thick-heeled styles that gained popularity in the 1970s.

But as 3 recent reviews show,[2,3,4] research has not yet established that running barefoot can prevent injuries. And some experts on running injuries, including Davis, are treating patients who kicked off their shoes too carelessly.

The barefoot trend seems to be gaining momentum. Even after the advent of specialized running shoes, a handful of top athletes, such as Olympian Zola Budd, refuse to wear anything on their feet.

More recently, Christopher McDougall's Born To Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen,[5] which was published in 2009 and spent years on the New York Times Best Sellers list, helped fire up popular enthusiasm for unshod exercise.

McDougall's book popularized the research of Davis and her Harvard colleagues, including Daniel E. Lieberman, PhD. An evolutionary biologist, Lieberman speculated in a 2004 article in the journal Nature that being able to run long distances was essential to the survival of the species, and so the bodies of Homo sapiens are exquisitely adapted to it.[6]


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