<img style="float: right; margin-left: 3px;" src="https://opedge.com/Content/OldArticles/images/2010-04_06/04-06_01.jpg" alt="Morgan Stanfield" /> Michael Sandler has beautiful feet—tan, arched like a drawn bow, and muscular and restless as young racehorses. As he chats happily about running, his bare toes rhythmically ball up, then grip at the tile floor like fingers. You believe him unhesitatingly when he tells you he runs an easy 15 to 20 miles every morning before breakfast. To make a point about biomechanics, he pulls up his warm-up pants to expose a pair of legs that could belong only to a lifelong professional athlete—they're sculpted into seemingly perfect paragons of muscle. Perfect, that is, until he points out the scars. The 39-year-old former speed skater and cyclist carries a titanium hip and femur, the leavings of ten knee surgeries, and a recent history of almost every chronic foot ailment known to an athlete—debilitating plantar fasciitis, pancake-flat feet, patellar tendonitis, and shin splints, just for starters. His right leg is nearly an inch shorter than his left and has no anterior cruciate ligament (ACL). Three years ago, in fact, Sandler was told that he'd be lucky to even walk after a career-ending accident. How did he make his way back into this condition? "By taking my shoes off," he answers. <h4>Ancient Modern</h4> The practice of barefoot running has a paradoxical air about it. One of the most common methods of human (or at least hominid) transportation for the past 1.75 million years or so, it's recently become associated in the popular media with lost tribes of superathletes, seeming miracle cures for biomechanical problems, and a handful of eccentrics who run hundreds of miles at a go for fun. Sort through the exotica, and you'll find not only compelling stories, but also a growing body of research that suggests going shoeless may still deserve top honors as the way to get around. <h4>What the Research Says</h4> <table class="clsTableCaption" style="float: right;"> <tbody> <tr> <td><img src="https://opedge.com/Content/OldArticles/images/2010-04_06/04-06_02.jpg" alt="" /></td> </tr> <tr> <td><a href="https://opedge.dev/3339" target="_blank" rel="noopener noreferrer">RunBare.com</a> cofounders Michael Sandler and Jessica Lee run barefoot on all types of terrain, including the coarse slickrock in Moab, Utah. <i>Photograph by Kennan Harvery.</i></td> </tr> </tbody> </table> In 2001, Michael Warburton, PhD, of Gateway Physiotherapy, Capalaba, Queensland, Australia, published a literature review in <i>SportScience</i> on the published data regarding barefoot running, with some literature directly comparing barefoot running to the use of running-specific shoes. His findings were startling: Running in shoes designed for runners appeared to increase the risk of plantar fasciitis, iliotibial-band syndrome, and other chronic injuries of the lower limb by modifying the transfer of ground-reaction forces. It appeared to increase the risk of ankle sprains, either by decreasing awareness of foot position or by increasing ankle torque. In one study, shoes that cost more than $90 racked up twice as many injuries as shoes that cost under $40. Shoes weren't completely dismissed, of course. Warburton noted that shoes are important for a variety of kinds of people and in a variety of circumstances, particularly for patients with lower-limb disorders. More recent studies now support Warburton's findings about the trouble with running shoes. A 2009 team led by D. Casey Kerrigan, MD, of JKM Technologies, Charlottesville, Virginia, found that on a laboratory treadmill, volunteers wearing running shoes experienced an average of 54 percent greater internal-rotation torque in the hips, 36 percent more knee-flexion torque, and 38 percent more knee-varus torque than volunteers running barefoot. A team led by Daniel Lieberman, PhD, of Harvard University, claimed in a January 2010 letter to <em>Nature</em>, "kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who forefoot strike generate smaller collision forces than shod rear-foot strikers." A team led by Caroline Divert of the Université de Valenciennes, France, writing in the June 2008 <i>International Journal of Sports Medicine</i>, claimed that shoes' weight can also affect runners. Her team found that for every 100 grams of weight on each foot (in the form of either shoes or ankle weights), runners lost one percent of metabolic efficiency. This means that for a 26-ounce pair of running shoes, runners would lose more than seven percent of their metabolic efficiency. <h4>Intelligent Feet</h4> These discouraging facts about shoes aside, it would likely still take a great deal of motivation for most runners to brave unshod the broken glass, pointy rocks, blistering blacktop, icy sidewalks, and chemical and biological excreta that their sneaks usually trot right over in the course of normal workouts. Why, then, does the Barefoot Running Club, run by Sandler and his fiancée, Jessica Lee, currently have more than 200 members? For many barefoot runners, the practice offers far more than injury prevention. Some, like Sandler, find it a pathway to internal and external healing. By the time he shattered his femur and hip, Sandler was already "Mr. Plantar Fasciitis," he says, and after the bones started to heal, he experienced a shifting set of lower-limb afflictions ranging from shin splints to what he suspected was Morton's Toe. He had almost a dozen pairs of custom foot orthotics, but pain plagued his every step. On a trail one day, he simply gave up on his ultra-controlled shoes, slid them off, and walked home barefoot. That night, he coincidentally came across research about barefoot running and decided to try it. "On that first day, after all my years as a professional athlete, I went a hundred yards," he says. "I iced for the next two days. On the third day, I went 200 yards, then I iced. Two days later, I went 300 yards. Every other day I made progress until three months later I was able to run a 10K faster than I'd been running in shoes, and <i>without any pain.</i>" The explanation for Sandler's recovery may lie in research by Steven E. Robbins, PhD, and Adel Hannah, PhD, who wrote in the June 1987 <em>Medicine and Science in Sports and Exercise</em> that during barefoot running, the sensory feedback from a nerve-rich layer of tissue in the foot called the glabrous epithelium might help runners rapidly adapt to changing conditions. The researchers blame the high injury rate among runners on "sensory insulation inherent in the modern running shoe." Though the running shoes of 2010 may have different composition and design than those of 1987, the sensory insulation they provide is similar. That lack of sensory insulation brings Sandler and Lee, whose self published book, <i>Barefoot Running</i>, is due for release in April, another benefit. "People ask, 'What about glass? What about pebbles?'" Sandler says. "You watch every crack and groove on the ground because if your heel hits something, you're going home. That brings you into the moment. You're in the now.... The whole world seems more marvelous, more spectacular." "It's also just joyful," Lee says. "People come to the club, take off their shoes in the grass, and get these big beaming smiles and say, 'I feel like a kid again.'" <h4>The Middle Way</h4> According to Lee, many runners who join the Barefoot Runner's Club are recovering physically from major biomechanical problems, and these people develop their barefoot skills the fastest. They tend to follow the three-month program that Sandler says is essential for rebuilding foot factors such as sensitivity, calluses, and muscle strength. Healthy athletes, on the other hand, tend to add far too much distance at the beginning, push themselves past pain into injury, then have to progress even more slowly as they recover. "Can the foot completely come back after a lifetime in shoes?" Sandler ponders. "We don't have the answer to that—so far, all those we've worked with who started slowly have succeeded, but we don't say that everyone can do it. And in this society, I doubt that everyone can, not because their feet can't do it but because it takes so much patience and time. That's where the challenge lies." Then he smiles. "Barefoot running is about one thing and one thing only: having fun. It makes us healthier and younger. So just go out and have fun." <i>Morgan Stanfield can be reached at <script language="javascript">linkEmail('morgan','opedge.com');</script></i>
