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from the American Academy of Orthopaedic Surgeons

Diseases & Conditions



Staying Healthy

Is barefoot running better?

Elizabeth Matzkin, MD

Elizabeth G. Matzkin, MD

Any views or recommendations shared in the Ortho-pinions blog are solely those of the authors and do not necessarily represent those of the American Academy of Orthopaedic Surgeons.

Since Christopher McDougall published “Born to Run” in 2009, there has been a surging interest in minimalist or barefoot running.

Before we address whether or not minimalist or barefoot running is better or results in fewer injuries, we must first understand a little about the mechanics of running.

The way the foot hits the ground when running is called “foot strike.” Foot strike pattern when running can be simply classified as forefoot strike (contacting the ground initially with the front or ball of the foot) or rearfoot strike (contacting the ground initially with the heel). In general, barefoot runners tend to have a forefoot strike pattern and shod runners, a rearfoot strike pattern. Modern, cushioned running shoes can better absorb the heel impact.

There have been many studies to determine if certain strike patterns can result in fewer injuries or even assist in preventing injuries. Different injuries may occur more commonly depending on foot strike pattern. For example, forefoot strikers are more prone to metatarsal stress fractures and rearfoot strikers are more prone to patellofemoral pain.

Does barefoot/minimalist running result in fewer injuries? The data we have to date is not sufficient to answer these questions definitively.

If you are a runner and have been running injury free with minimalist or fully cushioned shoes — you should probably keep doing what works for YOU!

If you have been struggling with running injuries and think a change may be beneficial, speak with someone trained to help analyze your gait/strike pattern and make recommendations to improve your running mechanics.

If you are thinking of switching to barefoot/minimalist running, it is important to recognize that this takes TIME. Transitioning too quickly can result in injuries — commonly forefoot stress fractures. Remember, most running injuries are multifactorial; changes in training, mileage, surface, shoes, mechanics, nutrition and overuse can all result in problems. Running is a great way to stay healthy, either barefoot or shod. Our goal is to keep you moving — so consult your local orthopaedic surgeon if you are unable to maintain your running routine.

Learn more about  Stress Fractures of the Foot and Ankle.

This Ortho-pinion was originally written for A Nation in Motion, the AAOS's award-winning public awareness campaign dedicated to sharing the stories of people whose lives were improved by orthopaedic surgery.

Last Reviewed

March 2019

Contributed and/or Updated by

Elizabeth G. Matzkin, MD

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.