Better off barefoot?

When Eric Vouga goes out for a run, he draws curious stares and even blatant pointing.

"Look! It's a barefoot runner!" people exclaim as they pass by, as if he is an endangered species, a fleeting vision to be marveled before it vanishes from sight.

Frequently, the reaction is one of detest rather than admiration and frankly, most people have no problem telling him they think he is, well, a little misguided.

Dr. Michael Nirenberg runs too, though not completely unshod. He sports a "minimalist" shoe known as the Vibram Five Fingers, designed to protect him from the elements and other hazards while giving him the experience of running in bare feet.

He too, is met with curious looks as he breezes past runners bouncing along in all the latest marvels of shoe engineering, designed to cushion, uplift and insulate their feet from the pounding they deliver to them daily.

Both these runners, Vouga, a 49-year-old personal trainer from Fox Lake, Ill., and Nirenberg, who is, of all things, a podiatrist, are embracing the barefoot running movement and putting to the test the notion that supportive shoes, not running itself, are the cause of many of our podiatric ills and that our feet are actually architectural marvels, perfectly designed to run, just the way they are.

The foot is a work of architectural genius, some experts say, absorbing shock, getting stronger with each step and dispersing weight effectively while the supportive shoe weakens the structure and alters the way feet function, essentially making them wimpy and addicted to even more support. Some podiatrists say building up to more barefoot activity in general is preferable while others say it puts a society accustomed to support at risk for injury.

The barefoot running movement gained momentum with the release of Christopher McDougall's book, "Born to Run" in 2009. McDougall was intrigued by Mexico's Tarahumara Indians, who could run long distances well into old age, without injury, on nothing but thin homemade sandals, for hundreds of years. The author reportedly set out to find out why his feet hurt and theirs didn't. En route to discovering his own inner athlete, he learned many things, namely that injury-free running is largely about skill and learning to land lighter on one's feet.

The book was the impetus behind what has become Vouga's new passion, which he says was fueled largely by the allure of being outside and connecting with nature.

The treadmill in December is where Vouga started the process of toughening up his feet. On the first warm day in March, he mustered the courage to take his "baby butt soft and atrophied feet" out to the trails of Volo Bog in Fox Lake, Ill.

"Why, of all the things we do, why should running or walking around on your bare feet cause so much consternation? It shouldn't. I knew my feet were hard enough so I took off down the trail," he says.

After six miles, Vouga emerged from the wood unscathed and quite proud of himself, Vouga hasn't put on running shoes since that day and in fact, has plans to run his sixth Chicago Marathon in bare feet this October.

Vouga points out the wisdom of McDougall's explanation of the architecture of the foot, which he recounted in an essay he wrote following his first outdoor barefoot running experience.

"Your foot's centerpiece is the arch, the greatest weight-bearing design ever created," McDougall writes. "The beauty of any arch is the way it gets stronger under stress; the harder you push down, the tighter its parts mesh. No stonemason worth his trowel would ever stick a support under an arch; push up from underneath, and you weaken the whole structure. Buttressing the foot's arch from all sides is a high-tensile web of 26 bones, 33 joints, 12 rubbery tendons and 18 muscles, all stretching and flexing like an earthquake-resistant suspension bridge."

Nirenberg, of Friendly Foot Care in Crown Point, wondered why populations that don't wear shoes or wear shoes with minimal support have fewer injuries. He started researching the effects of footwear on the foot.

Nirenberg strongly advocates barefoot activity in general except for those with systemic problems such as diabetes, poor circulation, nerve disorders or osteoporosis, for example. They, he disclaims, are at higher risk for serious injury and will need good supportive footwear for the rest of their life.

Nirenberg points out that all the support we've given our feet has weakened them; the muscles just aren't required to work and as a result, they atrophy and become lazy -- dependent on even more support.

The key to fewer injuries, as McDougall suggests in his book, is related to skill, form and paying attention. He refers to shoes as morphine, a sedative to deaden the pain and turning off the body's natural cues to help it avoid injury.

Vouga knows exactly what he means. Running in bare feet helps him to listen to his body more acutely in addition to forcing him to change his running stride, landing more on ball of foot instead of heel-to-toe. When his feet are screaming at him, he has no choice but to back off and this in itself may prevent injury. Running in wooded areas, he adds, is like interval speed training. If it's grassy and smooth, he takes off. If it's rocky or slippery, he takes it down a notch.

 "The body is an amazing thing," Vouga says. "When you put all this cushion underneath your feet, your body knows that and actually the impact of pounding is harder then when you run in your bare feet."

Minimalist footwear

What about the hazards out there threatening to poke, lacerate, scrape and otherwise maim the runner's workout? Vouga has not yet suffered any injuries, presumably because his feet are more calloused and tough. He does it largely to be closer to nature. But those who like the concept of running barefoot can do so without the dirt, germs and hazards.

Nirenberg says you can protect yourself from the elements while reaping the benefits of barefoot running in minimalist shoes such as the Nike Free and Vibram Five Fingers, which he prefers, and in fact, wears daily. These shoes are essentially gloves for the feet that enclose each toe.

Dalila Center, 25, of Chesterton noted that the shoes change her stride with her heel barely breezing the ground, landing more on the ball of the foot. She says she can actually feel the muscles being used in her feet that had been wrapped up and immobilized before. It took some getting used to, with pain at first, making her realize the transition to running in her new foot gloves had to happen gradually.

Nirenberg says this natural change in gait that minimalist shoes or barefoot running imposes is part of the benefit.

"When you land on the ball of your foot and you feel the surface you are actually landing lighter and you're landing in a more controlled way to some extent and you are taking the landing off your feet and you are dispersing it more evenly over your foot," Nirenberg says.

While there isn't published evidence yet to prove scientifically that barefoot running is better than in supportive shoes, Nirenberg says there is much research that leans toward the benefits of being barefoot. Plus, he is going on the fact that his own plantar fasciitis (heel pain) that he suffered before shedding his shoes has not returned.

Some podiatrists say barefoot running too risky for most

He might share a practice with Nirenberg, but podiatrist Dr. Michael Lacey disagrees with his partner.

He says the support is a good thing, especially in a culture where we simply aren't brought up walking on rough terrain from birth.

"If everybody stopped wearing shoes from the moment they are born, maybe it would be an easier transition, but right now, for someone to transition all of a sudden to doing barefoot running, I don't think it's a good idea," Lacey says.

Walking around with padding all your life puts you more at risk for a stress fracture when you go without it, he reasons.

"I just kind of think that everybody can benefit from good arch support and orthotics and I think that is the most beneficial thing for people is to have good arch support," Lacey says. "That goes completely against what the barefoot running thinking is, but that is what I am most comfortable with and that is what I recommend to patients."

Chesterton podiatrist Dr. Marc Bruell, of Lakeshore Bone and Joint, thinks barefoot running is perhaps only for a very small subset of the population and is too risky for most people. Those who are very athletic, young and lightweight can probably run barefoot without much trouble but this isn't most people.

Also, Bruell doesn't buy the argument that shoes weaken the foot muscles, which he says are small and few.

"I say do things that protect your feet. Decrease the shock. Increase shock absorption. Increase your stability," he says.

Also, Bruell believes running more on the ball of the foot, which barefoot runners tend to do instinctively, increases the risk of stress fractures in the front of the foot, especially for those who are a little older or overweight.

Prepare for a tough transition

If nothing else, the opinions of Bruell and Lacey validate the need for a long, calculated transition from shoes to bare feet.

Vouga for one has experience with the painful transition first-hand.

That first day on the treadmill, he could only make it about a quarter of a mile before his feet started screaming at him. At one point, he took on too much too fast and thinks he might have suffered a stress fracture as a result.

"I started very slowly where I only jogged very lightly on grass surfaces for like 10 minutes and that was it," Nirenberg says. "I've slowly worked up to the point where I run every day for about 30 minutes."

Though they share a common thread, and would likely exchange high fives instead of puzzling looks when passing each other on the road, Vouga and Nirenberg have varied reasons for shunning shoes.

Vouga imagines he is Geronimo flying through the woods. Nirenberg imagines a world where people begin to wean themselves off their shoe addiction and stay healthier as a result.

"Running on those trails unshod made me feel closer to nature," Vouga writes, "almost part of it. So many things in our lives separate us from the world we live in -- from air conditioning in our cars and homes to wearing shoes almost 24 hours a day -- that actually feeling the Earth with my feet was a renewing and invigorating experience."

Nirenberg says "My hope is that discussing it and people will be willing to come in and try to get themselves well in a more conservative, natural and holistic way."