Northwest Health Spring 2011


Should You Go Barefoot?

You may have seen them out on a trail, or even on the road: runners with no shoes.

Go to: Northwest Health Index

Barefoot running is officially a fad, with a best-selling book ("Born to Run," by Christopher McDougall), and thin-soled shoe styles meant to mimic a barefoot feel. Proponents claim it can alleviate running-related injuries, cure back problems, and restore a more natural running gait. Not everyone is convinced of the benefits though, and doctors are concerned about problems that barefoot running can cause.

"Advocates of barefoot running think stress fractures, tendonitis, and issues with bones in the foot, shin, and knee might be reduced by running barefoot," says William Huff, MD, a doctor with Group Health Physicians with expertise in sports medicine. "This might be the case for a few people, but many others increase their injury risk, depending on bone and joint health, how much they run, and on what type of surface. It needs to be a considered choice, knowing the potential risks as well as benefits."

Potential Risks

People with certain health conditions should avoid walking or running barefoot outdoors, says Dr. Huff. This includes individuals with osteoporosis who are at risk for fractures, those with diabetes that can cause numbness, and those with circulation and skin problems that can lead to foot ulcers or infections.

One obvious risk for everyone is the danger of getting cuts or abrasions that can lead to infection. Barefoot running, in particular, may also put you at risk for toe-related injuries as runners tend to land closer to their toes when barefoot, rather than their heels. Plus, barefoot toes have no protection from missteps.

Older adults also may want to steer clear of barefoot running. "Bone density deteriorates and our natural shock absorbers — the fatty pads on the heels and balls of our feet — get thinner," says podiatrist Douglas Monson, DPM.

A more general concern is that those who run shoeless to cure running injuries aren't necessarily addressing the cause of their injuries, says Brian Nakagawa, a physical therapist at Group Health Medical Centers Northgate in Seattle. "Sometimes the problem isn't with their shoes but with some other issue, such as pushing too hard and not pacing themselves."

And anyone who dives into going barefoot is likely to regret it since the foot lands in a different way when running barefoot than it does with shoes. You may find yourself with Achilles tendinitis, strained calf muscles, or pain in the bottom of your feet, known as the plantar surface.

Any Benefits?

If your health allows it, going shoeless in a safe space free of sharp objects can strengthen the foot and help with balance, says Nakagawa. Competitive runner and physical therapist Joe Jereczek, who sees patients at our Capitol Hill Campus in Seattle, sometimes goes barefoot on a track and says this can help runners remember proper running mechanics. He doesn't advise it for the casual runner, but says that going barefoot can be a reminder of how feet move naturally, without shoes.

To get that feeling, or to strengthen your feet and improve your balance, you might consider trying yoga or Tai Chi, barefoot activities that emphasize awareness of feet as well as the rest of the body. Or do as Dr. Huff does, and just take a barefoot walk around your house or yard. "I like walking outside barefoot in summer when I can," he says, mentioning one of the other benefits of going barefoot. "It just feels good."

Finding Shoes

Running shoes are generally sorted into three categories, says Dr. Huff. If you're not sure of your foot type, the staff at an athletic shoe shop can usually help.

  • Stability shoe: For those with average feet who don't need much additional arch support.
  • Motion control shoe: For anyone with flat feet who needs more arch support.
  • Neutral or flexibility shoe: For those with a higher, rigid arch, who need extra cushioning to absorb shock but less arch support.
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