Reduction in ground reaction force variables with instructed barefoot running

BackgoundBarefoot (BF) running has recently increased in popularity with claims that it is more natural and may result in fewer injuries due to a reduction in impact loading. However, novice BF runners do not necessarily immediately switch to a forefoot strike pattern. This may increase mechanical parameters such as loading rate, which has been associated with certain running-related injuries, specifically, tibial stress fractures, patellofemoral pain, and plantar fasciitis. The purpose of this study was to examine changes in loading parameters between typical shod running and instructed BF running with real-time force feedback.MethodsForty-nine patients seeking treatment for a lower extremity injury ran on a force-sensing treadmill in their typical shod condition and then BF at the same speed. While BF they received verbal instruction and real-time feedback of vertical ground reaction forces.ResultsWhile 92% of subjects (n = 45) demonstrated a rearfoot strike pattern when shod, only 2% (n = 1) did during the instructed BF run. Additionally, while BF 47% (n = 23) eliminated the vertical impact transient in all eight steps analyzed. All loading variables of interest were significantly reduced from the shod to instructed BF condition. These included maximum instantaneous and average vertical loading rates of the ground reaction force (p < 0.0001), stiffness during initial loading (p < 0.0001), and peak medial (p = 0.001) and lateral (p < 0.0001) ground reaction forces and impulses in the vertical (p < 0.0001), medial (p = 0.047), and lateral (p < 0.0001) directions.ConclusionAs impact loading has been associated with certain running-related injuries, instruction and feedback on the proper forefoot strike pattern may help reduce the injury risk associated with transitioning to BF running.