From barefoot hunter gathering to shod pavement pounding. Where to from here? A narrative review

Abstract

Understanding the current prevalence and incidence of running injury from an evolutionary perspective has sparked great debate. Proponents of the evolutionary approach to understanding running injury suggest that humans ran using less injurious biomechanics prior to the invention of cushioned running shoes. Those who disagree with this view, point to the many runners, wearing cushioned running shoes, who do not get injured and suggest that the evolutionary approach is indulging in a ‘natural fallacy’. This polarises the scientific debate into discrete categories such as ‘shod’ vs ‘barefoot’. This review aims, first, to describe humans’ innate impact moderating mechanisms which arise from our evolutionary legacy. Second, we discuss the impact of footwear on these mechanisms and the potential link to injury in some runners. Finally, we discuss the role of barefoot training in sports medicine and attempt to make some practical suggestions as to how it might be integrated in our modern urban environments.

Footstrike patterns and race performance in the 2017 IAAF World Championship men’s 10,000 m final

“…At all measurement distances, the athletes ran faster than ~22 km/h (Figure 2(a)), which is consistent with speed and footstrike pattern trends observed previously (Forrester & Townend, 2015). It is therefore possible that these athletes adopted MFS and FFS patterns because those patterns were the most habitual to them (Francis & Schofield, 2020), and small differences in speed were insufficient to cause them to substantially change whatever footstrike pattern they had developed over time in training and racing (Forrester & Townend, 2015). With regard to contact times, these were largely the same throughout the race despite the changes in speed and could relate to how all athletes maintained anterior footstrike patterns.…”

Evidence of humans in North America during the Last Glacial Maximum

“…S3). The WHSA tracks, similar to the fossil tracks from Namibia, are flatter-footed than the modern samples, similar to what is commonly reported for habitually unshod individuals [e.g., (21)]. The WHSA footprints also have longer toe pads that we suggest are associated with slippage of the foot during locomotion (18).…”

Barefoot Running on Grass as a Potential Treatment for Plantar Fasciitis: A Prospective Case Series

“…This type of running may allow runners to capitalise on the inherent variability of the foot (33-joints) and the natural surface to produce a consistent action (running) via different patterns of tensioning, stiffening and joint relations. Indeed, the energy return from connective tissues associated with the medial longitudinal arch [ 2 ], transverse arch [ 37 ] and heel [ 38 ] make a significant contribution to energy turnover during running [ 4 ]. It may be that liberating the foot from the shoe and the almost permanent state of ‘windlass’ associated with the upward curvature of toe springs [ 2 ] allows runners make greater immediate use of their foot arches, thereby reducing overload to the plantar fasciitis and the symptoms associated.…”

“…Plantar fasciitis is the most common musculoskeletal condition of the foot in the general population and in the running community [ 1 , 2 , 3 ]. Mounting evidence suggests that it is caused by repetitive tensile loads applied to the plantar aponeurosis due to excessive deformation of the foots longitudinal arch [ 2 , 3 , 4 , 5 ]. Excessive deformation of the arch is facilitated by weakness of the intrinsic foot muscles [ 2 , 3 , 4 , 6 , 7 ].…”

“…Mounting evidence suggests that it is caused by repetitive tensile loads applied to the plantar aponeurosis due to excessive deformation of the foots longitudinal arch [ 2 , 3 , 4 , 5 ]. Excessive deformation of the arch is facilitated by weakness of the intrinsic foot muscles [ 2 , 3 , 4 , 6 , 7 ]. Modern footwear use is associated with weaker intrinsic foot muscles [ 7 , 8 ] a greater prevalence of flat feet [ 9 ] and changes to the shape of the foot that are not seen in habitually barefoot or minimally shod populations [ 7 , 10 , 11 ].…”