In June 2013, the second Barefoot Connections conference  was held in England, and most fittingly, it met inside  the prestigious Natural History Museum which is located just outside London. Several leading practitioners and thought leaders in natural lifestyle and barefoot activity (walking and running) gave talks there.  Family commitments kept me from making the trip across the ocean, but I presented a talk though Skype.

Here’s a copy of my talk “What I Have Learned From Barefoot and Minimalist Running”:

The writer James Joyce once said : “A man’s errors are his portals of discovery”. I have made almost all the errors in my life. I am a Family Physician who has been working in primary care clinics for 20 years.  I entered this field of medicine since it seemed to be the area where one can have the most influence and impact on healthy lifestyles.  I offer the prescription of daily exercise to every patient and ask them what activity they can do and like to do.  A common reply is: “Well, I can’t run….”.  My response is always “Tell me a little more about that.”

The conversation flows from  “I have a bad back, knee, ankle”  to “My last doctor told me to do something safer” to “it’s too difficult and painful” . My inquiry continues… “tell me some more about that.”

We are now at minute 14 of the traditional 15-minute patient visit, and this is not even the reason they came to see me.  How much training did I get in medical school or residency specific to evaluating, preventing, and rehabilitating running  injuries?  The answer is near zero for me and most physicians and what we did learn was always based on treating a symptom and not the cause.

So I am here to tell you that you were designed to run and yes you can run.  There is no pill invented for prevention of chronic disease.  In certain high risk situations there are medications that reduce risk of future events, but true prevention is not allowing the condition to evolve. Diabetes and heart disease prevention? The evidence is strongest for the largest prevention being in the form of the daily walk or run and in what we eat.

The current minimal running movement is the confluence where doctors, podiatrists, health professionals, coaches, and runners are now joining and discovering the prevention prescription.  I go back to a 1975 quote from Dr. George Sheehan: “If athletes were given less care and more thought, the doctors might come up with some original ideas on why illness persists, why injury doesn’t clear up.  If more non-physicians– podiatrists and physiotherapists for instance–could be induced to lend their ideas and talents, we might see a completely new approach to sports medicine.”

My goal is simply to get folks outside, moving, enjoying their activity, and not be in pain.  This has led to a number of developments in my own community of Shepherdstown, West Virginia, and which has involving hosting races and even my opening a small running store called Two Rivers Treads with a focus on teaching running form and minimalism.

Screen shot 2013-06-21 at 11.46.36 AMI have made a transition myself over the last 10 years after multiple injuries, foot surgery, and being told not to run. In my delving into the rabbit hole of running I have sought advice from the leading experts. Before recommending anything to others I try it myself.  Six years ago I began cutting shoes down to a level drop, and gradually as my understanding of foot mechanics and kinetic chain evolved I started going into thinner and thinner shoes.  Somehow through my store, writing, and competing I became one of the early leaders in “barefoot running” and was asked to present this topic with true experts Dr. Dan Lieberman and Dr. Irene Davis at the 2011 Boston Marathon.

Dan and Irene were the research leaders in the field. I had been teaching running form, but in shoes.   What could I learn from taking my shoes off? I set out to find out and made a gradual transition to running barefoot on grass and roads in the spring of 2011 before the Boston Marathon talk. We filmed and presented Barefoot Running Style showing the art and science of this.  We followed this year with The Principles of Natural Running video on the components of proper running form.

I have reset many assumptions that most believe to be true about the risks of minimal and barefoot running:

•    You land softer barefoot, especially on the hard roads. After a barefoot run where you must self regulate, there is less overall soreness. You experience discomfort and fatigue in the feet well before tissue breakdown (if of course you listen to the messengers- the feet).  The day after running the 2011 Boston Marathon (a 2:34.00 at age 44) in a thin and flat shoe I had some of the usual post marathon soreness.  I set out on a gentle barefoot run along the Charles River.  After this run my body was reset.  There was something magical about this that I could not fully explain.

•    Your feet become thicker and softer.  One does not develop hard callous, but rather a soft and thicker skin that is very resilient to surface irregularities.  The road is the ultimate pumice stone as Dr. Irene Davis has said. The muscles of the foot thicken too.  I cannot fit in any shoe I wore two years ago.  My feet look like the hands of a lumberjack now and I have a large buffer to injury.  My skin, muscles, bones, and tendons have become nearly bombproof.

•    I have not cut my foot on needles or glass.  Actually if I were to run over small pieces of glass or sharp rocks I am not worried.  Like our primal ancestors who ran on rocks, the skin is tough and shapes around the object.  A sharp hidden protruding object, that is a different story and I try to avoid these by doing most of my barefooting on the roads.  This is where eyes come in.  Tune in and watch for hazards.

•    I have fixed form flaws. You cannot create friction running barefoot on pavement. It forces me to engage my glutes and get my foot down to the ground in the correct vector (accelerating backwards).

•    There is more work in barefoot running, especially when the surface is not super smooth.  For racing I can go faster and more reckless in thin shoes, but the barefoot teaches me the foot control, stability, form, and recoil that I can use better when I put a thin shoe back on.

•    Muscles and tendons feel discomfort, joints do not.  This is really important.  A little soreness is a training effect as tissues get stronger.  The worst running injuries are arthritis of major joints and these joints (big toe, knee, hip) are not wired for pain until extreme damage has occurred.  So yes, everyone should fix their form and learn to land better even if one is not “hurt”.

Screen-shot-2012-11-12-at-4.21.14-PM-resized-6001•    I’m waking up my springs.  Running is mostly elastic, and the more we are braced the smaller the springs become.  I do supplemental drills to retrain this mechanism which was really strong as a rabid barefoot Ultimate Frisbee player in high school.

•    The small but essential springs are the intrinsic foot muscles, peroneus longus/brevis,  and posterior tib-essential for strength in toe off, balance, and proprioception (important especially in ankle stability). The large springs which are the Gastro/Soleus, Achilles, plantar fascia, and the long flexors of toes which stabilize the foot and recoil us off the ground.  The small springs send important messages to the larger ones and should not be masked or made weak.

I have found a new enjoyment in running which comes from the sensations of the foot with the ground.  My first running was barefoot on the beach and I am reconnecting with my inner child with a new sense of play when I run.  The transition is patient and slow.  Even after almost two  years of barefooting I’m still adapting, and this is after almost 10 years of minimal shoes.