Comparison of Minimalist Footwear Strategies for Simulating Barefoot Running: A Randomized Crossover Study

Possible benefits of barefoot running have been widely discussed in recent years. Uncertainty exists about which footwear strategy adequately simulates barefoot running kinematics. The objective of this study was to investigate the effects of athletic footwear with different minimalist strategies on running kinematics. Thirty-five distance runners (22 males, 13 females, 27.9 ± 6.2 years, 179.2 ± 8.4 cm, 73.4 ± 12.1 kg, 24.9 ± 10.9 km.week^-1) performed a treadmill protocol at three running velocities (2.22, 2.78 and 3.33 m.s^-1) using four footwear conditions: barefoot, uncushioned minimalist shoes, cushioned minimalist shoes, and standard running shoes. 3D kinematic analysis was performed to determine ankle and knee angles at initial foot-ground contact, rate of rear-foot strikes, stride frequency and step length. Ankle angle at foot strike, step length and stride frequency were significantly influenced by footwear conditions (p<0.001) at all running velocities. Posthoc pairwise comparisons showed significant differences (p<0.001) between running barefoot and all shod situations as well as between the uncushioned minimalistic shoe and both cushioned shoe conditions. The rate of rear-foot strikes was lowest during barefoot running (58.6% at 3.33 m.s^-1), followed by running with uncushioned minimalist shoes (62.9%), cushioned minimalist (88.6%) and standard shoes (94.3%). Aside from showing the influence of shod conditions on running kinematics, this study helps to elucidate differences between footwear marked as minimalist shoes and their ability to mimic barefoot running adequately. These findings have implications on the use of footwear applied in future research debating the topic of barefoot or minimalist shoe running.     

Pattern classification of kinematic and kinetic running data to distinguish gender, shod/barefoot and injury groups with feature ranking

The identification of differences between groups is often important in biomechanics. This paper presents group classification tasks using kinetic and kinematic data from a prospective running injury study. Groups composed of gender, of shod/barefoot running and of runners who developed patellofemoral pain syndrome (PFPS) during the study, and asymptotic runners were classified. The features computed from the biomechanical data were deliberately chosen to be generic. Therefore, they were suited for different biomechanical measurements and classification tasks without adaptation to the input signals. Feature ranking was applied to reveal the relevance of each feature to the classification task. Data from 80 runners were analysed for gender and shod/barefoot classification, while 12 runners were investigated in the injury classification task. Gender groups could be differentiated with 84.7%, shod/barefoot running with 98.3%, and PFPS with 100% classification rate. For the latter group, one single variable could be identified that alone allowed discrimination.     

Stiffness adaptations in shod running

When mechanical parameters of running are measured, runners have to be accustomed to testing conditions. Nevertheless, habituated runners could still show slight evolutions of their patterns at the beginning of each new running bout. This study investigated runners' stiffness adjustments during shoe and barefoot running and stiffness evolutions of shoes. Twenty-two runners performed two 4-minute bouts at 3.61 m.s-1 shod and barefoot after a 4-min warm-up period. Vertical and leg stiffness decreased during the shoe condition but remained stable in the barefoot condition, p < 0.001. Moreover, an impactor test showed that shoe stiffness increased significantly during the first 4 minutes, p < 0.001. Beyond the 4th minute, shoe properties remained stable. Even if runners were accustomed to the testing condition, as running pattern remained stable during barefoot running, they adjusted their leg and vertical stiffness during shoe running. Moreover, as measurements were taken after a 4-min warm-up period, it could be assumed that shoe properties were stable. Then the stiffness adjustment observed during shoe running might be due to further habituations of the runners to the shod condition. To conclude, it makes sense to run at least 4 minutes before taking measurements in order to avoid runners' stiffness alteration due to shoe property modifications. However, runners could still adapt to the shoe.     

Pattern classification of kinematic and kinetic running data to distinguish gender,shod/barefoot and injury groups with feature ranking

The identification of differences between groups is often important in biomechanics. This paper presents group classification tasks using kinetic and kinematic data from a prospective running injury study. Groups composed of gender, of shod/barefoot running and of runners who developed patellofemoral pain syndrome (PFPS) during the study, and asymptotic runners were classified.

The features computed from the biomechanical data were deliberately chosen to be generic. Therefore, they were suited for different biomechanical measurements and classification tasks without adaptation to the input signals. Feature ranking was applied to reveal the relevance of each feature to the classification task.

Data from 80 runners were analysed for gender and shod/barefoot classification, while 12 runners were investigated in the injury classification task. Gender groups could be differentiated with 84.7%, shod/barefoot running with 98.3%, and PFPS with 100% classification rate. For the latter group, one single variable could be identified that alone allowed discrimination.     

A comparison of the physiological exercise intensity differences between shod and barefoot submaximal deep-water running at the same cadence

The purpose of this investigation was to identify whether physiological exercise intensity differed with the use of aquatic training shoes (ATS) during deep-water running (DWR) compared to using a barefoot condition. Eight male intercollegiate (National Collegiate Athletic Association Division III [NCAA III]) varsity distance runners were videotaped from the right sagittal view while running on a treadmill (TR) and while barefoot in deep water at 60-70% of their TR VO2max for 30 minutes. Based on the stride rate of the barefoot DWR trial, a subsequent 30-minute session was completed while wearing ATS. Variables of interest were energy expenditure, oxygen consumption (VO2), heart rate, respiratory exchange ratio (RER), and rating of perceived exertion (RPE). Multivariate omnibus tests revealed statistically significant differences for energy expenditure (p < 0.011), VO2 (p < 0.001), RPE (p < 0.001), and RER (p < 0.002). The post hoc pairwise comparisons revealed significant differences between barefoot and shod DWR conditions for energy expenditure (p < 0.005) and VO2 (p < 0.002), representing a 9 and 7.6% increase in exercise intensity demand while running shod vs. barefoot. These comparisons also revealed significantly higher RPE and RER values while DWR than those found in TR. Wearing the ATS may be recommended as a method of statistically significantly increasing the exercise intensity while running in deep water as compared to not wearing a shoe. Shod compared to TR yields very small differences, which indicates that the shoes may help better match land-based running exercise intensities.     

The effect of stride length on the dynamics of barefoot and shod running

A number of interventions and technique changes have been proposed to attempt to improve performance and reduce the number of running related injuries. Running shoes, barefoot running and alterations in spatio-temporal parameters (stride frequency and stride length) have been associated with significant kinematic and kinetic changes, which may have implications for performance and injury prevention. However, because footwear interventions have been shown to also affect spatio-temporal parameters, there is uncertainty regarding the origin of the kinematic and kinetic alterations. Therefore, the purpose of this study was to independently evaluate the effects of shoes and changes in stride length on lower extremity kinetics. Eleven individuals ran over-ground at stride lengths ±5 and 10% of their preferred stride length, in both the barefoot and shod condition. Three-dimensional motion capture and force plate data were captured synchronously and used to compute lower extremity joint moments. We found a significant main effect of stride length on anterior–posterior and vertical GRFs, and sagittal plane knee and ankle moments in both barefoot and shod running. When subjects ran at identical stride lengths in the barefoot and shod conditions we did not observe differences for any of the kinetic variables that were measured. These findings suggest that barefoot running triggers a decrease in stride length, which could lead to a decrease in GRFs and sagittal plane joint moments. When evaluating barefoot running as a potential option to reduce injury, it is important to consider the associated change in stride length.     

Biomechanical analysis of the stance phase during barefoot and shod running

This study investigated spatio-temporal variables, ground reaction forces and sagittal and frontal plane kinematics during the stance phase of nine trained subjects running barefoot and shod at three different velocities (3.5, 4.5, 5.5 m s(-1)). Differences between conditions were detected with the general linear method (factorial model). Barefoot running is characterized by a significantly larger external loading rate than the shod condition. The flatter foot placement at touchdown is prepared in free flight, implying an actively induced adaptation strategy. In the barefoot condition, plantar pressure measurements reveal a flatter foot placement to correlate with lower peak heel pressures. Therefore, it is assumed that runners adopt this different touchdown geometry in barefoot running in an attempt to limit the local pressure underneath the heel. A significantly higher leg stiffness during the stance phase was found for the barefoot condition. The sagittal kinematic adaptations between conditions were found in the same way for all subjects and at the three running velocities. However, large individual variations were observed between the runners for the rearfoot kinematics.     

Footwear affects the gearing at the ankle and knee joints during running

The objective of the study was to investigate the adjustment of running mechanics by wearing five different types of running shoes on tartan compared to barefoot running on grass focusing on the gearing at the ankle and knee joints. The gear ratio, defined as the ratio of the moment arm of the ground reaction force (GRF) to the moment arm of the counteracting muscle tendon unit, is considered to be an indicator of joint loading and mechanical efficiency. Lower extremity kinematics and kinetics of 14 healthy volunteers were quantified three dimensionally and compared between running in shoes on tartan and barefoot on grass. Results showed no differences for the gear ratios and resultant joint moments for the ankle and knee joints across the five different shoes, but showed that wearing running shoes affects the gearing at the ankle and knee joints due to changes in the moment arm of the GRF. During barefoot running the ankle joint showed a higher gear ratio in early stance and a lower ratio in the late stance, while the gear ratio at the knee joint was lower during midstance compared to shod running. Because the moment arms of the counteracting muscle tendon units did not change, the determinants of the gear ratios were the moment arms of the GRF's. The results imply higher mechanical stress in shod running for the knee joint structures during midstance but also indicate an improved mechanical advantage in force generation for the ankle extensors during the push-off phase.     

The influence of footwear on foot motion during walking and running

There are evidences to suggest that wearing footwear constrains the natural barefoot motion during locomotion. Unlike prior studies that deduced foot motions from shoe sole displacement parameters, the aim of this study was to examine the effect of footwear motion on forefoot to rearfoot relative motion during walking and running. The use of a multi-segment foot model allowed accurate both shoe sole and foot motions (barefoot and shod) to be quantified. Two pairs of identical sandals with different midsole hardness were used. Ten healthy male subjects walked and ran in each of the shod condition.The results showed that for barefoot locomotion there was more eversion of the forefoot and it occurred faster than for shod locomotion. In this later condition, the range of eversion was reduced by 20% and the rate of eversion in late stance by 60% in comparison to the barefoot condition. The sole constrained both the torsional (eversion/inversion) and adduction range of motion of the foot. Interestingly, during the push-off phase of barefoot locomotion the rate and direction of forefoot torsion varied between individuals. However, most subjects displayed a forefoot inversion direction of motion while shod. Therefore, this experiment showed that the shoes not only restricted the natural motion of the barefoot but also appeared to impose a specific foot motion pattern on individuals during the push-off phase. These findings have implications for the matching of footwear design characteristics to individual natural foot function.     

Effect of training in minimalist footwear on oxygen consumption during walking and running

The present study sought to examine the effect of 5 weeks of training with minimalist footwear on oxygen consumption during walking and running. Thirteen college-aged students (male n = 7, female n = 6, age: 21.7±1.4 years, height: 168.9±8.8 cm, weight: 70.4±15.8 kg, VO₂max: 46.6±6.6 ml·kg⁻¹·min⁻¹) participated in the present investigation. The participants did not have experience with minimalist footwear. Participants underwent metabolic testing during walking (5.6 km·hr⁻¹), light running (7.2 km·hr⁻¹), and moderate running (9.6 km·hr⁻¹). The participants completed this assessment barefoot, in running shoes, and in minimalist footwear in a randomized order. The participants underwent 5 weeks of training with the minimalist footwear. Afterwards, participants repeated the metabolic testing. Data was analyzed via repeated measures ANOVA. The analysis revealed a significant (F_4,32= 7.576, ηp2=0.408, p ≤ 0.001) interaction effect (time × treatment × speed). During the initial assessment, the minimalist footwear condition resulted in greater oxygen consumption at 9.6 km·hr⁻¹ (p ≤ 0.05) compared to the barefoot condition, while the running shoe condition resulted in greater oxygen consumption than both the barefoot and minimalist condition at 7.2 and 9.6 km·hr⁻¹. At post-testing the minimalist footwear was not different at any speed compared to the barefoot condition (p> 0.12). This study suggests that initially minimalist footwear results in greater oxygen consumption than running barefoot, however; with utilization the oxygen consumption becomes similar.     

Comparison of lower limb kinetics,kinematics and muscle activation during drop jumping under shod and barefoot conditions

This study was to investigate the acute effects of wearing shoes on lower limb kinetics, kinematics and muscle activation during a drop jump. Eighteen healthy men performed a drop jump under barefoot and shod conditions. Vertical ground reaction force (GRF) was measured on a force plate during the contact phase of a drop jump, and GRF valuables were calculated for each condition. The angles of the knee and ankle joints, and the foot strike angle (the angle between the plantar surface of the foot and the ground during ground contact) as well as the electromyography of 7 muscles were measured. The shod condition showed a significant larger first peak GRF, longer time to first peak GRF from the initial ground contact and lower initial loading rate than the barefoot condition. The shod condition showed a significant larger ankle joint angle at initial ground contact, smaller knee joint angle between the second peak GRF and take-off as well as smaller foot strike angle at both initial ground contact and take-off than the barefoot condition. There were significant correlations between relative differences in ankle joint at the initial ground contact and relative differences in the initial loading rate. The muscle activity of all muscles during foot ground contact did not differ between two conditions; however, in the shod condition, muscle activation of 150 ms before foot ground contact was significantly higher in the rectus femoris, whereas it was lower in the biceps femoris and tibialis anterior muscles than the barefoot condition. These results indicate that wearing shoes alternates the GRF variables at initial ground contact, joint kinematics at the ground contact and muscle activation before foot ground contact during a drop jump, suggesting that the effects of wearing shoes on drop jump training differ from being barefoot.     

Footwear Decreases Gait Asymmetry during Running

Previous research on elderly people has suggested that footwear may improve neuromuscular control of motion. If footwear does in fact improve neuromuscular control, then such an influence might already be present in young, healthy adults. A feature that is often used to assess neuromuscular control of motion is the level of gait asymmetry. The objectives of the study were (a) to develop a comprehensive asymmetry index (CAI) that is capable of detecting gait asymmetry changes caused by external boundary conditions such as footwear, and (b) to use the CAI to investigate whether footwear influences gait asymmetry during running in a healthy, young cohort. Kinematic and kinetic data were collected for both legs of 15 subjects performing five barefoot and five shod over-ground running trials. Thirty continuous gait variables including ground reaction forces and variables of the hip, knee, and ankle joints were computed for each leg. For each individual, the differences between the variables for the right and left leg were calculated. Using this data, a principal component analysis was conducted to obtain the CAI. This study had two main outcomes. First, a sensitivity analysis suggested that the CAI had an improved sensitivity for detecting changes in gait asymmetry caused by external boundary conditions. The CAI may, therefore, have important clinical applications such as monitoring the progress of neuromuscular diseases (e.g. stroke or cerebral palsy). Second, the mean CAI for shod running (131.2 ± 48.5; mean ± standard deviation) was significantly lower (p = 0.041) than the CAI for barefoot running (155.7 ± 39.5). This finding suggests that in healthy, young adults gait asymmetry is reduced when running in shoes compared to running barefoot, which may be a result of improved neuromuscular control caused by changes in the afferent sensory feedback.     

Tibiocalcaneal kinematics of barefoot versus shod running

Barefoot running kinematics has been described to vary considerably from shod running. However, previous investigations were typically based on externally mounted shoe and/or skin markers, which have been shown to overestimate skeletal movements. Thus, the purpose of this study was to compare calcaneal and tibial movements of barefoot versus shod running using skeletal markers. Intracortical bone pins with reflective marker triads were inserted under standard local anesthetic into the calcaneus and tibia of five healthy male subjects. The subjects ran barefoot, with a normal shoe, with three shoe soles and two orthotic modifications. The three-dimensional tibiocalcaneal rotations were determined using a joint coordinate system approach. Test variables were defined for eversion and tibial rotation. The results showed that the differences in bone movements between barefoot and shod running were small and unsystematic (mean effects being less than 2 degrees ) compared with the differences between the subjects (up to 10 degrees ). However, differences may occur during midstance when extreme shoe modifications (i.e. posterior orthosis) are used. It is concluded that calcaneal and tibial movement patterns do not differ substantially between barefoot and shod running, and that the effects of these interventions are subject specific. The result of this in vivo study contrasts with previous investigations using skin and shoe mounted markers and suggests that these discrepancies may be the result of the overestimation with externally mounted markers.     

What are causes and treatment strategies for patellar-tendinopathy in female runners?

Patellar-tendinopathy (PT) is a common overuse injury in long distance runners, especially in women. Until today, no definite combinations of clinical, biomechanical, or training variables, or causative factors in the development of PT have been found. This study focused on assessing the differences in biomechanical characteristics between healthy runners (CO) and runners with PT only. We examined a total of 42 women. 21 CO and 21 PT. 3D kinematics of barefoot running was used in the biomechanical setup. Both groups were matched with respect to height and weight. After determining dropouts due to forefoot running, poor quality of data and lack of matching subjects in CO in terms of body height and weight, the final population comprised 24 subjects (CO=12, PT=12). Biomechanical evaluations indicate eccentric overloading of the quadriceps muscle group (knee extensors), increased pronation velocity as well as a lack of joint coordination as major etiological factors in the development of PT. We assume that eccentric strengthening of the knee extensors, as well as reduction of pronation velocity through orthotics, proper running shoes, and balance training will help treat and possibly prevent PT.     

The effects of squatting footwear on three-dimensional lower limb and spine kinetics

Altering footwear worn during performance of the barbell back squat has been shown to change motion patterns, but it is not completely understood how this affects biomechanical loading demands. The primary objective was to compare lower back and extremity net joint moments in 24 experienced weightlifters (12M, 12F) who performed 80% one-repetition maximum back squats under three different footwear conditions (barefoot, running shoes, weightlifting shoes). Results showed that there was a significant main effect of footwear condition on the knee extension moment (p = 0.001), where the running and weightlifting shoes produced significantly larger moments than the barefoot condition. There was also a main effect of footwear condition on knee external rotation moments (p = 0.002), where the weightlifting shoe produced significantly larger moments than both other conditions. At the hip, there was also a main effect of footwear condition on the extension moment (p = 0.004), where the barefoot condition produced significantly larger moments than either the running shoe or weightlifting shoe condition. Lastly, there was also a significant main effect of footwear condition on both hip external (p = 0.005) and internal (p = 0.003) rotation moments, where the barefoot condition produced greater internal rotation and less external rotation moments than either shod condition. This study indicates that altering footwear conditions while performing the barbell back squat may redistribute the internal biomechanical loading patterns amongst the lower extremity joints and perhaps alter the musculoskeletal adaptations elicited.     

T2 relaxation time measurements in tibiotalar cartilage after barefoot running and its relationship to ankle biomechanics

The influence of ankle kinematics and plantar pressure from mid-range barefoot running on T2 relaxation times of tibiotalar cartilage is unknown. This study aimed to quantitatively evaluate the T2 relaxation time of tibiotalar cartilage and ankle biomechanics following 5 km barefoot running. Twenty healthy runners (who had no 5 km barefoot running experience) underwent 3.0-Tesla magnetic resonance (MR) scans and assessment of running gait before and after 5 km barefoot running. Participants were divided into two groups consisting of marathon-experienced (n = 10) and novice (n = 10) with equal number of males and females in each group. Three musculoskeletal radiologists measured T2 relaxation times in 18 regions of the ankle cartilage: anterior zone, central zone, and posterior zone, or lateral, middle, and medial sections in the sagittal plane. Three-dimensional ankle kinetics, kinematics, and plantar pressure were all also assessed during barefoot running. In the novice group, the T2 relaxation time in the posterior zone of tibial cartilage (p = 0.001) and lateral section in both tibial (p = 0.02) and talar (p = 0.02) cartilage were significantly increased after barefoot running. Ankle kinematics exhibited significant changes in females. Plantar loading was shifted from the medial to lateral aspect after running. This included a significant reduction in the loading under the toes and the 1st, 2nd and 3rd metatarsals, with a significant increase under the 4th and 5th metatarsals and lateral midfoot. The results suggest that plantar pressure may directly lead to local increases in cartilage T2 signal, which was not associated with changes in ankle kinematics.     

A comparison of forefoot stiffness in running and running shoe bending stiffness

This study characterizes the stiffness of the human forefoot during running. The forefoot stiffness, defined as the ratio of ground reaction moment to angular deflection of the metatarsophalangeal joint, is measured for subjects running barefoot. The joint deflection is obtained from video data, while the ground reaction moment is obtained from force plate and video data. The experiments show that during push-off, the forefoot stiffness rises sharply and then decreases steadily, showing that the forefoot behaves not as a simple spring, but rather as an active mechanism that exhibits a highly time-dependent stiffness. The forefoot stiffness is compared with the bending stiffness of running shoes. For each of four shoes tested, the shoe stiffness is relatively constant and generally much lower than the mean human forefoot stiffness. Since forefoot stiffness and shoe bending stiffness act in parallel (i.e., are additive), the total forefoot stiffness of the shod foot is dominated by that of the human foot.     

Effect of footwear on intramuscular EMG activity of plantar flexor muscles in walking

One of the purposes of footwear is to assist locomotion, but some footwear types seem to restrict natural foot motion, which may affect the contribution of ankle plantar flexor muscles to propulsion. This study examined the effects of different footwear conditions on the activity of ankle plantar flexors during walking. Ten healthy habitually shod individuals walked overground in shoes, barefoot and in flip-flops while fine-wire electromyography (EMG) activity was recorded from flexor hallucis longus (FHL), soleus (SOL), and medial and lateral gastrocnemius (MG and LG) muscles. EMG signals were peak-normalised and analysed in the stance phase using Statistical Parametric Mapping (SPM). We found highly individual EMG patterns. Although walking with shoes required higher muscle activity for propulsion than walking barefoot or with flip-flops in most participants, this did not result in statistically significant differences in EMG amplitude between footwear conditions in any muscle (p > 0.05). Time to peak activity showed the lowest coefficient of variation in shod walking (3.5, 7.0, 8.0 and 3.4 for FHL, SOL, MG and LG, respectively). Future studies should clarify the sources and consequences of individual EMG responses to different footwear.     

Effects of footwear on three-dimensional tibiotalar and subtalar joint motion during running

Running is a popular form of recreation, but injuries are common and may be associated with abnormal joint motion. The objective of this study was to determine the effect of three footwear conditions – barefoot (BF), an ultraflexible training shoe (FREE), and a motion control shoe (MC) – on 3D foot and ankle motion. Dynamic, biplane radiographic images were acquired from 12 runners during overground running. 3D rotations of the tibiotalar and subtalar joints were quantified in terms of plantarflexion/dorsiflexion (PF/DF), inversion/eversion (IN/EV) and internal/external rotation (IR/ER). Across the early stance phase (defined as footstrike to heel-off), BF running demonstrated greater tibiotalar joint range of motion for PF/DF (28.2±8.3°) and IR/ER (7.0±1.4°) than the shod conditions (FREE: PF/DF=15.1±5.9°, IR/ER=4.8±2.1°; MC: PF/DF=15.0±6.2°, IR/ER=4.3±0.7°). Also at the tibiotalar joint, BF running resulted in a position significantly more plantarflexed (BF: 2.0±12.5°, FREE: 15.7±12.2°, MC: 16.5±9.3°) and internally rotated (BF: 12.9±4.5°, FREE: 10.7±4.3°, MC: 10.6±3.9°) at footstrike compared to both shod conditions. No differences were detected between the shod conditions at any point in the early stance phase at the tibiotalar joint. The MC condition demonstrated significant differences compared to FREE at several points throughout the early stance phase at the subtalar joint, with the greatest differences seen at 30% in PF/DF (MC −1.4±8.8°: FREE: −0.5±9.0°), IN/EV (MC −8.1±5.7°: FREE −6.3±5.5°) and IR/ER (MC −9.5±5.3°: FREE: −8.7±5.2°). These findings indicate that footwear has subtle effects on joint motion mainly between BF and shod conditions at the tibiotalar joint and between shod conditions at the subtalar joint.