troy m. smurawa, m.d., faap akron childrens hospital sports medicine center barefoot running: is it...

Troy M. Smurawa, M.D., Troy M. Smurawa, M.D., FAAPFAAPAkron Children’s Hospital Akron Children’s Hospital Sports Medicine CenterSports Medicine Center

BAREFOOT RUNNING:BAREFOOT RUNNING:IS IT FOR EVERYONE?IS IT FOR EVERYONE?

Running GaitRunning Gait

Three Types of Gaits:

o Walking Gaito Running Gaito Sprinting Gait

Walking GaitWalking Gait

Phase I: Heel-Strike

Phase II: Mid-Stance

Phase III: Toe-Off

Insert fig. 4-3


Phase I: Heel-Strike

• Extended leg and foot are in front of the body mass– Creates a braking and adapting effect before the next phase

• The foot is a loose adapter– The ankle acts as a great adapter to all terrain– The ankle can either pronate or supinate to adapt to the

changing surface



• Upper body is centered over the midfoot and balanced with gravity

• The foot is stable and locked ready for the toe-off phase


Phase III: Toe-Off

• The foot is in a levering and propulsive position• The upper body mass is forward of the toeing-off foot• The body is moving forward


• A process of braking, adapting, locking, levering and propelling

• Very efficient gait with little impact forces• The legs and hips lever the body very efficiently• The foot is in contact with the ground for a long time with

a large surface area contact• Braking muscles and propulsive muscles are isolated• With walking speeds impact forces are minimal


Phase I: Midfoot/Forefoot-Strike


Phase III: Toe-Off

Insert fig. 4-4


Phase I: Midfoot/Forefoot-Strike• land on midfoot/forefoot • The ball of the foot first touches lightly to sense the

surface• The foot settles down to touch the ground lightly

Insert fig. 4-4


Phase II: Mid-Stance• foot becomes parallel to the ground surface• settling of the heels initiates elastic recoil• upper body moves forward over center of mass

Insert fig. 4-4


Phase III: Toe-Off• foot starts to lever• a simple lift of foot off the ground occurs

Insert fig. 4-4

Sprinting GaitSprinting Gait

Phase I: Forefoot-Strike• land on forefoot • The ball of the foot first touches lightly to sense

the surface


Phase II: Mid-Stance• foot stays up on forefoot• elastic recoil starts without the heels setting on ground• upper body remains over and slightly forward of center of

mass


Phase III: Toe-Off• foot immediately starts to lever• a toe-lift of foot off the ground occurs

Heel-Strike Running GaitHeel-Strike Running Gait

Running with a heel-strike walking gait• Results in overstriding• Increases braking/impact and rotational forces• Slower cadence secondary to extended time on ground from heel-

strike and mid-stance phases• Increased muscular forces needed to push off the ground to keep

momentum and start a new stride • Inefficient cycle in which you are always trying to catch up:

– planted foot is on the ground longer– more difficult to increase cadence– push off to start new stride– more muscular force needed to start a new stride and keep momentum– center of mass lags behind – body is back in same position as on the previous stride

Evolution of the Running ShoeEvolution of the Running Shoe

Traditional Running Shoe Design• Increased heel cushioning with a dense, soft elastic foam (EVA –

ethylene vinyl acetate)• Increased heel height with a steep heel to toe ramp angle• Thick outsoles and built up arch support and pronation control• Accommodates the heel-striking running gait


Traditional Running Shoe Design

38 mm

15 mm14.7%

Evolution of the Running ShoeEvolution of the Running ShoeThe shoes impact on running formBody Position:

Level foot-balance point is midfoot

and balanced with gravity

Elevated heel-recenter balance point under rearfoot

-hips tilt forward, low back arches

-upper body leans back

-forces a heel-strike gait

Elevated toe-balance point is forefoot

-hips tilt backward, low back pushes backward, upper body leans forward


The traditional shoes impact on running form• Encourages heel-striking gait and does not allow the heel to land

naturally and parallel to the ground• With heel-strike the foot is in the braking position, creates

overstriding and slower cadence• The whole body is unbalanced and unable to react quickly• Soft foam midsole dampens sensory input with ground for

proprioceptive response• Elevated heel gets in the way and is the first part of the shoe to hit

the ground• Negates the elastic recoil of running gait by foot sinking into the

cushion and dissipates energy laterally

Impact of Running Shoes on KinematicsImpact of Running Shoes on Kinematics

• Braking, Pushing and Bouncing

• Impact Rotational and Propulsive Forces


• Braking, Pushing and Bouncing• Heel-striking causes brakingbraking with the ground in front of

the body mass• With the body leaning backward counteracts forward

motion• Increased need for power to push-offpush-off hard and keep

momentum forward• Increases vertical oscillation (bouncingbouncing up and down)



1. Heel striking creates braking requiring increased push off forces

2. Shearing on lower back and spine

3. Excessive body rotation

4. Ankle becomes a loose (unstable) adaptor with ground

5. Overpronation and oversupination

6. Increased rotational forces at the joints

7. Increased vertical bounce

Heel-Strike Running GaitHeel-Strike Running Gait

Natural Running GaitNatural Running Gait

• Running Efficiently and Economically

• What is Natural Running?

• Barefoot Running

• Common Running Form Mistakes

• Minimalist Running Shoes

Adapting Natural RunningAdapting Natural Running

• Is all about feet, form and whole body movement• Running in a relaxed manner• Having the awareness to touch the ground lightly and lift

quickly on every stride• Leads to more efficient running mechanics:

– Upright posture with a slight forward lean at the waist– Compact arm swing– Quick cadence with center of mass over midfoot– Maintains forward momentum with each stride

• Results in less impact forces and fewer rotational forces on the foot and body


• Quicker and higher stride cadence than walking• A series of one-legged stances landing under the center of mass• A new stride is started immediately after foot strike• Upper body needs to remain upright with a slightly forward-leaning

posture to maintain momentum• Foot strikes under center of mass• Upper body never lags behind• Start new stride by lifting leg instead of pushing off• Quicker cadence and less impact• less rotational forces and less propulsive muscular forces


• Minimizes vertical oscillations

Barefoot Running Barefoot Running


• Running unshod your foot naturally seeks out the ground by landing at the midfoot/forefoot

• Maximizes sensory feedback from your forefoot for proprioceptive responses to the ground

• Barefoot running allows a runner to:1. Run with an upright posture and slight forward lean

2. Have a compact and consistent arm swing

3. Run with low-impact footsteps near the ball of your foot

4. Maintain a forward moving momentum

• Under controlled running environment and surfaces injuries can be minimized

• Lightweight shoes can allow your feet to mimic the flexibility and motion of barefoot running


• http://www.youtube.com/watch?v=FGSjpUIGbZs• http://www.youtube.com/watch?v=FGSjpUIGbZs&feature=related

Zola Budd

Dr. Daniel Lieberman

E:\Barefoot Running\Nature barefoot running.htm

Studied the impacts of barefoot running vs. shod runningfound that habitually barefoot runners tend to land on their forefoot with less force and more efficiency when compared to shod runners whose cushioned shoes promote heel striking.

Lieberman, D.E., M. Venkadesan, W.A., et. al.. “Fott Strike Patterns and Collision Forces in Habitually Barefoot vs Shod runners. Nature. 2010 Jan 28; 463&7280):531-5

Barefoot Running Barefoot Running • Regular small doses can improve running mechanics and teach you to land

lightly at your midfoot/forefoot

• It can strengthen the muscles and fascia in your feet and ankles

• Allows you to use your muscles as suspension springs to dampen impact forces and propel forward with elastic recoil

• Enhances running efficiency by putting you in the proper running form and strengthening the muscles to execute these movements

• Not every barefoot runner lands on the forefoot/midfoot

• You do not need to be a barefoot runner to become a forefoot runner – improve posture, cadence and striking under your center of gravity

• Questionable whether barefoot running will enhance performance

Common Running Form Mistakes

• Braking Impact and Excessive Rotation– Caused by running with a heel strike gait– Causes abrupt braking of forward momentum - overstriding– Leads to excessive rotation in feet, ankles, knees, legs and hips

• Excessive Muscular force– Requires runner to use more force to create forward propulsion– With every heel-strike in front of your center of mass your upper

body pushes back behind your center of mass

• Both mistakes lead to excessive vertical oscillation, inefficiency and more impact, rotation and muscle tendon stress

Minimalist Running ShoesMinimalist Running Shoes

Minimalist Running ShoesMinimalist Running Shoes• Allows your feet to mimic the flexibility and motion of barefoot

running

• Has a level profile and firm material under the midfoot/forefoot

• Allows the natural settling of the heel after impact so the foot is parallel to the ground

• Enables the energy return of elastic recoil to begin the next stride

• Protects feet from unnatural surfaces and hazards on the ground

• Provides thermal properties to protect from hot pavement or frozen ground

Minimalist Running ShoesMinimalist Running Shoes

15 mm28 mm

Developing a Natural Running FormDeveloping a Natural Running Form

• Dynamic Strengthening

• Forms Drills

• Barefoot running

• Repetition

Developing a Natural Running FormDeveloping a Natural Running Form

Landing lightly under the body at midfoot/forefoot allows:

1. Properly sensing the ground to respond appropriately

2. Lock the ankle and eliminate excessive rotational forces

3. Eliminates braking forces and slower cadence

4. Diminishes the impact forces with the ground

5. Maintains an upright posture with a slight forward lean and compact arm swing creating forward propulsion and momentum

6. Placed in position to lift knee to begin a new stride

7. Eliminates the inefficent vertical oscillation

8. Run relaxed mentally and physically

Developing a natural running form

http://video.nytimes.com/video/2009/10/04/health/1247464987589/barefoot-running.html



Is Barefoot Running for Everyone?Is Barefoot Running for Everyone?

Not everyone may be able to run barefoot, but the principles of barefoot running can help a runner achieve a more efficient, economical and injury-free running form.

This can be achieved by adopting a natural running form through dynamic strengthening, form drills, barefoot running, minimalist shoes and repetition.

Questions?

troy m. smurawa, m.d., faap akron childrens hospital sports medicine center barefoot running: is it...

Documents

running gait phase

phase slide

heelstrike running gait

walking gait phase

sprinting gait phase

heelstrike phase

heelstriking gait

heel strike