The Art of Patience: Preventing Barefoot Transition Injuries

I want to return to the discussion of minimalist or barefoot walking and running to stress a point about transitioning to minimalist or barefoot shoes and the process of changing one’s walking and running form.

There are many runners who transition way too quickly. They quickly pick up their mileage so as not to lose any of their shod running conditioning. But this prevents them from adequately addressing the necessary changes that need to be made in their form. After six to twelve months of running either barefoot or in minimalist shoes they get a nasty injury. This is a shock to most of them, because they feel that they effectively made the transition safely. When in fact, they did Too Much Too Soon (TMTS). Unless you are injured in a collision, all injuries are TMTS injuries. Plain and simple. This is a very slow process. It only takes eight weeks for your muscles to adapt to a new training program. So you may feel ready to push your limits. But, it takes over two years for your fascia to adapt. Which means you will need to follow a well thought out, thorough, and patient transition program.

Have you decided to embrace a barefoot lifestyle? Congratulations, you are embracing a change that will be good for your body for the rest of your life.  That said: please, be patient with your body. Take your time. This not a good time to have a shoe burning ceremony and run off barefoot into the sunset.  Even if you ditch your shoes and hit the pavement unshod, your body will still be running as if you were shod.  Barefoot running is very very different.  If you are not patient, you will get hurt. Until you develop strength and stabilization in each foot and leg, even half a mile of barefoot running can cause a serious injury that can take months of recovery.

“The heel cushions and arch supports within modern shoes have made our feet weaker, the foot has so much support in these shoes that the muscles don’t need to work as much as they would otherwise and have grown weaker… If you transition to barefoot running slowly and run correctly, so you build up to it, you could decrease the risk of injury over the long term.” Science News

WARNING: changing your walking/running mechanics will place new demands upon muscles, joints, and tendons that are weak and unstable due to under use. If you are a habitual barefoot runner or walker, then your body is more prepared to make the transition to full time. For everyone else, plan for the transition out of shod running/walking into minimalist or barefoot running/walking to be very slow.

What do I do? Good question.  It will take at least six months and up to three years to fully transition into barefoot/minimalist running/walking safely. This is for all runners. It doesn’t matter how many marathons or ultras you have run.  Barefoot, or even minimalist, is a whole new ballgame; especially if you have a history of running related injuries. A very small handful of runners out there can make the transition quicker, but they are taking a very big risk. Far too many people who attempt a quick transition end up injured. Spend the extra time now. It will pay off for the rest of your life.

Follow the program I lay out here and spend at least six weeks retraining your body to walk barefoot or minimalist.

Once you are capable of walking 30 minutes a day, six days out of seven, with no pain or soreness, you are ready to slowly add in running. Here is a twelve week running program to help you have a pain and injury free transition.

Buy a foam roller and begin a daily practice of self massage and flexibility. The foam roller is by far the best investment in your long term health.

This is the foam roller I recommend: The Grid by Trigger Point Therapy

Find a highly qualified and experienced fascial therapist to help your body through this process. A good therapist can break down adhesions and restrictions associated with poor gait mechanics. This will help speed up the process tremendously and make significant reductions in your risk for injury.

No Pain = Your Gain

My number one goal with my clients is pain-free movement. Pain is an indicator that there is a problem.  Pain is the body’s way of communicating to the mind that something is wrong. It is important to listen to this 911 call.  When pain calls, stop what you are doing.  Seek out and utilize the appropriate treatment for the issue before returning to the activity that brought on the pain.

Good indicators that you are doing too much too fast:

  • extreme soreness in the calves, Achilles tendon(s), and/or arches
  • Top of foot or metatarsal pain
  • knee, hip pain, or low back pain
  • Neck or shoulder pain

It is not just pain during or immediately after you run that you need to pay attention to. It is important to be aware of any new pains in your body during the week, day or night.

When you choose to ignore your pain you are placing yourself at an increased risk of significantly more pain and injury. I cannot stress this enough. I consistently see it each week with new clients. Ignoring your pain leads to even greater pain down the road.


9 Replies to “The Art of Patience: Preventing Barefoot Transition Injuries”

  1. I see me in all of this….especially the TYPE A, too much too soon. And, now…I am paying. And learning valuable lessons to pass on. Great material, and beautifully stated as always.

  2. …and I forgot to mention this: I was very ambitious to do a l/2 marathon after only NINE WEEKS of barefoot running. I do NOT recommend that …no matter HOW fit/athletic you are…unless you have ancestors that are from Kenya or the Tarahumara Indians in Mexico!! 🙂

  3. I am curious to know if you have any peer reviewed research to back up your transition to barefoot running workouts? Does it truly strengthening your plantar muscles? If so, how do you know that? What if runners who run shod did the same kind of slow progression in their training volume while running shod? How would this affect injury risks?

    1. Hi Mark,

      Thanks for the great questions. I do not have any peer reviewed research. I know some is out there and more is on the forefront. The research has been dominated over the past 30+ years by shoe companies. The best research I have seen comes from a Harvard Dr Daniel Lieberman who studies the evolution of human running. I’m sure there is more out there. I’ve come across stuff in the past, but I don’t have the sites handy. Most of the research for both shod and barefoot running leaves much to be desired.

      Barefoot training will significantly strengthen all the muscles of the arch and lower leg, as well as increase balance and stability through the hips. The arches of the feet are made up of muscles. Shoes act like a brace which prevents these muscles from functioning correctly. Over time, these muscles weaken and atrophy; and the arch collapses. Going barefoot creates adaptational changes in these muscles. They are forced to be actively engaged and not rely on the structure of the shoe to do the work. It becomes a basic strength training equation: load x repetition = strength gains.

      The foot is the foundation of posture. A collapsed arch changes the postural structure of everything above it. This is one of the primary reasons people experience pain and injury. A stronger, stable arch sets the tone for every movement that takes place above. The stronger the foundation, the stronger the body. The stronger the body, the less risk of injury. This is not the end of the story though. Just switching to being barefoot will not magically make all injuries disappear. There is a lot more corrective work that needs to be done. But this is a huge place to start.

      Here are some other articles of mine that may go into more detail.

      Heel Strike Compared To Forefoot Strike
      Free Your Feet
      What is Posture
      You Cannot Control Your Posture
      Functional Movement

      My knowledge has been acquired from over 13 years in the profession. It comes from focused studies in the exercises and sports sciences (exercise physiology, anatomy, kinesiology, ect.); hands on experience helping 100’s of clients heal and recover from issues of chronic pain and injury as a strength and fitness coach and massage therapist; and experiencing it myself in my own lifestyle changes over the years.

      Thanks again Mark for the questions. Please feel free to contact me if you have any more.

      Jesse James Retherford

  4. I work on a cold concrete floor and have to wear steel toe shoes. I have developed severe foot pain and have tried many insoles nothing helps. Any suggestions would be greatly appreciated. Carol

    1. Hi Carol,

      Thank you for the question. You are not alone with this issue. I am working on a detailed response and will post it in my next blog.

      Jesse James Retherford

    2. Hi Carol,

      Here is the first of my responses to your question. I have more to share in regards to foot health, but this should give you something to practice. Please let me know how it goes… especially if you find it too painful.

      Jesse James Retherford

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