1. Enhancing the Health of the Everyday Athlete – Efficient Barefoot Movement Stephen Gangemi, DC, DIBAK

2. Moving - Gait Gait dysfunction Health dysfunction Kinesthetic sense: the relationship between the nervous system and the sensory feedback provided by each foot – 7,000+ nerve endings Proprioception: sense of position, posture, equilibrium

3. What Disrupts Gait? Health Problems: – Structural (current or past injuries, posture, excessive training – duration / intensity) – Nutritional (diet, hormonal stress) – Emotional Improper footwear Orthotics – a brace that supports dysfunction

4. Nothing worn on the foot can improve its function A bare foot moves in the most efficient, natural, and healthy way (in a healthy individual)

5. Modern Footwear Soft midsole

6. Elevated Heel

7. Line of falling weight moves forward with heels

9. Motion Control

10. Footwear Industry Claims Run faster Jump higher Be stronger Exercise muscles not otherwise used with competitors shoes or while barefoot Yet there has never been any research to validate such claims

11. Injury Prevention? None of which can be substantiated through any scientific study Numerous studies on injury promotion: – Journal of Injury, Function & Rehabilitation, Dec 2009: Running shoes protect the feet at the expense of increased joint torques at the hip, knee, and ankle – British Journal of Sports Med 2010: Elevated heels and cushioned shoes relationship to injuries – Medicine & Science in Sports & Exercise 1991: Running shoes and diminished sensory feedback and injury increase – More: runblogger.com, naturalrunningcenter.com, philmaffetone.com

12. Barefoot or Shod? Recently, there has been a significant move towards minimalist type shoes and barefoot walking and running

13. Experienced, habitually barefoot runners will avoid landing on their heel. The natural motion during barefoot running is to land with a midfoot, or even a somewhat forefoot strike.

14. A heel strike (while running) most often results in a significant stress to the body, whereas a midfoot or forefoot strike does not Most running shoes are developed to promote a heel strike, and therefore an unnatural running and gait cycle Heel strike Midfoot/forefoot strike Ideally the bodys center of mass should be over the foot for the lowest loading rate

16. Healthy Footwear No arch support – the arch needs to flatten upon impact to dissipate shock Arch supports support the arch, not the ends of the arch a weak and dysfunctional foot

17. Stack Height 11mm heel7mm forefoot 11-7=4mm drop Drop Zero-Drop Low Stack & Drop

18. Shock No Stability or Motion Control – natural pronation deflects shock Tibialis Posterior plays an important role

19. Toe Box No cramped toe box – so the toes can splay apart to soften landing Widest at the toes

20. Cushioning? No! Cushioning does not absorb shock – it tricks the body by sending false information to the brain – Is this a soft surface or hard?

21. The Harder the Surface the Softer the Landing Nice Gait Kid!!

22. The harder the ground the more the body will adjust with more knee flexion and pronation Pavement is the easiest to walk/run on barefoot Natural terrain is unpredictable

23. The Ideal Shoe? Depends on the individual, But generally: Roomy forefoot (1/3-1/2 in front of big toe) Close to the ground throughout (low to zero-drop and a low stack height) Wide Toe Box Flexible in all directions Firm sole (not soft or cushiony)

24. Barefoot as much as possible, shoes when needed Wear shoes that will not harm you during your daily activities and during exercise; this includes disrupting your gait Notice that the word benefit was not used, as footwear is not meant for this reason Footwear should only protect the feet from damage that may occur from the particular environment There is a transition period into more barefoot walking and minimalist-type shoes as the weakened muscles, tendons, & ligaments regain their strength; transition as comfortably and as safely as you can

25. More on Barefoot, Minimalism, and Injury Prevention & Treatment www.sock-doc.com