Barefoot Running and Minimalist Shoes

This piece is more of a personal opinion based on my own experiences with patients who have tried or are wearing minimalist/barefoot running shoes, and on my own experience as a runner. Barefoot running shoes and minimalist running shoes have been quite a fad over the last few years. However, I have seen less people in these shoes at races and training outside this past summer. I have also seen less patients in my office who tell me they are running/ walking in them. I personally feel this is a good thing.
The claim is that barefoot running/minimalist shoes “can improve runner’s times, decrease vertical forces on the feet, strengthen the foot muscles and decrease risk of injury.” People who run in these types of shoes tend to have to convert to a midfoot or forefoot strike pattern. This is said to decrease vertical forces to the leg/body. However this type of running and these shoes increase load to the metatarsal bones which commonly results in stress fracture/stress reactions. It is stated in literature, and I have found, an increase in stress fractures of the feet, Achilles tendonitis, plantar fasciitis and neuromas in patients who experiment running in these shoes. The Achilles tendon is more stressed in barefoot running due to the midfoot/forefoot strike pattern. The plantar fascia trends to be more stressed. The forefoot has increased load with barefoot/minimalist shoes tending to irritate forefoot nerves (neuroma). Traditional padded sneakers provide a more stable base and protection for the feet. Traditional sneakers, with the addition of OTC or custom orthotics, can provide better stress distribution over the foot and less stress on knees. It is not to say that runners in traditional sneakers do not experience the above foot problems, but I find the shoes less of a causative factor for them. Also, treatment of these problems usually involves correcting biomechanical problems in the feet with proper sneakers and inserts. Can any running shoe/lack of shoe make running injury free?, No! It is important to undergo proper training, slow increase of mileage, proper stretching, and proper support.