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Running Injuries: Shod vs Barefoot Runners

Article: Prospective comparison of running injuries between shod and barefoot runners (Altman ER, et al., Br J Sports Med doi:10.1136/bjsports-2014-094482)

Written by : Geneviève Rochette Gratton , MD, CCFP, Fellow in Sport & Exercise Medicine at University of Ottawa

Advisor: Dr. Taryn Taylor, BKIN, MSC, MD, CCFP (SEM), Dip Sport & Exercise Medicine


There is a lot of controversy surrounding barefoot running. For one thing, it can be associated with an increase incident of injury when the progressive transition from shod to barefoot running is not done adequately. The prospective study by Altman and Davis looks at the incidence and rate of injuries between the two forms of running in the long term, once the transition has been correctly made.

One major finding between the two types of running is that barefoot is associated with forefoot strike, compared to rearfoot strike with shod running which could influence the nature of the injuries seen in both.  Forefoot strike is accompanied by shorter stride length and lower hip abduction. Moreover, it decreases the vertical load. Barefoot running provides more sensory input which may not only be protective for metatarsal overloading, but increases ankle joint position sense and arch musculature.

As to be expected, more plantar surface injuries (cuts, bruises and blisters) were observe with barefoot running. This could be alleviated by wearing minimal footwear, still maintaining the benefit from barefoot running.

Overall, the study showed fewer injuries but also less mileage with the barefoot runners. The injury rate, when normalized to mileage, was similar in both groups. While the frequency of foot injuries (metatarsal stress fractures/syndromes etc…) was similar in both running styles, injuries to other body parts seemed to be lower with barefoot running.  This was particularly true at the hip, knee and ankle joints. These results are encouraging with respect to the future of barefoot running.

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