Born to run barefoot? Some end up getting injured

LOS ANGELES (AP) — Swept by the barefoot running craze, ultramarathoner Ryan Carter ditched his sneakers for footwear that mimics the experience of striding unshod. The first time he tried it two years ago, he ran a third of a mile on grass. Within three weeks of switching over, he was clocking six miles on the road. During a training run with a friend along a picturesque bike path near downtown Minneapolis, Carter suddenly stopped, unable to take another step. His right foot seared in pain. "It was as though someone had taken a hammer and hit me with it," he recalled. Carter convinced his friend to run on without him. He hobbled home and rested his foot. When the throbbing became unbearable days later, he went to the doctor. The diagnosis: a stress fracture. As more avid runners and casual athletes experiment with barefoot running, doctors say they are treating injuries ranging from pulled calf muscles to Achilles tendinitis to metatarsal stress fractures, mainly in people who ramped up too fast. In serious cases, they are laid up for several months. Many converts were inspired by Christopher McDougall's 2009 best-seller "Born To Run," widely credited with sparking the barefoot running trend in the Western world. The book focuses on an Indian tribe in Mexico whose members run long distances without pain in little more than sandals. While the ranks of people running barefoot or in "barefoot running shoes" have grown in recent years, they still represent the minority of runners. Some devotees swear they are less prone to injuries after kicking off their athletic shoes though there's no evidence that barefoot runners suffer fewer problems. In some cases, foot specialists are noticing injuries arising from the switch to barefoot, which uses different muscles. Shod runners tend to have a longer stride and land on their heel compared with barefoot runners, who are more likely to have a shorter stride and land on the midfoot or forefoot. Injuries can occur when people transition too fast and put too much pressure on their calf and foot muscles, or don't shorten their stride and end up landing on their heel with no padding. Podiatrist Paul Langer used to see one or two barefoot running injuries a month at his Twin Cities Orthopedics practice in Minneapolis. Now he treats between three and four a week. "Most just jumped in a little too enthusiastically," said Langer, an experienced runner and triathlete who trains in his barefoot running shoes part of the week. Bob Baravarian, chief of podiatry at the UCLA Medical Center in Santa Monica, Calif., said he's seen "a fair number" of heel injuries and stress fractures among first-timers who are not used to the different forces of a forefoot strike. "All of a sudden, the strain going through your foot is multiplied manifold" and problems occur when people don't ease into it, he said. Running injuries are quite common. Between 30 to 70 percent of runners suffer from repetitive stress injuries every year and experts can't agree on how to prevent them. Some runners with chronic problems have seized on barefoot running as an antidote, claiming it's more natural. Others have gone so far as to demonize sneakers for their injuries. Pre-human ancestors have walked and run in bare feet for millions of years often on rough surfaces, yet researchers surprisingly know very little about the science of barefoot running. The modern running shoe with its cushioned heel and stiff sole was not invented until the 1970s. And in parts of Africa and other places today, running barefoot is still a lifestyle. The surging interest has researchers racing for answers. Does barefoot running result in fewer injuries? What kinds of runners will benefit most from switching over? What types of injuries do transitioning barefoot runners suffer and how to prevent them? While some runners completely lose the shoes, others opt for minimal coverage. The oxymoron "barefoot running shoes" is like a glove for the feet designed to protect from glass and other hazards on the ground. Superlight minimalist shoes are a cross between barefoot shoes and traditional sneakers — there's little to no arch support and they're lower profile. Greg Farris decided to try barefoot running to ease the pain on the outside of his knee, a problem commonly known as runner's knee. He was initially shoeless — running minutes at a time and gently building up. After three months, he switched to barefoot running shoes after developing calluses. Halfway through a 5K run in January, he felt his right foot go numb, but he pushed on and finished the race. He saw a doctor and got a steroid shot, but the pain would not quit. He went to see another doctor, who took an X-ray and told him he had a stress fracture. Farris was in a foot cast for three months. He recently started running again — in sneakers. "I don't think my body is made to do it," he said, referring to barefoot running. Experts say people can successfully lose the laces. The key is to break in slowly. Start by walking around barefoot. Run no more than a quarter mile to a mile every other day in the first week. Gradually increase the distance. Stop if bones or joints hurt. It can take months to make the change. "Don't go helter skelter at the beginning," said Dr. Jeffrey Ross, an associate clinical professor of medicine at Baylor College of Medicine and chief of the Diabetic Foot Clinic at Ben Taub General Hospital in Houston. A year and a half ago, Ross saw a steady stream — between three and six barefoot runners a week — with various aches and pain. It has since leveled off to about one a month. Ross doesn't know why. It's possible that fewer people are trying it or those baring their feet are doing a better job adapting to the new running style. There's one group foot experts say should avoid barefoot running: People with decreased sensation in their feet, a problem common among diabetics, since they won't be able to know when they get injured. Harvard evolutionary biologist Daniel Lieberman runs a lab devoted to studying the effects of running form on injury rates. He thinks form matters more than footwear or lack of — don't overstride, have good posture and land gently. In a 2010 study examining different running gaits, Lieberman and colleagues found that striking the ground heel first sends a shock up through the body while barefoot runners tend to have a more springy step. Even so, more research is needed into whether barefoot running helps avoid injury. "The long and the short of it is that we know very little about how to help all runners — barefoot and shod — prevent getting injured. Barefoot running is no panacea. Shoes aren't either," said Lieberman, who runs barefoot except during the New England winters. Carter, the ultramarathoner, blames himself for his injury. Before he shed his shoes, he never had a problem that kept him off his feet for two months. In April, he ran his fourth 100-mile race — with shoes. Meanwhile, his pair of barefoot running shoes is collecting dust in the closet.

Walk Your Way to Fitness

A regular walking workout can benefit your overall health. Find out why fitness walking is so important and how you can get started.

If you’re like most people, you walk just under three miles every day in the course of your normal activities. Now it’s time to get a little more purposeful. The Centers for Disease Control and Prevention, the American College of Sports Medicine, and the Surgeon General all agree that at least 30 minutes of brisk physical exercise is good for your health, and walking is one of the easiest forms of exercise to get.

Some of the many benefits of a regular walking workout include:

Cardiovascular health. Fitness walking strengthens your heart, improves your circulation, and lowers your blood pressure. A study published in The New England Journal of Medicine evaluated 73,743 postmenopausal women enrolled in the Women's Health Initiative Observational Study and found that women who walked briskly 2.5 hours every week reduced their chance of heart disease by 30 percent.

Bone health. As a weight-bearing exercise, walking can stop some of the bone loss of osteoporosis and may slow down arthritis.

Weight loss. A regular walking workout burns calories. If you walk 4 miles four times a week, you can walk off about a half-pound of fat every month. Weight loss combined with a healthy diet can also decrease your risk of type 2 diabetes.

Mental health. Studies show that fitness walking reduces stress and improves your overall sense of emotional well-being. A regular walking workout can help you enjoy deeper, more restful sleep, which may decrease your risk for anxiety and depression. How to Start Your Walking Workout

The speed and distance of your walking workout are not as important as the time you spend walking at a brisk pace. If you have any health issues talk to your doctor first and find out what is a safe pace for you. Start gradually and walk only as far and as long as is comfortable. Follow these fitness walking guidelines:

Work up to at least 30 minutes of brisk walking a day. Warm up by walking at your normal pace for about 5 minutes and then pick up the pace for about 15 minutes. While you walk, swing your arms and maintain good posture. Take long strides, but don't strain yourself. Slow down at the end of your walk and do some gentle stretching. Every week you should try to add about 5 more minutes to the brisk part of your walking workout until you can get it to over 30 minutes.

Keeping Up the Pace

Once you have decided to start walking for fitness, it's important to stick with it. The benefits of your walking workout take place and are maintained only over time. Here are some tips to keep you going:

Wear comfortable shoes. One sure way to lose interest in your walking workout is having sore feet. Take some time to get the right shoes. Your walking shoes need to fit your foot and the type of arch you have. Remember that your feet change over time. As you get older you may need more padding, more support, and more room, so have your feet measured regularly. It’s best to get your feet measured at the end of the day when your feet are larger; try on shoes with the socks you would wear for walking; and walk around for a while in the store before you buy.

Cultivate companionship. Walking with somebody else is safer, less boring, and more motivating. Many communities have walking groups you can join or you could start your own group. Walking with a friend or partner, taking along your dog, and making your walking workout a time you look forward to can help you stick with it.

Stay hydrated. Drinking enough water is an important part of a walking workout. Remember that you lose water through sweat even in cooler weather and that you don't start to feel thirsty until you’re already starting to become dehydrated. Drink about two cups of water before you start and another cup about every 15 minutes. Don't wait until you get thirsty.

Count the miles. Setting goals and keeping track of your progress can be a good motivator. You can set weight loss goals or mileage goals. Use a pedometer to measure the number of steps you take during your walking workout and keep track of your progress.

New Balance Faces Potential Class Action Over Toning-Shoe Claims

Boston, MA: New Balance, the Boston-based sneaker maker is being sued over allegations of deceptive advertising, specifically, that its toning shoes create more sculpted legs than traditional walking shoes are not accurate.

The complaint, filed on Monday in the US District Court of Boston, is seeking class action status, and $5 million in damages.

The suit was filed by Bistra Pashamova of California, who claims that she and others like her have been harmed by New Balance. New Balance has promoted its toning shoes with claims that the shoes increase muscle activation by about 27 percent and increase calorie burn by as much as 10 percent with each step.

However, results from a study completed by the American Council on Exercise, released in the summer of 2010, showed that "toning shoes" do not live up to the claims made by several manufacturers. The report concluded there was “no statistically significant increases in either exercise response or muscle activation’’ as a result of wearing toning sneakers."

Additionally, reports of injuries have raised concerns that the shoes, which retail for about $100 a pair, could in fact do more harm than good.

Pashamova is also seeking to “halt the dissemination of this false and misleading advertising message, correct the false and misleading perception New Balance has created in the minds of consumers, and to obtain redress for those who have purchased any New Balance toning shoes.’’