Comparing Custom Orthotics and Off-The-Shelf Insoles
Barefoot running has been a hot topic now for years and will surely continue to be on the minds of runners for some time to come. As Pedorthists, we have many patients who run on a wide variety of levels; everything form the casual weekend runner to ultra competitive marathon athletes. We are often asked by our patients, friends, colleagues and neighbours what we think about barefoot running. The answer is never simple, as every runner is different, as their mechanics and needs vary so widely. We do not advocate one way or another for every person, but rather off individualized recommendations based on many factors.
First, let’s define some of the core principles of barefoot running. The principal difference between barefoot (minimalist) running and shod running (running with shoes) is the landing pattern associated with either choice. Barefoot running is associated with a forefoot strike (landing on the front of your foot) where shod running is associated with a heel strike pattern.
The barefoot running community claims that a forefoot strike pattern makes runners less prone to injury, but what does the research say? Nigg & Enders (2013) investigated the barefoot running style’s effects on foot motion, training and injury and found that the available research actually doesn’t align with a reduction in injury. No “hard evidence” could be found to show a reduction in incidence of injury. They instead found that other factors like running surface, speed, shoe choice and runner preferences play too large a role for such generalizations to be made.
Research does show, however, that forefoot strike patterns are associated with a decrease in stride length, increase in stride rate, and a decreased range of motion for the ankle, knee and hip joints. At first glance, these results seem impressive — you might be thinking “Isn’t that what I want; less load on my joints?!”
While the results are encouraging, there is still no evidence to suggest that there is a relationship between forefoot strike pattern and a reduction in injury. Taking a closer at the math, if you decrease the length and increase the frequency of your stride, you are taking more steps in each run. While you will be spending less time with your foot in contact with the ground, you will be taking more steps to accomplish that. These hasn’t been a study to investigate the effects of this increase in repetitive stress on the joints, despite the reduction in joint loading.
Thinking also about the mechanical sequence of a forefoot strike, increased load is placed on the achilles tendon in the initial phases of gait. Each step results in 59% of the force required to rupture the achilles tendon(1), putting it at an increased risk of injury.
These are the conundrums we face with our patients when they ask for advice on barefoot running. Runners always want to be training better, performing better and seeing improvements in their distance, time and recovery. We are frequently put on the spot with the “Which is better for me?!”
Instead of asking “Which is better for me?”, ask instead; “Which running style aligns best with how I prefer to run, my injury history, individual mechanics and subjective preferences?” All runners perform best when they are comfortable. If you decide that you would like to make a change in your running style, make sure you make the change VERY gradually. Set yourself up to succeed; allow your body to gradually adapt so that you can truly discover which running style suits you best.
Hungry for more information? Wonder where you stand with your running kinematics? Check out our website for more information on our gait analysis and how we could help you better understand you running style.
References:
2) Benno Nigg, Hendrik Enders. Barefoot running: some critical considerations. Footwear Science, 2013; 5 (1): 1
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