Barefoot running: weighing the benefits and the risks

http://www.abstractsonline.com/Plan/ViewAbstract.aspx?sKey=7f4ec5bc-f7ec-4d1c-b298-a3b7a5fcd2c4&cKey=14829510-3350-4f29-bd30-7ce4fd1f21b0&mKey=%7b31EB97E9-7ED4-4166-ACFC-DBE541BE7D75%7d

Session:	P401-P475-Sports Medicine/Arthroscopy Posters
Date/Time:	Tuesday, March 24th through Friday, March 27th, 7:00 AM - 6:00 PM, and Saturday March 28th, 7:00 AM - 3:00 PM
Location	Academy Hall G
Presentation Number:	P456
Posterboard Number:	P456
Title:	The Effect of Training Shoes on Running Kinematics in Older Runners
Classification:	+Foot and Ankle (Sports Med/Arthro)
Keywords:	Foot / Ankle; Injuries
Author(s):	Scott M. Mullen, MD, Highlands Ranch, Colorado E B. Toby, MD, Kansas City, Kansas Damon Mar, Kansas City, Kansas Megan Bechtold, DPT, Greenwood, Missouri Heath Melugin, BS, Kansas City, Kansas Terence McIff, PhD, Kansas City, Kansas
Abstract:	INTRODUCTION: Recently there has been enthusiasm for minimalist shoes or barefoot running to create a more natural running style featuring forefoot strike as opposed to heel strike typically seen in the large heeled training shoes. A previous study looking at elite competitive adolescent runners showed that these athletes changed from a heel strike pattern to a forefoot strike immediately upon transitioning from the large heel trainer to either a track flat or barefoot running condition.1 It is unknown whether more experienced runners would exhibit this same quick change in running pattern with change in shoe condition. METHODS: Twenty-six runners of greater than 10 years running experience and all over the age of 30, were tested upon a treadmill with various speeds. Shoe heel-to-toe drop was measured using a digital caliper. They ran in both their normal running shoe and in the barefoot condition. Additionally, their running shoe was measured with respect to the height of the heel versus forefoot thickness. Running speeds of 6, 7 and 8 mph were used for the women and 7, 8 and 9 mph were used for the men. A motion capture system was utilized to analyze foot strikes by a single blinded examiner skilled in the use of the camera system and running mechanics. Statistical analysis was performed. RESULTS: Heel-to-toe thickness of the running shoe did not significantly correlate with percent heel strike either in the shoe or barefoot conditions. Alterations in speed also did not change foot strike pattern. Running barefoot resulted in a significant drop in percent heel strike at all shared speeds (p-values < 0.001 ). However, 40% of the men and 20% of the women persisted with consistent strike patterns across all speeds with and without shoes. DISCUSSION AND CONCLUSION: A forefoot strike has potential advantages, but recent reports indicate a high injury rate as athletes adopt a barefoot or minimalist running shoe condition.2. Alteration in foot strike pattern does not always occur immediately when older experienced athletes go from a training shoe to the barefoot running condition, in contrast to adolescent runners. Some of these runners persist with a heel strike even when barefoot and at high speeds. These more mature runners may have a much more established gait and a longer period of time may be needed to accustom to a forefoot strike with a barefoot running condition or minimalist shoe. This may lead to frequent injuries in individuals who attempt to either run barefoot or with minimalist shoes, but persist with the heel strike pattern. Older runners should be cautious when beginning a barefoot or minimalist shoe running regimen and might consider an assessment of their foot strike pattern. References:1. Mullen S, Toby EB. Adolescent runners: The effect of training shoes on running kimenatics. J Pediatr Orthop 2013; 33(4):453-457. 2. Ridge ST, Johnson AW, Mitchell UH, Hunter I, Robinson E, Rich BSE, Brown, SD. Foot bone marrow edema after a 10-wk transition to minimalist running shoes. Med & Sci in Sports & Exercise 2013; 45(7):1363-1368.