Rethinking footwear for runners Published June 21, 2013 By Rebecca Burylo Air University Public Affairs MAXWELL AIR FORCE BASE, Ala. - -- With thousands of innovations marketed for runners, surprisingly, the running shoe should not be one of them, according to 18-year, U.S. Air Force team runner and five-time Air Force Half Marathon masters champion Lt. Col. (Dr.) Antonio Eppolito. He shared his running expertise during a seminar workshop hosted by Maxwell's Health and Wellness Center June 13 inside the Officer Training School. Eppolito said swapping out old, clunky sneakers for a barefoot running style would greatly reduce runner injuries, now the second highest cause of recreational injuries in the Air Force. "We found 4,000 runners so far, have seen a 50 percent reduction in their running injuries after adopting this methodology," said Eppolito. "For the past 40 years, we've all been sort of engrained with the idea that you need to wear running shoes when you run, and now we're trying to roll back the clock with barefoot running. It's always been around; it's not just a fad." One participant, Master Sgt. Will Schwartzer, 42nd Medical Clinic diagnostic and therapeutic flight chief, made the switch from a traditional running shoe to a minimalist shoe a few years ago after suffering from shin splints and pains in the arches of his foot. "This was about the time that minimalist shoes were really breaking into the market," said Schwartzer. "So, I did some research; the theory seemed sound, so I switched. The benefits were immediate. I no longer had any pain during running and I was running at a faster pace with less effort. What was nice about the workshop is that it validated what I had experienced." Eppolito and other team members present Armed Forces Efficient Running, a two-hour workshop, and have traveled around the country to discuss running at many different military installations during the past two years. Chief of the United States Air Force Telehealth and Telemedicine and an experienced athletic runner, Eppolito covered the art and science of proper running form in preventing injuries, natural advantages of barefoot running as well its history for survival and as a sport. During the second hour, Eppolito took the class outside for a hands-on approach focusing on barefoot running form, aerobic development and simple strength and mobility drills. Running barefoot seemed strange to some as military and civilian attendees left their shoes behind for jogging drills at the OTS track, but it is the way man was created to run, according to Eppolito. "We were born to run; we're running creatures," said Eppolito. "It's inherent in our DNA, and that means everyone is capable of running prodigious long distances. Running is not only natural; it's what we were designed to do." After the workshop, several participants said they were able to take something away from the class, whether it was a new technique in form, agility drills or breathing habits, or changing their view on shoes. Many were unaware that heavily padded running shoes could increase their chances of injury. Senior Master Sgt. Scott Sikorski, an educator at the Air Force Senior NCO Academy, said that before attending the workshop, he had a running injury and appreciated Eppolito's simple techniques for safer running. "I realized that I have been running improperly, which is why I am nursing a lower leg injury now that has been persistent for the last couple of months," said Sikorski. "With this new technique, I should be able to heal faster and avoid other injuries." The exercise physiologist at the HAWC will continue to offer Eppolito's information and running workshop each month. Big shoes vs. bare feet Recently, the minimalist trend of running shoes has taken a foothold among several prominent athletes and recreational runners, including Eppolito, who admits to once wearing the big cushioned sneakers he refers to as the "big shoes." Eppolito said barefoot running is the natural, most efficient way humans were created to run, and big shoes only prohibit the functionality of the foot. Transition or minimalist shoes are healthier alternatives and will reduce the risk of running injuries, he said. When running barefoot, the foot strikes the ground with the mid-foot or a whole-foot strike. The natural running gait is a complex system of movement, which allows the foot to roll inward and stretch. The arch collapses, acting like a spring mechanism, and the toes expand to grasp the ground, propelling the foot forward. The knee is slightly bent over the body's center of gravity. Wearing shoes, however, changes this natural gait and eliminates all the special features of the unshod foot, according to the research Eppolito and his colleagues found from slowed videos while testing runners' performances. "The shoe is blocking all four things the foot needs to do. It needs to stretch the Achilles, stretch the arch, roll inward and splay the toes," Eppolito said. "Then all those ligaments, tendons and bones in a split second come back together in a tremendous spring and the foot reforms itself." A wide, cushioned heel in traditional running shoes raises the body off the ground like a sloped ramp, forcing body posture to change, legs to extend outside the center of gravity and heels to strike the ground first. A shoe's arch support actually prohibits the foot from collapsing and necessary muscle growth needed for absorbing shock. Narrow toe boxes and tight laces cramp toes inside. Lastly, the weight of big shoes causes fatigue. Transition and minimalist shoes are lightweight and flexible alternatives that mimic barefoot running while still protecting the foot from debris. Born to run Man has been running for hundreds of years and has only been doing so in a shod-foot for the last 50 years, according to Eppoltio. Originally, for survival, man ran to catch prey for food, Eppolito said. Though it is impossible for humans to run more than 23 mph for long distances, humans are created perfectly for long-distance endurance running. "Animals are obviously faster, but they can only sustain that for a quarter of a mile," he said. "So ultimately, we can run them down over marathon-like distances." Unlike animals that can only maintain high speeds for a quarter of a mile, humans have four characteristics unique to endurance running: light lower torso, independent breathing, ability to stand erect and body heat regulation. With most of the humans' body mass in the upper torso, longer legs are left light with a few key strong muscles, ligaments, tendons and joints in the feet, a strong Achilles tendon and the gluteus maximus. Together, the design creates a perfect platform for shock absorption and propulsion. Humans, who stand erect on two legs, can breathe independent of their stride, unlike those on all-fours that are constrained to breathing in sync with their gallop. Thus, man has more efficient regulation of oxygen. Also, standing erect allows humans to carry extra food and water in their free hands for further endurance. Standing on two legs rather than four allows for better thermal regulation since less of a human's body mass is exposed directly to the sun, Eppoltio said. Standing up higher from the ground allows contact with cooler air and cross winds which also allow for cooling. Lastly, man is designed with sweat glands and less hair than animals, which also contribute to cooling. Race for gold Running has over time transformed from primal survival into a globally recognized recreational sport. Instituted by the Greeks and Egyptians, running had its beginnings as a competitive sporting event. The marathon race began in 1896 with a distance of 26 miles at the Grecian Olympics to honor the mythological legend of Pheidippides. Pheidippides, a Greek messenger, raced from the battlefield of Marathon to Athens announcing that the Persians were defeated in 490 B.C. After running the entire distance, he entered the city, announced their victory, collapsed and died. After United States Olympian Frank Shorter won gold for the marathon event in 1972, American enthusiasm for the sport intensified, thus kicking off the running fitness craze, the birth of the high-heeled, cushioned running shoe and the plethora of sporting injuries, according to Eppolito. He aims to prevent more injuries through education.