Are We Born To Run Barefoot?

I just finished reading Christopher McDougall’s book Born to Run (Alfred A. Knopf, New York, 2009), which one of my patients actually mailed to me as a gift. This best-selling book is a fascinating read and highly recommended for all podiatric physicians.

Why? This book has proposed many challenges to current podiatric theories about normal and abnormal foot function. Some of these challenges have merit and some lack scientific foundation.

McDougall focuses much of the book on his own experience trying to become a successful long-distance runner. He suffered numerous injuries including Achilles and hamstring strains as well as bilateral ankle sprains. However, the injury that sets him on the journey to find better foot health is an “aggravated cuboid,” which was diagnosed by an orthopedic surgeon.

Many sports podiatrists, including myself, doubt that a true “cuboid syndrome” actually exists. Forget the fact that Chris McDougall is 6 feet 4 inches tall and weighed 230 pounds at the time of this injury. Despite the recommendations of a sports podiatrist and a physical therapist, McDougall refused orthotic therapy as a treatment option. He sought other options instead.

The book chronicles McDougall’s journey to the Copper Canyons of Mexico, where he discovered the Tarahumara Indians, who are an incredible society of barefoot running athletes. The author eventually succeeds in running a 50-mile ultra marathon and credits all of his success to the secrets of the Tarahumara Indians and their barefoot running style. He also embraced the vegetarian diet of these people and lost significant body weight, which probably made the biggest difference in his running success.

This book contains many compelling insights into the evolution of the running human and the characteristics that make us unique in comparison to all other primates. Yet the book also makes wide, sweeping criticism of shoe companies, especially Nike, which McDougall holds responsible for the plethora of running injuries treated by podiatrists today.

The link between running injuries and footwear is indeed a complex and misunderstood subject. Our patients will be asking questions about shoes, orthotics and barefoot running after reading this book. I will give some more insight into this subject in next month’s blog.