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Tuesday, March 16, 2021

The Risks and Benefits of Running Barefoot or in Minimalist Shoes

 

RunningResearch :Nine formal systematic reviews of the evidence have so far been published looking at the evidence on barefoot or minimalist running having systematic benefits or not. Every single one of them concluded the same thing (reviewed here and here and here). Despite those conclusions, all by people from different backgrounds and published in a variety of different journals, you still see claims that the evidence is that there are systematic benefits. I can’t figure that out. Now we have yet another systematic review of the evidence:

The Risks and Benefits of Running Barefoot or in Minimalist Shoes; A Systematic Review
Kyle P. Perkins, William J. Hanney, PhD, PT, DPT, ATC and Carey E. Rothschild, PT, DPT, OCS, SCS, CSCS
Sports Health: A Multidisciplinary Approach November/December 2014 vol. 6 no. 6 475-480
Context: The popularity of running barefoot or in minimalist shoes has recently increased because of claims of injury prevention, enhanced running efficiency, and improved performance compared with running in shoes. Potential risks and benefits of running barefoot or in minimalist shoes have yet to be clearly defined.
Objective: To determine the methodological quality and level of evidence pertaining to the risks and benefits of running barefoot or in minimalist shoes.
Data Sources: In September 2013, a comprehensive search of the Ovid MEDLINE, SPORTDiscus, and CINAHL databases was performed by 2 independent reviewers.
Study Selection: Included articles were obtained from peer-reviewed journals in the English language with no limit for year of publication. Final inclusion criteria required at least 1 of the following outcome variables: pain, injury rate, running economy, joint forces, running velocity, electromyography, muscle performance, or edema.
Study Design: Systematic review.
Level of Evidence: Level 3.
Data Extraction: Two reviewers appraised each article using the Downs and Black checklist and appraised each for level of evidence.
Results: Twenty-three articles met the criteria for this review. Of 27 possible points on the Downs and Black checklist, articles scored between 13 and 19 points, indicating a range of evidence from very limited to moderate. Moderate evidence supports the following biomechanical differences when running barefoot versus in shoes: overall less maximum vertical ground reaction forces, less extension moment and power absorption at the knee, less foot and ankle dorsiflexion at ground contact, less ground contact time, shorter stride length, increased stride frequency, and increased knee flexion at ground contact.
Conclusion: Because of lack of high-quality evidence, no definitive conclusions can be drawn regarding specific risks or benefits to running barefoot, shod, or in minimalist shoes.

Like all the other reviews, they concluded the same thing: there is no evidence for the claimed benefits!

They did find some strength of evidence that for this

overall less maximum vertical ground reaction forces, less extension moment and power absorption at the knee, less foot and ankle dorsiflexion at ground contact, less ground contact time, shorter stride length, increased stride frequency, and increased knee flexion at ground contact

Which is evidence that barefoot/minimalism is different to shod. None of that says its better, it just says its different. For some runners that may help and for other runners that may hurt – ie its subject specific.

As always, I go where the evidence takes me until convinced otherwise….and this is what ALL the evidence is saying … nuff said.

Perkins, K., Hanney, W., & Rothschild, C. (2014). The Risks and Benefits of Running Barefoot or in Minimalist Shoes: A Systematic Review Sports Health: A Multidisciplinary Approach DOI: 10.1177/1941738114546846

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