By Art Horne
Art Horne, MEd, ATC, CSCS, is Strength & Conditioning Coach
and Coordinator of Care for men's basketball at Northeastern
University, and is currently serving as the Interim Director of Sport
Performance. He can be reached at: a.horne@neu.edu.
At the 1960 Summer Olympics in Rome, Ethiopian runner Abebe Bikila
earned worldwide fame by winning the marathon with a world-record time
of 2:15:16. The attention focused not just on his remarkable feat, but
on his remarkable feet--Bikila completed the marathon without wearing
shoes or socks.
Some would say that event catapulted the concept of barefoot
training into mainstream consciousness. But in reality, athletes around
the world trained barefoot in various ways long before Bikila's
accomplishment--in fact, you might argue that barefoot training is as
old as athletics itself. Barefoot training advocates argue that "shod"
(shoe-wearing) athletes miss out on many benefits, ranging from
proprioception and motor development to recruitment of important
muscles that remain underutilized and practically dormant inside rigid,
restrictive modern footwear.
There is very little research providing clear answers on how best to
implement barefoot work into today's training strategies. But as an
athletic trainer and strength coach who has employed barefoot training
with basketball players at Northeastern University for several years, I
firmly believe it's well worth the time investment. In this article,
I'll explain the concepts behind barefoot training, outline how I use
it with my athletes, and discuss the benefits I've seen from having
athletes bare their soles during workouts.
THEORY BEFORE PRACTICE
Anyone who has walked barefoot on a beach or grassy field can grasp the
theory behind barefoot training and its athletic benefits. By letting
the foot return to its primitive state, in which it must grip the earth
to produce efficient movement, you can feel the engagement of intrinsic
muscles of the toes, midfoot, heel, and ankle--muscles that receive
little opportunity for strengthening in our shoes-required world.
The idea behind barefoot training is that developing these muscles
improves foot and ankle function, while also providing benefits up the
entire kinetic chain. Barefoot proponents point to increased
proprioception related to the movement of the feet and ankles in time
and space, lower impact forces due to reduced heel strike, higher
efficiency in running as measured by lower oxygen consumption, and an
increase in bone density throughout the foot and ankle.
Humans' relationship with shoes is a surprisingly complex one,
involving both physical and psychological elements. For example, in a
1997 study, researchers had subjects repeatedly step onto and off of a
box, each time landing on a pad made of material commonly found in shoe
insoles. The material was the same each time, but the authors used
different terms to describe the landing pad, and found that
participants landed with greatest impact forces when stepping down onto
surfaces described with words like "advanced technology" and "used in
the most expensive sneakers."
The authors noted the natural human tendency "to be less cautious
when using new devices of unknown benefit because of overly positive
attitudes associated with new technology and novel devices." If that's
true, it may mean today's athletes, who wear more and more advanced
footwear and often receive custom tape jobs before each practice and
competition, pay less attention than ever to the fundamentals of foot
movement and function, possibly harming their performance and
increasing their risk for injury. Barefoot training can help reverse
those practices.
Consider a more specific example: High-top sneakers with stiff soles
are worn almost universally in basketball, and many athletes wear ankle
braces or tape underneath them, even for workouts. This practically
ensures a weak and dormant foot and ankle complex. Kinematic data
suggests that the hallux (big toe) requires 20 degrees of extension and
the ankle needs around 20 degrees of dorsiflexion to allow for normal
forward motion. Both those movement dimensions are commonly limited by
basketball shoes, tape, and braces.
In addition, modern sneakers are usually built with some form of
"air cells" or other shock absorbers or supports that raise the heel
above its normal resting elevation during standing, planting, and
running. For many athletes, this effect contributes to an adaptive
shortening of the gastroc/soleus complex and Achilles tendon over time.
On the advice of our podiatrist, we have actually made lateral cuts
to the bottom of many of our basketball players' shoes. The cuts extend
from one side of the forefoot to the other through the full-length
fiberglass insert, directly under the first metacarpophalangeal (MP)
joint, basically running across the ball of the foot to alleviate
manufactured stiffness and allow for normal big toe extension. We
started doing this after several complaints of Achilles tendon pain and
anterior knee pain, both of which were alleviated after normal foot
motion was restored. Increasing natural foot mobility can also help
athletes improve their movement mechanics.
FREE THE FOOT
When athletes perform activities such as dynamic warmup and movement
prep with bare feet, they recruit the muscles of their feet and ankles
and experience feedback and proprioception in the plantar surface of
the foot. At Northeastern, we strongly believe this leads to better
positional sense and may contribute to injury prevention and
performance enhancement. For those reasons, we have implemented
year-round strategies for our men's basketball players to promote the
normal motion of the athletes' feet, toes, and ankles.
During evaluations at the beginning of the year, each player
undergoes goniometric testing of the ankle, knee, and hip, traditional
movement screening (including jumping and landing measures), and an
examination of their feet for existing pathologies or mechanical
challenges. This is essential, because certain foot-related conditions
can make barefoot training counterproductive and even dangerous.
For example, athletes with excessively high arches are excluded
from our barefoot work, because most physicians agree that high-arched
feet require support to prevent excessive plantar stress and decrease
injury risk. In addition, we exclude athletes who have experienced a
stress fracture or other serious injury, or have had surgery on the
foot or ankle (such as fixation of the navicular bone). To let these
players' feet strike the ground repetitively without support during
barefoot training would produce injury risks that outweigh any
potential benefits.
Some believe that excessive pronators must have firm support from
custom orthotics during all activities, but it's been my experience
that these athletes do very well in a progressive barefoot program. In
fact, I've found that symptoms such as anterior knee pain typically
seen in pronators are often resolved when barefoot work is added to
their overall training plan. Nonetheless, it's always best to consult a
physician, preferably a podiatrist, if you have doubts about the safety
of barefoot training for a particular athlete.
BARE ESSENTIALS
Before beginning our barefoot program, we hold an educational session
to introduce the athletes to this strategy and explain what they should
expect. We tell them it's normal to feel some residual foot soreness
after training in bare feet, especially if they've never trained this
way before.
However, we note that if the soreness lasts for more than a day, if
it's accompanied by sharp or shooting pain, or if it leads to sudden
knee or back pain, they should see us for an evaluation, which might
lead us to discontinue their barefoot program. These symptoms may
indicate an unresolved previous injury, such as a stress reaction or
fracture.
For those with normal soreness, we recommend general soft tissue
work, such as plantar fascia rolls on a tennis or field hockey ball and
basic warmup activities such as ankle mobility drills, static
gastroc/soleus stretching, and general dynamic movement patterns. We
tell them their foot muscles have been dormant for years in their
shoes, so this new engagement and mobilization will be fatiguing--but
it shouldn't be seriously painful. If it is, we want to know right away
so we can determine the cause.
One of the first priorities when implementing barefoot training is
to find a workspace with the right type of surface. Synthetic turf is
the best choice, and we are fortunate at Northeastern to have two
indoor surfaces (a field house and a turf area located in our
weightroom). Since much of the benefit of barefoot training comes from
athletes' ability to use their foot muscles to "grip" the ground and
feel feedback from a soft ground-foot interface, synthetic turf is far
superior to a gym floor or weightroom mat.
So what does the barefoot portion of a workout actually look like?
For us, it begins with cold stretching, including plantar fascia rolls,
foam rolling, and standard static pre-workout stretches. We'll then put
the athletes through a series of simple dynamic movements and agility
ladder drills such as skips in all directions, butt kickers,
spidermans, toe kicks, inchworms, and shuffles in all directions.
Next come mobility drills, such as lunges in various planes, hurdle
walks/duck-unders, single-leg reaches in multiple planes, and various
balance activities such as one-quarter jump-and-lands on one or two
legs, hops, balancing on one leg with eyes closed, single-leg chopping
patterns with core balls, and light bounding.
We also use our barefoot training time as an opportunity to develop
the core with a number of upright standing exercises, such as partner
anti-rotation, cable chops, and resisted lumbar cable extensions. By
placing the athletes in positions that imitate live basketball action
but without the usual support of their shoes, we enhance the
sport-specific foot and ankle sensory system. And by improving the
foot's tactile feedback and gripping strength, we provide benefits not
only for the foot and ankle complex but all the way up the kinetic
chain to the knee, hip, and lumbar spine.
At the end of a barefoot session, stretching and recovery includes
strap stretches and foam rolling. We also use light jogging in the
cooldown portion of some workouts, along with locomotion patterns such
as walking with toes and feet pointed in, out, and up, walking on toes,
shuffling in circular patterns, and backward jogging and running.
In addition to our traditional cooldown modalities, we also employ
yoga during some sessions, particularly in the summer and the early
preseason. This allows additional opportunities to stretch and maintain
tissue quality while providing a refreshingly different type of
ground-foot interaction.
The most striking thing about yoga work with our players is the
extent to which they struggle to maintain the balance necessary for
even basic poses such as the warrior series, high lunges, extended
triangles, and downward facing dog. But improving balance is part of
the reason we use barefoot training in the first place, so as they make
progress in yoga, we know they are adding a new dimension of awareness
and proficient mobility that will transfer to the entire kinetic chain.
As our athletes grow more comfortable with barefoot training, we
gradually get them out of their shoes more and more often. For example,
after regular conditioning sessions, weightroom workouts, and sled
work, we might have them perform cooldown and stretching in bare feet
on our indoor turf to keep the foot muscles engaged and maintain the
strength gains they've made.
One question we have considered at length is how much barefoot
training athletes should perform. We believe that once they've been
evaluated and introduced to barefoot work, they should do as many
training activities unshod as is practical. In our conditioning
program, the barefoot portion of a workout typically takes between five
and 20 minutes--so while it's certainly not the bulk of training, it is
a significant part of the broader program.
I've seen demonstrably positive results from incorporating this type
of training into athletes' workouts on a regular basis. Since we first
implemented barefoot work in the summer of 2007, we have noticed a
significant drop in episodes of anterior knee pain, ankle sprains, and
low back pain among our basketball players. In fact, during the 2008-09
men's season, no one missed a game due to an ankle sprain or any form
of lower extremity pain. I'm confident that our barefoot protocols
contributed to this success.
Is barefoot training the secret to solving all foot, ankle, and
gross movement problems? Certainly not. But with the outcomes we've
witnessed, we won't be dropping it from our training program any time
soon. After all, why would humans have such an incredibly complex
mechanism as the foot if it wasn't intended to move freely?
Sidebar: STAYING SAFE
While barefoot training is a safe way to enhance foot strength and
functionality, like every training activity it carries some risk. Here
are a few pointers on how to minimize the chance of injury:
• Before every barefoot training session, inspect the surface for
sharp objects, such as broken glass, pieces of metal, or anything else
that could cause cuts or puncture wounds.
• Athletes with a wound on their foot should not train barefoot,
especially if they cannot keep the wound covered with a secure bandage.
Diabetic athletes should be especially cautious, as they have an
increased tendency to develop foot ulcers.
• In most cases, athletes should not go barefoot in the
weightroom--the risk of dropping a plate, dumbbell, or other piece of
equipment on an exposed foot is too great. There are just two
exceptions in our facility: during prep work when no one in the
weightroom is handling free weights, and while I evaluate squatting
technique, because it is beneficial to see the unshod foot as it moves
during squats.
• As mentioned in this article, athletes with high arches and those
with pre-existing foot or ankle conditions usually should not go
barefoot, as they may need cushioning and/or orthotic support at all
times to avoid injury. When in doubt, consult a podiatrist.
• As with any new form of training, the body requires an adaptation
period. When introducing barefoot training, start with just a few
minutes of light stretching and movement prep at each workout, and
gradually add greater challenges as the athletes grow more comfortable.
