Categories: Training
Tags: Running
Emmi Aguillard

In the spotlight

Emmi Aguillard

Emmi Aguillard is a physical therapist at Finish Line Physical Therapy in New York City. She graduated from Tulane University, where she competed all four years for the Women’s NCAA D1 Track & Field and Cross-Country programs, and went on to earn her Doctorate of Physical Therapy from Columbia University.

She currently trains with the Dashing Whippets Running Team, and is a Nike+ Run Club pacer.

The whys and why nots of barefoot running

May 31, 2018

Around a decade ago, something weird started happening in the running world: Runners started ditching their beloved Brooks and awesome Asics in favor of running without any shoes at all.

Research at the time – not to mention the popular book Born to Run – showed that running barefoot could, in fact, make you a better, stronger athlete.

Minimalist running is beloved by some, but it isn’t for everyone.

Soon, racers were lining up at start lines across the world in Vibram FiveFinger shoes or, for the very bold, in nothing at all. The barefoot boom has since slowed considerably, but many athletes are still going shoeless, and are fascinated with the natural running trend. Minimalist running is beloved by some, but it isn’t for everyone.

Here’s what Finish Line Physical Therapy’s Emmi Aguillard, PT, DPT, FAFS, says running sans shoes – and whether it’s something you should consider.

Do you still see many barefoot runners these days?

Not so many, but we definitely still get a steady trickle of them. I’d say around 10 percent of my patients favor a more minimalist running style.”

Why do you think people run barefoot? What are the biomechnical advantages?

“From an evolutionary perspective, it makes sense. Human beings were designed for endurance sports like running, and we definitely haven’t had a modern-day running shoe throughout history.

Wearing an overly-cushioned or supportive running shoe can ultimately weaken the intrinsic muscles of the foot.

Biomechanically, the foot is designed to handle the stress of running for prolonged periods without support. Sometimes, when a runner is wearing an overly-cushioned or supportive running shoe, it can actually limit the ability of the foot to pronate and supinate the way that it should, ultimately weakening the intrinsic muscles of the foot.

It can also cause a runner to over-stride or overly heel strike. This leads to decreased efficiency, increased ground reaction force – or impact – being absorbed with each step, and increased risk of injury.”

What are the pros and cons of running barefoot?

“The pros are decreased torque on the hip and knee, shorter step length – especially if you over-stride – increased mid-to-forefoot strike if you’re landing too hard on your heel, and decreased impact peak on landing. Natural running is a good option if you’re prone to shin splints, knee pain, or bone-related or stress-related injuries.

The major con is the increased torque on the foot and ankle. Minimalist running probably isn’t for you if you’re prone to plantar fasciitis, Achilles tendinitis, or calf strains.”

What type of treatment do barefoot runners require versus those who run in shoes?

“We don’t see many true barefoot runners in New York City – understandably so. What I do see are runners who favor a more minimalist shoe versus a traditional running sneaker.

Oftentimes, these runners are in rehab for foot, ankle, or Achilles tendon injuries ranging from neuromas to Achilles tendinitis, although other times there can be issues up the chain, like IT-band syndrome. Sometimes the injuries are totally independent of the footwear and stem from improper training, compensations from a sedentary lifestyle at work, or other biomechnical issues.

If the issue does stem from the footwear – or lack thereof – oftentimes part of the treatment is coaxing the runner to try a more traditional shoe, at least for a certain length of time, to give the body a chance to heal itself. Barefoot runners are stubborn! One of the hardest things to do is convincing them to change this.

Repetitive running on concrete or sidewalk is bad for nearly every runner, barefoot or not.

Other times, it’s simply about educating the runner on the importance of soft-surface training, and avoiding concrete and sidewalks in favor of asphalt, a track, or trails and dirt paths. Repetitive running on concrete or sidewalk is bad for nearly every runner, barefoot or not.

Practicing good soft-tissue hygiene in regards to stretching, foam rolling, and other methods of self-myofascial release is crucial.

Another component is teaching them proper maintenance for their calves, Achilles, and plantar. Because the load of this region is greater, proper recovery between runs is key. Practicing good soft-tissue hygiene in regards to stretching, foam rolling, and other methods of self-myofascial release is crucial.”

How exactly does the body react differently to the pavement pounding when you’re barefoot vs. when you’re running in shoes?

“Even though barefoot running does decrease the impact peak on landing, with pavement running it can simply be too much impact for the human body alone to handle, especially for someone who’s newer to running and hasn’t had the years under their belt to increase the tissue strength or bone density of the lower leg complex.

I’ve seen patients develop neuromas in their feet, stress fractures, calf strains, and knee pain due to too many miles spent pounding on the pavement without enough shock absorption from their shoes.”

Do different muscles need to fire and engage in order to offer the support you’re not getting from shoes?

“Yes! Running in minimalist shoes or no shoes at all increases the workload of the calf and Achilles tendon, as well as the muscles within the foot itself. That’s why it’s so important that, if you’re thinking about trying out barefoot running, you follow a proper training plan to help your body adapt.

The issue I see the most is people who have spent their whole lives in shoes, decide to try minimalist running. That’s three years of sleepy foot intrinsic muscles that are suddenly on fire!”

OK so ultimately, what’s your expert take on barefoot running?

“In a perfect world, it does make sense. I’ve read Born to Run, I’ve experimented with it myself, and I can definitely understand the perks of it.

What I tell my patients is that if we were still living like our ancestors did, or running on soft trains in Kenya or Central America, it has more of a place. But just as we’ve adapted over the years to create our modern society, so do we need modern shoes.

For life in most urban areas with the stress that concrete puts on our bodies, barefoot running is simply not sustainable on a regular basis.

For life in New York City or most urban areas, plus the stress that concrete puts on our bodies, barefoot running is simply not sustainable on a regular basis.

That said, I am a fan of the shift from minimalist to quasi-minimalist shoes.

That said, I am a fan of the shift from minimalist shoes to quasi-minimalist brands like Altra, creating shoes with a low- or zero-drop and a wider toe box to mimic barefoot running, but with that extra cushion and some support to help the body better react to hitting the pavement over and over again.

At the end of the day, every single body is different, as are every individual’s biomechanics. There truly is no one-size-fits-all approach to sneakers or footwear. Research actually supports that the shoe that feels the best on your foot is the one that has been correlated with the lowest risk of injury – and sometimes the problems have nothing to do with the shoe at all.

Barefoot running can have a huge benefit in a training cycle – it’s just important to approach it in moderation and when appropriate.”