From the Guidelines
Running barefoot is not recommended for everyone, especially for individuals with diabetes or those at risk of foot ulcers, as it can increase the risk of foot injuries and ulcers. According to the guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update) 1, walking barefoot, in socks without shoes, or in thin-soled slippers, whether indoors or outdoors, is not recommended for individuals with diabetes who are at risk of foot ulceration. This is because the feet of an at-risk person with diabetes need to be protected against high mechanical stresses and external physical trauma, which can cause foot ulcers.
Some studies suggest that running barefoot may have benefits, such as strengthening foot muscles and improving proprioception, but these benefits may not outweigh the risks for certain individuals 1. For example, individuals with existing foot problems, such as plantar fasciitis or severe biomechanical issues, should consult a healthcare provider before trying barefoot running. Additionally, minimalist shoes can offer a middle ground, providing some protection while still allowing natural foot movement.
When considering running barefoot, it's essential to weigh the potential benefits against the potential risks, particularly for individuals with certain health conditions or risk factors. The most recent and highest-quality study recommends avoiding walking barefoot, in socks without shoes, or in thin-soled slippers for individuals with diabetes who are at risk of foot ulceration 1. This recommendation prioritizes the prevention of foot ulcers and promotes the protection of the feet against high mechanical stresses and external physical trauma.
Key considerations for running barefoot include:
- Starting with short distances and gradually increasing time as the feet adapt
- Adopting a forefoot or midfoot strike pattern rather than heel striking
- Being aware of potential risks, including cuts, puncture wounds, infections, and stress injuries
- Consulting a healthcare provider before trying barefoot running if you have existing foot problems or certain health conditions
- Considering minimalist shoes as a middle ground for protection and natural foot movement
Ultimately, the decision to run barefoot should be made on an individual basis, taking into account specific health conditions, risk factors, and circumstances. Prioritizing foot protection and safety is crucial, especially for individuals with diabetes or those at risk of foot ulcers.
From the Research
Benefits of Running Barefoot
- Running barefoot may promote a forefoot strike pattern, which is associated with a reduction in impact loading and stride length 2
- Barefoot running can provide increased sensory feedback from the foot-ground contact and increased energy storage in the arch 2
- Some studies suggest that barefoot running may be beneficial for certain types of individuals, but differences in running stance and individual biomechanics may actually increase injury risk when transitioning to barefoot running 3
Risks of Running Barefoot
- Despite claims of injury prevention, there is no conclusive evidence to support the idea that running barefoot reduces injury rates in runners 3, 4
- Barefoot running may actually increase the risk of injury in some individuals, particularly those who are not well-trained or who have poor running biomechanics 5, 6
- Fatigue can negatively affect risk factors for injury in trained but not well-trained habitually shod runners when running barefoot 6
Individual Responses to Barefoot Running
- Not all individuals respond positively to barefoot running, and some may experience an increase in injury risk 5
- Individual responses to barefoot running can be influenced by factors such as ankle flexion angle, plantar flexion, and muscle activity 5
- Conscious instruction and training may be required for runners to acquire habitual barefoot running characteristics and reduce the risk of injury 5