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Evidence-Based

It is our philosophy at the SNRC that you will have the best chance of running injury-free if you run as designed. We base our approach on evidence, including our 25 years of research focused on the relationships between lower extremity structure, mechanics and injuries in runners.  The ongoing research at the SNRC laboratory, and that of others, continues to inform our clinical practice.

Shod Running

It has been suggested that running is innate, as it was a means of survival (Bramble and Lieberman, 2004). We enter this world without shoes and are provided everything we needed in our feet to withstand the forces of running. The earliest reported shoes were designed with a flat footbed and straps to hold it on the foot, and were simply to protect the soles of our feet (Stewart, 1972).  The modern running shoe has evolved as an assistive device to support, cushion and restrict our feet from their natural movement pattern.

When individuals run in modern running shoes, 75% land on their heels in a rearfoot strike pattern (RFS), 24% land with a flat foot in a midfoot strike pattern (MFS) and 1% land on the ball of their foot in a forefoot strike pattern (FFS) (Hasegawa et al, 2007).  These patterns are associated with very different mechanics.

Barefoot Running

When individuals run without shoes, they do not land on their heels….because it hurts.  This provides a compelling argument that we were not designed to land this way, especially if running were necessary for our survival.  Barefoot runners typically land on the outside of their forefoot, the foot rolls inward and the heel gently lowers, and then raises again for push-off.  As a result of the lack of heelstrike, barefoot runners do not experience the impacts that the majority of shod runners do, Since this impact has been associated with injury, eliminating it may reduce injury risk.  Further research is needed to confirm this.

There are other advantages to running with less shoe.  It has been shown that the less you place between the foot and the ground, the greater your dynamic stability (Rose et al, 2011).  The more cushioning between your foot and the ground, the harder you land (McNitt-Gray et al, 2004; Ferris et al, 1998; Ferris et al, 1999; Bishop et al, 2007).  The harder you land, the greater the impacts you experience.  Finally, research has suggested that removing the supportive nature of modern running shoes results in strengthening of foot and ankle musculature.  Stronger feet are likely to be healthier feet!



While we feel barefoot provides you with the most sensory information, running with less shoe does not have to mean running barefoot.  Clearly, there are times we need to protect our feet.  Fortunately, there are many choices of minimal footwear that allow the foot to function naturally, but protect our soles.  Interestingly, these shoes are very much like the shoes of the marathoners of the 60s and 70s such as Bill Rodgers and Frank Shorter.

Transitioning

Transitioning to less footwear and a different strike pattern takes time.  We will provide you guidance in this process, along with instruction in strengthening of the muscles necessary for the transition.  If your feet have been supported all of your life, they will need time to adapt.  As long as you have an intact neuromuscular system, and your muscles have the ability to strengthen, you should be able to adapt.  If you desire to wean off of your foot orthotics, and we feel it is appropriate, we will assist you with this process as well.

Gait Retraining

Our research has revealed that many gait related injuries are related to faulty mechanics and that these faulty mechanics can be changed through a process of relearning new motor patterns (ISDavis_CV.pdf).  Unless the underlying mechanics related to injury are addressed, the risk for reinjury is increased.  We have led the way in the area of gait retraining to reduce running (and walking) related injuries and will assist you on your quest for injury-free running.

Shod Running Videos

Barefoot Running Videos

PRE

POST

Rearfoot Strike

Forefoot Strike

Shoes of Ron Hill, winner of the 1960 Boston Marathon.

Landing with a RFS pattern results in a very distinct impact peak that is associated with high rates of loading to the lower extremity.  That impact peak is significantly attenuated or eliminated when landing with a MFS or FFS pattern (Lieberman et al, 2010, Williams et al, 2000.  This impact transient has been associated with a variety of running related injuries (Zadpoor et al, 2010; Milner et al, 2006; Pohl et al, 2009; Davis et al, 2010).

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