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Enhancing the Health of the Everyday Athlete – Efficient Barefoot Movement Stephen Gangemi, DC, DIBAK

Moving - Gait • Gait dysfunction  Health dysfunction • Kinesthetic sense: the relationship between the nervous system and the sensory feedback provided by each foot – 7,000+ nerve endings • Proprioception: sense of position, posture, equilibrium

What Disrupts Gait? • Health Problems: – Structural (current or past injuries, posture, excessive training – duration / intensity) – Nutritional (diet, hormonal stress) – Emotional

• Improper footwear • Orthotics – a brace that supports dysfunction

• Nothing worn on the foot can improve its function • A bare foot moves in the most efficient, natural, and healthy way (in a healthy individual)

Modern Footwear • Soft midsole

Elevated Heel

Line of falling weight moves forward with heels

Motion Control

Footwear Industry Claims • • • •

Run faster Jump higher Be stronger Exercise muscles not otherwise used with competitor’s shoes or while barefoot Yet there has never been any research to validate such claims

Injury Prevention? • None of which can be substantiated through any scientific study • Numerous studies on injury promotion: – Journal of Injury, Function & Rehabilitation, Dec 2009: Running shoes protect the feet at the expense of increased joint torques at the hip, knee, and ankle – British Journal of Sports Med 2010: Elevated heels and cushioned shoes relationship to injuries – Medicine & Science in Sports & Exercise 1991: Running shoes and diminished sensory feedback and injury increase – More: runblogger.com, naturalrunningcenter.com, philmaffetone.com

Barefoot or Shod? • Recently, there has been a significant move towards minimalist type shoes and barefoot walking and running

• Experienced, habitually barefoot runners will avoid landing on their heel. • The natural motion during barefoot running is to land with a midfoot, or even a somewhat forefoot strike.

• A heel strike (while running) most often results in a significant stress to the body, whereas a midfoot or forefoot strike does not • Most running shoes are developed to promote a heel strike, and therefore an unnatural running and gait cycle

Heel strike

Ideally the body’s center of mass should be over the foot for the lowest loading rate Midfoot/forefoot strike

Healthy Footwear • No arch support – the arch needs to flatten upon impact to dissipate shock • Arch supports support the arch, not the ends of the arch  a weak and dysfunctional foot

Low Stack & Drop • Stack Height 11mm heel

• Drop

• “Zero-Drop”

11-7=4mm drop

7mm forefoot

Shock • No Stability or Motion Control – natural pronation deflects shock • Tibialis Posterior plays an important role

Toe Box • No cramped toe box – so the toes can splay apart to soften landing

Widest at the toes

Cushioning? No! • Cushioning does not absorb shock – it tricks the body by sending false information to the brain – “Is this a soft surface or hard?”

The Harder the Surface the Softer the Landing

Nice Gait Kid!!

• The harder the ground the more the body will adjust with more knee flexion and pronation • Pavement is the easiest to walk/run on barefoot • Natural terrain is unpredictable

The Ideal Shoe? • Depends on the individual, • But generally: •Roomy forefoot (1/3-1/2” in front of big toe) •Close to the ground throughout (low to zero-drop and a low stack height) •Wide Toe Box •Flexible in all directions •Firm sole (not soft or “cushiony”)

Barefoot as much as possible, shoes when needed • Wear shoes that will not harm you during your daily activities and during exercise; this includes disrupting your gait • Notice that the word “benefit” was not used, as footwear is not meant for this reason • Footwear should only protect the feet from damage that may occur from the particular environment • There is a transition period into more barefoot walking and minimalist-type shoes as the weakened muscles, tendons, & ligaments regain their strength; transition as comfortably and as safely as you can

More on Barefoot, Minimalism, and Injury Prevention & Treatment

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