Born to hype? Christopher McDougall and the barefoot running movement
February 2, 2010The January 28th issue of Nature, one of the most prestigious scientific journals in the world, contains an article by Daniel E. Lieberman et al. titled Foot strike patterns and collision forces in habitually barefoot versus shod runners. In part, the study showed that
Habitually barefoot endurance runners often land on the fore-foot (fore-foot strike) before bringing down the heel…. In contrast, habitually shod runners mostly rear-foot strike, facilitated by the elevated and cushioned heel of the modern running shoe…. Even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers…. Fore-foot- and mid-foot-strike gaits were probably more common when humans ran barefoot or in minimal shoes, and may protect the feet and lower limbs from some of the impact-related injuries now experienced by a high percentage of runners.
Lieberman’s name is familiar to many runners these days, as his research was discussed at some length in the bestselling book Born to Run by Christopher McDougall. McDougall latched onto Lieberman’s work because it suggests that those crazy barefoot bipedalists may be onto something after all, and I find myself inclined to believe some of their ideas — that heavily padded shoes don’t necessarily protect you from injury, for example, and that being able to feel the ground through thin soles may help the body adjust more effectively to the terrain it’s covering. My complaint is that, in an effort to make a good story even better, McDougall and his ilk take some liberties that irk the scientist in me.
A typical example concerns injury rates among runners. With all of the high-tech shoes available to us these days, McDougall asks, why are injury rates among runners so high? It’s a very good question … but what is that alarmingly high injury rate, anyway? A recent review article by R.N. Van Gent et al. says that, according to different studies, anywhere from 19% to 79% of runners get injured in a given year. Now let’s look at how McDougall reports this in his book:
Up to eight of ten runners are hurt every year….. Next time you line up for a Turkey Trot, look at the runners on your right and left: statistically, only one of you will be back for the Jingle Bell Jog.
In other words, he takes a reasonable observation — runners do get injured a lot — and stretches it beyond belief by implying that two thirds of runners are injured every month (the approximate time between Thanksgiving and Christmas). That’s on page 9 of my copy of the book. On page 71, he uses somewhat similar language:
Every year, anywhere from 65 to 80 percent of all runners suffer an injury. That’s nearly every runner, every single year.
Has McDougall calmed down since the publication of his book last year? I’m not sure. In a January 3rd article for Parade magazine, McDougall gives the injury stat as “as many as six out of 10.” However, his zest for hyperbole resurfaces later in the article, where he says,
In a 2009 review article for the British Journal of Sports Medicine, researchers searched 30 years of studies and were unable to find one demonstrating that running shoes make people less prone to injury.
That statement — presumably referring to Is your prescription of distance running shoes evidence-based? by Craig E. Richards et al. — is not incorrect. What it omits, though, is the fact that Richards et al. could not even find a single study that quantified the impact (if any) of shoe use on injury rates. In other words, while they didn’t find any evidence that shoes helped, they didn’t find any evidence that shoes were harmful or inconsequential, either. See the difference?
Again, I suspect that the barefoot running movement has legs, and McDougall deserves credit for inspiring interest in it. I just wish that, as someone who presents himself as an investigative journalist, he wouldn’t get so carried away.
My Track Record 
I have a lot of bones to pick with McDougall, but I sort of feel like he gets too much credit/blame for the barefoot running "movement." It's not the central message of his book by a long shot, and after all, he ends the book in shoes himself. He never says "Barefoot is better;" he just gives a lot of ink to the arguments of Barefoot Ted, who does.I give McDougall a lot of credit for chasing down original research that supports his arguments, but I did notice he didn't spend a lot of time talking to people who disagree. He also frequently mistakes anecdote for data. I suspect, unfortunately, that this is a common approach for the magazine journalism background he comes from (Men's Health et al).I've always found a significant weakness in the "running shoes injure you more" argument to be in sample selection. The argument goes, "Back in the [50s and 60s, stone age, etc.] we didn't have high tech running shoes and we didn't get injured as often." What it doesn't point out is that in those eras, injuries were career-ending and/or not as high a fraction of the population ran; the population of runners self-selected to the biomechanically gifted. If running shoes enable a wider range of people to run, of course we're going to see more and different injuries as a wider range of gaits and body types join the running population.
@pjm: "What it doesn't point out is that in those eras, injuries were career-ending and/or not as high a fraction of the population ran; the population of runners self-selected to the biomechanically gifted."Hmm. People only ran after the sneaker was invented? Do you have any evidence to support this? Abraham Lincoln, for one, ran footraces regularly. (Barefoot, in fact, but that's beside the point.)Running is not a new activity. It certainly wasn't introduced in the 1970s. And the notion that you have to be "biomechanically gifted" to be a runner has no support in science (or in history) at all.It would enhance your argument if you wouldn't commit the same sin you're accussing McDougall of.
Another nitpick with the book: it mentions that the Marathon Monks of Mount Hiei run "an ultramarathon every day for seven years, covering some twenty-five thousand miles…". According to my math, 26 miles/day * 365 days/year * 7 years = 66,430 miles.Maybe Christopher McDougall is just mathematically/numerically challenged?Meg
Tuck, I think pjm is pointing-out that "more" people run now because of the high-tech running shoe era that started with Nike (according to McDougall) in the 70's. A result of marketing as much as anything. More runners, more injuries.The whole barefoot inspiration is cool, but has to be qualified. Mix-in some barefoot running on grass, move toward a racing flat, etc. The idea that you should be in a pair of Vibrams and running ultras is plain silly. The anecdotal evidence is the best. McDougall's discussion with the Stanford running coach carries more water than Barefoot Ted.In the end, barefoot running strengthens the feet. That seems pretty obvious. But I think the issue here, as this blog's author has pointed-out, is not to get carried away by a guy trying to make a name for himself.
There are so many problems/omissions in that piece its hard to know where to start (and in statistics, omissions are problems).Did you know that the more Churches there are in a city, the more rapes, murders, alcoholics, and drug users you will find? Great! Maybe I should go write a book called Born To Run (away from organized religion).But what I didn't tell you (conveniently) is that it is probably only a correlation to population size. In general, the larger the city, the more of -anything-. Convenient omission, no? Did I do my homework? Did I survey those alcoholics, etc. and find out if -they- in particular went to church? You'll never know, because I didn't publish it.In running as in anything, sure it makes sense the more of anything you use to protect yourself, the less 'hardened' that something will become. Do you have more calluses on your hands if you don't wear gloves? There are so many questions unanswered.How many people would not be running if it were not for being able to wear running shoes? What percentage of people do not wear running shoes? Is it a minuscule data set? Are those people just more careful and in tune with their bodies and taking breaks when appropriate? What is considered an injury after all? Knee tendonitis, shin splints, every day pains? Do shoe wearers and non-shoe wearers answer that question differently? Are barefoot people more proud of what they do and not answer they get injured unless its really bad? How many non-athletes and weekend warriors run barefoot versus those who wear running shoes? Are the shoe wearers able to run in all kinds of rocky/rooty terrain which puts them more at risk of injuries anyway?There seems to be such a lack of data it makes the entire premise (or almost the entire premise) useless.
Also, how does one define injury? I would say that in 2009 that I was injury free, as I never stopped running due to injury. However, I had a consistent achilees that was sore, a knee that hurt for a month and other odds/ends that anyone gets running 40-80 mpw.So if you use a loose definition of the word, I would probably have to say that I was injured at some point in 2009 and so would the majority of runners out there.
pjm: It's a good point that McDougall shouldn't be seen as the spokesperson for the barefoot running movement. Still, If you go to chrismcdougall.com and look at the "Barefoot Running Debate" page, it's pretty clear where he stands. And his website bio says that he does most of his running barefoot.Tuck: You are welcome to your opinions and welcome to post them here, but you seem to be deliberately distorting pjm's comment. pjm probably knows the history of the sport better than either of us.More generally, I agree that it's hard to know how to properly analyze injury rates over time, given the various factors that people are bringing up. Perhaps that is why, according to people like Dr. Lieberman, we still don't know whether running shoes increase injury rates or decrease them or neither.
My favorite commentary on barefoot running and one which I believe will appeal to you is http://www.downtown-runner.com/2010/02/7-reasons-why-you-should-never-run-barefoot – 7 Reasons Why You Should NEVER Run Barefoot.
It's just a book. It's an interesting read, cuz' I'm in it and know some of the characters. I know I won't be running barefoot, it's silly. I haven't been injured since 2000, I guess I'm one of those 10% that's lucky. But it depends what we call an "injury", cuz my arse hurts now…but I can run.
A couple of points:In the book, the Stanford coach says they (Stanford) do PART of their training barefoot, not the whole practice.The sandals and new "barefoot" shoes now sold are no different than the racing flats that have been available since the 1970's.If barefoot running was so beneficial, why are all the top runners not doing it?I read the book and saw the DVD on the Marathon Monks of Hiei. They don't run, they walk fast. In fact, it's discouraged and frowned upon if they go too fast. Hiking/walking 26 mpd is easier than running 26 mpd. I know – I hiked the Appalachian Trail.Running/walking barefoot has some therapeutic benefits. But much of the book borders on hyperbole/fiction.
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