Preventing Barefoot Running Injury

by Editor on December 8, 2011

Barefoot running has gained wide name recognition among runners of all sorts. As more runners discover this type of running, many decide to move to a true minimalist shoe or to ditch shoes for good. And yet, while it can be a wonder for many, barefoot running is not entirely safe from injury.

Barefoot running itself is not sole to blame. In fact, the leading cause of barefoot running injuries is the runner doing too much too soon, ignoring the body’s signals of pain and overload.

You can’t just run the same way barefoot as you used to do with shoes. Following this recipe can only lead to disaster.

If there is good news in the discussion of barefoot running injuries, it is that there are a few common, preventable issues. Here are a few, along with some useful tips for managing them and using them to learn to be a better barefoot runner.

Monster Blood Blisters

To many barefoot runners, blood blisters are the most common problem. Blood blisters start to crop up as soon as you start running barefoot, and they typically worsen during the first couple of weeks. They are usually the product of a combination of moisture, friction and heat. Mix these three components, and you’re almost sure to end up with a blister.

Blisters are not a cause for concern. As the skin on the sole of the feet thickens and strengthen, blisters will most likely stop forming.

If you have severe blisters, you should take a couple of days off or introduce back your shoes. Putting shoes back on your feet will protect the affected area and allow you to run in comfort. The debate continues as to whether it is best to pop the blister or to leave it alone. Regardless, you should clean it with soap. In my experience, if it affects your running gait, pop it; if not, just leave and let nature take its course.

Puncture wounds

Puncture wounds are pretty common among barefoot runners. When you run barefoot, you have minimal (or most likely, zero) protection against anything that you may cross on your path, including thorns, glass, nails or other debris.

It is mandatory to hone your skills at assessing and deciding immediately on the terrain in front of you.

During the early weeks, you need to put conscious effort into guiding yourself through the terrain. Fortunately, this awareness will become second nature as you practice it on a consistent basis. Until you acquire this skill, you should always watch your path and be extremely careful.  

Top of Foot Pains and Aches (TOFP)

It is extremely common to experience pain and aches on the top side of the foot when switching to barefoot running. Opting for barefoot running forces your stride to change and adopt to the new workload. Therefore, the mild aches are the result of anatomical changes taking place in the foot. The severity of the pain depends on your transition from running with shoes to barefoot. This is the reason why it is important to switch gradually into barefoot running and avoid doing too much too soon.

If you experience TOFP, the initial treatment is simple – RICE (Rest, Ice, Compression, Elevation). Rest is a vital part of the adaptation and strengthening process. This is especially true during the transitional phase when the chances of injuries are high. Otherwise, if you keep running with pain, you’ll only increase the likelihood of discomfort and even significant injury. Do that, and you will be stuck on the couch for months.

Ultimately, running barefoot is a process that involves the whole body, from the soles of the feet to the brain, and everything in between. If you can use your senses and your body in harmony, you’ll increase your chances of running pain and injury free for a long time to come.

~David Dack, Runners Blueprint

{ 8 comments… read them below or add one }

Kees van der Meijden December 13, 2011 at 8:52 am

I don’t recognize any of the problems above, I started barefoot running this year may (2011) and I never had blisters TOFP or simmular injuries. But I decide to take a period of 1 till 2 years to adapt this new runningstyle. So take it slow and read the book a complete idit’s guide to barefoot and follow the rules of the book and the only thing you experience is the fun of barefoot running!!

Arden December 13, 2011 at 11:16 am

What about Achilles pain & heel pain?

Bryan December 13, 2011 at 11:47 am

One of the most common complaints that I hear regarding the transition to barefoot running is posterior calf pain and soreness. This is due to the eccentric lowering of the heel which is not performed in a hell strike gait. The runner can train from this with doing negative heel raises on a platform.

joanne December 13, 2011 at 4:50 pm

I’ve been a forefoot/midfoot striker since I trained myself to do so in 2004. That made the transition to minimalist shoes fairly easy. I got them in October and would feel fatigue in my feet but no issues in my calves. Since I’m in a colder climate (southern ontario, canada) Nov/Dec aren’t the ideal months to begin barefooting and minimalist running. Still — I’ve worked up to about 20 kms in Vibrams and 3 kms barefoot. (a 6k run resulted in blisters – who knew? I do now.) I also have a pair of Saucony lightweight shoes that also work in when I feel I need the warmth of socks.

A few days ago I wasn’t thinking and just turned to my regular runners with support, thicker heel, etc (instead of the lightweight sauconys). Boy did I notice the heel!! Felt like I was wearing stilettos! It was a 10k trail run and my calves felt contracted the whole time.

I’m doing a 10-mile race on boxing day so I’ll be wearing the Vibrams around the house and trying to get in a few runs in hopes I can wear them for the race. I’ll try to avoid the comfort shoes as much as possible.

Rachelle December 13, 2011 at 6:30 pm

These are all great questions and suggestions.
Kees, you’re so lucky to have transitioned pain-free! It must be due to your smart, careful process. You’re a good example! Thank you.

Arden, the Achilles and heel pain is largely a result of your body adjusting. As Kees noted, going slowly is a good process – and as part of that, the more often you can be barefoot outside of your exercise time, the better. Your Achilles needs to stretch, as it has been shortened by years of wearing built up heels. The heel pain is likely due to your plantar needing to stretch and lengthen as well, unless you’re heel striking while bare or in minimalist shoes – in which case, you’re probably bruising the heels, and you might want to consult some of the exercises in the Idiot’s Guide to BFR for safe ways to transition to the midfoot. A great exercise is the 100Up, which is primarily a process of slowly running in place with perfect form 100x – you can google it for more information.

Bryan, you’re right about the calf pain – that, too, is a transitional pain that should subside with training. We’re engaging all new muscle groups when bare!

Joanne, good luck! Please let us know how the race goes!

Griet Roes December 28, 2011 at 4:38 am

I only run on trails, never pavement. I got toe-shoes and they initially felt great to run in. Untill I stubbed my little toe on a hidden stump and bent it backwards. My whole foot swelled and turned black and blue, keeping me from running all together for 2 weeks. My little toe stayed swollen for 2 months. I thought it was a freak accident but did the same thing (although not as badly) just walking on the trail with a friend. It only takes a split-second of inattention. Since then I have bought toe-less minimalistic shoes and are breaking them in (or more precisely breaking my body in) with short runs. I hope these shoes will prevent above injuries.

Ronnie B January 6, 2012 at 5:37 pm

I have been running bf for 15 months. I had the stiff calf muscles – too much too soon. I also had pain in the bottom of the forefoot after a couple of weeks. I researched that and figured that my metatarsal bones had fused together with cartilage over so many years of not going barefoot and that the running was breaking that up. True enough within 10 days – it had disappeared as predicted. Apart from that I have had no blisters at all and find I can quite happily run over small stones etc. Before bf running I had chronic knee and hip pains – I was a classic heel striker. After reading Michael Sandler’s book I changed to a forefoot landing, transitioned to bf running and now have no knee or hip pain after more than 20 years of putting up with the pain to keep fit. I run bf and keep my VFF’s in my waistband in case of emergency. Absolutely love bf running!

Rachelle January 19, 2012 at 8:14 pm

Ronnie,
Good for you! Great testimony, and a super shout out for the good folks at RunBare!

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