Sports Medicine

, Volume 43, Issue 11, pp 1131–1138 | Cite as

Barefoot Running: Does It Prevent Injuries?

  • Kelly Murphy
  • Emily J. CurryEmail author
  • Elizabeth G. Matzkin
Review Article


Endurance running has evolved over the course of millions of years and it is now one of the most popular sports today. However, the risk of stress injury in distance runners is high because of the repetitive ground impact forces exerted. These injuries are not only detrimental to the runner, but also place a burden on the medical community. Preventative measures are essential to decrease the risk of injury within the sport. Common running injuries include patellofemoral pain syndrome, tibial stress fractures, plantar fasciitis, and Achilles tendonitis. Barefoot running, as opposed to shod running (with shoes), has recently received significant attention in both the media and the market place for the potential to promote the healing process, increase performance, and decrease injury rates. However, there is controversy over the use of barefoot running to decrease the overall risk of injury secondary to individual differences in lower extremity alignment, gait patterns, and running biomechanics. While barefoot running may benefit certain types of individuals, differences in running stance and individual biomechanics may actually increase injury risk when transitioning to barefoot running. The purpose of this article is to review the currently available clinical evidence on barefoot running and its effectiveness for preventing injury in the runner. Based on a review of current literature, barefoot running is not a substantiated preventative running measure to reduce injury rates in runners. However, barefoot running utility should be assessed on an athlete-specific basis to determine whether barefoot running will be beneficial.


Ground Reaction Force Stance Phase Plantar Fasciitis Orthotic Device Collision Force 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No funding was obtained for the preparation of this paper. All authors declare no conflicts of interest relevant to this manuscript. The authors thank Eric Smith, M.D. and Tyler Skaife, M.D. for editorial suggestions for this manuscript.


  1. 1.
    Krabak BJ, Hoffman MD, Millet GY, Chimes GP. Barefoot running. PM R. 2011;3(12):1142–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Ruxton GD, Wilkinson DM. Thermoregulation and endurance running in extinct hominins: Wheeler’s models revisited. J Hum Evol. 2011;61(2):169–75.PubMedCrossRefGoogle Scholar
  3. 3.
    Bramble DM, Lieberman DE. Endurance running and the evolution of Homo. Nature. 2004;432(7015):345–52.PubMedCrossRefGoogle Scholar
  4. 4.
    Lieberman DE, Bramble DM. The evolution of marathon running: capabilities in humans. Sports Med. 2007;37(4–5):288–90.PubMedCrossRefGoogle Scholar
  5. 5.
    Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D’Andrea S, Davis IS, Mang’eni RO, Pitsiladis Y. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010;463(7280):531–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Lieberman DE. What we can learn about running from barefoot running: an evolutionary medical perspective. Exerc Sport Sci Rev. 2012;40(2):63–72.PubMedCrossRefGoogle Scholar
  7. 7.
    Lynch SL, Hoch AZ. The female runner: gender specifics. Clin Sports Med. 2010;29(3):477–98.PubMedCrossRefGoogle Scholar
  8. 8.
    van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007;41(8):469–80 (discussion 480).Google Scholar
  9. 9.
    Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE. Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc. 2012;44(7):1325–34.PubMedCrossRefGoogle Scholar
  10. 10.
    Richards CE, Magin PJ, Callister R. Is your prescription of distance running shoes evidence based? Br J Sports Med. 2009;43(3):159–62.PubMedCrossRefGoogle Scholar
  11. 11.
    Lohman EB 3rd, Balan Sackiriyas KS, Swen RW. A comparison of the spatiotemporal parameters, kinematics, and biomechanics between shod, unshod, and minimally supported running as compared to walking. Phys Ther Sport. 2011;12(4):151–63.PubMedCrossRefGoogle Scholar
  12. 12.
    Squadrone R, Gallozzi C. Biomechanical and physiological comparison of barefoot and two shod conditions in experienced barefoot runners. J Sports Med Phys Fit. 2009;49(1):6–13.Google Scholar
  13. 13.
    Hasegawa H, Yamauchi T, Kraemer WJ. Foot strike patterns of runners at the 15-km point during an elite-level half marathon. J Strength Cond Res. 2007;21(3):888–93.PubMedGoogle Scholar
  14. 14.
    Hatala KG, Dingwall HL, Wunderlich RE, Richmond BG. Variation in foot strike patterns during running among habitually barefoot populations. PLoS One. 2013;8(1):e52548.PubMedCrossRefGoogle Scholar
  15. 15.
    Kasmer ME, Liu XC, Roberts KG, Valadao JM. Foot-strike pattern and performance in a marathon. Int J Sports Physiol Perform. 2013;8(3):286–92.PubMedGoogle Scholar
  16. 16.
    Larson P, Higgins E, Kaminski J, Decker T, Preble J, Lyons D, McIntyre K, Normile A. Foot strike patterns of recreational and sub-elite runners in a long-distance road race. J Sports Sci. 2011;29(15):1665–73.PubMedCrossRefGoogle Scholar
  17. 17.
    Delgado TL, Kubera-Shelton E, Robb RR, Hickman R, Wallmann HW, Dufek JS. Effects of foot strike on low back posture, shock attenuation, and comfort in running. Med Sci Sports Exerc. 2013;45(3):490–6.PubMedCrossRefGoogle Scholar
  18. 18.
    De Wit B, De Clercq D, Aerts P. Biomechanical analysis of the stance phase during barefoot and shod running. J Biomech. 2000;33(3):269–78.PubMedCrossRefGoogle Scholar
  19. 19.
    Divert C, Mornieux G, Baur H, Mayer F, Belli A. Mechanical comparison of barefoot and shod running. Int J Sports Med. 2005;26(7):593–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Keller TS, Weisberger AM, Ray JL, et al. Relationship between vertical ground reaction force and speed during walking, slow jogging, and running. Clin Biomech (Bristol, Avon). 1996;11(5):253–9.CrossRefGoogle Scholar
  21. 21.
    Giandolini M, Arnal PJ, Millet GY, Peyrot N, Samozino P, Dubois B, Morin JB. Impact reduction during running: efficiency of simple acute interventions in recreational runners. Eur J Appl Physiol. 2013;113(3):599–609.PubMedCrossRefGoogle Scholar
  22. 22.
    Ferris DP, Louie M, Farley CT. Running in the real world: adjusting leg stiffness for different surfaces. Proc Biol Sci. 1998;265(1400):989–94.PubMedCrossRefGoogle Scholar
  23. 23.
    Grimmer S, Ernst M, Gunther M, Blickhan R. Running on uneven ground: leg adjustment to vertical steps and self-stability. J Exp Biol. 2008;211(Pt 18):2989–3000.PubMedCrossRefGoogle Scholar
  24. 24.
    Bishop M, Fiolkowski P, Conrad B, Brunt D, Horodyski M. Athletic footwear, leg stiffness, and running kinematics. J Athl Train. 2006;41(4):387–92.PubMedGoogle Scholar
  25. 25.
    Chatterjee A, Garcia M. Small slope implies low speed for McGreer’s passive walking machines. Dyn Stab Syst. 2000;15(19):139–57.CrossRefGoogle Scholar
  26. 26.
    Divert C, Mornieux G, Freychat P, Baly L, Mayer F, Belli A. Barefoot-shod running differences: shoe or mass effect? Int J Sports Med. 2008;29(6):512–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Frederick EC. Physiological and ergonomics factors in running shoe design. Appl Ergon. 1984;15(4):281–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Larson P, Katovsky B. Tread lightly: form, footwear, and the quest for injury-free running. New York: Skyhorse Publishing; 2012.Google Scholar
  29. 29.
    Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations. Med Sci Sports Exerc. 1987;19(2):148–56.PubMedCrossRefGoogle Scholar
  30. 30.
    Robbins S, Waked E. Hazard of deceptive advertising of athletic footwear. Br J Sports Med. 1997;31(4):299–303.PubMedCrossRefGoogle Scholar
  31. 31.
    Marti B. Relationship between running injuries and running shoes—results of a study of 5000 participants of a 16-km run—the May 1984 Berne “Grand Prix”. In: Segesser B, Pforringer W, editors. The shoe in sport. Chicago: Year Book Medical Publishers; 1989. p. 256–65.Google Scholar
  32. 32.
    Ryan M, Fraser S, McDonald K, Taunton J. Examining the degree of pain reduction using a multielement exercise model with a conventional training shoe versus an ultraflexible training shoe for treating plantar fasciitis. Phys Sportsmed. 2009;37(4):68–74.PubMedCrossRefGoogle Scholar
  33. 33.
    Perl DP, Daoud AI, Lieberman DE. Effects of footwear and strike type on running economy. Med Sci Sports Exerc. 2012;44(7):1335–43.PubMedCrossRefGoogle Scholar
  34. 34.
    Baxter DE, Zingas C. The foot in running. J Am Acad Orthop Surg. 1995;3(3):136–45.PubMedGoogle Scholar
  35. 35.
    Hreljac A. Impact and overuse injuries in runners. Med Sci Sports Exerc. 2004;36(5):845–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Barton CJ, Levinger P, Menz HB, Webster KE. Kinematic gait characteristics associated with patellofemoral pain syndrome: a systematic review. Gait Posture. 2009;30(4):405–16.PubMedCrossRefGoogle Scholar
  37. 37.
    Ribeiro AP, Trombini-Souza F, Tessutti VD, Lima FR, Joao SM, Sacco IC. The effects of plantar fasciitis and pain on plantar pressure distribution of recreational runners. Clin Biomech (Bristol, Avon). 2011;26(2):194–9.CrossRefGoogle Scholar
  38. 38.
    Milner CE, Ferber R, Pollard CD, Hamill J, Davis IS. Biomechanical factors associated with tibial stress fracture in female runners. Med Sci Sports Exerc. 2006;38(2):323–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Bennell K, Crossley K, Jayarajan J, Walton E, Warden S, Kiss ZS, Wrigley T. Ground reaction forces and bone parameters in females with tibial stress fracture. Med Sci Sports Exerc. 2004;36(3):397–404.PubMedCrossRefGoogle Scholar
  40. 40.
    Zadpoor AA, Nikooyan AA. The relationship between lower-extremity stress fractures and the ground reaction force: a systematic review. Clin Biomech (Bristol, Avon). 2011;26(1):23–8.CrossRefGoogle Scholar
  41. 41.
    Novacheck TF. The biomechanics of running. Gait Posture. 1998;7(1):77–95.PubMedCrossRefGoogle Scholar
  42. 42.
    Pohl MB, Hamill J, Davis IS. Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners. Clin J Sport Med. 2009;19(5):372–6.PubMedCrossRefGoogle Scholar
  43. 43.
    Bredeweg SW, Kluitenberg B, Bessem B, Buist I. Differences in kinematic variables between injured and noninjured novice runners: a prospective cohort study. J Sci Med Sport. 2013;16(3):205–10.PubMedCrossRefGoogle Scholar
  44. 44.
    Williams DS 3rd, McClay IS, Hamill J. Arch structure and injury patterns in runners. Clin Biomech (Bristol, Avon). 2001;16(4):341–7.CrossRefGoogle Scholar
  45. 45.
    Williams DS 3rd, Davis IM, Scholz JP, Hamill J, Buchanan TS. High-arched runners exhibit increased leg stiffness compared to low-arched runners. Gait Posture. 2004;19(3):263–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Crowell HP, Davis IS. Gait retraining to reduce lower extremity loading in runners. Clin Biomech (Bristol, Avon). 2011;26(1):78–83.CrossRefGoogle Scholar
  47. 47.
    Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for plantar fasciitis: a matched case–control study. J Bone Joint Surg Am. 2003;85-A(5):872–7.PubMedGoogle Scholar
  48. 48.
    Stackhouse CL, Davis IM, Hamill J. Orthotic intervention in forefoot and rearfoot strike running patterns. Clin Biomech (Bristol, Avon). 2004;19(1):64–70.CrossRefGoogle Scholar
  49. 49.
    MacLean C, Davis IM, Hamill J. Influence of a custom foot orthotic intervention on lower extremity dynamics in healthy runners. Clin Biomech (Bristol, Avon). 2006;21(6):623–30.CrossRefGoogle Scholar
  50. 50.
    Mayer F, Hirschmuller A, Muller S, Schuberth M, Baur H. Effects of short-term treatment strategies over 4 weeks in Achilles tendinopathy. Br J Sports Med. 2007;41(7):e6.PubMedCrossRefGoogle Scholar
  51. 51.
    Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. Br J Sports Med. 2009;43(3):169–71.PubMedCrossRefGoogle Scholar
  52. 52.
    Ryan MB, Valiant GA, McDonald K, Taunton JE. The effect of three different levels of footwear stability on pain outcomes in women runners: a randomised control trial. Br J Sports Med. 2011;45(9):715–21.PubMedCrossRefGoogle Scholar
  53. 53.
    Ridge ST, Johnson AW, Mitchell UH, Hunter I, Robinson E, Rich BS, Brown SD. Foot bone marrow edema after 10-week transition to minimalist running shoes. Med Sci Sports Exerc. 2013;45(7):1363–8.PubMedCrossRefGoogle Scholar
  54. 54.
    Mercer JA, Devita P, Derrick TR, Bates BT. Individual effects of stride length and frequency on shock attenuation during running. Med Sci Sports Exerc. 2003;35(2):307–13.PubMedCrossRefGoogle Scholar
  55. 55.
    McDougall C. Born to run: a hidden tribe, superathletes, and the greatest race the world has never seen. New York: Alfred A. Knopf; 2009. p. 287.Google Scholar
  56. 56.
    Burge C. Comment on barefoot running (Internet). In: SPORTSCIENCE; 2002. Accessed 17 Sep 2000.
  57. 57.
    Salzler MJ, Bluman EM, Noonan S, Chiodo CP, de Asla RJ. Injuries observed in minimalist runners. Foot Ankle Int. 2012;33(4):262–6.PubMedCrossRefGoogle Scholar
  58. 58.
    Nicola TL, Jewison DJ. The anatomy and biomechanics of running. Clin Sports Med. 2012;31(2):187–201.PubMedCrossRefGoogle Scholar
  59. 59.
    Puttaswamaiah R, Chandran P. Degenerative plantar fasciitis: a review of current concepts. Foot. 2007;17(1):3–9.CrossRefGoogle Scholar
  60. 60.
    Dierks TA, Manal KT, Hamill J, Davis IS. Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run. J Orthop Sports Phys Ther. 2008;38(8):448–56.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Kelly Murphy
    • 1
  • Emily J. Curry
    • 2
    Email author
  • Elizabeth G. Matzkin
    • 2
  1. 1.Tufts University Medical CenterTufts UniversityBostonUSA
  2. 2.Division of Sports Medicine, Department of Orthopaedic SurgeryBrigham and Women’s HospitalBostonUSA

Personalised recommendations