The Art and Science of Fitness | Decoding the fuss around barefoot running

Minimalist shoes became popular because of the hypothesis that they led to reduced running injuries. After almost a decade and a half, what does the evidence suggest?

A case is made

Minimalist shoes became popular because of the hypothesis that they led to reduced running injuries. After almost a decade and a half, what does the evidence suggest? (Shutterstock)

It was in 2009 that Born To Run, a best-selling book by award-winning writer Christopher McDougall, globally popularised barefoot running like never before. Throughout the book, McDougall talks about Tarahumara — an indigenous Mexican tribe of extraordinary long-distance runners who run in sandals.

McDougall built a case in the book for barefoot running and how being connected to the earth was important to lessen injuries. However, even with the best of intentions, he glorified the lifestyle, while looking at it all from a western perspective. (A parallel can be drawn to India's yoga story going West: What is seen as a way of life in Indian culture is reduced to a few stretches and poses in the West.)

Luis Guerrero, a Mexican ultra-runner narrated his experience from 2009, when Born to Run had just been released. “I met Christopher at the Outdoor Retailer Show just when he published his book. One week later, I met Micah True, known in the ultra-running community as “Caballo Blanco” or “White Horse”, at Leadville. It was a coincidence since I was just relaxing and reading the book at the hostel. When Caballo showed up at the hostel, I told him that I was reading the book he and his race were featured in, but he was not happy about the book. He expressed that Christopher invaded his privacy. He thought that McDougall had twisted the real Tarahumara essence and they were misrepresented to suit his narrative. It hurt Caballo because he had done a lot of humble work to help the Tarahumara, and he thought that the book invaded their privacy too. It was like contaminating their spirit, bringing them out of their natural environment, for a vested interest. Caballo used to organise a race in Copper Canyon, Chihuahua, Mexico, where the prizes were corn and beans. He was against bringing sponsors. Tarahumara is losing its traditions, courtesy the westerners who think of them as exotic.”

Dr Nick Tiller, a researcher in exercise physiology at Harbour — University of California, author of an award-winning book, The Skeptic’s Guide To Sports Science, and a columnist for Skeptical Enquirer and Ultra-Running Magazine, says, “Despite regularly running hundreds of miles across rough canyon country to accomplish inter-village communication, transportation, and hunting, the Tarahumara are perhaps best known (rather unfairly, thanks to McDougall’s account) for their huaraches — traditional sandals made of leather or rubber soles and ankle straps. They use huaraches not to shun modern technology but rather due to some combination of tradition, culture, and necessity. The author makes an impassioned plea for us to follow in the tribe’s footsteps, so to speak.”

Tiller adds, “McDougall goes to great lengths to explain that barefoot running is about more than just the kinesthetics of feeling the ground underfoot, reconnecting with nature, or regaining our souls by discarding our soles. ​​From a practical standpoint, he is one of many claiming that minimalist shoes mitigate injuries that have rendered generations of runners incapable of pursuing the sport.”

Two tales of two Christophers

Caballo and Tarahumara in Born to Run reminded me of Christopher Robin, a fictional young boy whose charming adventures with Winnie the Pooh, Piglet and other animals were brought to the world almost a century ago by AA Milne. The character was based on the author’s son, also known as Christopher Robin. Even though everyone associates Winnie the Pooh and Piglet with fun and joy, most fans are unaware of the darkness beneath the surface. In real life, Robin had a dysfunctional relationship with his parents who were more focused on being socialites than caring for their son. Christopher was paraded around as a child to promote the stories and books of Winnie the Pooh and Piglet, while being disregarded as a child.

This exotification, of Christopher (Robin) and by Christopher (McDougall), is where the problem lies. Emotional connections to their art and science led them to disregard what truly matters in their pursuit. Christopher McDougall and AA Milne had something in common. McDougall was a war correspondent in Angola and Rwanda, who accepts having ADHD and Milne had served in the British Army in World War I and then suffered from post-traumatic stress disorder. 

In his autobiography, Christopher Robin talks about this: "It seemed to me almost that my father had got where he was by climbing on my infant shoulders, that he had filched from me my good name and left me nothing but empty fame.” He resented both the stories and his father. Guerrero suggested that Caballo felt a similar feeling towards McDougall and his book.

Does science back McDougall?

A 2010 study, Foot strike patterns and collision forces in habitually barefoot versus shod runners, by Daniel Lieberman — a Harvard University paleoanthropologist, showed that “habitually barefoot endurance runners often land on the fore-foot (fore-foot strike) before bringing down the heel, but they sometimes land with a flat foot (mid-foot strike) or, less often, on the heel (rear-foot strike). In contrast, habitually shod runners (running in cushioned shoes) mostly rear-foot strike, facilitated by the elevated and cushioned heel of the modern running shoe.”

And then Lieberman went on to say something that contributed majorly to a craze of minimalist running shoes. “Kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers. Fore-foot- and mid-foot-strike gaits were probably more common when humans ran barefoot or in minimal shoes, and may protect the feet and lower limbs from some of the impact-related injuries now experienced by a high percentage of runners.” The reduced impact force is predicted to reduce running-related injuries.

Dr Tiller pointed out that Lieberman’s study was in part funded by Vibram, a prominent barefoot shoe manufacturer — a major red flag. But soon enough, they had competition. More than 150 barefoot shoe brands rapidly emerged worldwide. Probably to address that, a few years later Lieberman appeared online endorsing the Vibram barefoot brand in a YouTube video.

The tale of toning shoes – Lessons 

As pointed out by Tiller, back in 2010, there was no scientific data that linked barefoot running to reduced running injuries, and yet, manufacturers of barefoot running shoes claimed so. It was an extrapolation from preliminary research from the likes of Lieberman. In 2012, a runner named Valerie Bezdek filed a suit against Vibram because the company had deceived her and others that their footwear could strengthen the muscles of the foot and reduce injuries. The company was fined $3.75 million.

Cushioned running shoe companies were not to be left behind. Toning shoes had become popular around the same time with the companies claiming that just wearing the toning shoes, which had a “rocker bottom”, made the person’s legs work harder, supposedly leading to toned glutes and making them run faster. The New York Times (on September 28, 2011) reported sales of over $1 billion toning shoes. Pretty much all the traditional running shoe manufacturers (Skechers, Reebok, MBT, Avia, New Balance and Champion) jumped on the bandwagon. Reebok alone sold more than five million pairs of toning shoes. After all, money makes the world go round.

These claims, however, landed Skechers USA and Reebok International in trouble because in court they were proved to be indulging in unsubstantiated advertising, misleading the consumers with false claims. Skechers and Reebok faced class-action lawsuits in the United States, with settlements of $40 million and $25 million respectively.

Much ado about nothing

There are contradictions in McDougall's entire thesis. The most blatant is that he talks about the benefits of barefoot running, suggesting that we shouldn’t wear regular cushioned running shoes, but then builds a case for running in sandals. It appears counterintuitive that in order to get the benefits of barefoot running, cushioned running shoes are demonised, but the solution then lies in barefoot shoes.

To my simple brain, what makes sense is that if running barefoot is good, we should run barefoot. As soon as there is a layer between the sole of your foot and the earth, you are no longer connected to the “nature” that McDougall, Lieberman and others want us to be. 

A study published in 2020 led by Dr Erica A Bell from East Carolina University used ultrasound elastography to measure the intrinsic foot stiffness among runners who got injured after transitioning to barefoot running shoes. They compared the feet of those who were used to running in barefoot (minimalist) shoes to those in traditional cushioned shoes. They didn’t find any stiffness in those running in barefoot shoes. They concluded, “If running in minimalist shoes increases loading on these structures without resulting in stronger tissues, it is possible that minimalist footwear may increase injury risk.” 

Another study published in 2020 did a systemic review of 53 studies and found that running in barefoot shoes reduced impact forces through the lower leg but didn’t lead to any lesser injuries in them. The authors concluded that if runners don’t have any injury, they shouldn’t be looking at making a major transition to barefoot shoes. An earlier systemic review study from 2017 looked at 20 studies. They found that runners who changed to barefoot footwear had a similar injury rate as compared to those who carried on running in cushioned shoes.

A simple solution

Knowing what we know today, I would recommend that to take short strides and land softly, you don’t need to change your shoes. If you don’t know how to run, get shoes that you and your feet like, and get started. Don’t fall for the fad of the season. Do remember that buying a minimalist car or a rickshaw isn’t going to make you a better driver. Then why expect that for your running?

As for connecting to the earth and going back to nature, whenever you have access to walking or running on grass, do so for 5-10 minutes. This will help activate nerve endings in the sole of your feet. You don’t need to be running barefoot on tarmac or concrete. Once you get the hang of running, do what works for you.

Keep miling and smiling.

Dr Rajat Chauhan (drrajatchauhan.com) is the author of The Pain Handbook: A non-surgical way to managing back, neck and knee pain; MoveMint Medicine: Your Journey to Peak Health and La Ultra: cOuch to 5, 11 & 22 kms in 100 days

He writes a weekly column, exclusively for HT Premium readers, that breaks down the science of movement and exercise.

The views expressed are personal