One in Six Podiatrists . . .

On his America’s Podiatrist blog, Dr. Michael Nirenberg points us to a survey of podiatrists in the magazine Podiatry Management. The survey asks “Do you recommend barefoot running?”

The response is (somewhat) better than I thought it might be.

First, you should go read Dr. Nirenberg’s blog article, Surprise! 16% of Podiatrists Recommend Barefoot Running.

Here are the actual results:

Survey Results

I think we’re all surprised that podiatrists are slowly coming around. No, 16% is not a huge percentage, but it’s a lot more than I would have guessed.

Note: it’s an online survey, so all the usual caveats about not being scientific apply. However, we can safely say that there are 126 podiatrists out there who do recommend “barefoot” running. And of those, 17 recommend it for all runners.

Dr. Nirenberg, quite correctly, notes the caveat about “foot type”:

As background, Podiatry Management’s editor, Dr. Barry Block, has featured a wide-range of content in his magazine, website and newsletter. He brings to light new innovations and technologies, and other advances related to podiatry and feet. I often learn more about what is going in the podiatry profession from his publications than from the American Podiatric Medical Association.

However, Dr. Block’s survey implies that a key factor in whether or not barefoot running should be recommended is “foot type.” In fact, 14% of podiatrists believe foot type IS a determining factor.

However, he has experience regarding “foot type”, and tells us about it.

Today I know that foot type has no bearing on your ability to run barefoot.

Many years back, I too (like these podiatrists) did not realize the remarkable ability of some runners to “tune in” to their own biomechanics and run barefoot, regardless of their foot type

There’s nothing like actual experience. As he says

I have seen first-hand the incredible achievements of people who are committed to running (and walking) barefoot. It has totally turned everything I thought I knew upside down. I have seen severe high arched people run bare, as well as people whose feet are like two pancakes.

I have a couple of extra comments on this.

First, the “foot type” you have if you are a regular shoe wearer is often different than your “foot type” when you regularly go barefoot. We’ve heard time after time how barefooters feet change when they quit wearing shoes (particularly bad shoes). The toes spread; the whole foot spreads. In addition, the arch rises as all the muscles and tendons and ligaments go back to working again. So the “foot type” these podiatrists are seeing are not indicative of what those feet can do.

Second, what’s the “foot type” concern based on? If you read various sites that podiatrists comment on you’ll see that the anti-barefoot ones are always pointing out the lack of scientific evidence that running barefoot is better for you. This is pretty much true—there is actually very little research that doesn’t have ambiguous results. It’s hard to properly do such research, because there are so many confounding factors. (Yes, there are various studies that look at one small factor, like knee-loading, but it’s not a given that that necessarily translates into a definitive result for overall barefoot running). It should also be pointed out, though, that there is equally no research that running shod is better for you (and there is research showing all the injuries from running shod).

Anyways, if there’s little definitive research regarding barefoot running overall, there’s even less (I don’t know of any) regarding injury and “foot type”. “Foot type” seems to be just an excuse podiatrists use when they have to concede that there are barefoot runners out there doing just fine, but feel they have to say something negative to justify their opposition to barefoot running.

There is one small bit in Dr. Nirenberg’s article I have doubts about.

When I say “barefoot” I am talking today about minimalist shoes or barefoot. If you are running in an area where you fear cuts or scratches to your feet, then you should opt for minimalist shoes. If you fear a puncture wound from rusty nails or worse, then you should not run there. Period.

Personally, I always where minimalist shoes: in my office, at meetings, weddings and so on. I do go completely barefoot at times but this is infrequent and only in the safest of areas.

I suspect that if he gets more experience in this, he might modify his views, just as he did on the “foot type” front. The fears of cuts, scratches, or punctures are greatly exaggerated.

Yes, it can occasionally happen, but it is rarely a problem at all. A scratch on your foot is no more of a problem than a scratch on your hands. I get them on my hands all the time whenever I’m doing a household project—I almost always have more scratches on my hands than on my feet. And the scratches on my feet are usually on the tops of my feet or on my ankles or lower legs (from bushwhacking through brush). The soles have nice thick leather that resists most untoward surfaces.

I also object to the “rusty nails” reference. I don’t think I’ve ever seen one in a position to puncture my sole. But let me tell you, wearing a minimalist shoe is not going to protect you from one.

Anyways, it’s a very nice article and gives a good perspective from a podiatrist—a podiatrist who is undoubtedly among the 16%.

So read it.