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Recently, there seems to be an increase in the number of individuals wearing “minimal” footwear while running, lifting weights or participating in core fitness exercises. As the health care integrator and monitor of medical diagnosis trends on base, I am curious if this footwear is helpful, hurtful or hype.
Musculoskeletal concerns of the lower leg, foot and ankle are the No. 1 reason people are seen at Ramstein’s physical therapy clinic. In addition, musculoskeletal concerns are ranked No. 2 on our “Top 10 Diagnosis” list at the Family Health Clinic.
With 85,000 friends on one brand’s Facebook page and their strange visual appearance, it’s not surprising these unique sneakers are attracting more attention. Proponents of the minimal footwear suggest that conventional sneakers with their raised heel and mid foot support contribute to lower extremity and back injuries.
Biomechanical studies demonstrate that those who wear conventional sneakers have a heel strike running gait, most likely developed as a result of all that cushioning in sneakers.
In contrast, barefoot runners, lacking the heel cushioning of sneakers, use a mid strike or forefoot strike gait. Advocates of barefoot running suggest that a midfoot/forefoot strike reduces forces and shocks through the skeletal system and thereby has the potential to reduce injuries. (For more information or slow motion videos of different foot strikes, visit www.barefootrunning.fas.harvard.edu.)
Though research has never concluded that wearing conventional sneakers is directly related to injuries, Kerrigan, Franz, Keenan, Dicharry, Croce and Wilder (2009) reported increased torque through the hip, knee and ankle of running individuals when they wore sneakers in comparison to when they were barefoot.
Of note is that this study had a small sample size and therefore lacks the power to be statistically significant, but the authors found increased joint torques.
At this time, there is no concrete evidence to indicate one method is proven to reduce injuries or improve performance.
For those members who are interested in trying minimal sneakers, it is important to review the information at www.barefootrunning.fas.harvard.edu. (Note: This Web site is partially funded by one brand of minimal footwear, but it does have several good training tips that are worthy to mention: Build slowly and begin with walking. Walk no more than a quarter mile to one mile every other day in the first week. Do not increase mileage by more than 10 percent per week. Stop and let your body heal if you experience pain. Be patient and build gradually. It may take months for your body to transition to mid/forefoot strike patterns. Stretching and massage is essential for calves and hamstrings.)
In addition, plyometric movements, such as box jumping, put significant strike forces through the skeletal system, so it may be helpful to minimize high impact activities for several months while adjusting to minimal sneakers.
In summary, the debate between “barefoot”/minimal sneakers and conventional sneakers continues to evolve. Individuals who are considering purchasing and trying minimal sneakers should review literature and adhere to conservative training principles to reduce their risk of injury.
