2.  Current Research:
› team of 3 + Capstone Professor
› literature review: biomechanical differences of barefoot vs
shod running
› 10 week transition program
 11 participants
 Supervised practice
 Transition exercises
 Barefoot activity
 Walk jog run transition
› Final data gathered last night!
 Analyze data for strike, cadence, intrinsic strength,
dynamic balance “Y” balance
› Next: analyze data, present findings

3.  What exactly is “minimalist” running?
› History
› Minimalist foot wear defined
 Why bother?
› Foot strike pattern
› Biomechanical pro/cons
 Who should try “minimalist” running?
› Screening criteria
 How?
› Transition Program
 Clinical applications
 Bottom Line

4.  Imitate barefoot running
technique
 But with shoes for protection!
 Proposed theory for injury
reduction/prevention
› …I’ll review the evidence, and
let you decide for yourself…

5. 2004-2005:
Nike Free &
Vibram
2009:
release
of “Born
to Run”2
1960s-70s:
cushioned
heel 1
1960s:
Abebe
Bikila &
Zola
Bud1
45,000 yrs
ago:
moccasin
1
2.3
million
yrs ago:
stone
age

6.  Lightweight
 Highly flexible
› No stiff sole, arch support
 Expandable toe box
 No elevated heel (<5mm
drop)
› “Drop”: Heel-toe
drop/offset (=lift)

7. 10-12mm
• “Standard” running shoe
• Brooks Adrenaline
• Asics Gel Nimbus
8mm
• Nike Free
7-4mm
• “Racing Flats”
0mm
• “minimalist shoes”
• Vibram 5 fingers
• New Balance Minimus

8.  Q: every try sprinting or jumping
barefoot? (kids?)
› Likely land on balls of feet to reduce impact
› Use more motor control for eccentric landing
& land softly
› Incr. motor control = decr. load on joints
 BLUF:
› MFW → no cushion heel →promote forefoot
strike → decr. Step length → incr. cadence
→closer BOS →less joint torque/GRF

9.  Rear foot strike
 Mid foot strike
 Fore foot strike
 Strike pattern and drop
correlation
 Strike pattern and
Ground Reaction Force
(GRF)4***
› Collision force
› ≈LE load
› Force plate
› Impact peak
› Active peak

10. FFS RFS
GRF4 ↓ or 0 impact peak Prominent impact peak
Loading Rate (slope)5,6,7 Slower rate Quicker rate
Joint Torque8 38% ↑ knee flex & varus
torque

11. FFS RFS
Extrinsic Strength1,7,9 Eccentric GS complex;
stronger FHL FDL in MFW
(arch)
Eccentric Ant Tib
Intrinsic Strength9,10 MFW ↑ Abductor Hallucis
& Quadratus Plantae vs
shod
habitually shod children
decreased arch height
& lig support vs barefoot
Proprioception 11,12 Barefoot = highly
protective sensation
=absorb ground impact
better
Inflexible rubber sole has
vibration dampening
properties ↓ sensory
feedback = ↑ injury
Postural Changes13 Ideal posture; Shorter
stride = neutral pelvis,
neutral L spine
Longer stride = Ant
pelvic tilt = L lordosis; RFS
↑ sagittal movement L
spine

12. FFS RFS
cadence1 170-180 steps/min 150-160 steps/min
Stride Length5 Shorter, foot land closer
to body’s COM, reduce
load on LE joints
Cushioned heel
encourages over-
striding, further from
COM

13. FFS RFS
Impact ↑ impacts/min, ↓ peaks ↓ impacts, ↑ peaks
Injuries MT stress fractures, achilles
tendonitis, stress to plantar fascia
Shin spints
Orthotics Not compatible c MFW Are compatible c
standard shoes
Protection Minimal c harmful terrain Motion control,
cushioning, stabilization

14.  Not for everyone
› Heel strikers
› “If it’s not broke, don’t change it”
› RRI? Maybe so…
 Screening Criteria:
› Sensory screening
› No orthotics
› Previous stress fracture
› Solid running base
› Mobility Test:
 Ankle 25-30° DF ROM
 MTP 30° Ext
› Intrinsic strength (FHB)
› SLS balance (barefeet)

15.  Form & Technique instruction
› Incr. cadence = shortens strike = encourages MFS/FFS
› Daniel Lieberman 3 tips: (http://sanjayguptamd.blogs.cnn.com/2013/11/04/run-the-right-way-like-
prehistoric-man-3/)
 Good posture
 Fast rhythm
 Quiet steps
 Transition shoe wear
› Motion control>stability>neutral>nike free>racing flat>vibrams
 Transition program is recommended
› Structured
› Gradual progression of….
 Barefoot activity
 Walk-run program wearing MFW
 Balance/proprioception training
 Intrinsic strength
 Plyometrics

16. Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Week 1 Walk 15
minutes
 Transition
Exercises
 Barefoot
activity
 Stretching
Walk 20
minutes
 Transition
Exercises
 Barefoot
activity
 Stretching
Walk 25
minutes
 Transition
Exercises
 Barefoot
activity
 Stretching
Week 2 Walk 30
minutes
 Transition
Exercises
 Barefoot
activity
 Stretching
Walk 9
minutes/ Jog 1
minute x 3
 Transition
Exercises
 Barefoot
activity
 Stretching
Walk 8
minutes/ Jog
2 minutes x
3
 Transition
Exercises
 Barefoot
activity
 Stretching
Week 3 Walk 7
minutes/ Jog
3 minutes x 3
 Transition
Exercises
 Barefoot
activity
 Stretching
Walk 6
minutes/ Jog 4
minutes x 3
 Transition
Exercises
 Barefoot
activity
 Stretching
Walk 5
minutes/ Jog
5 minutes x
3
 Transition
Exercises
 Barefoot
activity
Stretching
Week 4 Walk 4
minutes/ Jog
6 minutes x 3
 Transition
Exercises
 Barefoot
activity
 Stretching
Walk 3
minutes/ Jog 7
minutes x 3
 Transition
Exercises
 Barefoot
activity
 Stretching
Walk 2
minutes/ Jog
8 minutes x
3
 Transition
Exercises
 Barefoot
activity
 Stretching

17. Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Week 5 Walk 1
minute/ Jog 9
minutes x 3
 Transition
Exercises
 Barefoot
activity
 Stretching
Jog 10 minutes  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 11
minutes
 Transition
Exercises
 Barefoot
activity
 Stretching
Week 6 Jog 12 min  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 15 min  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 17 min  Transition
Exercises
 Barefoot
activity
 Stretching
Week 7 Jog 17 min  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 20 min  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 20 min  Transition
Exercises
 Barefoot
activity
Stretching
Week 8 Jog 25 min  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 25 min  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 30 min  Transition
Exercises
 Barefoot
activity
 Stretching

18. Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Week 9 Jog 30 min  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 30 min  Transition
Exercises
 Barefoot
activity
 Stretching
Jog 30 min  Transition
Exercises
 Barefoot
activity
 Stretching
Week 10 Jog 20 min  Transition
Exercises
 Barefoot
activity
 Stretching
 Videotaping
Jog 10 min  Transition
Exercises
 Barefoot
activity
 Stretching
 Videotaping
Day off/
Prepare for
race day!
5K Race!

19.  Dynamic Warm up (c forefoot striking):
› High Knees
› A-Skip
› B-Skip
› Sprints
 Plyometrics
› Line hops → cone hops
› Squat jumps → tuck jumps → drop jumps
› Single leg hops → for distance
 Intrinsic Strengthening
› Towel scrunches
› Marble pick ups
› Arch builders
 Balance
› SLS → SLS c TB → SLS foam → SLS foam c TB →SLS
bosu

20.  General patient curiosity?
 Relationship with Running Related Injuries:
 Chronic Shin Splints = maybe try
› heel strike → ecc ant. Tib → fatigue=“foot slap”
 Achilles Tendonitis = no way!
› forefoot → ecc GS
 Hx of MT stress fractures? Nope!

21.  It’s more about the FOOT STRIKE
 Minimalist shoes can facilitate a MFS-FFS
› MFW → no cushion heel →promote FFS→
decr. Step length → incr. cadence →closer
BOS →less joint torque/GRF
 But, if you don’t change strike pattern,
RFS in MFW = calcaneal/heel stress

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medical perspective. Exercise & Sport Sciences Reviews. 2012;40(2):63-72.
2. McDougall C. Born to run: a hidden tribe, superathletes, and the greatest race the world
has never seen. Alfred A. Knopf; 2009.
3. Rixe JA, Gallo RA, Silvis ML. The Barefoot Debate: Can Minimalist Shoes Reduce Running-
Related Injuries? Current Sports Medicine Reports (Lippincott Williams & Wilkins).
2012;11(3):160-165.
4. Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in
habitually barefoot versus shod runners. Nature. Jan 28 2010;463(7280):531-535.
5. Altman AR, Davis IS. Barefoot running: biomechanics and implications for running injuries.
Current Sports Medicine Reports (American College of Sports Medicine). 2012;11(5):244-
250.
6. Zadpoor AA, Nikooyan AA. The relationship between lower-extremity stress fractures and
the ground reaction force: A systematic review. Clinical biomechanics. 1// 2011;26(1):23-
28.
7. Hall JPL, Barton C, Jones PR, Morrissey D. The Biomechanical Differences Between Barefoot
and Shod Distance Running: A Systematic Review and Preliminary Meta-Analysis. Sports
Medicine. Dec 2013;43(12):1335-1353.

23. 8. Kerrigan DC, Franz JR, Keenan GS, Dicharry J, Della Croce U, Wilder RP. The
Effect of Running Shoes on Lower Extremity Joint Torques. 2009.
9. Brüggemann G-P, Potthast W, Braunstein B, Niehoff A. EFFECT OF INCREASED
MECHANICAL STIMULI ON FOOT MUSCLES FUNCTIONAL CAPACITY.
Conference Proceedings of the Annual Meeting of the American Society of
Biomechanics. 01// 2005:553.
10. Rao UB, Joseph B. The Influence of Footwear on the Prevalence of Flat Foot
- a Survey of 2300 Children.
11. Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations. /
Prevention des traumatismes dus a la couse a pied par des adaptations du pied nu.
Medicine & Science in Sports & Exercise. 1987;19(2):148-156.
12. Squadrone R, Gallozzi C. Effect of a five-toed minimal protection shoe on static and
dynamic ankle position sense. Journal of Sports Medicine & Physical Fitness.
2011;51(3):401-408.
13. Delgado TL, Kubera-Shelton E, Robb RR, Hickman R, Wallmann HW, Dufek JS. Effects of
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science in sports and exercise. 2013;45(3):490-496.