The effects of a 4-week barefoot exercise intervention on plantar pressure, impact, balance and pain in injured recreational runners: A pilot study

Background: With recreational running's continued popularity and incidence of lower extremity injuries increasing, it is important from an osteopathic practitioner perspective, to be aware of treatment/interventions that may enhance recovery or prevent injury. With an osteopathic lens we postulate that improving function leads to symptomatic benefit in not only structure but throughout the kinetic chain.

Objectives: The present study aimed to assess the effects of a 4-week barefoot (BF) training intervention on; visual analog scale (VAS) pain scores, postural sway, plantar pressure, stride and foot impact.

Methods: In this parallel design study, eight recreational runners were recruited and blindly randomised to a control (CO) (1 M & 2F; aged 28.0 ± 12.1 years; weight 63.3 ± 11.6 kgs) or intervention (I) (4 M & 1F; aged 33.4 ± 9.3 years; weight 69.8 ± 7.6 kgs).

Results: No significant differences in plantar pressure or stride pre- or post-intervention for CO or I group. However, there were significant reductions in the intervention group for VAS walk (pre:mdn = 3 (IQR = 3.0–5.5; post:mdn = 1.5 (IQR = 1.0–4.0) and run (pre:mdn = 6 (IQR = 4.5–7.5; post:mdn = 2.0 (IQR = 1.5–5.0). Also, for medial-lateral eyes open sway condition for both left (pre:mdn = 2.94 (IQR = 2.54–5.42; post:mdn = 2.26 (IQR = 2.05–3.18) and right leg (pre:mdn = 3.55 (IQR = 2.79–4.32; post:mdn = 2.71 (IQR = 2.26–3.34). Finally, a significant decrease in rear-foot strike impulse (pre:mdn = 4.66 (IQR = 3.01–5.14; post:mdn = 2.66 (IQR = 1.81–3.54).

Conclusion: The present study assesses short-term balance and impact changes through a BF intervention. It is entirely probable plantar cutaneous mechanoreceptor activity has increased leading to peripheral and centrally mediated improvement in balance through reduction in sway. The reductions in impact outline the neuro-bio-mechanical relationship and importance of plantar sensitivity. For injuries where either factor is at play, BF activity may have clinical benefits.