The Effects of a Minimalist Running Transition Training Program on

Recreational Runners

Brittany Rainbow SPT, Taylor McSheehy SPT, Tina Postrel SPT, Dr. Carey Rothschild PT, DPT, OCS,CSCS

University of Central Florida ● Department of Health Professions ● Program in Physical TherapyIntroduction

Estimates suggest that nearly 50 million Americans participate in jogging or running each year1. The yearly incidence of running related injury has been estimated to be between 19.4-79.3%2. Runners seeking longevity in sport, both recreationally and competitively, are interested in methods to prevent injury and improve performance. Since the release of McDougall’s 2009 publication Born to Run: A Hidden Tribe, Super Athletes, and the Greatest Race the World Has Never Seen, there has been a growing interest in minimalist footwear (MFW)3. MFW can be defined as “any footwear that lacks high cushioned heels, stiff soles, and arch support,” is lightweight (< 8 oz.), high flexible, with an expandable toe box, and no elevated heel (heel-toe < 5 mm). Evidence supports that there are beneficial biomechanical differences when utilizing a mid or forefoot strike compared to rearfoot strike,5 which can be facilitated by MFW6. However, switching to minimalist running without a proper transition program can result in injury.

MethodsEleven runners meeting inclusion/exclusion criteria were recruited from the local community. During the initial assessment participants’ demographic information was collected. Data collected pre and post 10-week training program included ankle dorsiflexion and great toe extension range of motion, flexor hallucis brevis strength, a balance assessment using the Y-balance test, and an analysis of running gait. The 10-week program consisted of barefoot exercises, plyometrics, a gradual increase in running mileage with minimalist shoes, and was supervised one time per week.

Results All 11 subjects (3 male, 8 female) completed the 10-week program. Subjects had a mean age of 23.27 years, weight of 145.41 lbs, and height of 67.73 inches. Subjects had an average of 50.82 months of running experience and trained 22.14 miles per week at an average pace of 8.65 minutes/mile. A paired-samples t test was used to compare the pretest and postest variables. A significant increase from pretest to the conclusion of the program was found in right ankle dorsiflexion (t(10)=-3.234, p<0.05) and left ankle dorsiflexion (t(10)=-3.061, p=<0.05). A significant increase in range of motion was also found for right and left great toe extension following the program (t(10)=-2.45, p<0.05; t(10)=-3.12, p<0.05). Insignificant improvements (p>.05) were found for flexor hallicus brevis strength and Y-balance composite scores. Insignificant changes were also found for footstrike angle. Cadence remained unchanged. Two mild injuries were sustained (cuboid pain and metatarsalgia) but resolved with short-term modification of the program.

ConclusionThis program resulted in significant improvements in ankle and great toe range of motion. A pattern was observed in participants adopting a less rearfoot strike angle. A supervised transition program appears to aid runners in adopting minimalist footwear without adverse effects.

Clinical ApplicationSports Medicine professionals can utilize barefoot exercise, plyometrics, and this MFW transition program to increase ankle dorsiflexion and great toe extension range of motion. This 10 week transition program can serve as a guideline for runners interested in transitioning to MFW.

References1. Life Time Fitness I. LifeTime Aims to Log 20,000 Miles on National Running. 2. Van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br. J. Sports Med. 2007;41(8):469-480.3. Warne, JP, Kilduf M, Gregan BC, Nevil AM, Moran KA, Warrington GD, A 4-week instructed minimalist running transition and gait-retraining changes plantar pressure and force. Scandinavian Journal of Medicine & Science in Sports. 2013.4. Rixe JA, Gallo RA, Silvis ML. The Barefoot Debate: Can Minimalist Shoes Reduce Running-Related Injuries? Current Sports Medicine Reports (Lippincott Williams & Wilkins). 2012;11(3):160-165.5. Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. Jan 28 2010;463(7280):531-535.6. Lohman EB, 3rd, Balan Sackiriyas KS, Swen RW. A comparison of the spatiotemporal parameters, kinematics, and biomechanics between shod, unshod, and minimally supported running as compared to walking. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine. Nov 2011;12(4):151-163.

Aims• Provide a supervised training program to

transition recreational runners from shod to minimalist footwear

• Analyze program’s effects on range of motion, strength, balance, and running mechanics

• Establish a recommended program for safe transition to minimalist running footwear

Footstrike Angle Analysis

Characteristics of the Transition Program

Transition Exercises

StretchingFoot Intrinsic Exercises

Strengthening ExercisesProprioception Exercises

Barefoot Activities

Plyometric ExercisesRunning Drills

Day 10 Week Transition ProgramMonday Walk-Jog in Minimalist Shoes

Tuesday Transition Exercises, Barefoot Activity, Stretching

Wednesday Walk-Jog in Minimalist Shoes

Thursday Transition Exercises, Barefoot Activity, Stretching

Friday Walk-Jog in Minimalist Shoes

Saturday Transition Exercises, Barefoot Activity, Stretching

Sunday REST DAY

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Range of Motion Analysis

Pre ProgramPost Program

Range o

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Initial AssessmentRearfoot Strike

Final AssessmentForefoot Strike