Central Manchester Osteopathy & Sports Therapy

Can barefoot running help with running injuries?

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It’s not uncommon for a runner to get injured at some point in its training life. Sometimes the cause of the injury is obvious, and sometimes it is not. However an injury normally brings two problems: pain from the injury and the pain from not being able to run.

As much as it ‘pains’ me to say: it’s a shame, but an Osteopath can get injured too! Yes, we also experience the exact same worries as the rest of our patients.  Not being able to do your sport can be very annoying.

I run regularly and I am a member of the Manchester Frontrunners club. I am a fairly mediocre runner but quite keen to improve. Back at Christmas I signed up for my first half marathon, I upped my training and three weeks down the line, the back of my left foot started to hurt while running. I seemed to have developed a common runner’s injury: Achilles tendinopathy.

I thought a couple of weeks rest and lots of stretching should make it go… but it wasn’t happening. Finally I took two months off running, I stretched like mad, I had some treatment, some specific exercises at the gym and changed trainers. It didn’t hurt anymore, until I started running again, and then the pain was back!

Running on the treadmill or outside was equally painful. I started to think there was something in the way I run that was stopping me from getting better.

Running and posture: the ‘Alexander Technique’ and ‘barefoot running’

Some years ago I took a workshop on the use of the ‘Alexander Technique and running’ and it was the end of my on-going shin-splints. I learnt that running was a whole body-posture exercise: you run with your whole body and not only with your legs. Keeping the neck straight, using your arms and avoiding heel striking was the recipe.

I thought my running technique was really good, until, years later, a different pain arrived. So, I did some more research and came across ‘barefoot running’.

If one observes different people running, it’s easy to see how everybody runs in a different way, also changing as we journey from mile one to mile 10, as the body tires.

Barefoot runners claim that wearing over-cushioned trainers can sometimes stop the foot sending the right information to the brain on how it is landing on the ground: this is called ‘propriception’. Most injuries in the extremities can bring a level of loss ‘propriception’. This means that, to an extent, if you have for example, an ankle sprain, you will need to ‘retrain’ your ankle so it doesn’t twist and further sprain shortly after recovery.

Most of the running shoes can be quite padded in the heel, which barefoot runners claim can promote ‘heel striking’. This is a problem: barefoot runners think that landing on your heel is unnatural to the body and this type of running makes you more prone to injury.

Through my experience as a therapist, I have seen a few runners coming for treatment after they have changed trainers, when a knee or an ankle pain has developed. I have developed some concerns regarding shoe technology for runners. One would imagine that so many different shoe solutions would have finished running injuries, but this seems to be far from the truth.

I decided I wanted to make up my own mind. Given that I was a bit worried of running barefoot on the streets of Manchester, I got what the barefoot people call a ‘minimum shoe’. They have no arch support and they are basically like a bit of wrapping for the foot.

So three weeks down the line I am running 3-4 times a week, a maximum of 6 K at a time. I am still mixing treadmill and runs outside. Now my pain has decreased a bit. I guess the interesting bit is that it has not increased with this type of running, which to me is already something. I also went for a 10 K run in normal trainers the other day, and the pain didn’t bother me much either.

I am really aware that these weeks of barefoot running have really made me change the way I run, and the benefit appears to be sustained when I am also in trainers too. Now, the downside is that I can get a bit of soreness on the ball of the foot, but nothing too dramatic.

Now my plan is to keep building up the barefoot running for the next months, but still doing the odd run on trainers until I can manage a 10 K run without a problem. I must admit I am starting to believe there may be some goodness in it…. but it’s still early days. I don’t think running barefoot would make me a faster runner, I think most possibly it will be the opposite, but if it helps me being injury free then it’s more than welcome. I should keep reporting.

Comments

5 responses to “Can barefoot running help with running injuries?”

  1. Neil Ryan Avatar
    Neil Ryan

    Hmmmm interesting point Jose, I do hope that you aren’t growing a runners mentality though!!! You should know how much of a bugger they can be when we say REST, it doesn’t mean a quick 2mile run lol!!!
    Have you thought about changing the training modes?? Intensity, duration and frequency?? Upping one mode may mean cutting back on another until you get used to it then build it back up again,
    I do agree though that there’s so much science going into trainers these days that the science itself is being clouded to a point that well…..what’s a good trainer???? It may be. Brilliant for the foot but throw the knees and hips out, best advice I give is find a good pair of trainers, fairly stable with inner arch support and heel pads that aren’t going to strangle the achillies or bursa, and a feeling that when you put them on they fit snuggly and dont want to fall off and fiinally stick with them and don’t change the model as the body doesn’t like change!!!! Asics seem to be the best at the mo

    Reply
    1. Jose Fernandez Avatar
      Jose Fernandez

      Hi Neil,

      Sorry it has taken me a while to respond to your last post. I have kept doing the barefoot running over the past months and now I can report back with some more experience.

      I was recently at a lower extremities tendinopathies course with a leading tendon expert, Peter Malliaras, who is a senior researcher in rehabilitation of tendons for professional athletes. In their research they have done studies over the change that tendons (like the Achilles) suffer following a sustained chronic injury. To cut the story short, it appears that the body, in its aim to repair the damage creates to many blood vessels in the area, which the substitute some of the elastic collagen fibres that make the tendon a healthy structure. Because more space is occupied by small arteries, there is less space for healthy tendon tissue. This makes the Achilles less flexible, and the lack of flexibility has the potential to inflame the bursa chronically.

      His recipe for rehab was a quite intense weight training programme to recondition gastrocnemius and soleus over 12 weeks. He also recommended and heel raise in the shoe, from the initial stages of the injury.

      Now the interesting bit was that he still recommends to the patient to continue running, as the the Achilles responds well to maintaining activity. The things to avoid were: interval training or any other increases of speed. He advocates doing a good warm up, followed by a steady run at a comfortable pace.

      We had an interesting discussion over barefoot running. He thought that there was still not enough research, however he appeared to accept that a mid foot or forefoot strike is less aggressive to the joints in the lower extremities (and of course, to the rest of the body) than heel striking. He would be cautious to recommend anybody ‘barefoot running’ and thought that in order for somebody to do barefoot running, the person should have already no issues with their feet: good arches and good food mechanics.

      Going back to my Achilles problem. Over the past months I followed Mr Malliaras training programme. I also kept running barefoot and had a few sessions of acupuncture to help with some trigger points in the muscles. Saw my osteopath to help with some issues in my sacra-iliac joint (as Osteopaths, we also need Osteopaths once in a while!) and I can say now that I am 95% injury free.

      I had the very odd twinge (funny enough in the foot that did not use to be injured), but the tightness in the ankle in the morning and the pain during the runs is long gone.

      Since then, I have given the re-conditioning training plan to a few of my ‘Achilles’ patients with good results. The main problem is that the programme needs strong ‘adherence’ as it takes two daily sessions of 20 minutes exercise each, ideally in a gym setting to do it, but I managed to transfer it to some home exercises.

      I am planning to run a marathon next year, if I manage to get rid of the colds I keep getting every time I run in this country in the cold… I guess I can change my gait, but my Mediterranean blood never will, even I have lived here for 18 years!.

      Have a great day

      Reply
  2. John Baron Avatar
    John Baron

    Hi Jose

    I managed to rupture a tendon in my right foot back in March this year whilst running and ended up taking four months off running. I decided to go the barefoot route after doing some reading and bought myself some vibram five fingers (Bikila LS) and found that the tendonitis went away completely. It did take a long time to even get up to 10k in them as vibram advise you to break them in, and your feet and legs, gently. My calves ached a lot at first but there was no pain at all. I managed a marathon in them in October and did all of my marathon training wearing only them. I did put my old trainers back on once but the tendinitis returned almost immediately. I think that the reason why the barefoot trainers work for me is because they allow my feet and toes to move and splay out in order to cushion some of the impact. I realise they aren’t for everyone and I’ve had some cuts from going off road in them and stubbing a toe etc but I couldn’t go back to regular trainers anymore.

    Reply
  3. central Avatar
    central

    Hi John,
    Thanks for sharing that!. Yes, my story is pretty similar to yours (minus the marathon!). I do use the Five Fingers regularly since May and they have worked fine with me. I did quite a lot of rehab at the gym as well, to re-build the calf muscles following an Achilles injury, but I have not had any major issues to re-adapt running with them. Certainly, I think you need to have decent foot mechanics and the arches of your feet in full-working condition in order to take on barefoot running, so I agree, not for everybody, but it is still an option.
    I had a chat with a colleague who works with me who is a podiatrist and biomechanics specialist, and she agreed with most of this. She still felt that running on the ground with no cushioning shoes, may be classed as a ‘high impact’ activity, particularly for the knee, but she was really open to reconsider that my approach to Achilles rehabilitation and running may be fine for a healthy individual with no any lower extremities issues, but should be taken with care to use as a therapeutic approach, so every case would be different (and I can only agree with that!)
    Anyway delighted it has worked for you, and hope to say hello sometime if I see you running in the club. Keep well.

    Reply
  4. Tim McConville Avatar
    Tim McConville

    Barefoot running is the natural way to run, it’s how are bodies have evolved to run. The running form is very furtive and gentle on the whole skeleton the muscles and tendons soon strengthen over months and the propensity for running injuries is reduced or is even entirely gone. The marketing of padded running shoes as safety equipment was a marketing ploy to capitalise upon a naive population when it came to exercise. The market potential was huge and whilst the design and subsequent promotion of these shoes was a genuine attempt at popularising running it was, we know understand, misguided and the shoes have the opposite effect. The benefit of Nike’s marketing of these shoes (and other brands) has been to popularise running but as our understanding of human biomechanics has increased it is now clear that our bodies have all they need to run in the complex design of the foot and and leg. Indeed being able to run and sweat, hunting our prey over many miles as early humans.

    Reply

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