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Spring / Two thousand thirteen

Barefoot / Minimalist / Natural

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RUNNING FrEE WITH THE RArÁMUrI
Maria Walton’s spiritual journey in northwestern Mexico

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WHAT WE CAN LEArN ABOUT rUNNING FrOM BArEFOOT rUNNING
A landmark study on the science of barefoot running

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HErOES OF RUNNING: HELEN HALL
Keep on running: They build them tough in Yorkshire

NatURaL BORN RUNNER
Spring / Two thousand thirteen / 2013
Published by The Eddington Media Group Ltd. Newton Lodge 15-17 Newton Way Woolsthorpe-by-Colsterworth Lincolnshire NG33 5NR, United Kingdom Telephone +44 1476 861 737 PUBLISHER John Eddington john@eddingtonmedia.com EDITOR Roger Crombie editorial@eddingtonmedia.com ADVERTISING advertising@eddingtonmedia.com SUBSCRIpTIONS subscriptions@eddingtonmedia.com EDITORIaL CONTRIBUTORS aND EDITORIaL PaNEL Daniel E. Lieberman, Department of Human Evolutionary Biology, Harvard University. Irene Davis, PhD, PT, FAPTA, FACSM, FASB Director, Spaulding National Running Center Department of Physical Medicine and Rehabilitation, Harvard Medical School Dr Mark Cucuzzella Dr Nick Campitelli Matt Wallden Barefoot Ken Bob Saxton Barefoot Ted McDonald Lee Saxby Helen Hall Maria Walton DESIGN + PRODUCTION Strano and Pettigrew Design Associates info@stranoandpettigrew.com
© The Eddington Media Group Ltd All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electrical, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. The views expressed in The Natural Born Runner are not necessarily those shared by the publisher. The Eddington Media Group Ltd., wishing to reflect the true nature of the market, we have included articles from a number of sources, and the views expressed are those of the individual contributors. No responsibility or liability is accepted by The Eddington Media Group for any loss, legal or physical, to any person as a result of any statement, fact or figure contained in The Natural Born Runner Magazine. The publication is not a substitute for advice on a specific point. The publication of advertisements does not represent endorsement by the publisher.

PUBLISHER’S NOTE

WELCOME TO THE LAUNCH ISSUE OF NATUrAL BOrN RUNNEr MAGAZINE.

The motivation for this magazine was the lack of clear information on barefoot and natural running style, when I started to look into it. Contradiction and misinformation seemed to abound. Some running magazines have looked superficially at the topic, but I wanted to read in-depth articles, not 400-word snippets suggesting that there might be something in it, but who knows? We decided to produce a magazine that could be the focus of debate and discussion around barefoot and natural running styles — a place where you can read the stories of experienced barefoot and natural runners; hear about the potential medical benefits of running with a more efficient gait; and where you can keep up to date with scientific developments on these topics. It is up to readers, of course, to choose which ideas work best for them, but if you are choosing from a selection of ideas presented by experts in the field, that is a better starting point. The aim then is to clarify in people’s minds what options exist, in the hope that everyone can enjoy their running more. In this first issue, we have a piece from Dan Lieberman that explains, from an evolutionary perspective, what we know about barefoot and natural running styles. The article explains what has been proven, what we know, what we don’t yet know, and where future research should look. It’s a great starting point for those looking to get a clear picture on the topic.

We also check in on some opinion on medical issues in articles from Dr. Nick Campitelli, Dr. Mark Cucuzzella, Lee Saxby and Barefoot Ken Bob. Dr. Campitelli looks at how MDs approach runners’ injuries and how reviewing form can often have more effect than the usual glance at the shoes. Dr. Cucuzzella explains how to run slower and build the aerobic engine in order to run faster. Lee Saxby discusses how the transition to barefoot running with a 21st century foot can take time. And Barefoot Ken Bob looks into whether a lack of use of cartilage can lead to its deterioration. In the first part of a series of articles, Matt Wallden looks into how we should be fuelling our bodies to run at our best. We all know some of the clichés around runners’ nutrition, but Matt explains a few things that may surprise you. We also hear from shoe manufacturers Luna Sandals, set up by Barefoot Ted, and hear a bit of the history of how the company came into being. Newton Running recently invited me to a coaching course and I jumped at the opportunity. I have written an article passing on my experience of the course, which I would thoroughly recommend. Helen Hall has contributed a personal piece in our Heroes of Running section. Helen is an inspirational Yorkshire woman who exemplifies the sort of determination that led Yorkshire to come 11th in the 2013 Olympic medal table (had it officially been an independent country!).

We hope that you enjoy the longer articles, Maria Walton has kindly provided a passionate which are presented in greater depth than in and fascinating piece explaining her experiences most running magazines. We also hope that at the Copper Canyon Ultra Marathon. I know you like the blend of scientific, technical and that for many runners the book Born to Run by storytelling articles. Let us know what you think Christopher McDougall will have been the entry of the magazine, and what you’d like to see in point to barefoot running. Maria is the race subsequent issues. director for the race, which was founded by her — John Eddington, publisher late partner, Micah True, alias Caballo Blanco.

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Maria Walton

RUNNING FrEE WITH THE RArÁMUrI
Maria Walton’s spiritual journey in northwestern Mexico

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Dr. Nick Campitelli

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Matt Wallden

PrIMAL NUTrITION FOr prIMAL rUNNING
You are what you eat. Run better by eating better

E N

O
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Luna Sandals / Barefoot Ted

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TrEATING rUNNING INJUrIES: FOrM VErSUS FOOTWEAr
Taking off is easy; landing properly is the trick

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HOW TO rUN HAppY
A few simple rules to make running a happier experience

Mark Cucuzzella

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SLOW DOWN TO BUILD THE ENDUrANCE ENGINE / PArT 1
Developing the correct systems to maximise your potential

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Lee Saxby

John Eddington

NEWTON rUNNING COUrSE
Learning about running from the ground up

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Daniel E. Lieberman

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WHAT WE CAN LEArN ABOUT rUNNING FrOM BArEFOOT rUNNING
A landmark study on the science of barefoot running

RE-AWAKEN YOUr INNATE BArEFOOT rUNNING SKILL
A training system to help runners transition to running barefoot

Ken Bob Saxton

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USE IT Or LOSE IT
A path towards becoming a gentler, safer, and more graceful person

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Helen Hall

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HErOES OF rUNNING: HELEN HALL
Keep on running: They build them tough in Yorkshire

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RUNNING FrEE WITH THE
MARIA WALTON + MICAH TRUE

RArÁMUrI
Deep in the recesses of the Sierra Madre Mountains in northwestern Mexico, the valleys and peaks of the rippled earth begin to tighten. Ravines and basins contract into a gnarly maze of twisting gorges, forming a mystical natural wonder known as the Barrancas del Cobre, or Copper Canyon. This vast labyrinth of clenched crags and crests stretches for 28,000 square miles. It is in this crude earth labyrinth that the Tarahumara, or Rarámuri, keep their antiquated customs and rituals alive. MARIA WALTON
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“ WHILE THEY ARE AT wAR, wE COME TO CREATE PEACE AND HOPE AT THE BOTTOM OF THE CANYONS.” —— MICAH TRUE

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W

ith ancient blood coursing through their veins, many of the Rarámuri still live as their ancestors did more than 2,000 years ago, in adobe huts and even in caves. A reclusive, solitary people, the Rarámuri represent a very minimalist culture, compared to that of the Western world. Men dress in simple, neon-colored blouses that are cropped short and billow in the wind — the colours a vibrant contrast to the muted earth tones of the canyons. The vivid blouses are paired with coarse, plain-woven fabric skirts also

Tarahumara’s spirit of Korima, which symbolises a circle of sharing, a practice of giving freely from the heart, with sincere generosity and no expectations of return, thanks or gratitude for the simple act of giving, to act out of love with no attachment to results. The people of the Sierra Madre have shared with us their beautiful land, the privilege of running and celebrating with them. Their friendship is a gift. The following morning, we departed on a beautiful, 18-mile hike through narrow canyons; a 1,200 foot climb in six miles,

worn short, dipping into defined points in front and back. The women adorn themselves in long, flowing ankle-length skirts that boast colourful and feminine floral prints. Some wear their skirts in layered ruffles; others choose to pleat their faldas. Traditionally, all the Rarámuri use simple huaraches, sandals made from scraps of tire and cow leather. On March 2, 2012, the Canyon town of Urique became alive, as the celebration of running people shared the beauty of the Sierra Madre. The event having originated in 2003, the largest group of athletes lined up for the adventure of a lifetime. The team of Mas Locos was represented by 84 international athletes, 110 Mexican internationals, and 260 Rarámuri people from throughout the Copper Canyons.

followed by a gradual descent into the steep, and rocky downhill trails leading into the vast, 6,200 foot Urique Canyons. As the week progressed, the International Team enjoyed long, slow group hikes along the 51-mile course, as we were joined by the Rarámuri runners from the Batopilas Canyons, and Mestizos from Mexico’s state of Zacatecas. While staying in the Pueblo of Urique, Dona  Tita  Quintana was diligently organising meals at La Plaza, and coordinating the lodging for guests staying in town. Her enthusiasm, and genuine passion for the spirit of the race, was contagious. 

Tita and Prospero Torres, who owns the ranch at Los Alisos, were Caballos’ original race sponsors. Prospero always offers the sweet fruits of his orchard: freshly ground  pinole, deeply The journey traditionally begins on Tuesday afternoon, in the roasted coffee beans, and hand-patted tortillas. He proudly Canyon town of Cerocahui, at Rancho Del Oso. The Mas Locos shares memories of his years of Trail Guide work throughout family is greeted by proprietor Diego Rhodes, Caballo Blanco, Las Barrancas with his friend, El Caballo Blanco. and La Mariposa. We are welcomed by the local Tarahumara school children, who playfully share their traditional race After long days of running the trails, swimming in rivers, activities, running happy and free. The students and teachers visiting the kids’ school, or challenging the local children to a of the community share meals, photos and stories of their game of basketball, many Mas Locos retreat to the lush organic gardens of Keith Ramsey’s Entre Amigos. respective countries. Afterwards, everyone honours the
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The people of the Sierra Madre have shared with us their beautiful land, the privilege of running and celebrating with them. Their friendship is a gift.
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“When the message we carry is of truth, peace, beauty and love, we will always have the strength to find our way home, on this, our beautiful Mother Earth.” — Micah True

Urique’s  Director of Tourism,  Cecy  Villalobos,  is instrumental in promoting the race among the State of Chihuahua, and throughout Mexico. She coordinated all official race ceremonies between the international runners and Rarámuri families. Race Director Micah True proudly shares this journey with those who honour the beauty of the Rarámuri. “They live closer to the Earth,” he says. “They live closer to their memories, their cellular, muscular and natural memories. So they run. The point of the race is to have fun and to run free and to encourage the Rarámuri people to continue their age-old traditions of running free. Love is love. Joy is joy. And, running is running,” True says. While the compelling component behind many elite ultras is the very nature of extreme competition, the great majority of athletes involved in the Copper Canyon Ultra Marathon (CCUM) professed that this race is more about the experience, and about the intercultural exchange between local Rarámuri running legends and ultra runners from the modern world.  The true message of the race is creating peace and harmony in the bottom of the Canyons. Each participant in the race who completes each loop is awarded vouchers (vales), which provide to the Rarámuri families the opportunity to purchase needed food supplies for the sustenance of their community. It is tradition for the international athletes who earn their vales to offer them to the Rarámuri and related organisations such as local schools and orphanages. Much of the prize money and larger quantities of corn vouchers awarded to the top 10 finishers are also commonly donated. Miguel Lara of Urique Canyon, followed closely by Daniel Oralek of the Czech Republic. And, minutes later in third place, the two-time winner of the New York Marathon, Mexico’s German Silva. The champions earned $14,000 in prize money, through sheer talent. Every athlete celebrated as one, accomplishing great personal victories each mile of the way. It was humbling to realise that the power of the Canyons challenged the human spirit on many levels. It was a physical and spiritual awakening, personally enlightening my drive to overcome every obstacle set before me. As one of the last straggling finishers, I found my strength from the indigenous women who participated.

The peaceful yet determined strength and speed of the Rarámuri moved me. The women, who unfortunately live in a culture of little admiration or respect, ran with such grace and elegance, their bright, colorful dresses flowing. Their This year was an unforgettable memory, as the top three lovely faces absolutely glowed. The communities embraced champions represented the embodiment of the Running the women’s competitive abilities, equal to the men’s. Hurting People: each set course records. The first-place finisher was doesn’t matter when the Canyons become doused in the red tones of the sunset. Ultimately, the race is meant to memorialise what many consider to be a complete running experience; one that evokes reverent enchantment. I embraced every magical moment as it occurred, then and there. The sun warmed my heart during the day. The mountains continuously blessed my soul. My fellow athletes strengthened my spirit. And, the moon was absolutely glowing, guiding me closer home. “When the message we carry is of truth, peace, beauty and love, we will always have the strength to find our way home, on this, our beautiful Mother Earth.” — Micah True
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“Love is love. Joy is joy. And running is running.” - Micah True

TREAtInG RUnnInG InJURIEs: FORm VERsUs fOOtWEAR
Running injuries can be very frustrating for physicians, as such injuries can be extremely timeDR. NICK CAMPITELLI

consuming and the stereotypical runner will not curtail running to resolve an injury.

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I

f you tell a runner not to run, most of the time he or she will not listen to you and not follow through with your prescribed treatment regimen. This challenge leads many physicians to not treat runners. Added to this frustration is the recommendation of shoe gear. Whether someone has been running for many years or is just starting out, he or she will tend to place a lot of emphasis on what shoes to wear. Form is traditionally ignored. Runners, as well as practitioners, will typically make a change their shoes in an attempt to fix an injury.

There exists a common misunderstanding that all aspects of gait, whether walking or running, should begin with a heel strike. Following heel strike, the force is carried toward the outside edge of the foot and then moves inward to the great toe joint. There, a large amount of force is created to propel the body forward. Much of this is attributed to Root et al, in their discussion of walking mechanics, which over the years has somehow carried over to running (20). The practitioner sometimes will examine the shoe gear to see if any wear patterns exists that would indicate increased pronation, as What most practitioners do not realise is that there is no indicated by wear seen more on the inside of the heel than on evidence-based literature on recommending a running shoe to the outside. The problem with this pathway is that we have no evidenceprevent or reduce injury (Footnotes 1 to 8). Following the popular paradigm of recommending a based studies to indicate that heel striking is the correct way running shoe based on foot type leads to frustration, as to land when running. In fact, recent studies demonstrate numerous models are introduced frequently. Not only does higher injuries amongst collegiate cross-country runners that this complicate matters, but when we analyse the reasons heel strike than among those who forefoot strike (21 and 22). that we use a particular shoe, the situation becomes even Numerous studies have compared shod and unshod runners and a forefoot strike pattern is adapted among those who run more blurred. There exists no clear scientific basis for using one particular without shoes (23 to 27). We all see that elite runners tend shoe model over another for given foot types or pathologies, to forefoot strike more than slower recreational runners, as demonstrated by Larson et al (28 and 29). Evidence exists despite what some manufacturers claim (1). The term that the human body has a natural tendency to forefoot or ‘appropriate shoe’ is a misnomer when judged by the outdated midfoot strike when running barefoot or in minimalist shoes paradigm of selecting a shoe according to arch type, yet many (23 and 26). still advocate shoes this way. Even the implementation of orthotics has little if any bearing on reducing or correcting injuries in runners (9 to 12). We also live in a society where some people incorrectly believe they have a flat foot or are over-pronated. Associated with this is the stigma that foot types (especially flat feet) influence injury patterns (13). This, however, is not true (14). Evidence suggests that training patterns actually play more of a role in increasing the incidence of running injuries (15 and 16). The key is understanding that form and training patterns play more of a role in improving one’s running and at the same time reducing injury (17). Before seeking treatment for an injury, most runners will run through the pain, thinking that it will eventually resolve itself. When the pain finally becomes too severe to allow the runner to continue, medical advice is usually sought. The standard protocol for a physician or sports medicine specialist treating a runner is as follows: 1) Ask the athlete how many miles a week he or she is running. 2) Evaluate shoe gear. 3) Find out the number of miles on the current shoe gear. 4) Carry out a biomechanical assessment of the feet and lower extremities. If the runner is seen in a more specialised clinic, gait analysis is sometimes performed. Overpronation is commonly diagnosed and an effort to control this excessive motion is usually attempted with orthotics. High-tech scans and pressure analysis may also be performed, although very little if any applicable information can be generated from this. Heel strike Versus fOrefOOt/midfOOt strike Form analysis, on the contrary, focuses more on the runner’s By striking the ground with the heel first, the rear foot joints style with respect to foot strike, cadence and the runner’s and ankle take the brunt of the force, which overuses the lower overall body posture. Form analysis is slowly becoming a leg muscles, leading to injuries such as severe tendonitis or panacea to help improve someone’s running and reduce or conditions commonly called ‘shin splints’. We also see that resolve injuries (17 and 18). Runners tend to develop injuries during a rearfoot strike, the forefoot (including the toes) and as a result of poor or incorrect form and overuse, which midfoot joints really serve no purpose in absorbing shock. If, many times overlap (15 and 19). Debate exists as to what is instead, we use these joints with a forefoot or midfoot strike, the ‘proper form’ for running. Proper form will certainly vary the entire foot can work to absorb shock, as opposed to only from one runner to the next, making each runner’s form ‘ideal’ the rear foot joints and leg (30). When we forefoot or midfoot for him or her. There are, however, certain aspects of form a strike, we can control the amount of pronation innately by runner should strive to attain: adequate foot strike, cadence activating our leg musculature. and posture. Consider that one common complaint of those who make

At the same time, the notion that runners with high arches “need a great deal of shock attenuation because they don’t absorb shock naturally through pronation” implies that we need to pronate to absorb shock. It becomes extremely crucial to look at pronation in terms of the entire foot, as opposed to only the subtalar joint, because more shock attenuation can be achieved using the forefoot and midfoot.

“ Before seeking treatment for an injury, most runners will run through the pain, thinking that it will eventually resolve itself. When the pain finally becomes too severe to allow the runner to continue, medical advice is usually sought.”
from striking the ground. They are contracting eccentrically to ‘slow’ pronation. This does not need to be scientifically demonstrated in future studies, as we already know that if pronation of the foot is dorsiflexion, eversion and abduction, then these muscles collectively are contracting as they are lengthening in order to ‘slow’ pronation. As they become strong enough, they will control the pronation that occurs during foot strike (31 and 32).

Even if we consider implementing an orthotic into the shoe to control pronation, we have to consider the purpose of doing this. The orthotic for an overpronator is typically designed to control motion at the subtalar joint that results in the increased pronation. With forefoot striking, we have to look at this from an entirely different perspective, in which the orthotic would not serve the same purpose; therefore, its use is of question.

Landing

Running shOes
Examining the categories of traditional running shoes reveals that manufacturers have created them according to three foot types: flat foot, normal arch, and high arch. The American Academy of Podiatric Sports Medicine (AAPSM) has defined the categories as maximum stability, stability, and neutral. For example, ASICS defines its stability category shoe as “structured cushioning” (33). According to ASICS, “the structured cushioning segment is designed for runners who pronate slightly more than normal and generally have a normal arch” (33). This infers that the runner is heel-striking. Otherwise, why would there be a need to control motion? Some of the normal pronation that is encountered when a runner forefoot or midfoot strikes could be inhibited by this motion-controlling apparatus. Why then are running shoes created with a thick cushioned heel and motion control support? That question is debatable, but it is clear that as running shoes have evolved over the past 40 years, we have seen no reduction in injury rates and marathon times have remained largely unchanged. Many physicians still abide by the rule of changing your shoes every 300 to 500 miles. This became popular after a 1984 study that demonstrated shock absorption loss after 250 to 500 miles of running (34). Since then, studies have demonstrated that as absorptive qualities of a shoe are lost, the foot becomes more stable, leading to the likelihood of reduced injury with greater mileage (35, 36 and 37).

foot planted directly beneath the hips
Where the foot strikes in relation to the rest of the body is also crucial. To increase efficiency and reduce shock to the lower extremity, the foot should be landing under the body’s centre of gravity, or close to it. This engages the body’s natural spring mechanism by using eccentric contractions of the muscles at the ankle, knee, and hip, during landing. In contrast, heel striking, with the leg reaching in front of the body’s centre of gravity, results in the leg impacting in an extended position, increasing the force to these joints. Even if one heel strikes with the foot below the centre of gravity, you will lose part of the spring as the reduction of direct force by its conversion to rotational force through the ankle is lost.

leaning forward from the ankle not the waist

Cadence
Cadence is another piece of the puzzle. Cadence is the number of steps a runner takes per minute. Examining elite runners and marathoners has determined that achieving a cadence
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FOOt Strike
Foot strike is the first aspect that needs to be addressed.
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the transition to minimalist shoes is ‘calf pain’. This is due to the activation of the calf muscles in efforts to slow the heel

“ THE bOdy’S OVERaLL POSItION SHOULd bE ERECt, bUt It SHOULd bE FaLLING FORwaRd.”

COnclusiOn

Posture forward

Focusing on the matters discussed will help to improve a runner’s efficiency, leading to reduced injury. New Balance has partnered with Kurt Munson, a well-known running shoe retailer from Michigan, to create the educational concept known as Good Form Running (18), which teaches these steps in a simplistic manner. Speciality running shoe stores across the United States are holding clinics to teach this method. Interestingly, children tend to run this way when they are unshod and playing outside (39, 40 and 41). The younger they are, the more noticeable this is, as their gait has not been altered by wearing shoe gear. As for paediatric shoes, the American Academy of Pediatrics recommends not wearing shoes until it is required by the environment (42). This helps to encourage natural foot motion, thereby enabling adequate development and strength gains. A final point it is crucial to mention is training patterns. Most recreational runners and even elite runners tend to train too hard (17). Improving the body’s aerobic capacity means continuously training at an aerobic rate (ibid). This is best achieved through the use of a heart rate monitor. Training too much at too high a heart rate can lead to overuse injuries (ibid). Runners too often focus on maintaining a pace instead of listening to their body and their training becomes borderline anaerobic (ibid). Obviously, there is more to running than has been discussed here, but having this as a foundation really helps anyone just starting to run, or even those who have been running for many years. It is crucial for physicians treating running injuries to understand this. In conclusion, it seems that most practitioners are straying from the path of helping a runner by focusing on shoes, as opposed to form. The term ‘appropriate shoe’ is a misnomer when viewed through the old paradigm of selecting a shoe according to arch type, yet many still advocate choosing shoes this way. Running should allow the foot to function as it was designed to: naturally, without inhibiting motion. Adding cushioned heels and motion control mechanisms can inhibit this.

Minimalist fOOtwear is neither a fad nOr a gimmick.
Think about sports specificity. We train in a heavy cushioned shoe with an elevated heel that puts our body in an abnormal position; then, when it comes time to race, we remove it. There’s not much logic behind that. As athletic trainers, we always put our athletes through a battery of tests to make sure they are ready for competition. These involve activity done the way it would be performed in the event. The logic behind not strengthening the foot by ‘casting’ it with a motion control shoe and heel striking makes no sense. As for the surge in injuries that practitioners are claiming to see from runners wearing minimalist shoes, it’s due to the training regimen and form. Shoes do not directly create injury. As for overweight people, or those with poor biomechanics using them, being overweight and heel striking certainly is illogical when compared to reducing shock by forefoot striking and obtaining proper form. The same is true for those with poor biomechanics. Remember we have to redefine ‘poor biomechanics’, because when you forefoot strike, what we learned from Root in terms of overpronation no longer applies. Shoes with a heel lift for plantar fasciitis work against the stretching that has been advocated in increasing ROM at the ankle joint. Consider that by placing a patient in a 14mm-drop shoe, we actually induce an equinus deformity and then tell the patient to function in it all day.

POsture
Finally, the body’s overall posture also needs to be assessed. This can be somewhat confusing, because some running instructors advise maintaining an upright posture, while others advise leaning forward. Both are actually correct. The body’s overall position should be erect, but it should be falling forward. ‘Leaning’ should not occur at the waist, as it does in bending over, but the entire body should be angled forward. Running in place and then leaning forward to begin movement
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By viewing shoes as the first line of treatment for most conditions, we must make sure they do not interfere with the foot’s natural function. The shoe should feel comfortable initially (not with time), without a need for the foot to ‘get used to the pressure pushing against the arch’. A gradual adaptation to this way of running is obviously needed, or injury can result, as our feet and bodies may have been accustomed to a different form and supportive shoe. The approach is very similar to creating a programme for someone just beginning to run, although more gradual.

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MINImaLISt FOOtwEaR

of 180 steps per minute or higher will result in increased efficiency (38). Running with a forefoot strike pattern makes it easier for one to increase the cadence (23). This high cadence keeps the runner closer to the ground, reducing the vertical motion associated with increased impact forces (23). Shorter strides are associated with a higher cadence, but as speed increases, the stride length will also increase (23, 27 and 32). It is important to understand that cadence should not vary with speed. For example, if running a 10-minute mile or slower, your cadence should remain at 180 or above. Faster paces, such as five to six minutes per mile, can sometimes reach cadences of 200 or above. The key is to understand shorter strides; faster turnover will increase efficiency and reduce ground reactive forces. will help to teach this concept. This increases efficiency by using forward momentum, as opposed to decelerating with each step, which recruits greater musculature.

FOOTNOTES 1. Knapik J.J., Trone D.W., Swedler D.I., Villasenor A., Bullock S.H., Schmied E., Bockelman T., Han P ., Jones B.H.: Injury reduction effectiveness of assigning running shoes based on plantar shape in Marine Corps basic training. Am. J. Sports Med. 2010 Sep; 38(9):1759-67. Epub 2010 June 24. 2. Clinghan R., Arnold G.P ., Drew T.S., Cochrane L.A., Abboud R.J.: Do you get value for money when you buy an expensive pair of running shoes? Br. J. Sports Med. 2008 Mar; 42(3):189-93. Epub 2007 Oct. 11. 3. Butler R.J., Hamill J., Davis I.: Effect of footwear on high and low arched runners’ mechanics during a prolonged run. Gait Posture. 2007 Jul; 26(2):219-25. Epub 2006 Oct. 20. 4. Kerr R., Arnold G.P ., Drew T.S., Cochrane L.A., Abboud R.J.: Shoes influence lower limb muscle activity and may predispose the wearer to lateral ankle ligament injury. J. Orthop Res. 2009 Mar; 27(3):318-24. 5. Marti, B. (1998): Relationships between running injuries and running shoes — results of a study of 5,000 participants of a 16K run. The Shoe in Sport. Chicago: Year Book Medical Publishers. 256–265. 6. Herzog W.: Running injuries: is it a question of evolution, form, tissue properties, mileage, or shoes? Exerc. Sport Sci. Rev. 2012 Apr; 40(2):59-60. Yeung S.S., Yeung E.W., Gillespie L.D.: Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst. Rev. 2011 Jul 6; (7):CD001256. Review. 7. Yeung S.S., Yeung E.W., Gillespie L.D.: Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst. Rev. 2011 Jul 6; (7). 8. Clinghan R., Arnold G.P ., Drew T.S., Cochrane L.A., Abboud R.J.: Do you get value for money when you buy an expensive pair of running shoes? Br. J. Sports Med. 2008 Mar; 42(3):189-93. Epub 2007 Oct. 11. PubMed PMID: 17932096. 9. Gross M.L., Napoli R.C.: Treatment of lower extremity injuries with orthotic shoe inserts. An overview. Sports Med. 1993; 15(1):66-70. 10. Stackhouse C.L., Davis I.M., Hamill J.: Orthotic intervention in forefoot and rearfoot strike running patterns. Clin. Biomech. (Bristol, Avon). 2004; 19(1):64-70. 11. Mattila V.M., Sillanpää P .J., Salo T., Laine H.J., Mäenpää H., Pihlajamäki H.: Can orthotic insoles prevent lower limb overuse injuries? A randomised-controlled trial of 228 subjects. Scand. J. Med. Sci. Sports. 2011 Dec; 21(6):804-8. doi: 10.1111/j.1600-0838.2010.01116.x. Epub 2010 May 12. 12. Kilmartin T.E., Wallace W.A.: The scientific basis for the use of biomechanical foot orthoses in the treatment of lower limb sports injuries — a review of the literature. Br. J. Sports Med. 1994; 28(3):180-4. 13. Hohmann E., Reaburn P ., Imhoff A.: Runners’ knowledge of their foot type: do they really know? Foot (Edinb.). 2012 Sep; 22(3):205-10. doi: 10.1016/j.foot.2012.04.008. Epub 2012 May 18. 14. Michelson J.D., Durant D.M., McFarland E.: Injury risk associated with pes planus in athletes. Foot Ankle Int. 2003; 23(7):629–933. 15. Hespanhol Junior L.C., Costa L.O., Carvalho A.C., Lopes A.D.: A description of training characteristics and its association with previous musculoskeletal injuries in recreational runners: a cross-sectional study. Rev Bras Fisioter. 2012 Jan.-Feb.; 16(1):46-53. 16. van Gent R.N., Siem D., van Middelkoop M., van Os A.G., Bierma-Zeinstra S.M., Koes B.W.: Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br. J. Sports Med. 2007 Aug; 41(8):469-80; discussion 480. Epub 2007 May 1. Review. 17. Maffetone, Philip. The Big Book of Endurance Training and Racing. Skyhorse Publishing. 2010 Sep. 22. 18. www.goodformrunning.com. 19. Edwards W.B., Taylor D., Rudolphi T.J., Gillette J.C., Derrick T.R.: Effects of stride length and running mileage on a probabilistic stress fracture model. Med. Sci. Sports Exerc. 2009 Dec.; 41(12):2177-84. 20. Root M.L., Orien W.P ., Weed J.H.: Normal and Abnormal Function of the Foot - Volume 2. Clinical Biomechanics Corp., Los Angeles, CA, 1977. 21. Goss D.L., Gross M.T.: Relationships Among Self-reported Shoe Type, Footstrike Pattern, and Injury Incidence. US Army Med. Dep. J. 2012 Oct.-Dec.: 25-30. 22. Daoud A.I., Geissler G.J., Wang F., Saretsky J., Daoud Y.A., Lieberman D.E.: Foot strike and injury rates in endurance runners: a retrospective study. Med. Sci. Sports Exerc. 2012 Jul.; 44(7):1325-34. 23. Lieberman D.E., Venkadesan M., Werbel W.A., Daoud A.I., D’Andrea S., Davis I.S., Mang’eni R.O., Pitsiladis Y.: Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010 Jan. 28; 463(7280):531-5. 24. Morley J.B., Decker L.M., Dierks T., Blanke D., French J.A., Stergiou N.: Effects of varying amounts of pronation on the mediolateral ground reaction forces during barefoot versus shod running. J. Appl Biomech. 2010 May; 26(2):205-14. 25. Eslami M., Begon M., Farahpour N., Allard P .: Forefoot-rearfoot coupling patterns and tibial internal rotation during stance phase of barefoot versus shod running. Clin. Biomech. (Bristol, Avon). 2007 Jan; 22(1):74-80. Epub 2006 Oct. 17. 26. De Wit B., De Clercq D., Aerts P .: Biomechanical analysis of the stance phase during barefoot and shod running. J. Biomech. 2000 Mar.; 33(3):269-78. 27. Robbins S.E., Hanna A.M.: Running-related injury prevention through barefoot adaptations. Med. Sci. Sports Exerc. 1987 Apr.; 19(2):148-56. 28. Larson P ., Higgins E., Kaminski J., Decker T., Preble J., Lyons D., McIntyre K., Normile A.: J. Sports Sci. 2011 Dec.; 29(15):1665-73. Epub 2011 Nov. 18. 29. Hayes P ., Caplan N.: Foot strike patterns and ground contact times during high-calibre middle-distance races. J. Sports Sci. 2012; 30(12):1275-83. doi: 10.1080/02640414.2012.707326. Epub 2012 Aug. 2. 30. Nigg B.M.: The role of impact forces and foot pronation: a new paradigm. Clin. J. Sport Med. 2001 Jan.; 11(1):2-9. Review. 31. Feltner M.E., MacRae H.S., MacRae P .G., Turner N.S., Hartman C.A., Summers M.L., Welch M.D.: Strength training effects on rearfoot motion in running. Med. Sci. Sports Exerc. 1994 Aug.; 26(8):1021-7. 32. Ardigò L.P ., Lafortuna C., Minetti A.E., Mognoni P ., Saibene F.: Metabolic and mechanical aspects of foot landing type, forefoot and rearfoot strike, in human running. Acta Physiol Scand. 1995 Sep.; 155(1):17-22. 33. http://www.asicsamerica.com/Shoe-Fit-Guide/. 34. Cook S.D., Kester M.A., Brunet M.E.: Shock absorption characteristics of running shoes. Am. J. Sports Med. 1985 Jul.-Aug.; 13(4):248-53. 35. Kong P .W., Candelaria N.G., Smith D.R.: Running in new and worn shoes: a comparison of three types of cushioning footwear. Br. J. Sports Med. 2009 Oct; 43(10):745-9. Epub 2008 Sep. 18. 36. Hamill J., Bates B.T.: A kinetic evaluation of the effects of in vivo loading on running shoes. J. Orthop. Sports Phys. Ther. 1988; 10(2):47-53. 37. Rethnam U., Makwana N.: Are old running shoes detrimental to your feet? A pedobarographic study. BMC Res. Notes. 2011 Aug. 24; 4:307. 38. J. Daniels’ Running Formula. Champaign, IL: Human Kinetics, 2005. 39. Wolf S., Simon J., Patikas D., Schuster W., Armbrust P ., Döderlein L.: Foot motion in children shoes: a comparison of barefoot walking with shod walking in conventional and flexible shoes. Gait Posture. 2008 Jan.; 27(1):51-9. Epub 2007 Mar. 13. 40. Wegener C., Hunt A.E., Vanwanseele B., Burns J., Smith R.M.: Effect of children’s shoes on gait: a systematic review and meta-analysis. J. Foot Ankle Res. 2011 Jan; 4:3. 41. Wolf S., Simon J, Patikas D., Schuster W., Armbrust P ., Döderlein L.: Foot motion in children shoes: a comparison of barefoot walking with shod walking in conventional and flexible shoes. Gait Posture. 2008; 27(1): 51-9. 42. Hoekelman R.A., Chianese, M.J. Presenting Signs and Symptoms. In: McInerny T.K., Adam H.M., Campbell D.E. (eds.) American Academy of Pediatrics Textbook of Pediatric Care, 5th edition, American Academy of Pediatrics, Elk Grove Village, IL, 2.

SLOw DOwN TO BUILD THE
“Train, dOn’t strain”
— Arthur Lydiard, 1960

ENDURANCE ENGINE
PARt One
MARK CUCUZZELLA

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A

natural runner is one who progressively improves his or her running economy. It is fun to move faster and more comfortably with less effort

In a scene from the movie The Matrix, Morpheus shows newcomer Neo two pills. “This is your last chance,” Morpheus says. “After this, there is no turning back. You take the blue The aerobic (oxygen dependent) system uses the powerful pill: the story ends, you wake up in your bed and believe •  hybrid engines (mitochondria) at the muscular level. Oxygen whatever you want to believe. You take the red pill: you stay in is delivered to the engines via a rich network of capillaries Wonderland and I show you how deep the rabbit hole goes.” (blood). Specific enzymes spark the process. For some of you, deciding to run slower is like taking the red If you lower the pace below the AnT (transition from pink to pill. Your choices are to take the blue pill and continue what you •  orange in Fig 1) to an oxygen-consuming zone, you get 36-38 are doing, or to take the red pill and open your mind to what ATP per molecule of glucose — this is gas/sugar power — and may be some new magical experience. If you are often sore, somewhat efficiently, as a fit person can store enough sugars injured, or moving much slower than you think you should, to give 90 minutes or so of activity. then go for the red. Now if you slow down a bit more to below the aerobic For running, you need to develop the correct system: the aerobic •  threshold (AT) (transition from from orange to red in Fig 1), system. This is the highly efficient system using oxygen, glucose you can develop the network to break down fat into energy. and fat metabolism to produce energy. The modern analogy is Your efficiency jumps exponentially to over 400 ATP per this: each of us is blessed with a hybrid engine, actually billions triglyceride molecule! This is electric power. If you drive a of hybrid engines, at the muscular level; these are the mighty Prius, you will benefit from the subtle mixing of gas and mitochondria. The electric battery is burning fat — highly electric, which you cannot detect as the driver. Your body is efficient, with stores to run for days on minimal added fuel. It is doing this all the time in exercise. You want more efficiency resistant to breaking down. … generate more electricity! Any activity lasting more than a The less efficient but more readily available engine is the gas couple of hours is largely electric. power, or sugars. We are constantly mixing and we always need

(AnT). You are demanding ATP faster than the system can produce it aerobically. You use muscle glycogen and lactate as fuel, but the hydrogen ion waste products produce the toxic acidosis. This is not sustainable for longer distances. You produce only two ATP per molecule of glucose and lots of nasty stuff, which accumulates.

important, but we are most efficient in hybrid mode with the aerobic capacity. On the nutrition side, the runners did fill the tanks heartily after these endurance efforts with real New majority of the power coming off electric (fat-burning). So how do you build the mitochondria in your muscles, more Zealand farm food. aerobic enzymes, and more capillaries so that your hybrid engines are at optimum performance? Your goal is to build a bigger engine — build billions of mitochondrial factories and the capillary blood supply to deliver the oxygen to them. The With six weeks before the key races, it was time to enhance the anaerobic system required for tolerating oxygen debt and acidity in events that were performed at efforts above the AnT. We have a limited capacity to endure this debt. With huge aerobic capacity, Lydiard’s runners were able to run at faster speeds for longer durations without accumulating acidity and oxygen debt, and thus accelerated from the field at the bell lap. Another master of this technique is Mark Allen. He describes his evolution to this method on his website markallenonline. com/heartrate.asp. Mark tried to finish each and every run all out. After seasons of inconsistencies and fatigue, he soon discovered that running harder and harder was not the answer. Sceptical but curious about Phil Maffetone’s lower-effort training, Mark put a heart rate monitor on, and at a pace of 8:15 per mile, his HR monitor would beep at the preset 155. This was slower than he ever ran. Convinced to take the slow-burn approach he ran for months at 155 HR. During these months he became more efficient and faster at the low heart rate. Before No endurance training Capillaries After endurance training Mitochondria

The effect Of endurance training
Red / Aerobic muscle

twO fuels fOr the endurance engine
Gas Electric

heart and lungs are the fuel pump; the engines are the billions of fat- and glucose-burning mitochondria in the muscles. The good news is that it is all about running ‘easy’. For most Sugar Stored fats highly motivated exercisers, the definition of easy is not uniform. What level of effort is easy to build and enables you to use the aerobic system? How can you assess this yourself? his epic victory over Dave Scott in the 1989 Ironman, he was The pioneer in this field was New Zealand’s Arthur Lydiard, running effortless 5:30 miles at this easy effort. who trained the best middle distance and distance runners in Mark Allen went on to win six straight Ironman titles. But the 1960s. His system is based on months of aerobic training, what Mark relays to his audiences is that before embracing followed by measured increases in intensity as events these methods, he lost six straight Ironmans to Dave Scott. approach. His principles still apply in almost all modern In 1989, he not only beat Dave Scott, but beat him on his best training. Lydiard’s runners were taught what ‘easy’ was day and won by 58 seconds, taking 18 minutes off the Ironman under the master’s eye. Eight-hundred-metre specialists were record. running 22-mile-long runs and 100-mile-weeks in their base Priscilla Welch won the 1987 New York Marathon at age 40, phase. Why? To build a massive and resilient aerobic system, a feat likely never to be repeated. She took up running as on which everything else later would be built. recreation in her 30s. Priscilla was a master of efficiency, with Most of us do not have a master teacher, so how do we learn this pace? The secret is a heart rate monitor. The modern masters of this technique are six-time Ironman Champ Mark Allen and British Marathon Legend Priscilla Welch. (Note: Lance Armstrong used these methods too, but his story now appears in the fiction section.) 10K times only a trace faster than her marathon speed. She pioneered the Maximal Aerobic Function Test (MAFT). Priscilla was a believer in the powerful feedback of the Heart Rate monitor. In her build-up to races, she did the bulk of her training below HR 150. She would not exceed this, even if it meant walking up a hill. She would judge her fitness not by a time trial (all out effort over a distance) but by the MAFT. Her HR was set to go no higher than 150 and she would measure her time over a five-mile course. She knew she was aerobically fit when she hit her goal times at the easy effort.

Anaerobic
1.5 mile pace

Anaerobic
1.5 mile pace Faster!

Glucose burning (gas) aerobic
cruising speed/ aerobic heart rate

Glucose burning (gas) aerobic
cruising speed/ aerobic heart rate Faster!

Fat and glucose burning (hybrid) aerobic Health Beginning Endurance Training

Fat and glucose burning (hybrid) aerobic Health Months/Years of Endurance Training
Healthier!

Fig 1 1.5 Mile pace = Anaerobic Threshold (AnT) Cruising Speed = True Aerobic Threshold (AT)

some gas in the tank. The proportions of electric and gas shift Many of us run too hard daily and constantly use and replenish as the effort and heart rate go up. The harder and faster, the the easily accessed sugar stores. When sugar levels drop or we create acidic waste anaerobically, we crash. Mind and body more gas and less electric. Let’s now differentiate aerobic and anaerobic and the sense an overwhelming fatigue. Topping off this tank with differences with each system. Both produce adenosine-5’- more sugar at high levels of exertion is problematic. Blood triphosphate (ATP), allowing muscle contraction, but there are is shunted from the gut to the active muscles. Even if you do force down calories, what you eat tends to sit in the gut, or critically important differences. worse you toss it back up. When this occurs you have options. Most understand the anaerobic because we feel it. Walk, try to recover, and refill your tank a bit. Or take the more • Explosive exercising (sprinting) with pure anaerobic comfortable option and call it a day. respiration produces six to 10 seconds of immediate energy Even worse is when unfit athletes, who have not built the with ATP and creatine phosphate stored in the fast twitch aerobic system, shift quickly into anaerobic mode as they power muscles. No oxygen is needed, but contractions stop cannot deliver oxygen to the system. In essence, they have few after 10 seconds. roads (capillaries) and few aerobic engines (mitochondria). • If you lower the pace to a hard effort you can sustain for only To constantly access the deep fat-burning tank, you must one to 15 minutes, you are still above the anaerobic threshold train correctly and eat correctly. Some added glucose is still
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Lydiard’s runners always started their build part of the pyramid with lots of easy aerobic runs, mostly in happy fatburning zone. This aerobic threshold is the fine and mostly undetectable line where you are converting from more efficient fat energy to the more accessible glucose energy. The former These experienced athletes and coaches also understood that has limitless supply, the latter is good for about an hour or two. mixing in hard anaerobic work during the aerobic building Paradoxically, training these fat-burning engines produces phase inhibited aerobic development. Many athletes are the rich capillary pathways that allow glucose to be used more constantly doing cycles of high intensity intervals, week-in, efficiently too when it is needed during faster running. week-out, all year long, and find themselves fatigued, injured, As the training pyramid progressed toward a season, harder or lacking joy in their life and activity. Aerobic running is aerobic runs closer to the AnT were performed. The runners the happy zone, where the runner’s high exists. Very short now had the aerobic capacity to perform these runs. They six- to 10-second sprints can be done all year round, in order did not eat before or during the longer runs, and through to develop biomechanical efficiency and improve movement this method, and glycogen depleting much of the slow twitch patterns. These short bouts do not produce the damaging fibres, the runners began capillarising and building factories acidosis. in the fast twitch aerobic fibres — essentially doing speedwork (In the next issue we will discuss how to specifically tailor your without the toxic by-products, and further increasing the heart rate and efforts to build the endurance engine.)

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LEE SAXBY

It’s a bit difficult to describe when you’re ‘done’ with this stage of the training programme. Ideally, you should be able to feel your weight move from your heel, right through your foot to your big toe. When you get it right, you’ll know. Troubleshooting

Dynamic Squat: A good dynamic squat is all about posture and balance. The best way to maintain the correct form and build up the appropriate muscles is to use a weighted pole of at least five kilogrammes. As with the sitting squat, keep your weight on the balls of your feet and concentrate on your balance.

RE-AWAKEN YOUr INNATE BArEFOOT rUNNING SKILL

If you’re struggling to feel relaxed and natural when walking Try not to think of the dynamic squat as hard work; it should be a ‘bouncy’ movement and one that uses as little muscle action barefoot, run through this checklist of possible pitfalls: as possible. Complete each squat quickly; the ‘dynamic’ part of • is your stride too long? If you can hear your heels smacking on this exercise means it’s much more about the movement than the ground, you’re probably walking with a heel strike rather holding the position. than a heel stroke. Take shorter strides and relax, softening Dynamic Squat 1: Hold out your arms horizontally and balance your knee. the pole across your collarbone. As you squat, concentrate on • are you leading with your head? If you are, you’ll feel tension in keeping the pole stationary; this will ensure that the rest of your your neck, lower back and hamstrings. Focus on leading with posture falls into place. your torso. Dynamic Squat 2: This time, hold the bar horizontally above • are you leading with your pelvis? You’ll feel some discomfort your head. Follow the same squatting guidelines as above. To in your hips and pelvis if you are. Again, lead with your torso to begin with, you’ll probably find the weight of the bar topples you counter this problem. forwards; thinking about maintaining your body weight over the • is your weight moving to the outside of your foot? This will balls of the feet and keeping your head and chest up will help. cause stiff ankles and knee discomfort. Try to concentrate on Troubleshooting stepping off your big toe — don’t be afraid to over-exaggerate If you’re struggling with any of these squats, run through this the movement! checklist: • is your weight on your heels? Or does it move onto them as you squat? Think about keeping your connection through the balls A natural barefoot squat requires the foot to be flat, but the of your feet. body weight to be predominantly applied to the ball of the foot. do you keep losing your balance? You might just need to build Notice the similarity to the healthy running plantar pressure. •  up the right muscles for the job. Try squatting without the pole The barefoot squat encourages and maintains the necessary or hold onto a door handle as you practice. mobility and stability required for barefoot activities.

SQuat

S

o, what now? Even though barefoot is in our blood, that doesn’t mean you’ll start doing it correctly the second you whip off your shoes and take to the streets.

Correct posture, an awareness of rhythm and a relaxed form will allow your body to receive the sensory feedback it needs to move efficiently and safely, as nature intended. This mantra applies whatever you have on your feet: trainers, minimalist shoes or nothing at all!

Stage 1b: SQuatting

Stage 2: BarefOOt jumping

If you’ve been wearing over-protective footwear all your life, your barefoot running muscles will be weak and your posture will be all out of whack. There’s a bit of work to do first. Running is a skill; once mastered, it will allow anyone to realise the joy of running efficiently and injury free. Here is a training system that uses physical and mental milestones to help runners transition from conventional trainers to barefoot: • like all natural systems, the human brain constructs complex patterns by adding simple patterns together. This is visible in the way babies progress from simple to more complex movements; that is, from creeping to crawling, sitting, standing and eventually walking and running. • do you know the saying, ‘you have to learn to walk before you can run’? It couldn’t be truer. If our brain doesn’t learn these simple movement patterns in the right order and to the right level of competence, our potential performance further down the line is jeopardised — for runners that means poor performance and injury. • this training system has three distinct movement milestones: walking/squatting, jumping and running. To fully realise the potential of your barefoot life, you must perfect each skill before moving onto the next.

Cultures that favour bare feet or minimalist footwear rarely The barefoot jump takes things up a notch. A jump is much more have many chairs in their homes, workplaces or public spaces. dynamic than walking or squatting, which means there are Instead, people spend a lot of time in a deep, balanced squatting more forces involved and more skill required. Learning to jump position — while, for example, they eat or work. Learning to squat properly, both as a held position and as a dynamic exercise, will help you develop your barefoot running style more quickly and with less chance of injury. Here’s why: • Balance: a proper squat will position your body’s centre of mass over the ball of your foot — essential for barefoot movement; • Strength: the squat won’t come easily to someone who hasn’t tried it before, but it will build strength in parts of the body needed for a correct barefoot running style; • Flexibility: the squat will also improve the range of movement in your ankles, knees, hips and spine, helping you stretch important tendons, muscles and ligaments. Balance, strength and flexibility all contribute to the improvement of posture, which, don’t forget, is the first rule in our movement mantra.

Stage 1a: BarefOOt walking
Can you remember the last time you were truly barefoot? Because we overprotect our feet so much, our brains have learned to interpret a lot of their feedback as a warning to ‘tread carefully’. In order to start using your feet effectively, your brain therefore has to ‘rewire’ itself and learn to read these sensations as useful feedback rather than as a potential threat. The objective of this first stage of training is for you to feel relaxed and confident walking barefoot across a variety of surfaces, both natural (grass, mud and sand) and man-made (concrete and tarmac). As your feet and your brain begin to communicate properly about the new sensory information available, your movement across these terrains will become safer, confident and more efficient.

HOw tO sQuat
Although squatting is one of the first steps towards barefoot running, that doesn’t mean it’s going to be easy! Not only will you need to build your strength up to maintain the position, you’ll also be stretching muscles and tendons in a new way. Be patient and take things slowly. Learning to keep your balance while in these positions is the most important take-away for these exercises. Sitting Squat: Keep your weight on the balls of your feet; avoid the temptation to shift it onto your heels. The best way to perfect the deep squat is to practice whenever you get the chance. If you’re watching TV or have a low table you can read from or write on, take the opportunity to build up your strength, flexibility and balance so that running barefoot comes even more naturally.
NAtURAL bORn RUnnER | Spring.2013 | 23

HOw tO walk barefOOt
In theory, you can learn to walk ‘barefoot’ in any type of shoe, but you’ll make the process much easier for yourself if you wear minimalist shoes or go barefoot. Our bodies are astonishingly adaptable; keep the following four points in mind, and you’ll be walking ‘barefoot’ in no time: • your weight should move from heel to big toe, but think of it more as a smooth heel stroke than a jolting heel strike; • keep your strides shorter than normal — this will help keep your body in its optimum alignment for efficient locomotion; • try not to look down; in fact, keep your gaze somewhere above the horizon and ‘lead’ with your chest; • keep your stride relaxed, balanced and symmetrical.

Skill
A quick movement mantra As you relearn the art of movement, this mantra will help to keep you on track, efficient and injury-free: PostUre RhYthm RelaX
22 | NAtURAL bORn RUnnER | Spring.2013

will build on the strength, balance and flexibility gained in Once you are happy walking, squatting and jumping with bare Stage 1, as well as improve the elasticity of your tendons and, feet, it’s time to move on to barefoot running. importantly, teach you about rhythmic motion. If you’ve completed the previous stages properly, you shouldn’t Tendons are a bit like elastic bands. You have them all encounter any problems as you move to barefoot running. over your body and they usually connect muscle to bone. However, it is still a new way of moving so do take things slowly; When stretched, these ‘elastic bands’ snap back into place, if you’re accustomed to running five miles in regular trainers, essentially providing you with ‘free’ energy. This is known as don’t expect to be able to run the same distance straight away with bare feet or minimalist shoes. the ‘stretch-shorten’ cycle. How we run affects this cycle because our tendons stretch and recoil most efficiently at a certain ‘cadence’ (beats per minute, or bpm). When the cadence is wrong, injury often occurs. We’ll cover this concept more fully in Stage 3 of this guide, but it’s important to understand while you’re learning to jump why elasticity and rhythm are such important factors for running.

HOw tO run
There’s a lot to remember when you start running barefoot for the first time. The following checklist will help: Posture: your posture is absolutely the most important thing when you run barefoot. As you run, keep your head and chest upright and relax as much as possible; the whole of your upper body should remain stable but un-tensed. Focus on landing on the ball of your foot. You probably won’t be landing on your heels (your brain and feet don’t like it), but you still need to avoid landing on the sides of your feet or too close to your toes.

HOw tO jump
Focus on using the balls of your feet, but don’t use your tiptoes. You’re not trying to jump too high; instead, keep your bounces small and light, and start with a rhythm at which the jumping feels most efficient and relaxed. You should be able to keep going for quite a while!

If you’re struggling, think back to the connection you made with the balls of your feet as you learned to walk, squat and Eventually, try to reach a rhythm of 180 bpm: this is the jump barefoot. When your running posture is correct, your feet optimum cadence to harness the elastic recoil of the body should feel like they are landing directly underneath your body and is a fundamental coaching point in efficient, injury free as opposed to out in front. barefoot running. Bouncy rhythm and short strides: to reach the correct cadence Try the following: Standard two-leg jump: put a piece of tape on the floor and do 20 small jumps without looking down. Ideally, you should end up on the same spot. If you don’t, work out which part of you need to align in order to fix the problem; for example, are you chasing your head forwards? Once you’ve perfected this skill, hold the weighted bar above your head to add an extra challenge to the exercise. One-leg jump/hopping: running is essentially a series of onelegged jumps! Do the same exercise as above but this time on one leg. Add the weighted bar once you’re able to hop comfortably on the spot. Jumping rope: an excellent conditioning exercise and warmup drill for barefoot runners (try five minutes before running to develop an awareness of your cadence and rhythm). Again, put some tape on the floor and make sure you don’t move away from the line as you jump. for a bouncy rhythm, your feet will probably have to touch the ground more often than you’re used to. However, because you don’t necessarily want to run faster, this means you’ll need to take shorter strides. It might take a few weeks to get to this stage, but you eventually want to run at 180 bpm. Relaxed body: most of your body should stay relaxed most of the time when you run. A relaxed body is more rhythmic and uses a lot less energy as it runs. Listen to the sound of your feet as they make contact with the ground. Quiet feet are relaxed feet! If you’re finding it difficult to un-tense, focus on specific parts of your body at a time (your hands are a good start). Contract the muscles for five seconds then completely let them go. This contract-relax technique is an excellent way to build awareness of the difference between relaxed and tensed muscles.

A fully relaxed and skillful technique is the sign of a master in any sport, so be patient for this last pointer; it will take time and NB: As a benchmark, if you can manage to jump rope at 180 bpm practice. for five two-minute rounds with a one-minute rest, you should Troubleshooting easily manage a 10-minute barefoot run at the same cadence. Here are a few of the most common problems for people Troubleshooting transitioning to barefoot running: If you’re struggling to jump in the manner described above, •  are you bent at the hip? Make sure you’re not head chasing and there are two main things you could be doing wrong: keep your gaze somewhere above the horizon. • if you keep losing your balance or moving away from the tape, •  is your foot landing too far ahead of your body? This will upset you need to check your posture. Stay relaxed but make sure your natural movement, so make sure to keep your foot landing that your head and chest are pointed up and are positioned directly underneath you. vertically above your hips. Try doing a few squats with a pole • are you landing on the wrong part of your foot? Heel striking is to help your body remember the correct form. out of the equation, but be wary of running on the side of your • if you’re finding the jumps really hard work, chances are foot (supinating), or too close to your toes. you’re using too many muscles! Keep your body relaxed and • are you reaching too far with your stride? Keep your strides don’t try to jump too high. short and rapid, rather than long and heavy.

USE IT OR LOSE IT
Barefoot Ken Bob Saxton

B

iological features that are not used regularly atrophy. Not only through generations of evolution, but in shorter periods as well: a lifetime; months; even within minutes, our bodies can divert resources from where they seem unnecessary to where they are currently needed. These responses affect mental capabilities as well as physical. The brain and its sensory inputs — such as the muscles, tendons, bones, etc., in our legs and throughout our bodies — also require regular stimulation and activity in order to justify maintenance. In this article, I’m going to discuss changes to both strength and intelligence that typically result when

we protect ourselves from activity. Contrariwise, we also need to allow time between activities for recovery. Ultimately, by dealing with these self-imposed weaknesses, I hope to help those of you who wish to benefit from barefooting, so that you can find a path towards becoming a gentler, safer, and more graceful person, while at the same time strengthening areas which have atrophied from lack of use. Because I am very familiar with barefoot running, I will focus on the changes that could occur as people employ barefoot running to become better runners.

Stage 3: BarefOOt running

• do you have a slow ‘sticky’ rhythm? Shorter strides means you should feel light and bouncy as you run — nothing should shake The exercises in Stages 1 and 2 will improve your posture and help you appreciate the natural rhythm of your body. These as you run past! activities will also reconnect your feet with your brain and • do you have a tense upper body and/or shoulders? Relax! the rest of your body — you’ll be using sensory feedback from the soles of your feet to move safely and more efficiently in This is one chapter from Lee Saxby’s free ebook that can be downloaded at http://trainingclinic.vivobarefoot.com everything that you do!
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HOw it all began
When I was younger, we played all summer, walking, even running, on all sorts of terrain, happily barefoot. And virtually all of our pre-historic ancestors went barefoot for much, if not all of their lives. Only the wealthy could afford to wear something as  debilitating  as footwear — showing off their fancy footwear while being carried or pulled  around  in some sort of carriage by barefoot servants. Only in an age where most people do not typically depend on walking or running for transportation could most of us practise wearing shoes all day. Some argue that “if our feet didn’t need shoes we wouldn’t have invented them”. One could equally argue, “We wouldn’t have invented refined sugar unless it was necessary.” I will concede that there may be times for protective footwear (for refined foods, not so much) as in extreme cold, or hiking or running for several days over sharp lava stone (though I have read reports of Kenyan children laughing and running barefoot on these terrains). Or, if our feet are tired or injured, we should provide support, just as we would with an injured arm. However, after healing begins, we remove the cast, so we can strengthen the arm again. Somewhere along the line, we forgot to remove our shoes! Now we wear shoes all day long, every day rain or shine, hot weather or cold, tired, injured, or not. Naturally, our feet become weak and much less useful.

to do too much, too soon (for example, if you currently walk less than a mile a week). However, when we build our distances very gradually, while learning to run gently, the Olympian in each of us will (probably sooner than expected) find it much easier, more comfortable, and more enjoyable to run further and faster more frequently. This will not be because we are constantly pushing Starting OVer again ourselves through pain, but rather because we have avoided pain, This feedback system works fine, if we have been barefoot most and should rarely be sidelined recovering from injuries. of our lives. However, when our chronically shod feet first touch As I’ve said, immediate pains, like when we step too hard on a rough ground, it’s less like a sensible message, and more like sharp pebble, teach us to walk and run gently. screaming! But how do we know when we’re doing too much, too soon? every step we take. If the soles of our feet hurt while we run, it is immediately and emphatically obvious that we should change the way we’re moving, in order to avoid those stresses. This is the most important, and ironically the most ignored aspect of barefoot running! And yet, I encourage beginners to start on stimulating (rough) terrain for very short distances, even just standing, or walking for a few steps. Why not begin on more comfortable terrain so that we can run further and faster more comfortably? Because it is not sensible to run further or faster until we have learned to stand, walk and run in a way that isn’t going to continue to injure us! We won’t, in most cases, until we finish our activity. The feedback (pain) that informs us when we’ve done too much, too soon is usually felt after we finish, probably for survival purposes. If we are being chased, or chasing down some food, it would not be helpful for our bodies to start complaining that we’re pushing our limits before we reach safety or catch dinner. Only after we Our shoes failed to teach us to run safely, so that experience stop can our brains assume that we are safe (or have dinner) and provides little useful reference. This is the reason I don’t like to it’s time to rest! think in terms of ’transitioning’ from shoes to bare feet. We don’t After we’ve improved our technique so that we aren’t abusing transition from hitting ourselves on the head with a hammer: we our bodies with each and every step, it is fine to push our limits stop doing it. — once in a while, even when we’re not being chased by huge carnivores. Then we begin doing something healthy. As with unreasonable expectations that our feet should become The old 10 percent ’rule’ is a good starting guide (not a strict rule). stronger when supported by shoes, it is also unreasonable to Most (at least 90 percent) of our outings should leave us feeling expect to run barefoot the same distances we did in shoes at the refreshed, rather than worn out. Unless we’re being chased by a huge carnivore, only occasionally (less than 10 percent of the beginning without problems. time) should we push our limits so that we hurt afterwards. How We should expect our bare soles to be overstimulated (hurt) at much should we push? That’s your choice. Basically, the more we the start, which will definitely limit how far we can go. This is a push (speed, distance, or frequency), the longer we will hurt and wonderful self-limiting mechanism, because we should not be the longer we should allow our bodies to recover. running or walking barefoot very far until we learn to run sensibly. Listening to your own body is your best guide — in the long run. Have fun. Sensible running Avoiding injuries when we begin barefooting is not as simple as avoiding ’barefoot running exuberance syndrome’ (i.e. too much, too soon). It has more to do with ‘doing too much before learning to run safely’. The trick is to completely relearn how to walk or run so that we are not abusing our bodies. Begin by playing like children. Or if that seems immature, experiment and test like an engineer before beginning production. We need to figure out how to intelligently reduce injurious stresses. Modern cars have traction control systems that use feedback from the wheels to limit spinning, or skidding. The cool thing is that because of these reduced stresses and strains the entire car lasts longer. Our bodies have an even more elegant system to protect us. Our sensors are actually on the surface of our ’tires’, intimately feeling how all areas of our bare soles are interacting with the terrain. This information is processed by one of the most sophisticated computers on this planet: our brains! When we step barefoot onto stimulating terrains where humans commonly run, our soles are going to feel pain, with each and every step — unless we change the way we load our weight onto our bare soles. Changes that are more comfortable for our bare soles reduce, eliminate, or redistribute pressure, impact, abrasion, and torque, which may have been comfortable and yet injurious in shoes. The stimulation of our bare soles directly stimulates our brains, and even if this doesn’t actually make us smarter, at the very least it ’smarts’, and encourages us to run smarter.

Under- and OVerwOrked areas
Our feet are two of the few parts of our body that we treat as if protecting them from activity will keep them strong and healthy. One factor that may account for this ’reasoning’ is that we often treat our brains the same way. With runners, the cause is mostly and obviously excess impact. However, even if we stop slamming our feet into the ground, eliminating impact, there is no vascular blood flow to deliver nutrients to the cartilage. This is the other reason There are few other parts of our body that we would expect people believe the joints cannot heal. to become, or to stay strong and healthy without regular I disagree with this too. stimulation and activity. But there are also areas that have Joint cartilage is a bit like a thin slippery sponge separating been over-used when we moved, as if our shoes, or the terrain, the ends of two bones. Nutrients are pumped in and out by provided some sort of protection from abusing our body. flexing and compressing the joints. If we immobilise the joint, It has never been absolutely necessary to know which specific structures in our bodies need more exercise or which need more gentleness — not for our pre-historic ancestors, not for modern infants, not for us. few healing nutrients are delivered. If we continue with the activity that caused the damage, we continue destroying the tissue faster than it can heal. We need an activity that moves the joints, without furthering the damage. Ironically, that While we learn to run naturally, areas that need exercise will be activity may also be running, but just more gently. exercised (mostly the more elastic muscle and tendon groups that return most of the energy absorbed while landing). Areas The mOst impOrtant aspect Of barefOOt running that require more gentleness will be used less harshly (e.g. The most important thing to know about barefoot running is that it helps us learn to run gently — to put less strain on areas knees, ankles, hips, and spinal column). that have been abused when we ran unaware. Ultimately, our The secOnd mOst impOrtant aspect joints will enjoy gentle flexing and loading and unloading, Of barefOOt running without severe impact. The second most important thing to know, if you want to If we have not been using our soles and suddenly begin using start running naturally, is that it can take several months to them, the skin will be soft and sensitive. As we move barefoot, strengthen your feet, especially the bones. Barefoot running, our soles will hurt, and consequently, we would change the however, is not even barely about ’toughening’ the feet. But I’ll way we move, so that it doesn’t hurt. discuss that in the next section. This is not unlike traction control systems in modern Many shod distance runners suffer from chronic joint pain automobiles. We protect the tires on our cars from wearing and injury due to abusive running technique. There are many out prematurely by making better tires, but also by avoiding experienced runners who believe that damaged cartilage in the skidding and sliding. This not only protects our tires — driving joints does not heal. I disagree. our cars more gently also reduces abusive stresses and strains Many runners with knee damage continue running until the on the entire vehicle. pain is unbearable. Then they take pain killers and run more. This is essentially how barefoot running teaches us to put If you hit yourself on the head with a hammer, you’re going to injure your head. Will it heal? Your circulatory system will deliver nutrients to heal the wound. And — wham! — you hit yourself again. Healing won’t be effective unless the cause is eliminated.
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less stress, obviously, on the soles of our feet, but also on our entire body. Every stress that causes chronic pain and injury in runners (other than running into trees, and such) necessarily passes through our soles. We have many nerve-endings in our bare soles serving as quality control inspectors for each and

Sensible training
I would encourage millions of people to simply walk or run a few miles, a few times each week. However, even then it is still possible
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Primal nutrition for primal running
Part One
MATT WALLDEN

I

t’s a minefield! One guru says we should eat only plants; another says only meats; still more say eat a balance, but only in specific ratios — and then it all changes, come race day! Who are we to believe?

Interestingly, this is not just a challenge that we runners face, but a challenge that even those who work professionally in the field of medicine, rehabilitation and performance conditioning face. And just like the million-dollar question, ‘How long will it take me to transition to barefoot running?’, the question of what a runner should eat is equally challenging to answer. Scientific studies abound, but the key to understanding if You will be glad to know that I believe I may have a solution for something is right or wrong for you probably lies in your you. It may not be the solution you were hoping for; indeed, when ancestral past. There is little doubt, for example, that to survive I first came to understand it, it wasn’t what I was hoping for — but, in the harsh outdoors is no simple feat. The ability to find food and to get enough sustenance from the environment, not just to for me, it is the solution that makes the most logical sense. survive, but to thrive, would (and in many cases does) challenge What are yOur ObjectiVes? any human being alive on the planet today. Before we take the discussion any further, as with any good The way we made inroads into developing the technologies that project, we need to understand the objectives, and what the see much of the world so comfortable for foodstuffs today was outcome is that we want to achieve. If we are running for health through running. Not exclusively, but, almost certainly, primarily and for enjoyment, then our nutritional requirements may well through running; and of course this was done long before the differ from those that apply if we are running for performance. advent of footwear, and in one of the harshest terrains on the And if we are running for performance, then it is key to know planet: the baked-hard-as-concrete planes and rocky, volcanic whether we are running short distances, middle distance, long regions of Africa. Our ancestors ran barefoot, on rock, for miles distance or ultra-long distance. In addition, are we planning on on end chasing deer and other creatures until they collapsed running these distances at a steady state, or are we planning on from heat exhaustion. using more variation in pace, and will we therefore require more Gurus and nutritiOn energy systems to be used? Having studied nutrition extensively for the last 20 years, it is clear to me that it is possible to ’take a stance’ on a given topic — for example, vegetarianism, protein powders, macrobiotics, supplementation and so on — and to convince oneself of the evidence one way or another. Simply, the sheer volume of research studies out there, whether with a vested interest or not, allows for any opinion to be rigorously ‘supported by research’. So, where to?
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This is the challenge facing any medically trained person and, indeed, everyone participating in the event we term ‘life’. When the next person tells you “I’ve found this wonder food, the magic supplement, this energy-maximising drink”, my advice is to ask yourself: “Does this relate to how we got here?” If the answer is yes, keep your ears open and consider if it’s for you. If the answer is no, keep your ears open and consider that this may not be for you. Of course, this applies to running shoes and other exercise equipment too!

There are many potential flaws with following a guru’s nutritional habits or recommendations. Firstly, we know that different stresses on the body create different nutritional requirements. Try feeding a high-carb diet to an Alaskan Inuit and he will probably freeze to death; it turns out proteins and fats are more thermogenic than carbs, and it just so happens that as you migrate further from the equatorial regions towards
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the Poles, nature provides fewer and fewer carbs until all you have left is proteins and fats (meats). Intuitively, we know that we simply don’t feel like eating a huge roast dinner on a hot summer’s day; and reciprocally, we don’t usually feel like eating a light chicken salad on a cold winter’s day.

GeOgraphy/climate/aVailability

Weston A. Price was a researcher and pioneer in the field of nutrition, who looked into geographical differences in nutrition and found that those groups who were in an environment with little exposure to meats and high exposure to vegetation (often deep in jungle ecosystems) had developed very long digestive tracts, not dissimilar to that of herbivores, such as cows — whereas those who had migrated to regions where there was almost no vegetation (such as at the Poles) and subsisted almost exclusively on meats and fish had shorter digestive tracts, more elite athletes guzzle pasta by the plate-load, and soda by the akin to those of carnivores, such as lions. CamelBak-load, we might think that in order to be like them, we What is key is that within either group, general health was must copy them. However, copying icons can prove to be a very excellent with an admirably low rate of degenerative diseases dangerous thing. (such as diabetes, cancer, heart disease or arthritis). Natural For example: first, athletic icons are normally pursuing selection had resulted in those who did better on a vegetation- performance to the detriment of health. If that, too, is your aim, dominant diet surviving and thriving in a jungle environment then you may want to mimic them. If it is not your aim, you and those who did better on a meat-dominant diet surviving may want to consider things more carefully. Second, it is highly and thriving at the Poles. The key question is: where does your unlikely that you have the same physiology, the same stressors personal physiology fit in to the picture? How far back do you and the same ancestral line as your icon (if you did, you might know about your ancestry? well be there competing with them) — therefore, follow their You’ll be glad to know that there are other ways this can be nutrition at your peril. assessed, such as through a questionnaire-based process known as ‘metabolic typing’. To learn more about this, see resources at Simplicity in the cOmpleXity One thing that has become apparent is that the more information the end of the article. that becomes available and the greater the complexity of the Stress and fOOd considerations, there is always simplicity in the complexity of Stress also changes our nutritional requirements. Interestingly, things. Nutrition is one of those simple things too. and some might think controversially, we need more cholesterol in our diet when we are under stress. This is because Meat and Vegetables cholesterol itself isn’t bad; in fact, it is critical for health. It is the Are we designed to eat meat? In a word: yes. In a few more words: inflammation in the body’s blood vessels, usually caused by over- without a shadow of a doubt. You may have noted above that we exposure to sugars, oxidised vegetable fats, or other dietary or need cholesterol to survive and perform healthily. Fortunately, the body manufactures around 85 percent of the cholesterol we environmental toxins that is bad. Cholesterol is released from the liver and is circulated in an need endogenously (within the body); the rest we must get from attempt to heal the inflammation in the blood vessels. Of our diet. If we do not, our hormonal system will be compromised: course, when people eventually die from heart disease, the first our sexual prowess will go (impotence, loss of libido), then autopsy shows it was cholesterol that blocked the artery; and our blood sugar regulation (feeling drowsy after meals, low on since 50 percent of westerners die from this very process, it is energy), then our fluid regulation (cellulite, a bloated, puffy look understandable how a $30 billion a year industry has grown up to the tissues) and finally our stress hormones will go (tired but wired, chronic fatigue, system shuts down). around it. However, cholesterol is the good guy… … the problem is that when cholesterol is measured as ‘high’, it is an indication that ‘bad stuff’ is going on. As my friend and colleague Paul Chek states: “blaming cholesterol for heart disease is like blaming the fire brigade for causing fires; they always show up when there’s a problem”. As it turns out, cholesterol is required to make our stress hormones, our sex hormones, our blood sugar regulation and our fluid regulation hormones. Most animals produce their own Vitamin C, but humans do not. As with cholesterol, we need to take in Vitamin C through our diet. Whenever we see this pattern, the current wisdom suggests that the reason we lost the ability to make Vitamin C is because we ate foods containing so much of it in our evolutionary past that we no longer need to produce it endogenously. The book The Complete World of Human Evolution states that all apes and humans are frugivores (fruit-eaters), with just a few species eating leaves as well. Chimpanzees and humans also eat animal flesh.

“bLamING CHOLEStEROL FOR HEaRt dISEaSE IS LIkE bLamING tHE FIRE bRIGadE FOR CaUSING FIRES; tHEy aLwayS SHOw UP wHEN tHERE’S a PRObLEm”

It emerges that what we did have was a unique capacity to track and run down prey over distance and that not only were we better at this than any other creature on the land, but we did it on a diet of meat, vegetation and fruit. In addition, it was the very diet of meat that facilitated the growth of the brain (which itself is composed of up to 60 percent cholesterol).

Health warning
Even this advice carries a health warning: fruit is only useful to you when you are active and moving. When you are sedentary, you should avoid fruit like you avoid table sugar. Current research tells us that fructose is an excellent source of energy when on the move for several reasons:

So: if that’s how we got here; if it’s required for optimal •  it is passively absorbed into the blood stream (i.e. you can stay hormone production; and if it’s what facilitated brain growth in fight/flight); in the first instance, do you think cutting out meat and • fructose can enter directly into the cell without the presence of therefore cholesterol is a good idea? insulin (which is in sparse supply during exercise); and

PreparatOry nutritiOn

• in muscle, fructose is converted into ready energy after just Preparing yourself to run a race, or to do any distance that takes one chemical reaction (as opposed to the 10 steps of glucose metabolism). beyond three minutes’ duration, means that you need to train your aerobic system, the system that uses fat as its primary However, when you are not active, fructose is rapidly converted energy source. If you train at intensities that are higher (and into fat stores and can result in weight-gain and even fattyshorter) in duration, then you may well be using carbohydrates liver syndrome, which is almost indistinguishable from that of too. Nutrition for running depends on how far, what intensity alcoholism. Nature is smart: fruit is only naturally available for and for what duration. The idea that pasta is what is required short spells of the year and it is exactly during those spells that for endurance is not only flawed and potentially injurious, you want to gain weight because winter is around the corner. but it also compounds a problem that is endemic in Western Fruit and fructose is the vehicle for doing just that. society: over-consumption of carbohydrates and therefore facilitation of glycolytic pathways burning carbs in the POst-eXercise nutritiOn body. Reciprocally, there is deconditioning of the oxidative After you’ve run, you will be going into a beautiful ‘parasympathic rebound’ (read rest/digest) state. You are now ready to eat, and to pathways, which burn fat. The key here for health and long-term performance is to eat foods that require active transport; proteins, complex carbs condition the oxidative pathways for the metabolism of fats in the form of starchy vegetables, and perhaps even a little sweet through appropriate dietary choices and through appropriate treat, ideally in the form of fruit; but if you’re going to eat sugar, intensities of exercise (see resources at end for more now’s the time. information).

This will facilitate the digestive and repair processes and allow Additionally, hormonal function should be optimised before you to recover more quickly, and will also allow you to produce any physical activity; therefore appropriate ratios of meats all the correct regulatory hormones to support recovery of your energy systems and your worked muscles and joints. to vegetables in the diet are a necessary pre-cursor for It is acknowledged there are greater complexities than what has performance and for health. been presented here, but this is the simplicity that carves a path Eating On the run through the complexity. Eating while in motion is only relevant for longer distances, In cOnclusiOn but it’s worth quickly applying a little basic physiology to aid your choices. Your body can only ever be in one of two Simply put, human nutrition, whether for performance or for states: fight/flight (when running) or rest/digest (when not health, is about respecting how we got here; eating a combination running). To ask the body to digest when running is like of meats, vegetables, nuts and seeds, with fruit and honey (but asking someone to pull their trousers up while pulling them only when in conjunction with exercise). If you’d rather eat fruit and honey every day? Well, I trust you can work out the solution down. This is simplicity in the complexity. to that! However, there are one or two loopholes, as a simple understanding of digestive physiology highlights. Nutrients can be divided into two groups: (1) those that require active ResOurces transport from the gut into the blood system and (2) those To learn more about cholesterol, see: that passively diffuse. The Cholesterol Myth by Uffe Ravnskov The first will of course mean that you must divert blood $30 billion reasons to lie about cholesterol by Justin Smith away from the working muscles, to the digestive system. The second is a smarter idea for those on the move, allowing To learn more about indigenous eating, see: them to remain in a fight/flight state. Nutrition & Physical Degeneration by Weston A. Price So, what is it that nature would have allowed us to eat on the move? Quite logically, it is fats, fructose and water. What does that mean in real terms? It means you can eat nuts, seeds and fruits (even some honey) — and drink water, too — the kind of thing you could carry with you or pick up on the fly if you were wandering the African savanna. What should you avoid? Sugar, complex carbs (grains/starchy vegetables) and meats; these all require active transport across the gut wall and will send you into a rest/digest state. Don’t let drinks manufacturers and scientifically engineered food producers tell you what their research proves; look at the physiology, and look at how we got here, and you will do just fine. To learn about customising your own nutritional requirements, see: The Metabolic Typing Diet by William Wolcott and Trish Fahey How to Eat, Move & Be Healthy by Paul Chek Or find a certified Metabolic Typing nutritional advisor here: http://www.mt-advisors.info/ To learn more about how to train with in your own aerobic zone, see: The Maffetone Method by Philip Maffetone Or contact Helen Hall at Perpetual Forward Motion; more details here: www.perpetualforwardmotion.com/coaching

EXercise

Then there is exercise: the optimal preparation before exercise, This is where it correlates back to cholesterol. Cholesterol is the calorific demands of the exercise and post-exercise only found in animal products; you can’t get cholesterol from vegetables. If our bodies have stopped producing all that we need, requirements for replenishment, repair and so on. What it all boils down to is that no one-size-fits-all approach to it must be that we were eating so much of it that we did not need nutrition exists. It depends where you are, what your demands to make it. are, what your health status is, and where your ancestral line It just so happens that the fossil record and the best evidence we came from. have from anthropology tells us that from around two million years ago, our ancestors began to eat meat. We know this due to COpying icOns the shape of the skull, the shape of the teeth and various other Then, aside from all of the above, we have the performance adaptations. However, what we didn’t have was tools (innate or factor. We know, for example, that sugars (or more loosely man-made) with which to hunt meat until around 200,000 years put, carbohydrates) are what fuel our muscles, right? So when ago. Or so we thought.
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LUNA SANDALS / BAREFOOT TED

How to

Run Happy
SMILE – As TED WOULD saY: “IF YOU WaNt tO RUN HaPPY, sMILE, DUH!”
Most people perceive running as a necessary evil required for getting is shape or losing weight, so they resist doing it. Think of it as having fun, because it is, especially in sandals. Light steps – Use your ears, the quieter your steps, the better your form. Quick cadence helps also – try for around 180 steps per minute. Good posture – Don’t bend forward at the waist. Lead with your heart then your head then your hips (just like in all of life). Engage your core to hold you stable, and then lean slightly forward and let gravity pull you. Don’t over-stride – Landing on your heels hurts – don’t do it! Land on your forefoot, foot underneath you. This allows your body to gently absorb the impact of the earth. Don’t believe me? Try skipping rope barefoot and landing on your heels. OUCH! Slow down – Unless you are racing, perhaps even then, remember the tortoise and the hare? When you run slowly you are less likely to get injured, will burn a higher percentage of fat, and see more flowers. If you can easily carry on a conversation with your running buddy – that’s perfect – if you are telling her how much you love running in Lunas, all the better.

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MANUEL LUNA

BAREFOOT TED

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JOHN EDDINGTON

W

hen Newton Running invited me onto a running course in Twyford in the UK, I was delighted. It seemed a great opportunity for me to check out my running gait and to learn a bit more. Also, into the bargain I would be trained to become a Natural Running coach. I have been running regularly for around five years now, and as time has gone by I have become more interested in running styles. I started running as a means of becoming a little fitter, but after entering a few races, and training more seriously for those races, I wanted to know how I could run more efficiently and with fewer overuse injuries. I started to read books about ultrarunners and running in general and came across the book Born to Run. This got me thinking about barefoot running,

NEWTOn RUnnInG COUrSE
Natural Running style and more. I read more books, such as Danny and Katherine Dreyer’s Chi Running and Ken Bob Saxton’s Barefoot Running, Step by Step. I also attended some barefoot running lectures in London given by Matt Wallden of Primal Lifestyle, and Barefoot Ted (of Born to Run and Luna Sandals fame). Over a period of a couple of years, I started to subtly change the way I run. I thought my form had improved a little, and I wanted to check if this was the case.
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< Running past Woolsthorpe Manor, birthplace of Isaac Newton

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PhilOsOphy
The following is an excerpt from Newton Running’s website. It tells you a little bit of what the company is looking to achieve. “Millions saw the apple fall, but Newton was the one who asked why.” — Bernard Baruch When it comes to designing running shoes, Newton Running is the first to design running shoes that mimic your natural barefoot running form. With this in mind, not only are we introducing a new line of running shoes, we also strive to be an information centre for better running form, injury prevention and training. Newton Running’s mission is to be the leader in running shoe technology while creating a culture with a focus on manufacturing environmentally friendly products, on social responsibility, on superior customer service and on creating an environment where every employee, customer and vendor is valued and respected.

3. High knees This drill is to give an exaggerated example of what is known as the preparation phase of the running gait, where we bring the knee up high before bringing the foot down directly beneath the body with our weight over the foot. We ran forwards with very high knees, with knee lift at 90 degrees to the body, and with a very high cadence. The benefit of this is the way the foot comes down underneath the body on the forefoot and is already moving backwards. With a heel strike, it tends to be out in front, which leads to impact, braking, and the body having to then haul itself over the foot, overcoming the inertia of braking. 4. Butt flicks In this drill, we started in the neutral position and ran forward at a high cadence, trying to literally kick our butts with the heel lift.

MOtiVatiOn
I live next door to the house where Isaac Newton was born, which might have inspired some extra motivation to go on the course. At the beginning, we were introduced to Mike Trees and John Needham. Mike heads up TCL Sports, who are responsible for bringing Newton Running to the UK. Mike has more than 25 years’ experience in triathlon as a professional triathlete, world champion and coach to elite triathletes. He also spent many years researching training techniques and triathlon clothing materials.

John, who led most of the coaching sessions, played rugby for 14 years, representing club, school, county and university. He moved into triathlon in 2010. Representing the University of Leeds, he had some success in the BUCS competitions, contributing to a team bronze in the biathlon event. He graduated in Sport —Bernard Baruch and Exercise Science with an industrial placement in Sports Development. He is passionate about all sport from grass roots to elite performance and has worked with athletes of all abilities as it. This time the finger hit our chests a lot harder than when we had tried tapping it. The reason for this is that, when tapping, we a sports massage therapist. use the force of muscle power, and when we release the pulledSo we knew we were in safe hands working with these two. back finger, we use the elastic recoil stored in the fascia around the muscle. If we can use that energy in running, it is free energy. THE COURSE On the first day of the course, we started by looking at balance and posture. The very first thing we learned from John was how better balance leads to better posture and more efficient movement. He explained how better balance means better posture and more efficient movement. We learned how to stand in the neutral, or athletic, position — ankles slightly relaxed, knees a little bent, hips relaxed, back straight, shoulders relaxed and in line with the ear. All exercise should start from this position. From this position, we identified that by raising the heel slightly (we did this by standing on the front of the shoes we had taken off) we threw the weight forward and the back curved backwards to compensate for this. It is immediately noticeable that this is an uncomfortable position to stand in. This highlights the position in which we stand in most running shoes with the heel higher than the forefoot. We then had some discussion on how the body changes through the three gaits of human movement: walking, running and sprinting. We then moved on to look at how using an efficient running form can help us to better use the natural elasticity in our muscles and tissue and to use the energy stored when landing.

“MILLIOns sAW tHE APPLE fALL, bUt NEWtOn WAs tHE OnE WHO AsKED WHY.”

This is to emphasise the high heel lift required in natural running. The benefit is that by having the leg folded, by virtue of how high the heel is, we have effectively shortened how much leg has to be swung forward. It is related to leverage and moments. It is easier to swing a short limb than the leg at full extension. 5. Body balance drill (Segway drill) For this drill, we started from the neutral position and ran on the spot, emphasising the high knee and heel lift. Then we leant forwards, and started to move forward. When we leant back, we moved back, and likewise side to side. The purpose of this drill is to show that you do not have to push off hard, rather just be lifting the knees and heels and leaning in the direction you wish to travel. 6. Body alignment The coach explained the importance of body alignment. It is critical to maintain symmetry when running. Legs and arms should be moving in the Saggital plane. Hands should not cross the centre of the body, helping to keep the feet in alignment.

The key point to remember here is that if you use your muscular system to absorb shock, it produces a far smaller impact than if you use the skeletal system. Landing on the heel transfers the shock through the heel, through the leg, hip, back and on up. Landing on the forefoot with a slightly bent knee, and the foot beneath the body, uses the springy elastic recoil to deal with the impact and also means you don’t have to experience the braking force of sticking a heel out in front. We moved on to some drills specifically designed to re-establish good habits by over-emphasising the correct movement. We had already highlighted that heel striking is a learnt gait that is only made possible by the thick-heeled running shoes; these exercises help to correct that gait.

We then did some demonstrations using hopping. When asked to hop on the spot, we all hopped at a relatively high, springy frequency, thanks to the elastic recoil. When we slowed the cadence down, it immediately became much more difficult. This is because we had swapped from using the elastic recoil to using muscle power to balance us on landing and power us to push off again. It really was the most obvious display of the benefit of elastic recoil. The key element to remember with elastic recoil is that the fascia will hold the energy put into it for 0.3 seconds. That means to fully use the recoil in running, the foot needs to land and take off within this 0.3 seconds. Many people tell us to run at a cadence of 180 steps per minute but this explains why most clearly. It is the cadence that fully employs elastic recoil. We then looked at the implications of impact on the body during running. We hopped on the spot again and realised that we all naturally land on the forefoot in a light and springy manner, before the heel touches down for a split second and we take off again. We tried to do the same exercise landing on the heel. The results were teeth-shatteringly awful: you would never choose to do this, but it highlights why you shouldn’t heel strike when running either. Using a mid-foot landing allows the muscular system to absorb the shock, minimising the impact on the skeletal system.

To demonstrate this, we tried running on the spot and then, in an exaggerated way, crossing the arms across the centre line. Try this for yourself to see what happens. Once you have To begin with, we ran barefoot whilst being filmed, so we done this, you will be more careful where you swing your arms could see what our gait looked like. Filming is a technique in future. used in many other sports, such as golf and cricket, to show After the drills, we went on to do some conditioning exercises you what you are actually doing. It is surprising how greatly to increase core strength. We will cover conditioning in this can differ from what you think you are doing. In my case another article. it was very clear that my arm swing was very small and not As part of the coaching, we were assessed on how we symmetrical either. This gave us something to focus on during presented different elements of the course to the coaches. the following drills. This was actually easier than I expected because of the logical 1. Marching in place way things had been explained, and how the various drills and Starting from the neutral position, we marched on the spot, exercises lock an idea into your brain. lifting our feet high off the ground. We focused on swinging From a personal point of view, I found the filming of our the arms with a 90-degree angle at the elbow, whilst keeping gaits very useful. I have read a number of books on barefoot hips level, back straight and shoulders square. This gets people running, chi running and so on, but it is great to see which used to the idea of lifting the feet rather than pushing off and parts you have adopted, and which parts you just think you is an essential part of Natural Running. have adopted. It was clear to me that my arm movements were 2. Running in place asymmetrical and the swing incomplete, so I came away with Again starting from the neutral position, we progressed something specific to work on to improve my running. Also from marching to running on the spot. We observed that the conditioning highlighted that I have neglected the top half we instinctively landed on the front of the foot, with a high of my body and need to greatly improve my core strength. cadence to make use of the elastic recoil, thereby avoiding I would recommend the course for anybody who is interested in the impact of a heel strike. It was also interesting to observe improving their running efficiency. The course is informative that when we slowed this cadence down, running became and well delivered, and they are a friendly and inspiring group more difficult. Again this highlighted the difference between of people at Newton Running. I think you would be very likely using elastic recoil at high cadence and muscle power at to improve PBs and hopefully go some way to reducing impact and overuse type injuries with tips learnt on this course. low cadence.
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The discussion turned to elastic recoil and how we can use that in our running. I had read about this concept, but it was explained and demonstrated in the clearest possible terms using a number of clever drills. To further highlight this point, we banged our heels on the ground Firstly we tried tapping a finger on our chests as hard as we could. in front of us, mimicking what heel striking would do without Then, in contrast, we tried holding our hand flat on our chests, shoes. Again, the shockwave can be felt running through the leg and pulling a finger back (loading it with energy) and releasing and all the way up to the head.
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What we can learn about running from barefoot running: an evolutionary medical perspective

DANIEL E. LIEBERMAN, Department of Human Evolutionary Biology, Harvard University, Cambridge MA This review makes the argument that we can learn much about running in general from barefoot running. I first review the current debate about barefoot running, highlighting points of general agreement and disagreement, as well as some misconceptions. I then review the evolutionary medical hypothesis that the human body is adapted to a barefoot running style. I next consider what we do and do not know about the biomechanical differences between the ways many habitually barefoot and shod runners run and relate these contrasts to issues of injury, most of which are unresolved. I conclude with a series of questions and problems for future research.

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H

umans have been walking and running without shoes for millions of years, but there has been a recent surge of interest in barefoot running among runners, the media and the sports medicine community. Although we know little scientifically about barefoot running, many diverse opinions have been expressed on the topic. As often is the case, extreme views tend to get the most attention. At one end of the spectrum, proponents of barefoot running argue that running without shoes is more natural and better for you and that shoes cause injury. At the other end of the continuum, sceptics argue that barefoot running is a dangerous ‘fad’ to be avoided. Other frequently expressed opinions are that barefoot running is unhealthy because the foot needs cushioning, protection, support, and motion control; that barefoot running may be safe on a beach or a lawn but hazardous on hard surfaces such as asphalt and concrete; and that only individuals who are blessed biomechanically should run without shoes.

skill, or novel environmental conditions such as hard, flat paved running surfaces. A related, widespread hypothesis is that many injuries result from ‘training errors’, when people run too far or too fast without properly adapting their musculoskeletal system, or when they run too much on hard unvaried surfaces without appropriate protection from their shoes.

The barefoot and minimal shoe running movement primarily stems from a different hypothesis: that many running injuries derive from poor running form. Unlike swimmers, golfers, and tennis players, few runners today are taught running form, in part because of a common assumption that running, like walking, is so natural that all humans develop a natural form appropriate to their anatomy and physiology. The evolutionary medical hypothesis discussed in the next section is that a barefoot style is, by definition, a more natural running style to which the human body must have been adapted over millions of years. If so, then a barefoot style might help runners avoid One also hears a wide range of other passionate views but injury. mostly confusion and many questions. Doesn’t it hurt? Why Many barefoot runners also believe that the proprioceptive are so many people interested in barefoot running? Is barefoot feedback one gets from being barefoot helps one learn this kind running better for you than shod running? How should people of form. However, it is important to stress that these hypotheses transition? What is the best way to run barefoot? What are the are so far untested. My impression is that most people who try advantages and disadvantages of minimal shoes? barefoot or minimal running do so because they read or hear As an anthropologist who studies the evolution and biology of running, I find this cacophony of interest, opinion, and questions to be revealing. Dennis Bramble and I (Footnote 1) have argued that humans have been running long distances for many millions of years, and, obviously, most of that running was done barefoot on hard, rough surfaces. Minimal shoes, such as sandals or moccasins, rarely survive in the archeological record, but they probably were invented in the Upper Paleolithic, which began only about 45,000 years ago (21). Everyone including athletes ran barefoot or in minimal shoes until the 1970s when the modern running shoe with a cushioned heel, arch support, and stiffened sole was invented. It follows that the human body must be well adapted to running barefoot. From an evolutionary perspective, barefoot running is as natural as barefoot walking or, for that matter, doing anything else our hunter-gatherer ancestors did, such as nursing infants. Therefore, it is incorrect to consider barefoot running a fad or even intrinsically dangerous. Another issue to consider is the conflation of running in minimal shoes with actual barefoot running. Many minimal shoes are advertised as barefoot shoes, but how can running in a shoe, no matter how minimal, be barefoot? The oxymoron ‘barefoot shoe’ partly is marketing but also reflects a widely held opinion that there is a barefoot running style, for which minimal shoes are appropriate. If so, what is this style? In addition, are minimal or even standard running shoes appropriate for this kind of running? Most fundamentally, the debate over barefoot running highlights concerns among runners, shoe manufacturers, and the sports medicine community about the high prevalence of running injuries. It is acknowledged widely that unacceptable numbers of runners — between 30 and 70 percent — incur running-related repetitive stress injuries per year (35-37), but there is no consensus on how to prevent these injuries. The lack of any apparent decline in running-related injuries over the last 30 years (36), despite much attention, considerable research and sophisticated shoe designs, suggests that current approaches are not working effectively. This lack of progress raises several widely held hypotheses. One is that running just intrinsically is injurious and that high rates of injury are normal and to be expected. Another common hypothesis is that many people today are maladapted to running long distances because of biomechanical abnormalities (e.g. asymmetries), modern lifestyles that diminish flexibility or neuromuscular
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evolutionary medicine is the mismatch hypothesis. The logic behind this important hypothesis is that the human body was moulded over millions of generations to cope with conditions during the Stone Age. Because agriculture was invented less than 10,000 years ago, and we ceased being hunter-gatherers, humans have changed their diet and physical environments so radically and so rapidly that natural selection has had little time to react. As a result, the Paleolithic bodies we inherited often are mismatched with modern environmental conditions. An uncontroversial example of this hypothesis is that humans were selected to crave formerly rare nutrients like fat and sugar. In the last few generations, our species has created superabundant and cheap sources of these nutrients, but most humans remain unable to control their inherited cravings effectively, leading to a propensity toward obesity. In other words, from an evolutionary perspective, it was ‘normal’ to have limited access to fat and sugar, and it is ‘abnormal’ to live in an environment where these foods are more abundant and less expensive than foods with complex carbohydrates and low percentages of saturated fat. This mismatch helps explain the obesity epidemic.

as food processing leads to low chewing forces and weak jaw muscles that result in inadequate jaw growth and a high frequency of formerly rare malocclusions and impacted teeth (21), individuals who grow up wearing highly supportive shoes may develop abnormally weak feet, especially in the muscles of the longitudinal arch. Such weakness may limit the foot’s ability to provide stability and other key functions. This hypothesis has never been tested rigorously (17), but unshod populations are reported to have less variation in arch form, including a lower percentage of pes planus (7), and a lower frequency of other foot abnormalities (30). In addition, there are some data that show using minimal shoes strengthens the foot (2 and 32). A strong foot may be more flexible and better able to control excess pronation and other movements that have been implicated in some running injuries (38 and 40).

anecdotal claims, because they are curious about more natural ways to live, or because interventions such as orthotics or changing shoes have not cured their injuries. However, what is a barefoot running form? Does taking off one’s shoes encourage this kind of form? And is it really less injurious? Is actual barefoot running less injurious than running in minimal shoes? How will barefoot running or wearing minimal shoes affect performance such as speed or endurance? The honest answer to these and other questions is that no one knows. My goal in this review is to first introduce why an evolutionary perspective on running is relevant to questions about the causes of running injuries. I then summarise what we do and do not know about barefoot running and how the study of barefoot running can be applied to the current epidemic of running injuries. The major hypothesis I propose is that the human body was adapted to running in a barefoot style whose kinematic characteristics generate less forceful impact peaks, which uses more proprioception, and which may strengthen the feet (6 and 20). I hypothesise that these factors may help runners avoid injury, regardless of whether they are wearing shoes. Put in simple terms: how one runs probably is more important than what is on one’s feet, but what is on one’s feet may affect how one runs. However, I stress that the data necessary to test this hypothesis conclusively are not yet available, so I conclude by highlighting key questions for future research that are of relevance to all runners, barefoot and shod.

Another basic prediction of evolutionary medicine is that many of the supposed symptoms of disease that we treat actually are evolved and beneficial adaptations. As an example, it is common to treat fevers with antipyretics such as aspirin, but an evolutionary perspective on the immune system encourages The mismatch hypothesis also may apply to shoes and running. one to consider fevers as part of the body’s immune response It is human nature to assume that the world around us is normal, system that evolved to help fight infections. Suppressing fevers but from an evolutionary perspective, wearing big, cushioned that are not life threatening may be counterproductive. shoes unquestionably is abnormal. Instead, it was normal for Shoes with cushioned, elastic heels may be another example millions of years to walk and run barefoot. This does not mean, of a counterproductive way of treating symptoms, not causes, of course, that how our barefoot ancestors lived ‘normally’ in the of injury, because the heel counter lessens the pain caused by Paleolithic is better than how we live today. This obviously is a impact peaks, which occur from rearfoot striking on a hard superficial and false kind of logic (would we be better off without surface (see later section on footstrike), but this kind of pain antibiotics or aseptic surgical methods?). However, the mismatch could be an adaptation to prevent the body from running in a theory does raise the reasonable hypothesis that humans are way that generates repeated high impact peaks in the first place. maladapted to wearing shoes in some ways that contribute to Focusing on treating the causes rather than the symptoms of certain injuries. From an evolutional medical perspective, three pain also may lead to different ways of thinking about common novel consequences of wearing shoes may be relevant to injury. injuries such as plantar fasciitis and runner’s knee. Plantar First, shoes limit proprioception. Sensory feedback from the plantar surface of the foot evolved in early tetrapods as an adaptation for sensing characteristics of the ground including hardness, roughness, unevenness, and the presence of potentially dangerous objects, such as sharp rocks. Plantar proprioception activates reflexes and helps the central nervous system make decisions that help increase stability and avoid injury. If so, then the way in which people run when barefoot likely is to reflect the effect of ancient evolved proprioceptive adaptations to maintain stability, to avoid painful impacts, and to modulate leg stiffness. In turn, these feedback mechanisms, which are curtailed in a shoe, may help avoid some traumatic and repetitive injuries (17). Second, modern shoes with elevated heels, stiff soles, cushioning, and arch support may either facilitate or encourage a different running form than appears to be common among habitual barefoot runners (described in the next section). If natural selection adapted the human body to this general, barefoot style of running, then it is reasonable to hypothesise that this sort of running form may be less injurious, because millions of years of natural selection would have promoted adaptations to cope with the stresses it generates. In other words, some runners today may be getting injured because the novel way they run imposes forces on the body for which it is adapted poorly. fasciitis, for example, is caused by too much tension on the plantar fascia and often is treated by prescribing orthotics or replacing one’s shoes, which reduces loads on the plantar fascia (see 26 and 29). An evolutionary medicine perspective suggests that these treatments only lessen the symptoms of plantar fasciitis, rather than curing whatever biomechanical problem causes the plantar fascia to be overloaded in the first place. According to this approach, a useful preventative therapy may be to strengthen the muscles of the arch or alter a runner’s kinematics to change the way the arch is loaded dynamically. The more biologists study evolution, the more they appreciate the power of natural selection to arrive at solutions to problems that affect organisms’ ability to survive and reproduce. No engineer possibly could come close to building artificial hands, arms, legs, and noses that function as well as a natural hand, arm, leg, or nose. As Leonardo da Vinci is reputed to have said, “the human foot is a masterpiece of engineering and a work of art”. A reasonable hypothesis is that engineers are unlikely to build a shoe that functions as well as the natural human foot. So when we test questions such as ‘Is barefoot running better?’ or ‘Should people run barefoot?’, we should determine what is the appropriate null hypothesis. From an evolutionary perspective, the correct null hypothesis is that running barefoot is less injurious than running in a shoe unless proven otherwise. Because of our skewed sense of what is normal, most scientists consider the alternative to be the correct null hypothesis, but I would contend that this logic is problematic.

Why dOes eVOlutiOn matter?
Sports medicine generally has not paid much attention to evolutionary biology, but this is a mistake. As the pioneering geneticist Theodosius Dobzhansky famously observed, nothing in biology makes sense except in the light of evolution (12b). All biological phenomena — from how DNA functions, to how humans run — are the consequence of millions of years of evolution, often through the action of natural selection. Therefore, considering phenomena such as running through an evolutionary lens, helps one answer proximate ‘what’ and ‘how’ questions such as ‘What is the normal way to run?’ and ‘How do people run without shoes?’ as well as more ultimate ‘why’ questions such as ‘Why do humans run?’ and ‘Why do so many runners get injured?’ The burgeoning field of evolutionary medicine explicitly asks how evolutionary logic and information can help address why we get sick and injured (25). One key assumption behind

Finally, there is reason to hypothesise that shoes can contribute to weak and inflexible feet, especially during childhood when the foot is growing. The musculoskeletal system is highly responsive to loading, most strongly during ontogeny, and the normal unshod mechanical environment in which human feet developed during most of human evolution surely was different from the What dO we knOw abOut barefOOt running? more cushioned, supportive environment that is common today Until recently, most studies of barefoot running were conducted among shod people. by asking habitually shod runners to take their shoes off in a Shoes with stiff soles, arch supports, and features that control laboratory (e.g. 3, 10, 11, 19 and 26). Although such research pronation and other movements may prevent muscles and has some utility, using only habitually shod runners to bones from adapting to stresses that used to be normal. Just study barefoot running is problematic, because one cannot
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in a modern running shoe, but the shoe does not eliminate the 40 bm.s-1, which was typical of many barefoot runners with an impact peak in the GRF. FFS. Because a large and rapid impact peak is painful when barefoot, especially on hard or rough surfaces, it should be no surprise that habitual barefoot runners often use an MFS or FFS. These strike types, of course, do generate an impact with the ground, as evident from high-frequency vibrations (usually between 10 and 20 Hz) in the GRFv, but many studies have shown that FFS and some MFS landings do not generate any discernable impact peak (e.g. 4 and 26). In addition, some runners who FFS had relatively stiff lower extremities and rates of loading that were higher than the most compliant shod landings. This variation raises the important point that a runner can alter lower extremity compliance in a number of related ways beyond using the elastic shoe heel, such as with shorter strides, more knee flexion, and less overstride (9). This point may explain why some barefoot runners sometimes RFS with no apparent discomfort (depending on In vernacular terms, runners who FFS land lightly and gently, in surface conditions, speed, and other factors) and why some the same manner as other mammals who also do not generate shod runners who RFS experience low impact forces (24). impact peaks during running. Consequently, as pointed out by Nigg (26 and 27), FFS runners do not need any cushioning from Stride rate and length a shoe to dampen the shock from impact, even on hard surfaces Stride rates vary enormously among runners for many reasons, such as a steel plate, because they do not generate any impact and few studies have explicitly quantified differences in stride peak in the first place. However, shoes do make FFS running rate between barefoot and shod runners. A number of studies more comfortable on rough surfaces in which abrasion or stress (e.g. 5) have found that elite shod runners typically use a stride concentrations from pebbles can be painful. Note from Figure frequency between 170 and 180 steps per minute even at low 1 that higher GRFv forces are placed on the musculoskeletal speeds such as 2.75 m.s-1; in contrast, non-elite runners often system at mid-stance, when the body’s centre of mass is at its adopt a lower average stride frequency of about 150 to 160 steps nadir, but these mid-stance forces rise more slowly than the per minute at similar speeds (e.g. 13). impact peak, and they generally are similar in barefoot and shod running (10, 11, 19, 20, 26 and 34).
Figure 1. Kinematics and vertical ground reaction forces at 3.0 mIsY1 in a rearfoot strike (RFS) (A), forefoot strike (FFS) with a short stride (B), and FFS with a long stride (C). The RFS has marked impact peak, and the overstride FFS in (C) has a steeper rate of loading than the less extended FFS in (B). Below, schematic illustration of the external moment at peak rate of loading for each strike, the product of the vertical ground reaction force (Fv), and its moment arm (Rext). The RFS produces a high dorsiflexing moment, and the overstriding FFS in (C) produces a much higher external plantarflexing moment than the less extended FFS in (B).

expect such subjects to have developed the musculoskeletal adaptations and kinematic habits of habitual barefoot runners, and so they may run differently from people who either grew up barefoot or who have practised barefoot running for a long time. It also is important to emphasise that all runners, barefoot and shod, vary in their form depending on a wide range of conditions such as speed, surface texture, surface hardness, and fatigue. Habitually shod runners when barefoot, for example, are more likely to rearfoot strike (RFS) on soft surfaces like grass and to forefoot strike (FFS) or midfoot strike (MFS) when running on hard surfaces (26). One hypothesis is that barefoot runners have even more variable kinematics than shod runners because they experience more proprioception from their feet. There is no such thing as a single barefoot running form but, instead, a highly variable range of kinematic styles.

FOOt strike

The best-studied aspect of barefoot running is foot strike, which can be the most painful moment of stance when running unshod. Foot strike classification is confusing because of different definitions, but I define an RFS as a landing in which the heel lands before the ball of the foot (a heel-toe run), an FFS as a landing in which the ball of the foot lands before the heel (a toe-heel-toe run), an MFS as a simultaneous landing of the heel and ball of the foot, and a toe strike as when the ball of the foot first lands, but the heel never touches the ground. An alternative classification is the foot strike index, which uses the centre of pressure at landing relative to maximum shoe length, with an RFS being less than 33 percent, an MFS between 34 and 66 percent, and an FFS as 67 percent or higher (4). However, this index is arbitrary with respect to the foot’s anatomy. My With these caveats in mind, a number of studies on habitually observation is that the fourth and fifth metatarsal heads often shod and habitually unshod runners indicate that habitual are less than 67 percent of the foot’s length, leading one to barefoot runners often differ from habitually shod runners in classify FFS and MFS landings in the same category. several major elements of form (10, 11, 17, 20 and 34). Whereas Although a collision between any two masses causes an impact, about 75 percent of shod runners RFS at moderate speeds on it long has been recognised that the majority of RFS landings flat, hard surfaces (16) experienced barefoot runners are more differ from FFS landings in causing a marked impact peak in likely to land toward the front of the foot, usually on the ball of the vertical ground reaction force (GRFv): a high spike of force the foot below the fourth and fifth metatarsal heads in either an that is superimposed on the upslope of the GRFv immediately MFS or FFS (see next section). after the foot’s initial contact with the ground (Figure 1). My That said, habitual barefoot runners sometimes RFS (20), and colleagues and I have shown that during a barefoot RFS at 4 m.sit is incorrect to assume that barefoot runners always FFS. 1 on a hard surface such as a steel force plate, the rate of loading Another common feature of habitual barefoot runners is a of the GRFv impact peak typically is 400 to 600 body weights relatively short stride and a fast stride rate (>170 steps per per second and the magnitude of the peak is between 1.5 and 2.5 minute), regardless of speed (11, 15, 19, 28 and 34). A relatively body weights (20). This impact then sends a shock wave up the shorter stride explains the observation that barefoot runners body that can be measured in the tibia within a few milliseconds often land with the foot more vertically aligned with the knee (ms) and in the head about 10 ms later (4 and 21). The elevated, and often the hip (less overstride). elastic heel in modern running shoes dampens the magnitude To consider how these aspects of barefoot running form are of the impact peak caused by an RFS by approximately 10 relevant to the evolutionary medical hypothesis of injury, it is percent, but slows the rate of loading approximately sevenfold, useful to review each of them in more detail to ask how they usually to between 70 and 100 body weights per second (2, 20 and 26). Rearfoot striking on a hard surface is thus comfortable affect a runner’s kinetics and performance.
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There are two major, related reasons for the variation in impact peaks between different strike types. The first is that during the period of impact in an FFS, the foot initially is plantarflexed and then undergoes controlled dorsiflexion at a compliant ankle, but in an RFS, the foot remains dorsiflexed, and the ankle is stiff during the same period. As a result, the percentage of mass that comes to a dead stop and thus exchanges momentum with the ground at the moment of impact (the effective mass, Meff) is much greater in an RFS (9 and 26). My colleagues and I (20) measured Meff in a sample of runners as 1.7 ± 0.4 percent body mass (bm) in FFS and 6.8 percent ± 3.0 percent bm in RFS running. As one predicts, these values roughly correspond to the percentage mass of the foot and the lower leg, respectively. The other reason FFS and some MFS generate no marked impact peak is compliance. An RFS runner usually lands with a more extended and stiffer knee and ankle than an FFS runner, whose ankle dorsiflexes and knee flexes Figure 2. Compliance versus rate of loading of the impact peak. Rearfoot strikes (RFS; open circles) usually are less compliant and generate a higher rate of loading than more during the period of impact, allowing the lower extremity forefoot strikes (FFS; filled circles), which usually are more compliant. Note that to dampen forces more effectively (20). This principle explains some FFS are relatively stiff with a high rate of loading, and some RFS are relatively why most people land on the ball of the foot when they jump, compliant with a low rate of loading, but that none of the RFS measured have as low a rate of loading as the most compliant FFS. [Adapted from (20). Copyright © 2010 and the same principle applies to barefoot running, which D.E. Lieberman. Used with permission.] essentially is jumping from one leg to the other. MFS runners seem to generate a wide range of impact peaks and merit further study (10). Note also that toe strikes, which are uncommon in A few studies of non-elite barefoot runners confirm that these distance runners, can generate an impact peak because the runners tend to use a high frequency, ranging from 175 to 182 steps per minute at speeds of 3.0 m.s-1 (11, 17 and 34); barefoot runner’s ankle can be relatively stiff at impact. runners also tend to use slower stride rates and take longer The influence of lower extremity compliance on the rate of strides when asked to run shod at the same speed (11 and 34). loading in the GRFv raises an important issue that merits further attention. Most studies measure compliance over the Why stride lengths tend to be shorter in non-elite runners entire stance phase, but for studies of impact, the key period who are barefoot rather than shod is poorly studied. Several for measuring lower extremity compliance is just the period hypotheses that merit testing are as follows: first, shortening of the impact peak itself or the equivalent percentage of stance one’s stride by flexing the knee more is an effective way to avoid in landings without an impact peak (20). Figure 2 graphs the an RFS and to increase compliance and decrease Meff for a given relationship between lower extremity compliance and the ankle angle, because a more flexed knee orients the foot’s plantar rate of loading of the GRVv during just impact for a sample of surface more in plantarflexion (Figure 1). Therefore, shorter habitually barefoot and habitually shod runners in both FFS strides will increase the tendency to FFS when barefoot and and RFS landings at approximately 4 m.s-1 in shod and unshod to MFS when wearing a shoe with an elevated heel. Second, to conditions (from 20). Note that, as predicted, the slope of this FFS with a more extended knee, hence a longer stride, requires relationship is much higher in RFS than FFS landings, but more plantarflexion. As Figure 1C shows, a more plantarflexed there are some very compliant RFS landings (in this case, all FFS increases the dorsiflexing external moment applied around shod) whose rates of loading ranged between 60 and 100 bm.s-1, the ankle in the sagittal plane, which needs to be countered by within the range of some barefoot FFS landings. However, no the plantarflexors. Therefore, a FFS runner with a shorter stride RFS landings in this sample had rates of loading as low as 30 to will have a less stiff ankle, a lower rate of loading, and will place
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There is no evidence that barefoot running has appreciable negative effects on performance (17). To be sure, most elite runners prefer to use shoes because they protect the foot and allow one to run on rough surfaces without worrying about foot placement, but barefoot runners such as Abebe Bikila and Zola Budd have set world records in the marathon and shorter distances. The world record holders for almost every long distance running event are FFS runners who race and less strain on the triceps surae muscles and Achilles tendon. sometimes train in racing flats or other kinds of minimal shoes. There may be additional reasons to use a fast stride frequency In addition, economy seems to be improved by being barefoot related to economy and elastic recoil, but these are relevant to or in minimal shoes. Several studies have shown that barefoot both shod and barefoot running. or minimally shod runners are between 1.0 and 3.8 percent less costly per unit mass and distance (3, 11, 15 and 34), which is AnatOmical adaptatiOns (calluses, muscles, due in part to less shoe mass, which increases running cost by and arch shape) approximately one percent for every 100 grammes (26). Different stresses applied to the body often elicit varied physiological and anatomical responses. Barefoot running is no A recent study from my laboratory (28) found that after exception and may stimulate several adaptive mechanisms, but correcting for shoe mass, stride frequency, and strike type, running in minimal shoes is 2.4 to 3.3 percent more economical none have been studied in depth. than running in standard running shoes. Such a difference The first and most obvious response to running barefoot is that could have substantial effects on performance over long friction on the glabrous skin of the plantar surface of the foot distances by allowing runners to go faster for the same effort. stimulates keratinocytes to produce a callus. Calluses typically form on the ball of the foot above the metatarsal heads, on the heel pad, and on the toes. Calluses, which obviously are natural, apparently provide little in the way of cushioning, but they do protect the surface of the foot from injury and impact. How much they affect proprioception has not been studied. A second, less well-documented change in need of further research is muscle hypertrophy or conditioning. Unlike RFS landings, FFS and MFS landings place eccentric loads on the plantarflexors during the initial part of stance (10, 17, 26 and 28). Because eccentric loads generate more muscle hypertrophy than concentric loads, it is reasonable to predict that runners who FFS or MFS or who transition to FFS or MFS gaits have stronger plantarflexor muscles. Because runners who habitually are barefoot or in minimal shoes without elevated heels undergo more controlled dorsiflexion during the initial phase of stance in an FFS (28), they place more stress and generate more muscle growth in the plantarflexors than RFS runners in shoes with elevated heels. Similar principles likely apply to the muscles of the foot. It long has been known that the arch of the foot functions as a spring during running by stretching (collapsing) up to mid-stance and then recoiling during the second half of stance (18). As Figure 3 illustrates, the arch does not lengthen in a RFS until after the ball of the foot has landed (foot flat), but in an FFS, the longitudinal arch of the foot is loaded in three-point bending immediately at footstrike (28). An FFS therefore engages the
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“The evolutionary medicine hypothesis is that the musculoskeletal system is better able to adapt to the forces generated by a barefoot running style.”

extrinsic and intrinsic muscles of the arch differently than an RFS. In addition, shoes with arch supports presumably limit how much the arch collapses, lessening how much the arch elongates and thus how much negative (eccentric) work these muscles do. However, this effect has not yet been measured. If foot muscles respond to loading like other muscles in the body, then running barefoot or in minimal shoes will strengthen the arch’s muscles more than running in shoes with arch supports; FFS running also may strengthen the foot more than RFS running. By the same logic, FFS and barefoot running likely also require more foot muscle strength to avoid injury. These hypotheses have yet to be tested thoroughly but are supported by one study, which showed that runners who trained for five months in minimal shoes (the Nike Free) had significantly larger and stronger extrinsic muscles (2). This study needs to be replicated and expanded. Research is also needed to quantify how variations in the stiffness of shoe soles affect how much work the foot muscles do.

HOw might barefOOt running be releVant tO injury?
A major question on the minds of many runners, coaches, trainers, physical therapists, and physicians is whether running barefoot has any effect on injury rates. To many, the null hypothesis is that shod running is less injurious than barefoot running unless proven otherwise, but an evolutionary perspective challenges this assumption. Furthermore, as argued above, asking whether barefoot running is more or less injurious than shod running is a naive question given the complex, multi-factorial bases for most kinds of injury. Simply comparing injury rates among runners who are barefoot, wearing minimal shoes, or wearing modern running shoes is likely to lead to confusing, probably conflicting results unless the studies control for aspects of running form and biomechanics that are the actual proximate causes of injury. Stated differently, putting a shoe on your foot (or taking it off) is no more a proximate cause of injury than training intensity. There are plenty of shod runners who do not get injured, even when they increase their training intensity, and there also are barefoot runners who do get injured. Therefore, the key question to ask is ‘‘What about the way that barefoot runners tend to run affects injury rates and patterns?’’ This question is relevant to all runners, barefoot and shod. Answering this question requires testing a model of the factors that cause injuries, especially repetitive stress injuries, which are so prevalent among endurance runners (35 to 37). At a very proximate level, most repetitive stress injuries are caused by the accumulation of microdamage in tissues caused by the repeated application of forces that generate stress, which then cause strain. More specifically, microdamage accumulation occurs from interactions between the number, magnitude, direction, frequency, and velocity of the forces applied; and the size, shape, and material properties of the tissue experiencing the force. A major cause of microdamage is high strain with high rates, which cause bones to become more brittle and increase elastic hysteresis: the difference between the stress energy required to generate a given strain in a material and the elastic energy that is stored for a given cycle of loading (23). Repeated high levels of hysteresis are potentially injurious in both bones and more viscous tissues such as ligaments and tendons because some of the energy lost during unloading is converted to friction, generating heat, but the rest of the energy can be converted into structural damage. In most materials, higher rates of loading increase elastic hysteresis, and the bone is no exception.

patellofemoral pain syndrome (runner’s knee), plantar fasciitis, and lower back pain (8, 24 and 29). More research urgently is needed, but one limitation of all these studies is that they examined only habitually shod RFS runners. It is reasonable to predict that runners who FFS, regardless of whether they are barefoot or shod, incur fewer injuries caused by impact peaks for the simple reason that FFS landings do not generate an appreciable impact peak (6). That said, FFS running places higher loads on the Achilles tendon and plantarflexors, possibly causing a trade-off in injuries. In addition, as Figure 1C shows, some FFS runners, such as those who overstride, have higher rates of loading than others, within the range of rates of loading caused by shod RFS running. If high rates and magnitudes of loading cause some repetitive stress injuries, then these FFS runners may be at greater risk of impact injuries, highlighting my basic hypothesis that running form is a more important determinant of injury than footwear. Two additional points regarding forces and injury merit brief mention. First, running generates many varied forces, and there is no question that internal forces in the lower extremity often are higher in magnitude than external forces generated by impact peaks (reviewed in 26). However, not all forces are injurious, and more research is necessary to determine which repetitive forces the body is adapted to tolerate, which cause injury, and under what circumstances. The evolutionary medicine hypothesis is that the musculoskeletal system is better able to adapt to the forces generated by a barefoot running style. Second, different running forces cause co-varying suites of different forces, making it difficult to separate cause and effect. For example, Davis and colleagues (8) found that individuals with higher impact peaks had higher rates of likely impact-related injuries such as tibial stress syndrome and higher rates of iliotibial band syndrome. The latter is unlikely to be caused by impact but could result from the same general RFS running form, which also applies higher external moments to the knee (19 and 39). In other words, certain aspects of running form are likely lead to co-varying suites of injury that do not have the same biomechanical bases.

PerfOrmance

Figure 3. Schematic of (A) longitudinal arch function during a forefoot strike (FFS) in a minimal shoe without a stiff sole, arch support, and elevated heel and (B) a rearfoot strike (RFS) in a shoe with a cushioned heel and arch support (shaded area). Fv is vertical ground reaction force at impact, Fb is force from body mass, Fp is plantarflexor force (in the FFS), and Fat is anterior tibialis force (in the RFS). Because the FFS causes three-point bending from the moment of impact, it causes more tension on the arch; in addition, the shoe’s arch support functions to limit how much the arch can tense (illustrated by schematic dashed lines below).

Other points to consider are the effects of shoe cushioning and proprioception. Elevated, elastic heels are designed to cushion the impact peak of an RFS, slowing the rate of loading and slightly damping the magnitude. One might therefore expect cushioned heels to mitigate or prevent injury from impact loading. However, several studies have found that runners who RFS adjust leg stiffness to surface stiffness and, thus, run with stiffer legs on more compliant Running generates a complex, dynamic set of forces, which surfaces, keeping the overall degree of stiffness the same (12). This adjustment also occurs in barefoot or minimally shod are repeated with every step, hence millions of times a year runners who FFS (20). for most runners. Given the proximate, mechanical causes of repetitive stress injuries outlined above, forces that cause However, a major difference between barefoot and shod repeatedly high rates and magnitudes of loading are likely running is that the barefoot runner will have more sensory to contribute to injuries. Of these forces, impact peaks stand feedback from impact and, thus, should be better able to out as the highest and most rapid loads the musculoskeletal adjust leg stiffness (17). The blocking action of cushioned system repeatedly experiences (Fig. 1). Some researchers heels on proprioception likely explains the evidence that have argued that impact peaks are not a cause of injury runners who wear more cushioned shoes are more likely to because injury rates are not affected by running on harder be injured than runners in less cushioned shoes (22). In other surfaces, shock absorbing insoles and heels consistently do words, barefoot or minimally shod runners tend to avoid not yield lower injury rates, and because one study found impact peaks, and they also are more likely to sense high that injury rates were lower in RFS runners with higher rates and magnitudes of loading when they occur and thus impact peak rates (26 and 27). Nigg also has hypothesised adjust their gait or contract muscles appropriately. that out-of-phase vibrations of the calf muscles are able to dampen impact peaks (27). In contrast, several recent studies have found that the rate and magnitude of the impact peak in runners is a significant predictor of injuries that one might expect to be impact-related: tibial stress fractures, Other possible but poorly studied contributors to injury are moments (torque forces) applied around joints. When external forces are applied to the skeleton, they generate external moments at joints that have to be counteracted by opposing internal moments generated by muscles, tendons,
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and ligaments. As with bone, high rapid rates of loading induce more hysteresis in connective tissues, which has the potential to lead to more tissue damage (23). In this regard, running form may be relevant because FFS and RFS gaits generate different moments. In terms of sagittal plane moments, FFS runners land with a more plantarflexed foot and, thus, undergo more ankle dorsiflexion during the first part of stance, causing higher external moments that must be controlled by the plantar-flexors (26 and 39). In contrast, lower GRFs in combination with a less extended leg generate significantly lower sagittal moments in the knee in an FFS (39). Barefoot runners have been shown to generate lower sagittal plane moments in the knee and hip than shod runners (19), a difference that may be explained partly by aspects of shoe design that affect moments. Shoes with wide or elevated heels increase joint moments acting around the ankle, knee, and hip (26). One irony of shoes that control pronation is that these shoes also have a number of other features such as stiffened medial midsoles that correct for increased pronating moment forces generated by the heel. We simply do not yet know if experienced habitually barefoot runners have fewer injuries than habitually shod runners, and this will be hard to test without correcting for confounding factors such as form as well as musculoskeletal strength and training intensity, which vary among both populations of runners. I hypothesise that if one holds other factors constant, what matters more for preventing injury is running form, rather than footwear. Runners with a barefoot running ‘style’, who tend to avoid or minimise impact peaks, overstride less and use a high cadence, may be less likely to be injured than runners who generate high impact peaks, overstride more and have a slow stride frequency, regardless of whether they are wearing shoes.

• Are there differences in injury rates among barefoot or minimally shod runners who use different strike types?

“It is remarkable how little we know about something so basic and fundamental as barefoot running...”
In short, barefoot running raises more questions about injury than we have answers for, at the moment. Runners, both barefoot and shod, will get injured, and I hypothesise that barefoot running per se is neither more nor less injurious than shod running because what matters most is how one runs, not what is on one’s feet. It is reasonable to expect that barefoot running with poor form can cause injury, and we already know that somewhere between 20 and 70 percent of shod runners do avoid injury (35 to 37), hypothetically because, among other factors, they have good running form. In this regard, minimal shoes may be problematic for some runners because they limit proprioception and provide no cushioning or support and, thus, may enable runners to run poorly without any of the protection afforded by a shoe. These runners may be at extra risk of injury. In addition, runners who transition from RFS to FFS gaits, or who transition from shoes to barefoot running, also risk injury, especially if they do so too rapidly without allowing the musculoskeletal system to adapt to the different forces this kind of running generates.

• Is actual barefoot running less injurious than running in minimal shoes? • Can we identify which runners are most likely to benefit from or should avoid barefoot running (e.g., runners with high or low arches, low flexibility, and other problems)? We have much to learn. However, if there is any one lesson we can draw already from the barefoot running movement, it is that we should be less afraid of how the human body functions naturally. The trend toward running without shoes also has provided a useful opportunity to question common assumptions about the relative benefits and risks of running with shoes or without them. There is nothing abnormal, faddish, unnatural, or even inherently dangerous about barefoot running, but taking off one’s shoes to run is no panacea. People should and will run however they want and in whatever footwear they want. That said, I would encourage anyone who runs or studies running to try running barefoot on a hard, smooth surface like a road for 500 metres to understand how it works and feels. Go ahead and try it! In the long run, I suspect that the most important benefit from studying barefoot running is that, by incorporating either explicitly or implicitly an evolutionary perspective, it may help us evaluate ways to help runners avoid injury. Humans evolved not only to run but also to run barefoot. It is a reasonable assumption that our bodies bear the traces of millions of years of natural selection that favoured adaptations to lessen a runner’s chance of injury. Unfortunately, we lack data on injury rates from the 20th century before the modern shoe was created, let alone from the Paleolithic period. However, over the last few decades, injury rates have remained stubbornly high despite considerable investment in shoes as well as orthotics. Running injuries are highly multi-factorial, and no single factor, such as shoe design, will explain more than a fraction of the injuries. In fact, several recent studies actually have found that motion control shoe prescriptions have no effect on reducing injury rates (31). These and other data, including the persistently high rate of running injury, suggest that many efforts to reduce injuries solely by tinkering with shoe designs are quixotic. I know of no evidence that points to a clear relationship between shoes and running injuries, and although there are millions of shod runners who are injured, there also are millions who are just fine. What about those different runners’ form may predispose them to injury or not? My prediction — which I readily admit is nothing more than a hypothesis that could be incorrect — is that shod runners with lower injury rates have a more barefootstyle form (after one controls for other confounding factors such as muscle strength). Likewise, I predict that injury rates are higher among barefoot runners who either lack enough musculoskeletal strength in their calves and feet (perhaps from insufficient time to adapt) or who still run as if they were shod with long strides and slow stride frequencies. In short, the most useful insight we can gain from barefoot running is how the body was adapted to run in the first place, which means that we have much to gain by devoting our attention — as many studies are — to what aspects of running form generate injury and why. In this regard, the way in which experienced, habitual barefoot runners get more proprioceptive feedback, often shorten their strides and increase their stride frequency, avoid RFS and impact peaks on hard surfaces, keep joint moments low, and have strong feet, may be ancient adaptations for avoiding injury. The answers to questions about these and other aspects of barefoot running will benefit all runners, regardless of what is on their feet.

This hypothesis requires prospective study, but we recently found in a retrospective study on a collegiate track team that the overall rate of repetitive stress injuries per distance run was more than twice as high in shod RFS versus FFS runners (6). In addition, more research is needed to test the effects of shoes on injury through mechanisms such as proprioception, rearfoot COnclusiOn motion, pronation control, and other factors. Another major and important category of injury to consider is It is remarkable how little we know about something so basic and the increased risk of injury from transitioning to either barefoot fundamental as barefoot running, and it should be evident that we running or a barefoot style. FFS running requires more calf need to roll up our shirt sleeves and take off our shoes to answer a muscle strength than RFS running, and it may also require more wide range of questions about how the bare foot functions during foot muscle strength and foot control, especially if one is using running and the relevance of barefoot running to injury. A list of minimal shoes. Runners who transition to barefoot or minimal key questions to be addressed includes the following: shoe running frequently complain of calf muscle strains •  How much do variations in running form, including those and Achilles tendinopathies, both of which reflect increased common in habitual barefoot and shod running, affect injury plantarflexor moments applied to the ankle during FFS gaits (26 rates? and 39). In addition, although FFS landings do not generate high • How much does the lack of proprioception in a minimal shoe forces upon impact, runners who transition may not have strong affect running form? enough extensor muscles or metatarsals to counter bending What is the best way for a runner to transition to barefoot or forces in the anterior foot (33), which could lead to increased risk •  of metatarsalgia or metatarsal stress fractures (14). Research is minimal shoe running? How much does the body need to adapt to barefoot running urgently needed to establish which runners might benefit from •  transitioning and what sorts of injuries runners who transition anatomically if one previously has been running only in shoes? get and to devise effective transitioning strategies to avoid injury. •  Do children adapt differently to barefoot running than adults? The final category of injuries to consider includes traumas •  What are the effects of speed, substrate, and other environmental caused by sudden accidents such as falls or landing on sharp variables on barefoot and minimal shoe running form? objects. Because shoes protect the sole of the foot, one expects • How much does barefoot running affect foot strength and arch barefoot runners to have more traumatic injuries from shape? lacerations, bruises, splinters, and punctures. However, because • How much do shoes affect foot strength and flexibility, and how shoes limit proprioception, it is possible that barefoot runners  may be less likely to fall and incur sprains. Muscle strains relevant are these factors to injury? probably are common equally in barefoot and shod runners. •  How much and when do barefoot runners use MFS and RFS Controlled prospective studies are needed to test all of these landings, and if so, how do they modulate lower extremity conjectures (see 17). compliance?
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Acknowledgments Funding for some of the research reported study was made available by The American School of Prehistoric Research (Peabody Museum), Harvard University, The Hintze Family Charitable Foundation, and Vibram USA. I am grateful to M. Cucuzzella, A. Daoud, I. Davis, P . Ellison, L. Saxby, D. Teyhen, M. Venkadesan, and two anonymous referees for help, comments, and discussions. The author declares that the results of the present study do not constitute endorsement by the American College of Sports Medicine. The article, “What we can learn about running from barefoot running: an Evolutionary Medical Perspective” was written by Daniel E. Lieberman, Department of Human Evolutionary Biology, Harvard University, Cambridge M.A., and was originally published in Exercise and Sport Sciences Reviews 2012; 40 (2) : 59-115.

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HErOES OF rUNNING HELEN HALL
A MEANS TO AN END THAT BECAME A JOY.
HELEN HALL

P

ain’ instigated my journey towards Barefoot and Efficient or not. The successes were so many and varied that, having Running. It turns out that necessity is the mother of both been on the first MBT training course in the UK, I opened the invention and of taking matters into your own hands. first MBT shop in the UK, along with two osteopaths and a Shin splints and sciatica — the three Ss — became the bane of chiropractor. my life because, either together or alone, they made a misery of the one constant that had kept me sane since I was at grammar school: running. I ran as soon as I was old enough. I held the record for the mile walk at junior school, because we weren’t allowed to run it; we were too young. I ran the inaugural Stratford-upon-Avon half marathon aged 17. With two months to go to my 18th birthday, they wouldn’t allow me to run the whole distance. With knock-knees and gym knickers, I finished, telling the announcer off because he’d got my name wrong. Always was a stroppy Yorkshire girl! So exercises, uncomfortable insoles that I was to ‘break my feet into’, picking up pencils with toes, sitting cross-legged on the floor, strange shaped pillows, special seats for the car, for the desk and for the treatment couch, resting and not doing the very thing that I loved (what kind of a solution is that?) ... I tried them all. Some helped a little; some didn’t at all. The pain was always there — the only variance was the degree. Running in MBTs myself, and correcting people’s walking and running gaits in them, filled my life for quite a few years. There wasn’t much choice floating around the footwear industry, apart from some awful ‘looky-likey’ fakes. This was well over a decade ago, and everything else in the running shops had ever-growing heel cushions, springs, stability posts and socalled crash pads (if you’re wondering, that’s the name the industry gives the flared section of cushioning around the outside of the heel area. Interesting, eh?). Many runners ran with a walking gait pattern heel to toe, because, with all that cushioning protecting them, they could — couldn’t they? Why? Well, for all sorts of reasons (which is another article I’d gladly write), no! For a start, all that endless ‘toe-lifting’ to get the heel down ahead of the body was the source of my shin splints. Correcting my running technique to a midfoot/ forefoot touchdown sorted that out almost obscenely quickly. And so I continued on my life’s journey, weaving a not-quitestraight-and-therefore-endlessly-engaging path to where I am now. And, having said goodbye to my three Ss, I made steady forward progress. During my divorce, I was told my running symbolised running away from my problems. What rubbish: invariably, within 30 seconds of starting a run, even if I wasn’t actively thinking about it, the solution to whatever was stressing me would appear. Running has been my saviour, my waistline friend, my health and my sanity. For me, running wasn’t an option, it was part of who I was, and helping others find solutions to get back to their running was crucial to me too. On the look-out for another way to do the same things — help correct form and offer people choice — I discovered Newton shoes. It’s a delightful tale of
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Then, in 2002, came a breakthrOugh.
It started with the most unlikely predecessor to a barefoot shoe you could imagine — the original and enormous-soled MBT trainer —with the ground far, far away from the actual sole of my foot. But the B stands for Barefoot, so perhaps it was a clairvoyant peep into the future. Whatever, after 21 years of constant sciatic feedback of the grumbling-throughto-yelling varieties ... it went away. Extraordinary. And yet, when you looked at the postural improvements in both muscle tone and body alignment, it should have been expected. All my lymphoedema patients were cajoled into wearing them, to optimise venous return and drag the lymph along, willing
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two philanthropists who wanted to use their fortune to help and to tell the world of an ‘alternative’ running shoe option; their non-cushioned, lower-heeled, forefoot-lugged, garishcoloured invention. Well, we flew on our first run. I PB’d my five-mile loop by eight minutes! Whilst I knew the stats, that every 100 grammes on your feet is three percent effort, and that MBTs were (very) heavy, they had been the only shoe I could find where runners were able, through the technology in the sole, to run with intrinsically better biomechanics. As one door closes, another opens ... now we could both move in a more biomechanicallyfriendly way, without being weighed down by a couple of bags of sugar on each foot!

The hip flexor finally ‘went’ with 10 miles left of day two. I dragged my right leg between my poles (now crutches) to reach the end, only to be casevac’d home, and scolded for my stubbornness. Blasted hip flexor is now my nemesis.

Ironman of them all. As far as I was concerned, as I grabbed the blast, raising eyebrows along the 44-mile trail with our ‘nonfinish-line banner and wrestled it off the glamorous banner- standard’ attire. (Never mind our footwear choice: Barefoot Ted ran in a jumper and cut-off jeans with a leather sack for a holders, I’d won. I had been told I couldn’t and shouldn’t. But a challenge isn’t a hydration pack!) challenge if you know you can beat it. In my heart of hearts, I knew that if I used my body as well as I possibly could, as well as it was designed to be used, then I ought to be able to do it. After all, a bone knits together in about three weeks (the knit is strong by six weeks), so I had time to heal and to get strong, if I used my body with biomechanical kindness. This is what I passionately believe barefoot running to enable: fluid, flowing, comfortable, sustainable, efficient running with minimal injury risk, through biomechanically-friendly movement. So what does an opinionated Northerner wear on her feet when she gets married? Vibram Fivefingers. And what do Mr. & Mrs. Hall do on their honeymoon? Run round the vineyards of Languedoc in ‘his and hers’ VFFs, preparing to face the demons of her unfinished Druid’s Challenge ... of course! And, at the 11th hour of the 11th day of the 11th month of the 11th year of this century, we set off: Mr. Hall for his first 31-mile ultra distance run, and me to complete the three-day 84-mile Druid’s Challenge — because we could. My Efficient Running barefoot journey continues apace, immersing me in exciting projects and more adventures. The most experienced training provider in the UK, YMCAfit, approached me to write a manual to teach their instructors how to coach Barefoot Running, bringing the skills, and the joy, to more people. The creative British footwear company, inov8, brought me in to coach the finalists of their “eight-weeks to be a Natural” runner competition; accompanying those eight runners, from widely ranging ‘start points’ on their minimal/ barefoot journeys was an honour and a real pleasure.

With an uncompleted multi-stage ultra behind me, I overheard someone say “She couldn’t do it”. “Couldn’t do what?” I demanded. “Ironman”, was the answer. So I signed up for it. I’m not from Yorkshire for nothing. During training, I fell off my heavy winter bike by losing the back wheel descending a muddy country lane, and slightly broke my ankle. I say ‘slightly’ because it wasn’t until the black bruising subsided from my hip and thigh that I even noticed my ankle was crippling me. The X-ray confirmed the break, but by that time I’d been hobbling for a couple of weeks, so a cast seemed like overkill. PrOgress Good decision: nine weeks later I ran the Berkhamsted half The launch of Newtons in 2007/8 really marked the start of marathon. the energy towards natural running, minimal footwear and Not long after that, I fell off my brand new carbon race bike. ‘barefooting’. I’d already met Matt Wallden, the forward- This time I was standing still, telling a story. By getting thinking, inspirational MD of Primal Lifestyle, at the Back overexcited, I overbalanced and keeled over to the side my foot Show at Olympia. Wearing my much-loved toe socks, I’d been was still clipped in. Desperate not to damage my brand new able to try on his Vibram Fivefingers (VFFs) with ease. There race bike and realising I was going down, whether I liked it or was something in the air. Pose Method and chi running were not, I lifted my incredibly light bike out of the way, saving it. being discussed, people were becoming more talkative on Oh, how clever, balanced riders chortle when they hear this! forums and experiences were being shared. I’d been barefoot I saved my beautiful bike and broke two ribs, with only three and pregnant in East Africa, only to come home and be totally months left before Ironman. There’s nothing like an injury unable to fit into any ‘traditional’ shoe I owned. My children’s to focus the mind on perfect running technique. 2.4 miles of feet were perfect until they went to school in the UK and swimming, 112 miles of cycling and 26.2 miles of running in were moulded by Clarks and Start-Rite footwear. There was Austria later, I became the world’s first barefoot Iron(wo)man. definitely something about shoes that didn’t seem to do much Now I’d done it, I was satisfied. Wearing my medal in the shop but cause grief. But not many were talking about it. (sad Yorkshire girl that I am) I was asked which Ironman I had We took the plunge. It’s so long ago now, it feels as if it happened completed. “Austria”, was my reply. My next adventure began overnight, but I’m sure it didn’t. Wearing our first pair of VFF with the words that followed, “Ah yes, the ‘soft’ Ironman”. It KSOs, we headed off for our first run. I still remember it. It was was like a red rag to a bull ... dark, it was somewhere off-road; we got lost in the moment and then actually got lost; we laughed; we felt the cool mud Training began almost immediately, followed by a bike crash squeeze up and squelch between our toes; our arches were six weeks later, where another lack of handling skills, plus a stabbed by cruel stones hidden along the path; we ran further bit of bad luck, saw me wrap myself around a concrete post. than we’d planned, and even that was further than we should A gradual loss of power and feeling to my left arm preceded have ... and all three of us probably had one of the best runs of the thunderbolt that I ought to seek help, when my eldest son, who’s 6’ 2”, came home from university and I couldn’t reach up our lives. We were hooked. Without a how-to manual, we made lots of mistakes — which to give him a hug. was all part of the journey, because now we’ve written the manual! My own running, fixing people and run coaching was now almost exclusively done in VFFs. Choice was important to clients and customers, so the search for great footwear that allowed feet to be, well, feet, continued in earnest. I had a few other footwear options for wet and cold days, both of the minimal and ‘barefoot’ variety (Vivo Barefoot, inov-8 and Merrell Barefoot), but I spent more and more time either VFF’d or just barefoot. In December 2010, the wonderful Mr. Sabin kindly gave me back full use of my left arm by performing a double discectomy with spinal fusion levels C5-C7. Within 24 hours, all symptoms had completely disappeared. Five days later, in the snow up at Coombe’s Hill, I ran 50 yards because, with skilled, nonimpactful, barefoot running skills ... I could. Frustratingly, eight weeks later, just as I was about to get back on my bike, the umbilical hernia, which had popped out simultaneously with the two discs, had to be repaired. Permission was granted to ‘start very gentle exercise’ at my six-week check-up. I nodded obligingly, opting to omit the news that I’d just returned from a warm weather training camp, where (gently) cycling 112 miles had been our final day’s action.

Running technique was honed unshod along the five-mile country lane of the local Pednor Loop — it’s amazing what you learn about the mechanics of the human frame in motion when you are totally connected with it. Returning from one such session, I was stopped by a lovely older lady with blue That training camp sticks in my memory for more reasons hair, driving a blue Volvo estate. She wound the passenger than ignoring recovery advice. (Based on what evidence? I’m window down and asked “Are you ... alright?” not stupid, and I don’t like pain; if my body had wanted me I confirmed that indeed I was, but she hesitantly pointed to the to stop, I would have, but it was fine, so I carried on.) Despite apparent loss of my senses. “You seem to have, er, forgotten my outward bravado, I had been really worried about the impending Ironman sea swim; a mindset not helped by getting your shoes, dear,” she said. I still chuckle, bless her! I was asked how far I could run in them so often that I decided bitten by a foot-sucking fish during a training session. A friend to go and find out. After an endlessly frustrating summer ‘reframed’ the bite into a ‘kiss from the sea’ and the evidence is trying to sort out a hip flexor injury caused by riding too big a now my avatar on a number of forums. gear on too high a saddle (my bike handling skills leave much to be desired), I began my ultra-distance running journey in the VFF Flow. I completed two of the three days of the Druid’s Challenge (29 and 27 miles respectively) in November 2009.
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My running buddy James Poole, having completed his transition from traditional footwear to minimal and barefoot running, joined in the fun at my last ultra, the Vanguard Way, and won! In the process, he caught the eye of the race organiser, both for his finishing time in Noah’s Ark conditions (another story in the pending tray, but just for now) and for his footwear choice: VFF Spyridons. We now coach together under the banner of Perpetual Forward Motion, confident that more speed for less effort and fewer injuries is obtainable for Remembering the start still catches me at the back of my all those that start to use their bodies really, really well. throat. I didn’t know I could do it, but I thought I could. So I tried. Not famous for paying attention, I got lost every day (‘just follow the acorn signs’, they said — how difficult could E s it be?), but finally found the finish line. I was more emotional than I was after the first Ironman, more emotional even than Perpetual forward motion the second Ironman. Completing Druid’s Challenge was utterly overwhelming. And now I could tell people that so far, the furthest I’d tested the concept of barefoot running was For the mathematicians amongst you, here’s a new formula to apply: It’s possible that we might also be known for not-very87 miles. subtly encouraging runners to swap out their clod-hopping As someone said: “Like riding a bike, to have a balanced life, trainers for ... well ... less!  you need to keep moving” (that is, if you can stay on the bike). Matt Wallden and I have started bringing the science and Now Mr. Hall, having supported me through two Ironmans, the practical together with runIQ workshops for the ‘curious wanted to give it a go himself. Upping the ante, he opted for his to know more but you need to show me the evidence’ crowd, first triathlon to be the hardest Ironman in the world, so back as well as the ‘I want to start but I don’t know how’ runners. to Lanzarote we went. Having even more demons regarding It’s nerve-wracking being in front of larger audiences, but the the sea swim than me (Mr. Hall being a non-swimmer), he positive feedback is rewarding and encourages me to be more moved mountains to achieve his goal. And being a big bloke, confident, standing my ground against the endless backdrop he needed to move as efficiently as possible, so naturally he of negativity surrounding the heel-strike/midfoot debate and ran the marathon like me, in ‘barefoot’ shoes. I ran in the VFF its sister, the shod/unshod debate. As Steven Lord, the first Seeyas: gorgeously ultra-thin and super comfortable and, I barefoot Ironman, tweeted it: “Describing running the way discovered, without heat insulation. I ran faster than usual nature intended as a ‘fad’ seems bizarre. Next walking will be until I was able to slow up a bit when the sun went down. a fad, or sleeping”. The ground was h-o-t! That probably got me my ‘win’ by 10 Intertwining and underpinning all this work is my joint project minutes, and in my mind, reinforced my life mantra: If you with my running protégé and musical genius, Kirsty Wright think you can do it, you probably can. (aka Hawkshaw). Barefoot Audio is the result of a coincidental A fortnight later I was itching to run again, but knew I ought to meeting of a musician (Kirsty) and a barefoot running coach allow a little more ‘recovery’ time, so with my returning energy, (me). I was endlessly frustrated by the lack of appropriate decided to do a bit of gardening. Actually, I don’t do gardening; music with a fast enough beat to help my runners improve I have a track record of knocking off green things rather than their running cadence and technique, and Kirsty was in search doing anything nurturing, like growing them. I decided to play of a convenient way to improve her health and fitness safely safe and do some landscaping instead, laying 50 slabs of Welsh and comfortably following the birth of her third child. We slate over my dying green bits. I was a bit stiff after Ironman, combined beautiful music at just the right beat, with step-bybut I couldn’t move after gardening. I’d managed to prolapse a step progressive coaching, to create a tool we are immensely disc and couldn’t feel my right foot ... and I was third ‘man’ on proud of, to coach the feel for skilled, efficient running. the Barefoot Relay Team for the Classic Quarter in just over a In running, I found pleasure, release, fitness, independence week’s time. and freedom. The pain of the three Ss of shin splints and

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With the scar on my foot still visible, on May 21, 2011, five months after major neck surgery and three months after abdominal surgery, I completed — in a time 40 minutes faster than my first ‘soft’ Ironman — Ironman Lanzarote ... the hardest

It turns out, by using the muscle memory of skilled running, with as little impact as possible, running 12 miles along the beautiful, if rather lumpy, Cornish coastline with a prolapsed disc is do-able without pain. Not at speed, but do-able. The Adventures of Team Shambolic — featuring Matt Wallden, Tim Bishop, the world’s barefoot best-friend ‘Barefoot Ted’, and me — deserves a story all to itself. Suffice to say we had a

sciatica took that all away. Developing my running form with ‘technical’ footwear and then my running strength with the emerging ‘barefoot’ footwear gave all those positive emotions back to me, and then some. So from gym knickers and Northern roots ... to the co-founder of the world’s first minimalist running music label. Whatever comes next on my barefoot running journey: bring it on!
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