Minimalist Running Shoes: Good for your feet??

After speaking to the Rotary Club of Brentwood this morning, I was asked the question:  Do running shoes cause injuries?… as minimalist shoes or barefoot running is known to decrease your stride length.  I was not able to thoroughly answer the question as we were running out of time for everyone to get on with their day.  So here goes a little further explanation.  The answer is yes.  However, any shoe or orthotic can cause injuries if they are not ideally fit or if they do not maintain the normal functioning of the feet. 

 The stride will decrease in minimalist running but then one usually will change from their normal rearfoot strike to a forefoot strike.   A forefoot strike provides increased shock absorption, but it also creates a stronger deforming force on the foot.  If the forefoot has poor alignment with the ground, this can create problems such as excess dorsiflexion movement of the 1st metatarsal, thus transferring weight to the 2nd metatarsal, thus potential for 2nd metatarsal stress fractures, not to mention possible increased osteoarthritis formation in the 1st MPJ (big toe joint at the ball of the foot).
One response was, “It is only “natural” to go minimalist?”   Well, maybe, but the surfaces that most people run on are not natural.  E.g. asphalt, concrete.
If one chooses minimalist running, the best advice I would give to them would be to start very slowly and go very slowly.  Also, if one had bunions, hammertoes or poor alignment of joints, then I would not recommend minimalist running.
The second question was can orthotics be made for and help someone who has already had bunion surgery.  Yes they can.  In most cases, a bunion is caused by faulty alignment and function.  Therefore, I believe nearly all patients with a bunion or who had bunion correction, need to have a functional orthotic to help maintain the ideal mechanics of the foot.  This will help address why the bunion developed in the first place.  Simply surgerizing the bunion usually does not address the cause.
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