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Whoa there! A quick switch to 'barefoot' shoes can be bad to the bone

Researchers say transition should be done slowly to avoid injury

For the growing number of runners who are considering trying "barefoot" five-finger running shoes, researchers at BYU have a message for you: Take it slow!

A new study from a team of exercise science professors found that runners who transition too quickly to minimalist shoes suffer an increased risk of injury to bones in the foot, including possible stress fractures.

With minimalist shoes now making up 15 percent of the $6.5 billion running shoe market, the findings are nothing to run from.

“Transitioning to minimalist shoes is definitely stressful to the bones,” said Sarah Ridge, study lead author and assistant professor of exercise science at BYU. “You have to be careful in how you transition and most people don’t think about that; they just want to put the shoes on and go.”

The research, appearing online ahead of print in the journal Medicine & Science in Sports & Exercise, studied 36 experienced runners over a 10-week period.

Each runner first underwent MRIs on their feet prior to the study period. Half of the runners were then asked to gradually transition into five-finger minimalist shoes while the other half continued to run in traditional running shoes.

Subjects in the experimental group followed an industry suggested protocol. They did one short (1-2 mile) run in the minimalist shoes the first week, and added an additional short run each week so that they ran at least 3 miles in the new shoes by week three. They were then told to add mileage in the minimal shoes as they felt comfortable, with the goal of replacing one short run per week in traditional shoes with the new shoes.

At the end of the 10-week period, MRIs were again conducted. The MRIs revealed that those who had transitioned to the minimalist shoes suffered greater increases in bone marrow edema (inflammation causing excessive fluid in the bone) and more stress injuries than those in traditional shoes.

“Whenever a bone is impacted by running (or some other repetitive action), it goes through a normal remodeling process to get stronger,” Ridge said. “Injury occurs when the impact is coming too quickly or too powerfully, and the bone doesn’t have a chance to properly remodel before impact reoccurs.”

Interestingly, the study found the majority of those who suffered stress injuries were women.

Ridge and her coauthors, which include BYU exercise science faculty Wayne Johnson, Ulrike Mitchell and Iain Hunter, said the study does not mean minimalist shoes are bad.

Rather, to minimize the risk of injuries, runners should transition over a longer duration than 10 weeks and at a lower intensity (miles per week).

“People need to remember they’ve grown up their whole life wearing a certain type of running shoes and they need to give their muscles and bones time to make the change,” Johnson said. “If you want to wear minimalist shoes, make sure you transition slowly.”

This is the first of many studies looking at minimalist running shoes, the authors said. Over the next several months they plan to publish enough research to begin to establish clear recommendations for anyone considering making the switch.

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Nice Study
  2/19/2014 4:49 PM by Raul

I've been using Vibram minimalistic shoes for 4 years and yes at the beginning there was some injury, but now I would not run in anything else. Once your calves, ankles, and feet get used to forefoot striking (which does take a few months with good breaks to let your legs heal) they do help with transferring shock that's normally placed on your knees, causing quicker deterioration/injury, to your feet and calves, where nature intended it to go. Wolff's law will take place over time, your bones and tendons in your feet will get stronger and will no longer be much of a problem as far as injury goes. It's all in making the transition and would be happy to offer myself as subject if there is any further testing as a control for someone who has been running minimalistic for a while now.

Congratulations!
  12/27/2013 6:51 PM by Barbara

Sarah - so proud of you getting this recognition! Fantastic!

Barbara

Response to Ross
  3/14/2013 11:42 PM by Steven

In my experience, even one to two miles is too much for a first time barefooter. It may be "industry suggested protocol," but you're far better off listening to your body than following a "one-size-fits-all" regimen.

Just a fad?
  3/11/2013 12:58 AM by Jacob

I've been running competitively since I was in 7th grade, and I've competed as high as the collegiate level in Cross Country. 100% of my coaches and trainers have told me to avoid minimalist running shoes as it will only lead to injury. I agree with what Richard said about minding our surface. Our bodies were made to run on softer surfaces than we will typically run on. If you can find a marathon or even a 5k which is all grass dirt or sand, I'm sure minimalist shoes or even running barefoot would be acceptable with the right training. However, it seems to me that the longer the distance the more concrete or asphalt you're going to be exposed to.

Full Transition?
  3/8/2013 1:16 PM by Jay

Although I've never tried the minimalist running shoes yet, as a marathon runner, they intrigue me. I've run barefoot on occasion (carefully) to work on my form.

I'd like to point out my opinion that few, if any runners should make a "full" transition to these shoes. If they want to do it, this article is a very helpful caution to them, but please, this is not an everyday shoe for the average joe!

Other research
  3/8/2013 12:24 PM by Trevor

Yes, the experiment was sound since the article is aimed at those who are thinking of switching and are in the same boat as the test subjects.

I would be interested to know how these shoes impact you knee meniscus pad. Long term studies for how it will effect you in 10 or even 20 years would also be nice.

Consider your surface
  3/8/2013 9:42 AM by Richard

I strongly agree with the minimalist concept. However, after a year of trying to make the transition I have found that the surfaces I run on are not conducive to the lack of padding on the soles of most minimalist running shoes. I prefer a zero slope running shoe that has reasonable cushioning to compensate for the lack of sand, dirt, and grass we were born to run on.

Appreciate the research
  3/7/2013 8:11 PM by Lowell

I converted to minimalist running shoes back in 2010. My first few months were not very pleasant, as I didn't take it slow enough to adjust the multiple bones and muscles in my feet that hadn't been used for years.

Three years later, I can never consider going back to a normal shoe. Minimalist running has changed my entire approach to exercise. I love it.

Response to Steven...
  3/7/2013 9:45 AM by Ross

not exactly...

Subjects in the experimental group followed an industry suggested protocol. They did one short (1-2 mile) run in the minimalist shoes the first week, and added an additional short run each week so that they ran at least 3 miles in the new shoes by week three.


  3/6/2013 6:56 PM by Steven

So they threw a bunch of runners into minimalist shoes who were not accustomed to them, then are shocked when they get high levels of injury. Hmm.


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Exercise science professor Sarah Ridge led the study on the effect of transitioning quickly to minimalist shoes.

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Minimalist five-finger running shoes, subject of a new BYU exercise science study.

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A runner demonstrates using five-finger minimalist running shoes.
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