Prof Dan Lieberman and Panel: "We are abnormal…compared to our ancestors 2 million years ago"

Sun, 17 April 2011 - 8:12 a.m. MT
Credit: AMAA - American Running Association

By Steve Nearman

For American Medical Athletic Association

BOSTON, April 16 – When it comes to the hot topic of barefoot running, Daniel Lieberman is not one to mince words. 

“Everybody is abnormal,” said Dr. Lieberman, a professor of human evolutionary biology at Harvard University. “Compared to from where we evolved.”

True, we no longer are hunters and gatherers chasing food in bare feet. Now we run around with shoes on our feet. Heavily cushioned shoes at that.

These running shoes, Lieberman contends, have produced a large proportion of runners who land on their heels when they run.

“As an evolutionary biologist, I strongly believe that nothing in biology or medicine makes sense outside of evolution,” said Dr. Lieberman in his opening comments before 175 doctors and sports medicine professionals at today’s 40th Annual Sports Medicine Symposium at Boston Marathon sponsored by the American Medical Athletic Association. 

Dr. Lieberman, a foremost expert on the issue of barefoot running, was joined by Irene Davis, PhD, Director of the Spaulding National Running Center and Mark Cucuzzella, MD, professor of family medicine at West Virginia University, who ran a 2:34 marathon last year at Boston at age 43.

“About 75 percent of runners today are predominantly heel strikers,” Dr. Lieberman said. “Heel strikers generate a collisional impact. Running shoes make it comfortable to heel strike.”

According to Dr. Lieberman’s research, injury rates have not declined in 30 years even as major advances seem to have been made in running shoe technology over that time. Some 30 to 70 percent of habitually shod (shoe-wearing) runners are injured each year, he added. And with all the advances in motion-control running shoes, Dr. Lieberman stated, there is no evidence that they prevent injuries. 

Dr. Davis recounted a story about a 55-year-old male patient who suffered from stress fractures. As a rear-foot striker, his body experienced increased impact with the ground. So the man changed his form into a forefoot striker and he subsequently developed Achilles tendonitis.

When he returned to his old rear-foot strike ways, the stress fractures returned.

“The impact-related loading was greater in those with histories of stress fractures,” Dr. Davis concluded. “Unless the underlying mechanics are addressed, injury rates may increase.” 

To that end, Dr. Davis said she “retrains” runners in a two-week course consisting of eight sessions in her office. Her retraining teaches athletes to land softer on their forefeet rather than harder on their heels. “Tibial shock is reduced by 30 percent,” she said, thus reducing impact-related injuries to the ankles, bones and knees.

She further added that by running on your forefoot, “injury risk is reduced by taking shorter strides.” 

Dr. Davis also cited a study she conducted with 5,026 runners who participated in a marathon. What she discovered was that runners in shoes costing $95 or more were twice as likely to get injured than runners in shoes which cost them under $40.

We also now finding that “static and dynamic stability decreased in running shoes,” a conclusion Dr. Davis said she has just reached and she will be announcing more results of her research on this topic soon.

The take-away on Dr. Davis’ presentation was: “we don’t listen to our bodies, we were not built for the speeds we are running, we push ourselves too hard, we were not meant to land on our heels and we’ve taken away the function of our feet by putting them in shoes.”

Dr. Cucuzella agreed with Drs. Lieberman and Davis that educating people about running in proper form is crucial. “The science behind this, I 100% agree,” he said.

Cucuzella even owes a running store that only sells minimalist running shoes. He is not alone: at this year’s Boston Marathon Expo, quite a number of vendors were selling minimalist running shoes, including several of the major running shoe manufacturers. 

Dr. Lieberman reiterated during his presentation the same message he has been telling the general media for the past few years – “If you think barefoot running is a fad, it’s a two-million-year-old fad,” he mused.

“The lesson on barefoot running,” said Dr. Lieberman, who claims he runs barefoot at times during his training, “it’s not about whether you run with or without shoes. More important is your running form. But what is on your feet can affect your run.

“If you run with poor form, you are better off in shoes that protect you. But if you are a fore-foot striker, you might consider running barefoot or in minimalist running shoes.” And if you do decide to try barefoot running, he said, “do so gradually and carefully. It is crucial to build up foot strength, calf strength and learn good form.

“But most importantly,” he added. “Be a skeptic. Do what you want, have fun, avoid injury, don’t fix what ain’t broke.”

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