Friday, February 26, 2010

The Barefoot Running Debate Isn't Really About Running

The subject of barefoot running has exploded into the public eye in the last year. It started in earnest with the widespread popularity of Christopher McDougall's book Born to Run, and most recently culminated in the results of a study by Dr. Daniel Lieberman. He scientifically showed that the forefoot strike when running barefoot is bio-mechanically efficient in avoiding injury creates less biomechanical impact force than a heel strike *.

A lot has been said about this topic. I have numerous friends with whom I've connected across the world who have chimed in on this "debate." We've all posted tweets, blog posts and articles with our take on the issue. Shoe company executives have even begun to share their thoughts.

On the "pro-shoe" sided of the issue, podiatrists, shoe companies and others claim that the forces and mechanics of running are too much for the bare foot. Even if they're not, they remind us that running barefoot has inherent risk of injury from stepping on rocks or other sharp objects.

On the "pro-barefoot" side of the issue, these runners claim less injury due to a forefoot strike. Many, including myself, have even accused the same podiatrists and shoe companies of promoting shod running primarily for financial gain. If we barefooters get hurt less and buy fewer shoes, that affects their bottom lines.

Justin Owings, owner of Vibram Fivefingers fan site, recently made a very good point about running in his recent blog post. It's an observation similar to what I've mentioned previously in this space. Justin writes (the bold emphases are his):

"The barefoot running debate is curious. It feels backwards. Most know Occam's Razor: the simplest answer tends to be the best one. What is the simplest answer when it comes to what human beings were meant to put on their feet in order to walk or run? Nothing. We are barefoot by default... Starting from the default human condition, the onus regarding the merits of shoes should be on the shoe companies. But of course it's not. It's the opposite."

In a way, I kind of feel like the two sides are a married couple in a knock-down, drag-out shouting match with each other that all began over who should do the dishes. Any married couple can tell you that those kinds of arguments are never really about the dishes, are they? Let's dig deeper.

I am a barefoot runner only because I first live a barefoot lifestyle. If the weather is at all decent -- and when I'm not injured -- you can find me barefoot around the house, at church, out shopping, attending family gatherings and sometimes even dining out. I live barefoot because it is the most comfortable way to have my feet and is actually quite sanitary and safe. It is just as normal for me to go barefoot as it is for most people to live without gloves on their hands.

I've dealt with criticism from people, sure. I've been asked by a few store managers to put on "shoes" if I wanted to continue on in their establishment. I haven't enjoyed that part of going barefoot. I've blogged here on numerous occasions about the difficulties I've faced from my lifestyle choice to go without shoes where many people wouldn't.

Back to the topic at hand, I began running because I wanted to be healthier. I wanted to do something to lose a little weight, be more fit and feel better. I found a wonderful community of runners online and have enjoyed sharing goodwill with them.

Running with "regular" sneakers was never an option. That would be like wanting to become a pianist and putting on gloves every time I sat down to play. The concept never fit because that's not who I am. I don't really think of myself as a "barefoot runner," just as piano players aren't "barehanded pianists." I'm just a runner.

When I look at it from that perspective, the barefoot running debate isn't about running. It's not even about money.

Think for a moment: When's the last time you heard of an exercise style stirring up so much controversy? Free weights versus machine weights? Sweatin' to the Oldies versus Tae Bo? In any case when exercise styles differed, I can't recall a time where athletes didn't just decide to do their own thing after trying different styles. You don't see a groundswell of people railing against weight machines. You didn't see Richard Simmons getting out there and telling people to avoid Billy Blanks' way of exercising. For some reason, though, barefoot versus shod running is SO polarizing! Why?

Barefoot running, like a barefoot lifestyle, strikes a nerve in our deepest core about feet and our perceptions of them. It makes us really step back and look at what role our feet could -- or more importantly should -- play in our lives. How do we move across the ground? How much sensation do we allow into our psyche? What dangers lie just below our feet? How much of ourselves do we expose to those around us? How much of others are we comfortable seeing?

When it comes to those last two questions, an interesting thing cropped up while I was writing this blog post. It had to do with a person that I follow on Twitter. Kate (@KateColberg) and a couple of other Twitter users decided to make Wednesday, Feb. 24, "Avatar Feet Day." They changed their Twitter profile images, a.k.a. avatars, to pictures of their feet. Fun, right? It was briefly...until she wrote to me, "I had no idea it was going to upset people." I told her that I wasn't offended by anything, and she replied, "Other people have commented that they hate feet & it grosses them out & please change my pic back." Wow.

I actually had a conversation with someone who objected to Kate's feet being prominently shown in her avatar (Because I'm not interested in calling anyone out or embarrassing them, let's call this person "Sam"). I asked Sam what issue they had with feet. They ended up repeating four times the same basic sentiment: "I just dont like feet. Plain and simple." That's pretty much as much detail as I got. Now, Sam may have specific reasons that they're not interested in disclosing as to why they have such a problem with others' feet, but nevertheless it's a sentiment that I have heard so many times.

For a part of that body that's not considered "private," -- after all, people go barefoot on TV shows, in magazines and on Web sites -- feet are arguably the most rejected of them all. You don't hear people say, "I just don't like ears. Plain and simple." They don't say that about hair, chins, shoulders, elbows, hands, knees or anything else. There's something about feet. And people's objections about feet aren't even that consistent. For example, someone may say that they "hate" feet, but are perfectly fine with going to the public pool where everybody is barefoot.

Only on rare occasions is going barefoot embraced. This usually happens
when somebody goes barefoot for charity, as if seeing someone withstand the torture of going without shoes makes people want to donate money. Weddings are sometimes performed on the beach or in soft grass so that the wedding party can go barefoot as a way of being in tune with nature. Other, isolated times of barefooting are briefly allowed. "How quaint," people think for each occasion. "Ahhhhh."

All right. Snap out of it.

Let's face it: In general, whether it's for the purpose of running, worshiping, shopping, play or even online avatars, the general idea of going barefoot is controversial in the U.S. and other parts of the world. Somewhere along the line shoes became the "norm." As Justin pointed out, our baseline isn't barefoot and then explain why shoes are needed. Shoes are expected and you'd better have a really good reason to take them off.

A lot of the arguments against going barefoot in any activity are the same. A prominent idea about feet is that they are sweaty and inherently smell. Some fear catching a disease from the ground/floor into the bottom of their feet. Many people claim that there are broken beer bottles and AIDS-laced syringes just lying around everywhere. The idea of lacking any arch support while going barefoot is troubling to lots of people. I've even had people tell me personally, "You know, it's not good for your back to go barefoot." The list goes on and on.

So the prominent stigmas against going barefoot carry over to running barefoot. It isn't about comparing a heel strike to a forefoot strike. It isn't about avoiding blisters or not losing toenails. It's not about any of the other perfectly good arguments for running unshod. I'd bet you that most runners who reject the idea of barefoot running could not care less about any of that. The decision is made based on the word "barefoot," not the word "running."

I have also personally heard someone reply -- on more than one occasion, actually -- after hearing all the benefits of barefoot running, "I'll stick to wearing my shoes." No pause for personal reflection on whether it could have benefit to them. No challenging of what they "know" about the capability or characteristics of the human feet. Just outright rejection. What's more, these same negative sentiments are reinforced by the podiatrists and shoe company executives who I mentioned earlier.

So where does all this leave us? With a lot of work to do.

We barefoot runners and general barefooters need find ways to better educate the public about feet. We need to become advocates of what, to many, has become a demonized part of the body. Most importantly, we need to do it together. Only then, maybe, will feet get the respect they deserve.

I'm up for the challenge and will soon be making a major announcement with regard to this. I'm very much looking forward to what lies ahead.

Please comment below. I would love to hear your feedback.

(* NOTE: Entry edited Monday, March 8, 2010, to clarify the results of Dr. Lieberman's study. See comments below.)

My Achilles Heel: Transitioning & Balancing

I went to the doctor today for a four-week followup in the wake of being diagnosed with a calcaneal contusion and stress fracture in my left foot. It was caused by poor training choices while preparing for a 5K race. It's been more than six weeks since I began feeling pain.

I didn't actually see my doctor. He was out of town to support a U.S. Men's Volleyball tournament in Denver. I saw his associate, a very nice gal who also specializes in sports medicine.

After getting caught up on my condition and how my ankle is feeling, she recommended that I begin water physical therapy. It will be for the purposes of building up my leg muscles again while my heel finishes its recovery. If my insurance won't pay for that, I'll do "regular" PT.

As far as weight bearing and using the boot, she feels I should be in the mode of "weight bearing as tolerated." That means that if it hurts to walk on it, don't. She didn't give me any hard and fast numbers of how many more weeks to stay off of it or wear the boot. I should gauge for myself what I think is best. She did mention, however, that she'd like to see me walking around some at home "in a shoe."

Pain is the real guide here. She doesn't want to order any images if it seems like pain is slowly going away; on the flip side I shouldn't do anything that causes a lot of pain. She did share that most of the pain I've felt likely came from the contusion in the heel and not necessarily the fracture itself. The fracture is likely healing, but the contusion will take a long time to fully go away.

Because of that and all the walking I do with my job, she feels that wearing more of a "walking shoe" or cushioned shoe at work from now on would be best. She understands my preference for minimal footwear, and I understand her points, so it may be that I'll wear the insoles that came with my Terra Plana VivoBarefoot shoes and maybe even an additional cushioned heel cup for a while. Split the difference, in other words.

So we'll play it, foot, and see what happens. I'm looking forward to PT, because that tells me I'm on my way back to an active lifestyle and running. I have another followup with my regular doctor again in two weeks. We'll see what happens between now and then. As always, I'll keep you posted.

I welcome your comments below. Have you ever dealt with a foot injury? I'd be interested to hear your experience in the comments section, too.

Friday, February 19, 2010

My Achilles Heel: Three-Week Update & Vitamin D Information

Here's a quick update on what's been going on with my barefooting lately. It's been non-existent. It's now been three weeks since I was officially diagnosed with a stress fracture and bone contusion in my left heel and just over five weeks since I started noticing pain. The injury occurred as a result of poor training decisions while preparing for a 5K race.

Since the diagnosis I've been faithfully wearing my soft cast boot about 23 hours per day -- the one hour being the time from when I wake up in the morning to when I put it on right before leaving for work. By restricting the motion of the foot and ankle, it's given my heel an opportunity to heal without the achilles tendon pulling on it. That was part of the issue that led to the stress fracture in the first place. The boot's not been a terrible thing. I've gotten used to my ankle and foot being immobilized and I even tweeted a while back that it no longer feels like the boot is on my leg, but instead a part of my leg. I have noticed some atrophy in my calf. Hopefully that won't take a long time to build back up after this is all said and done.

Because of the nature and location of the injury, I've also been non-weight-bearing for most of that three weeks. I have a job that requires a lot of walking, so I've been using a combination of crutches and a wheelchair (pictured) to get around. The wheelchair is used only at work for longer distances (like from building to building) and the crutches are for everywhere else, including shorter treks or spaces in which a wheelchair's not feasible. At first using these devices was a pain, literally. My arms HURT from using them. Now, my arms are much stronger and I come away from each workday simply tired. I'm also finding that I can eat darned near anything I want because I burn most of it off pushing or crutching myself around all day.

My heel doesn't generally hurt like it used to. A lot of that can be attributed to the fact that I have been non-weight-bearing most of the time and the boot is usually immobilizing my ankle joint. I do find that, by the time I'm finished getting ready in the morning, my heel does ache a bit. I hope that it's healing well and that the aching is from the bone contusion that went along with the stress fracture.

I have a follow-up with my doctor next Friday, Feb. 26. It may be that he'll determine that non-weight-bearing for four weeks is enough and I should stick with the boot. Maybe he'll clear me altogether and put me in PT. I kind of hope that's not the case, because I keep hearing that stress fractures of the heel take six to eight weeks to fully recover. I don't want to do anything to jeopardize my recovery and delay my return to running. I guess we'll have to see.

As a side note, but on somewhat related subject, I've begun taking Vitamin D supplements. I've been hearing a lot lately from work and Twitter friends about Vitamin D's relation to bone health. What I've found out is that most people are Vitamin D deficient and that such a deficit can cause bones to be weakened and more susceptible to stress fractures.

I've begun taking 4,000 IU of a Vitamin D3 supplement each day to help boost my levels and then plan on cutting back to about 2,000 IU a day as recommended by a well-known Vitamin D researcher named Michael Holick, PhD, MD (pictured). He recently presented a Grand Rounds on Vitamin D at my workplace and shared a lot of interesting information. To put it simply, he recommends that EVERY adult take a 1,000-2,000 IU supplement of Vitamin D every day to offset the amounts we no longer get from regular sun exposure. More information is available at his Web site,

So I'll be non-weight-bearing with the cast boot for another week. I'm hanging in there with only a little pain, but I'm doing what I can to make sure this never happens again by taking a Vitamin D supplement. We'll see what happens.

I welcome your comments below. Also, if you haven't found me on Twitter, I'm a regular user there at the username "BarefootMichael." Come say hi! FYI, my last few "tweets" are always listed in the right panel of this blog.

Friday, February 12, 2010

Why A Women's Running Shoe for 'That Time of the Month' Makes Sense...and Why You Still Shouldn't Buy It

An online friend of mine (thanks, @bareminimalist) today posted to Facebook information about a new running shoe made by Asics. They're called the Gel-Kayano 16 (pictured). The special thing about these shoes is that they're designed to adjust to a woman's changing arches during her menstrual period.

According to the original article in The Mail Online, "When oestrogen is high, and a woman is at her most fertile, the arch drops. Later in the month, when she is menstruating, levels of the hormone are low but her arch is raised." The Gel-Kayano 16 has three layers of material in the arch that automatically adjust to this bio-mechanical change, theoretically providing the perfect amount of arch support as needed.

At first, I approached the announcement of these shoes from an incredibly cynical point of view. If it's not springs in the soles or thick, rounded soles for a more "barefoot" gait (see previous blog post), it's some other "gimmick" to make a buck. I was about to repost to Facebook the above-linked story. I was going to say how ridiculous it was to have a shoe that adjusts to your foot when your foot adjusts to itself already and -- wait a tick.

If you subscribe to the idea that our feet need shoes for running, these shoes are quite brilliant! High arch? The shoe knows. Low arch? The shoe adjusts. That's actually really cool and a great feature that lots of other shoes should have built in.

Everyone from doctors to running magazines give the advice that each runner needs to have the right shoe for their individual feet. Not all feet are made the same, so not all shoes should be made the same. Shoes can vary in arch support, cushioning, width and any number of other aspects. That's why there's so many different kinds of running shoes when you look up at the wall of your local sporting goods store or shoe retailer. Shoe companies say that they make different kinds of shoes to get the right fit for each person's bio-mechanics. This shoe might truly be the best one out there.

But there's a catch.

It's still a shoe.

With barefoot running there's no product to buy to adapt to your foot. Your foot just does its thing. If you want some kind of protection on your feet, wear something like Vibram Fivefingers or Terra Plana's VivoBarefoot shoes that have no kind of arch support and, inherently, let your foot be a foot.

You might say, "But Michael, isn't running without arch support bad?" Not if you properly train your foot to be strong and support its own arch.

Our feet are capable of amazing things if we let them be feet. Closing them up inside a shoe, no matter how adaptive to our foot they may be, is not the best option for most people. Sure, a shoe that adapts to our foot may prevent injury to some extent, but encourages weakness in structures of our body that are meant to be strong.

Barefoot running is generally best. Period.

(pun intended)

I welcome your comments below.

Shoe store image: Walker's Clothing and Shoes
Running in Vibram Fivefingers image: Photography on the Run
(The above recommendations for minimalist footwear are based solely on the author's use and personal endorsement of the products mentioned. Barefoot Michael has received no sponsorship or monetary compensation from said companies.)

Monday, February 8, 2010

When It Comes to Shoes, More is Less

I have watched as shoe companies have done everything they can to produce footwear that is intended to improve our ways of life. Years ago I remember when a new style of walking shoes came out that had little air bubbles in the soles. As you stepped, the air bubble would cushion your feet and then move through a channel to the front of your foot as you rolled off your forefoot. The idea was to provide more cushion to the walker, relieving pain and soreness that so many other shoes left in their wakes.

Those shoes still exist today, but more recently companies like MBT, Z-coil and Gravity Defyer have released footwear that adds even more cushioning to the sole in an attempt to remove as much shock to the body as possible while toning muscles and fixing what ails you. MBT, which stands for Masai Barefoot Technology, even calls themselves the "anti-shoe," claiming improvements in posture and muscle development while providing a more barefoot stride.

It has always baffled me that they claim that they provide an experience akin to walking barefoot. How could a shoe that has a thicker sole provide a more barefoot experience? The whole notion seems inherently counter-intuitive. Heck, people don't say that a walking shoe for a plaster cast is more barefoot, yet that is what MBTs remind me of.
Which one is for a broken leg and which one helps you walk more "barefoot?"

I have three issues with any manufacturer that claims that their shoes fix a problem with the body: First, any research I've seen has been based on comparisons of their products to regular shoes, not to bare feet. The new-fangled footwear is compared to a "baseline" running or walking shoe, which is all well and good except for the fact that each person's foot will react differently to any given shoe than someone else's foot would. Second, all of these shoes are designed, manufactured and marketed based on the same faulty premise that they will fix a problem when they really don't. All they actually do is compensate for it. Big difference. Third and finally, you never hear about how these shoes help the feet. All of their claims talk about improving the legs, hips and/or back. Why do the health of one's feet, the very base of our ambulation, get left out?

Research is a funny animal. The outcomes of your study can be forced in certain directions simply by how you set up the parameters. And let's face it. Shoe companies are in the business of selling shoes. They're going to make sure that whatever research they promote is going to support their claims about their product.

I believe that society's thinking about shoes is approached from the wrong direction. So many people from "experts" to lay people believe that footwear needs to be additive instead of subtractive. Additive thinking assumes that shoes are necessary and that adding features to a particular set of shoes will work to cure an ailment of the body. Subtractive thinking instead presupposes that removing footwear and letting the body act on its own accord is the better approach.

For example, when a runner has an issue with foot, ankle or knee pain, the typical course of action is to analyze how to adjust their shoes in order to fix what was wrong with the combination of the feet in the shoes. By adding an orthotic, arch support, cushioning or other feature, the shoe can be adapted to work better with the runner's physiology. The expected outcome is to counteract whatever dynamics about the feet within the shoes were causing injury.

But what if removing features of the shoe -- or the shoe altogether -- and letting the body's physiology work for itself is the best course of action? Instead of locking the foot in a rigid shoe and making the orthotic, legs and hips do most of the work, you could unlock the feet and allow them to do what they were born to do?

What if, instead of creating a shoe that has springs in the heels to counteract the forces of heel strikes, you work to strengthen the person's own muscles and encourage them to walk with a less forceful foot fall? Instead of a heel strike with every step, the foot is encouraged to flex and use its 26 joints, the ankle and knees to naturally cushion each step via a mid or forefoot strike?

The idea is to literally start from the ground up, something this entire blog is based upon. I believe that most people would do just fine going barefoot most of the time and in most places. They just need to give their own feet a chance. I'll admit that sometimes, even after some strengthening and time, someone may find that an orthotic is necessary due to complications from an injury or other problem. In those cases, why not try a minimalist shoe with whatever simple orthotic is required? Add only what is needed and otherwise let a foot be a foot.

Could it be that our feet would be healthier by subtracting footwear, giving our feet a chance and adding only the most necessary of "support," if needed? I welcome your comments below.

(Please Note: I realize that going barefoot is not a good option for people with conditions such as diabetes that hinder the body's ability to heal and/or fight infection. Anyone with conditions that leave them immuno-suppressed should consult their doctor first before trying a more barefoot lifestyle.)

Juggling Numbers Image: The IP-Kat
Feet Image: The Hub Pages

Friday, February 5, 2010

My Achilles Heel: The First Stressful Week

I thought I'd post a brief update about how things have shaken out regarding the stress fracture in my left heel.
I'll be honest, it's been confusing. My doctor originally said I should wear a cast boot (similar to the one pictured below) and my heel would heal in about four weeks. He said I could still walk on it but try to reduce how much walking I do each day. So for a couple of days following my diagnosis I wore a boot and walked on my heel like normal. This ended up causing continued pain in my heel due the cumulative effect of pressure on my foot.

With further research, I found that his recommendations seemed quite liberal compared to how many other doctors treat stress fractures. A standard treatment for an ailment like mine has usually been a cast boot and no weight bearing for at least a few weeks, with the total treatment time being six to eight weeks. Some outlets have even said that just walking on a stress fracture can cause more damage up to and including the need for surgery.

So I had a number of concerns.

First, it seemed like walking on a painful heel was a bad idea. It wasn't so much a problem for very short periods or distances (i.e. from one room to the other), but being on my feet for any length of time was painful. So I questioned my doc again whether I should even be bearing weight on my foot.

Second, walking with pain was compounded by the fact that my job is tied to walking a lot. Just to give you an idea, wearing a pedometer last year showed that I walk an average of 11,000 steps a day at work. That ends up being a little more than 5 miles each and every work day or a near-marathon length 26 miles a week. What's more, all that walking ends up being long distances in chunks spanning almost 1/4 mile one way to get from my office to another location in my workplace. I asked the doc if there was any way to help with getting from place to place during the day.

My doctor decided that I probably should be non-weight bearing if my heel continues hurting. As for how to get around, he said crutches or a wheelchair would work. I asked if an electric mobility scooter could be a viable option. He agreed it would but thought it would be cost prohibitive.

I have researched the possibility of getting a mobility scooter but have run into some bumps along the road. It seems as though insurance won't cover the rental of such things. My insurance also wouldn't pay for purchasing one as my condition is not a life-long or long-term disability. So it seems like the only options I have left are to either use some of the funds we've set aside in our Flexible Spending Account (you know, that "cafeteria plan" you can put tax-free money into at work to pay for medical expenses) or pay out of pocket. The FSA would be a good option, but we've already designated those funds to pay for outstanding bills from our baby's birth in August and other expenses. Paying out of pocket isn't a very good option because we don't really have money available to do that.

So right now I'm using a combination of crutches and a manual wheelchair (pictured), both which have been borrowed from friends who have no immediate need for them. They work out okay, but traversing the long distances has proven exhausting.

So my arms are tired and, quite honestly, my spirit is too.

It's bad enough not being able to go barefoot AT ALL for a couple of months (though I cheat at bedtime and when I shower each morning), but to have such limited mobility when my job is so reliant on me walking around? That really sucks, I won't lie.

But, I know I'll come out of this stronger and better for it. I already have a new appreciation for those that must always use crutches or wheelchairs. Maybe, just maybe, I'll also get some pretty hearty biceps, too?

I guess tickets to the gun show go on sale in six to eight weeks.

I welcome your comments below.

Tuesday, February 2, 2010

Q&A: Return to Running

When is your next run? - Submitted by Anonymous

Thanks for your question!

At this point it's hard to say when I'll return to running. Though my doctor wants a follow-up at four weeks, it could be a total of six to eight before I'm back out there. That could mean that I don't start running again until April. After that, it could take a while to recondition my legs to the point that I'd be ready to run an organized race.

As of right now I'm tentatively planning for my first race back to be the Hospital Hill 5K here in Kansas City on June 5, 2010. That should give me plenty of time to recover from the stress fracture and recondition for the race. Let's all cross our fingers.

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