Enhancing the Health of the Everyday Athlete – Efficient

Barefoot MovementStephen 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

Midfoot/forefoot strike

Ideally the body’s center of mass should be over the foot for the lowest loading

rate

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

• Stack Height11mm heel 7mm forefoot

11-7=4mm drop• Drop

• “Zero-Drop”

Low Stack & Drop

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

www.sock-doc.com