Knees

A friend asked me "what about knees?" in response to a previous post, so I said that knee's are cool in barefoot running because the style you adopt has lower force loading than shoe-wearing runners. I've read a few articles, but can't do lots better than the explanation in "Barefoot Running: A Natural Step For The Endurance Athlete? by Dennis G. Driscoll, Head XC Coach, Natick (MA) High School". Discussing biomechanical analysis Driscoll says "One study noted a compensation in the form of higher knee flexion velocity immediately after contact which reduced impact loading by lowering the effective mass of the barefoot runner's support leg". In another article on the angular stiffness of knees and ankles in barefoot and "shod" running by Coyles, Lake and Lees (2001) they say that in barefoot running the knee flexes more and is less stiff than the ankle, the reverse of the effect when wearing shoes. Amongst other biomechanical things this will mean that the shock loading on the knee is less when barefoot.

In the "Additional Implications" section of Driscoll's article he says "The barefoot runner can expect reduced knee injury frequency" . Before we all get too excited, however, there is evidence that while there is little/no evidence for the performance or injury protection value of shoes, the barefoot case is not so clear-cut either. I've just found the barefoot forum on Runners World (.com) and its a great resource. The "Comment on Barefoot Running" by Caroline Burge is a warning to caution. She points out that while some of the barefoot claims do actually have real evidence (yay!), most of the studies that they are reported in are not especially high quality in scientific research methodology terms (boo - more research required as they say).

I'll let Barefoot Ken Bob have the last say on the matter in this random treatise, because I like his style and because he talks sense. In his post on knees, calves and gentle running he says pretty much all you need to know without commissioning a randomised controlled trial study - you need to feel the balance and run smoothly and softly, letting your heals touch down and keeping cadence (foot rate) high. Once you've read his advise check out the following vids for graphic examples:

• The right way
• The wrong way
• Shoe Effects

So, whatever Carole Burge says, I reckon the evidence is stacked in favour of the shoeless, even if it does not come with premium science research. I've seen the comment elsewhere, but who will fund a randomised controlled research trial costing hundreds of thousands of pounds, if not into the millions, when you can guarantee no revenue to be gained from your investment? Hum.
Just to round of with proper anecdote I can tell you that I had a two hour VFF and barefoot run with a friend last night - alright Rob? - and my knees were totally fine. It was the gravel trail on my soles that got me back into the VFFs. Achillies tendons are sensitive today, but the rest of me has never felt better (except when I was fifteen possibly, but relatively never better).
Keep running and keep smiling.

Running, retraining and reading

There is surprisingly little published material on barefoot running, and what there is seems to fall into one of two camps - either evolutionary accounts of ability or health/ medical accounts comparing physiological measures of efficiency when in shoes or without. Although these literatures do not appear to come together all that frequently, they do make a compelling case in favour of running without shoes.

To give a couple of examples, in 1999 Dr William A. Rossi published a paper in Podiatry Management entitled "Why shoes make "normal" gait impossible: how flaws in footwear affect this complex human function". In this paper he makes a thorough assessment of exactly how modern heeled shoes (yes, men's shoes too) act to distort the natural posture of the body. A seemingly small difference at the heel actually serves to change not only the foot mechanics but the entire muscular loading on the body trying to keep upright. Not only do you lose sensation and spring at the foot, but you add distortion to your back and/or upper legs trying to keep your balance. Rossi concludes that the only way to retain a natural gait is to return to barefoot walking. The evidence in Rossi's paper also indicates why so many people say that back pains go when they move to barefoot walking or running.

At the anthropological end of the evidence spectrum the most persuasive and prolific writer I have come across is Daniel Lieberman, at Harvard. He has written several papers with Dennis Bramble and others, such as "The Evolution of Marathon Running" (Sports Med 2007: 37(4-5) 288-290) and "The evolution of endurance running and the tyranny of ethnography: a reply to Pickering and Bunn" (Journal of Human Evolution 53 (2007) 434-437). These papers, and many more cited in them, cover the sort of ground that Christopher McDougal sets out in "Born to Run", but in much more detail and mentioning even more evidence.

It is very clear that key parts of the industry are responding to this growing evidence base - the Nike Free is a trainer, still with a built-up heal, but with more flex in the forefoot, and there are lots of other shoes, like the Vibram FiveFinger or Feelmax shoes that have no heal or internal support so that the sole has some protection but the natural foot movement is not otherwise altered. However, these appear to be little more than nods of recognition rather than a full scale shift in the trend of trainer design. Most of the mainstream running magazines are carrying on with featured stablisation and cushioning shoes as if nothing has happened. Looking at the skeptical responses of some online posts about the "dangers of urban running" with razors, glass, needles and ninja dog poo round every corner its a wonder we even go out.

It seems ironic that it is the hardest outdoors running pursuits, in the hardest conditions - fell running and orienteering in the UK, and mountain/trail running in the US and elsewhere, where dedicated shoes (Inov-8, Walsh etc) have narrower and lower heals to avoid the ankle turning that wide heals can lead to. I've even seen reference to Anton Krupicka cutting the heal down on standard trainers for use in trail ultraruns. Full respect - I've set myself a goal of running an ultra this year, but haven't gone much over ten miles in training so far.

Read the arguments - where is it all going?

I quickly found that lots of other people had taken the barefoot journey years ahead of me, and that there are loads of cool groups and resources all over the internet, and paper publications too. The more I look into it and think about it the more I'm convinced that this is not a new movement - it is an old movement getting emboldened by the increasing evidence that much of the established "truth" circulated by the footwear, podiatry and linked training industries is just plain wrong.

Christopher McDougall seems to have very neatly tied up all the key themes in his book "Born to Run". This books sets the general tone for current thinking on barefoot running, giving people the information to enable them to reject the marketing junk from the shoe companies. Even RW (UK) recently ran a small advertorial that ostensibly espoused barefooting before returning to the more normal position of 'but most people need to have their toes strapped to a solid plate to avoid sucumming to their biomechanical imperfections'.

Biomechanical imperfection seems to be one of the podiary businesses rallying cries in the face of increasingly direct questioning on the need for fat shoes and acute ankle injury. I've read current posts (can't find citations now, so I'll have to stick with hearsay for the minute) by podiatrists suggesting that only people with 'perfect' gait can run barefoot. This seems to go unchallenged - possibly as it is too ridiculous to really argue back against - but what can this 'perfect' gait look like - and does it only work on 'perfect ground'?

I suppose the greatest disappointment for me is not that such arguments fall into general currency, there is clearly an invested interest in keeping people certain that their delicate feet need serious protection from the harsh ground. The real disappointment is that the majority buy it without question - and I include myself here. When I was a student - a good 15 years back now - I was a regular on a running forum that talked about running style. I ran in the 'classic' Nike Pegasus and my interpretation of Noakes advice to improve speed by increasing stride length (and turn-over) was to significantly increase my leg swing. This only permitted me to land on my heal, and so convinced was I by my marginal gains in speed that I ignored people who said things like "man is a forefoot striker" as dribbling idiots.

I then spent a large chunk of my competitive running career getting so far, but never realising the potential I thought I had. I saw people who I knew had weaker legs and less cardiovascular fitness beat me in races, but I just didn't get the whole running efficiency thing at all. I had a coach who said things like "keep your shoulders relaxed" but I never saw how much influence my running leg style had on my overall movement style.


Having quit competitive running in a great big unfulfilled-potential sulk, I seem to have inadvertently completely retrained myself to run. I've not run in trainers for over 6 months now, and use VFF Sprints as my running shoes of choice in all conditions, on and off road. They are a revelation - but not for the faint-hearted or bad-tempered in slippery mud conditions. I read all sorts of sports science articles about "unshod" performance gains, and Danny Dreyer's Chi Running (which made me cross, but that's another story), and went out slow, focusing on smoothness - taking advice from Barefoot Ken Bob and McDougal.

I can only say that running has got easier. I can't tell if I've got faster yet, as I've not put myself to a serious test. I did run a 10K in 42mins with a broken toe - you have to be careful when the light is fading on them hill runs I can tell you - but that's a few minutes off my track PB, so I'll have to go for a retest when I've got full strength back again.

Barefoot Running Project in Progress

I have joined the swelling numbers of people who are going barefoot - or at least minimalist shoes (VFF), mostly. It makes running feel so much better than in great big lumps of plastic.

The story started for me last year, in the summer of 2008, when I read a walking magazine (Trail or TGO, I can't remember which) that had reviews of minimalist shoes for hill walking. I cannot even remember the other two shoes, but that was when I decided I had to have a pair of Vibram FiveFingers. Barefoot Ted's reviews tipped me over the point of no return and got my money spent on Amazon. When my wife first saw them I was ordered to walk at ten paces behind, and on no account to go into town when people might see me.

I was so excited I walked when I would otherwise have driven, and took a series of exciting shots of my own feet. Almost a year later I have made every basic mistake in barefooting. Very early on I got too excited and went for a 9 mile run shoeless one morning. I thought that my feet felt a little sensitive after half an hour or so, but as I was running on mixed surfaces I thought no more about it - the damp grass was fantastic. It was only as I trailed foot prints of blood across the hall carpet that I realised I might have been a little silly.

I learned a lot about surgical dressings and walking really slowly on my heals after that. Two months lost. But no regrets - when the screaming pain died down anyway.