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Running Re-education

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Comment by Noelene Davey (AFAP Committee) 2012 on Barefoot Running:

In April 2011 I saw Professor Daniel E. Lieberman, a Human Evolutionary Biologist from Havard University, speak at the pre London Marathon "Royal Society of Medicine - The 28th London marathon medicine conference" on the topic of barefoot running - it was interesting to hear his own personal story of how he ended up doing it and his subsequent research - Prof Lieberman's webpage. Another researcher in barefoot running is Professor Irene Davis, from Delaware University.

Most runners who wear standard running shoes usually heel strike, but most barefoot or minimally shod endurance runners forefoot strike and sometimes midfoot strike. Funnily enough, when we tested this in one of our in-service training mornings, nobody followed the expected pattern!

He was very clear that bare foot running does not necessarily prevent injuries, but that it may decrease them. An increased forefoot strike will lead to increased load on the Achilles and may cause Achilles problems, just as a heel strike pattern can predispose to stress fractures as there is less impact being absorbed by the feet (modern shoes have very good shock absorbency, so the argument that they cause a heel strike pattern is less pertinent...unless the patient has not replaced their shoes regularly - shoes should be replaced between 400-600 miles dependent on many factors). The generally perceived wisdom in running training is that a mid-foot
strike pattern is best, but this can be very difficult to retrain.

The main advice is that running style is a personal preference, and that if you are going to try barefoot running, be prepared to build up very slowly (tendons take 4 months to respond to strengthen and respond to loading), and to protect the Achilles also remember that it can take up to 24 hours for tendons to recover from loading (see Dr Henning Langberg and Michael Kjaer's work from Copenhagen, Denmark).