Barefoot Running: Evolution or Trend?

If you are anything like me, you started to notice something different on the streets a few years ago.  The first time I saw a “barefoot runner”, he was jogging with his friend over the Mass Ave Bridge with absolutely nothing on his feet.  I was completely taken aback.  I was shocked as an orthopedic physical therapist that treats overuse foot injuries (and horrified as a citizen of Boston who has seen used hypodermic needles lying on the side of the street!)   For both reasons, I was very intrigued.

It got me thinking about everything currently being taught in medical school about the mechanics of the foot and shoe wear.   Even just as little as 10 years ago the conventional wisdom around jogging was that practitioners should advise their patient’s to wear cushioned sneakers that encourage landing on the heel.   This cushioning and built in motion control of the sneaker had been thought to reduce impact forces and decrease the risk of injury.  (The barefoot movement flies in the face of this conventional wisdom and encourages runners to land on their toes.)


However, with only a quick overview of the literature anyone can see that the number of jogging injuries has remained quite high over the past 30 years (despite much investment in cushioning technology).

Between 30-70% of runners who wear traditional sneakers sustain overuse running injuries.  Some studies have gone on to find that runner who spend > $95 become injured at higher rates than those who spend < $40.  So maybe the “Barefoot Running Movement” is a logical response?

The “Barefoot Running Movement” is based on the premise that humans have been successfully running for two million years with very limited footwear, and only since the 1970’s and the advent of sneakers we have started running in shoes.  You may think that this doesn’t really matter and that clearly running in a sneaker is better than running barefoot… until you consider that running in a sneaker fundamentally alters the mechanics of the foot.

Runners who use sneakers strike the ground with their heels first.  Runners who run in “minimalistic sneakers” strike the ground with their toes first.  This small change completely changes the forces that travel up the foot and leg when jogging.  Barefoot runners have been found to have significantly decreased ground impact forces than their “sneaker wearing” peers.  This increased impact in “sneaker wearers” has been correlated with injuries such as stress fractures in the tibia or bones in the foot.

It is a compelling difference and has been reproduced in a few well documented studies.  And it does make you think.  However, if you are considering becoming a “barefoot runner” you can’t just start running on your toes overnight.  There is a fairly strict protocol that one is advised to follow in order to successfully make the transition to running in minimalistic shoes.  So if you are considering making the switch to “barefoot running”, I will go over the protocol for the successful transition in the upcoming blog.

Learn something new!


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Diana grew up in a small suburb north of Boston. She received her clinical doctorate degree in Physical Therapy at Boston University in 2006. Diana started practicing as a physical therapist at Massachusetts General Hospital. While at MGH, she developed a specialty in the evaluation and treatment of complex lumbopelvic dysfunction. Diana is currently practicing at Spaulding Rehabilitation Hospital in Boston where she is the Orthopedic Clinical Supervisor of the Spine program. She is presently a Boston resident and her interests outside physical therapy include cooking, walking on the Esplanade, and international travel.

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