Too Much Too Soon Syndrome FAQ: A Look at Inside Ankle Pain

The most frequent question that barefoot runners ask me is, “Why does the top of my foot hurt?” Second, “Why do the insides of my ankles hurt?”  I will go a bit backward with my posts, because I’ve gotten two inside ankle pain questions in the past two weeks. I will try to address top of the foot pain in my next one.  First of all, what is Too Much Too Soon Syndrome (TMTS)?  TMTS is very common among us newly converted barefoot or minimalist runners.  Many of us have tried for years to run in traditional shoes and failed to run injury free, or failed to meet our goals, or just failed to run happy!  Running happy is the most important thing of all.  So, that being said, when we start running barefoot or even in Vibrams, something funny happens to us.  The first time, it’s a little weird, and we may even vow to never do it again.  All it takes is that second time.  Two barefoot runs, and you may find yourself addicted.  THIS IS FUN!! WHEEE!!!  All of the sudden, running is fun again, and it feels like play.  Sensation is on overload, your awareness is heightened, and you think to yourself, this is great!  I’m going to run my usual five mile route!  Now it’s very difficult for a barefoot runner to do their normal five mile route because their soles will force them to turn around, but this is where many Vibram Five Finger runners get in trouble.  We have a false sense of security from the rubber on the shoe, and we do not pick up the feedback that’s telling us to stop for the day. And that’s when I get an email, or a message on Facebook…

They usually go something like this: Leigh, I tried those stupid shoes (and yes I ignored you when you said to go barefoot first) and I started really slow by walking in them, and then I ran 4 miles.  Or 6 miles.  Or 8 miles.  Now, I can’t walk!  The top of my foot hurts, or my calves are dying a slow death, or the insides of my ankles hurt, or my whole body hates you Leigh, and I can’t even sit on the toilet correctly.  I broke myself.  These are all things that I’ve heard!  And guess what?  I’ve experienced all these things, because I too, am an impatient runner and ignore my own advice.  It’s true, PTs make the worst patients!

Anyway, what am I talking about? Right, TMTS.  So as new barefoot runners, we truly need to appreciate the amount of time it takes to build strength in the lower legs.  Not only that, but the mobility of our foot must be enough to accommodate our new running style which is decidedly different than say, running in a shoe with an 1.5 inch heel.  It is known that it takes about 8 weeks to gain strength and mass in a muscle.  While we may feel stronger after only a few sessions of weight training or barefoot running, this is only due to neurological factors, i.e. the signal from the brain to the muscle to tell it to contract is getting faster.  This is the common phenomenon that may happen when you’re trying to bench press for the first time.  The first time you try it in the gym, the bar wobbles around like a noodle, and everyone laughs.  Yes, it’s happened to me.  But after a few days of persistence, that bar is steady and you get to show off your mad skills.  Are you stronger?  Well, in a way.  You have better control.  But you won’t be maxing out on the bench press with the big boys and girls until you practice for a long time.  And so, there is the parallel to barefoot running. Just because you’ve been a runner, doesn’t mean that you can max out (run 5 miles barefoot) the second time you try.  We are learning to turn on muscles that have been off for a long, long time.

In the past couple of weeks, I’ve gotten questions from two different people about inside ankle pain after ramping up mileage in Vibram Five Fingers.  In both scenarios, the individual ramped up mileage very quickly. Because they were both runners before, they likely assumed they could do this.  Let me start out by saying that if you’re experiencing persistent pain after trying minimalist or barefoot running, please see a physical therapist who specializes in running.  If possible, seek an open minded, knowledgeable PT who has experience in minimalist running.  Physical therapists are movement and musculoskeletal experts, and they can evaluate and treat the specific problem.  While primary care doctors are a good starting point to get a referral to see a PT, they might not necessarily know exactly what’s going on or be open minded to a form of running that’s still considered to be “alternative” or “different.”

So let’s get back to inside ankle pain.  Inside ankle pain is not uncommon because the muscles that support the arch and muscles of the lower leg are usually atrophied from wearing regular shoes or running shoes with an arch support.  The arches including the intrinsic muscles of the feet need to learn to come alive again, but until then, sometimes certain muscles will try to do all the work to hold up and support the arch.  One such muscle that may become overworked while trying to control the arch, is a muscle called the posterior tibialis.  This muscle originates deep in the calf area and its tendon wraps underneath the inside ankle bone (medial malleolus) and connects to a small bone in the arch called navicular, and then attaches by fibrous expansion to many other small bones in the foot.  When this muscle is overworked, one could develop posterior tibialis tendonitis.  The action of that muscle inverts or brings the foot in towards the midline, plantarflexes the foot (points it like a ballerina)  supinates the foot (helps it roll out during running) and helps to control pronation (arch rolling in during running.)

Good Picture of Posterior Tibialis

So what can you do for this ailment? Well, for starters, RICE.  Rest, ice, compression, elevation.  Yes, it works!  Then, it will be necessary to restore normal mobility and strength in the feet and lower legs.  This is important for anyone who is considering barefoot/minimalist running!  So the question is, is there anything that could cause inside ankle pain other than the posterior tibialis tendon?  Of course! That’s why it’s important to talk to your PT.  But, these exercises below will be beneficial to ANYONE who is considering minimalist running, so you really can’t go wrong with them.

Stretch!

1. Gastroc/Soleus Stretch: Please perform this with knee straight and then bent to stretch both gastroc and soles muscles.  Soleus (knee bent) is of utmost importance as you will be eccentrically loading this guy with your barefoot running.  I like to hold this one for up to 1-2 minutes and repeat 3 times to really change the tissue and increase the dorsiflexion range of motion. Additionally, I like to use a slant board to obtain even more of a stretch. It is necessary for barefoot runners to have lots of dorsiflexion range of motion!

2.Ballerina Stretch: This will ensure the top of the foot has sufficient range of motion so that the muscles/tendons in back of the leg are not overworking. 

3. Roll Out!  Roll your calves out on a foam roller.  Get in there!  Also, roll out the arch of your foot on a golf ball.  Get in there! This should be a “good hurt” and the area should feel looser and freer afterward, not damaged and painful. The muscles/tendons need to be free of adhesions, rolling out can help bring circulation to the area.  Increased circulation means increased blood flow and oxygen, which brings the good stuff we need to repair tissue.

Strengthen!

1. Direct Isolated Posterior Tibialis Eccentric Strengthening: Tendonitis and eccentrics are enemies.  This one is a great addition to your toolbox! 

2. Short Foot Exercise: Janda’s genius idea.  This one is fantastic for intrinsic strength, so that posterior tibialis does not have to compensate for intrinsic weakness. Sanatan calls this the invisible arch support exercise:

3. Calf Raises with Eccentric Lower: Great strength exercise for minimalist runners, as we must have eccentric control via the muscles of the lower leg and foot to decelerate upon landing on the forefoot.  Please be sure that your weight is focused over the big toe.  In other words, do not allow the foot to roll out when lowering down. I use this daily! 

4. Calf Raise 100’s: Love this! 

5. Functional Posterior Tib Exercises: During the second video, you can stop watching at about 3:30, unless you want to know about the navicular drop test.  

These exercises are just a few things to put in your toolbox for minimalist barefoot running.  The most important thing to remember is that patience is key to success in your transition, and the reward in the end is well worth your time.  Run happy and run strong!

Have you experienced any TMTS injuries? What are/were they?  

Categories: Barefoot Education, Running | Tags: , , , , , , , , , , | 76 Comments

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76 thoughts on “Too Much Too Soon Syndrome FAQ: A Look at Inside Ankle Pain

  1. Jenna

    I love your blog Leigh! It’s very helpful!

  2. I don’t run barefoot because of a variety of issues with my feet, but this came at a perfect time for me because I’ve been fighting the most excruciating ankle pain for months now, and that on top of my Plantar Faciatis…this has helped me tremendously. Thanks so much for posting it! 🙂 I see some new work in my future!

    • I’m so glad!! Thanks for reading, and I wish you the best of luck! What shoes are you using for running?

      • I’m using the Mizuno Wave Inspire 9s. I have super high arches and use insoles for that, but these help my land my feet FLAT instead on the outsides of them where I was hurting myself. I’m tempted to get refitted for something different after I wear these out mile wise.

        I’m terrified to do the barefoot running since I hurt my feet so much as it is.

  3. You should have seen my feet before I ran barefoot!! I actually used to wear custom orthotics and a heel lift due to one leg being longer. It took me a few years of reading and researching barefoot running before I would ever even think about it. I used to think, “Yeah, that works for some people, but never would work for me! Look how awful my feet are!!” Then, one day, I had a game changing injury. I’ve been injured as long as I’ve been running which is almost my entire life, so that was the final straw. I haven’t looked back, and my feet feel and look so much stronger! I really think that when equipped with the right knowledge, anyone can run happy and injury free 🙂 and without shoes. The shoes you’re wearing are cushion/stability shoes for moderate overpronation (foot rolls in on landing.) So I wonder if you’re landing on the very outside of your feet and then rolling in? That would be what the shoe you’re in now is designed to correct. Either way, I have faith in you! The solution for many foot problems is to provide the foot with a good learning environment (ie take away a high heel/narrow toe box) and allow it to move properly (toes splayed, feeling the ground for feedback.) The foot’s mobility and strength will then increase, which will very likely alleviate some of the problems that ail you. I always encourage folks to go to a PT who is open to barefoot running, or a barefoot running coach, or a minimalist running clinic to learn. They are popping up all over!! In the meantime, check this post out: https://vegetarianbarefootrunner.com/2012/10/20/my-journey-to-becoming-a-barefoot-runner-part-2-the-why/

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  5. Amanda

    I have read so many articles about easing into barefoot running but it’s never more specific than that. I ran no more than 45 min in barefoot shoes for 6 months and than went up to an hour over three more months. I never experienced any discomfort during this time. Once I went past the hour mark my posterior tendon became painful. I am now training for something that requires I run long and now I am in a weird position: I can’t run in the barefoot shoes bc they hurt my feet, but now my old clunky shoes plus orthotics feel really awful to. I feel like I increased gradually and it will just meter happen. I also– bf ramping up to an hour– was religiously doing most of the exercises on your cite. What exactly dies gradual entail when you are pain free? Does it mean increase by five minutes every week? Why are specifics not offered?

  6. Amanda, thank you for your comment and questions. I feel your frustration and can personally identify with this. I do not prefer to give specifics on the idea of increasing your time running barefoot gradually in the form of a written plan with day to day suggestions for increasing mileage. The reason for me personally is because too often, I see people following training plans for everything from starting a running program to running a full blown marathon and beyond, and they result in injury due to failure to listen to one’s own body.

    When people begin to follow those programs, they are great general guidelines, however people can choose to ignore the signs of an injury. For example, if a marathon training plan (I’m talking people running in traditional shoes and “barefoot” style shoes) says to run 10 miles, a person will run that 10 miles. If the next day, they are injured, they should rest or discontinue that training plan. But since their training plan says to run another 5 miles the following day, they may still go out and run that 5 miles even though they are injured.

    The company Vibram offered a general guideline for increasing wear time of their Vibram Five Fingers. Recently a study was published which showed that their guideline of increasing wear time over a period of 10 weeks was an insufficient amount of time to build the strength needed to protect the foot from injury. Therefore, at the end of the study, some of the participants wearing Vibram Five Fingers who had converted from regular running shoes, showed inflammation around the long bones of the foot and one had a stress fracture. While Vibram is correct in asking the folks buying their shoes to ease into them slowly, the problem is that not enough research has been done yet to give a more proper training plan. We have all been wearing supportive shoes for so long and have variable experience with walking or running barefoot, so it’s tough to know what will work for the general population. Additionally, it doesn’t sound like the people in this study had any prior knowledge of barefoot running form and technique.

    Therefore, I feel that it would be inappropriate for me to say that everyone will have success if you increase your mileage by X amount this week, or your time by this amount, especially when you’re getting up there in mileage, like you are. I personally take a very individual approach with myself and with my patients as well. I do give a very general guideline for beginners, however when you already have experience in the big miles like you do, I don’t feel it’s a matter of strength at this point, but perhaps it’s a matter of form. My suggestion to you would be to find a barefoot running coach or a physical therapist who is experienced in analyzing gait during running, preferably barefoot running. Educate yourself as much as you can. Barefoot Running is a great book about form, as is Barefoot KenBob’s book, Amazon has both. If you are injured, please see a physical therapist who can help you treat your injury before proceeding with a training plan.

    Technique/form are so important during barefoot running. I really feel that everyone can run this way, but you must be knowledgeable of the correct form. For me, the best way to find my proper form, was to take my shoes off. You said you’ve been running in “barefoot shoes” so my advice would be to just take them off and try to run a bit. What you’ll likely find is that you are touching down and landing softer, you are lifting your foot underneath you versus pushing off and kicking back, and your knees are more bent upon landing. When you’re barefoot, you MUST run softly and the immediate feedback from your soles will help with tweaking your form. I find that a combination of barefoot running and minimalist shoe running (for longer distances) is what keeps me completely injury free. It truly sounds like something is just a bit off on your form, so running completely barefoot may just be enough to sort it out. If not, please seek help from a PT that can see you in person and come up with an individual plan. Running is always about trial and error, whether barefoot or in shoes, there simply is not a black and white answer to the question of what is right for every individual. We are all unique, including the way we run whether we choose to be shod or unshod.

  7. Hi Leigh,

    I’m hoping you might be able to give me some advice. I picked up an injury 11 weeks ago while training for my first marathon. It has been diagnosed as medial tibial stress syndrome, from overuse. I was running 5 days a week, all on tarmac in Adidas Supernova Glide 4. I was told that I over pronate slightly on my right leg, but the physio didn’t think it was enough to require extra support or motion control shoes. I was 9 months into my training for the marathon. I had successfully completed a couple of half marathons, and wasn’t having any pain whatsoever until 11 weeks ago, when I started getting a bit of pain in my inner lower leg. I stopped running, went to the physio immediately, and have been trying to recover ever since. I’ve had sports massage on my calves (they were super tight at the time) dry needling, I use a foam roller most days. I’ve been doing daily exercises to strengthen my lower legs, my feet and my core, and I have tentatively started running completely barefoot in the last 5 weeks. The pain has mostly gone from the inside of my shin, but in the last two weeks it has reappeared around my inner ankle (same leg). I am only running for 10 minutes max (all I can manage before the pain starts) and only doing this once every 5 days. The other days I do biking and swimming. The pain isn’t awful, it’s more like a dull ache, but I don’t want to run through it incase I do even more damage. I’m just worried that maybe barefoot running is making the injury worse? One physio advised me to get custom made inserts, but I am doing all I can to avoid this as I just don’t agree with the thinking behind it. But should I keep doing what I’m doing in the hope that my feet/legs will get stronger in time? Or am I making everything worse by running with no support? I know it’s difficult to advise since you haven’t seen me, but any advice you have would be really appreciated. I’m just desperate to run again. I’m having to pull out of the marathon next month, and I was running it for charity so I am absolutely devastated. And after 11 weeks, I would have thought whatever I have should have healed.
    Thanks for any help you can give,
    Sarah.

    • Sarah,
      What a bummer! I’m so sorry for what you’re going through. Withdrawing from a marathon is so hard, but remember there will always be more marathons. In light of the Boston bombings, I think it’s even more important for us to keep marathoning! But alas, your injury is so unfortunate, no doubt about it. I looked up your old running shoes, the Supernovas, and they certainly have all the characteristics in a shoe that I’m not crazy about i.e. small toe box, toe spring, high heel, etc. It sounds like your MTSS is getting better at this point, but your main concern is the inside ankle pain, which is lower down than your initial injury. First of all, great news that your MTSS is getting better! As runners, we have to look on the bright side 🙂 Your current discomfort is almost certainly related to wanting to do too much before you’re 1. entirely recovered from your initial injury (MTSS) which likely resulted in weakness and muscle imbalance and 2. before you have enough strength in your lower legs to run barefoot. You mentioned that you’ve been running barefoot for the last 5 weeks but only for 10 minutes at a time once every 5 days. My first reaction is, that’s too much! To run 10 minutes the first time you run barefoot, while you’re recovering from another injury is actually A LOT!!

      To make a long story short, I think in the long run, you will certainly appreciate the benefits that barefoot running and walking can bring to your life! Yes, you will eventually find that your feet and lower legs will be tremendously stronger if you stick with it. That being said, you need to make sure of a few things: 1. Rest. More than you think, since you’re recovering from an injury. 2. Start very slow. Walk barefoot, then work up to running, but only for 1-2 minutes at a time, then go from there. 3. Get help from your physio to look at muscles imbalances. If you’ve been running in Adidas Supernovas, you likely have shortened Achilles tendon, and maybe short hamstrings, etc. Stretch!! You need adequate range of motion AND strength to be able to move past the injuries you already have. 4. STRENGTHEN!! I know you say you’re strengthening which is GREAT! But, it takes a long time (much more than 5 weeks) to have adequate strength in your feet and lower legs to offset the stress of trying something new, like being barefoot. 5. Educate yourself. THis is the most important piece of advice that I can give to you. Technique is VITAL to your running health and happiness. Check out the book Barefoot Running by Michael Sandler. Wonderful “how to” guide. I cannot emphasize the importance of education and self awareness enough. 6. If you’re extremely flared up, that’s the only time I would suggest TEMPORARILY wearing an insert or supportive shoe, so that the inflammatory phase can pass. Otherwise, I would not recommend it as a permanent fixture. I doubt that custom made orthotics would be indicated, but that’s just my two cents 🙂

      I really hope this helps, and again, I’m sorry for what you’re going through. Be patient with your body! I know it’s hard, but it’s going through some changes with trying new things. I don’t know what exercises you’re doing, but some of my favorite exercises for strengthening are the Janda short foot exercise, eccentric calf lowering, and the eccentric posterior tibialis exercise which I believe are posted in this particular blog post.

  8. Sarah

    Thanks so much for your advice Leigh! I had no idea that 10 minutes barefoot would be too much at the start. I will certainly take it back a notch! And I’ve ordered the book you suggested, it sounds great! I’m looking forward to this new journey, and hopefully will become a much stronger runner as I a result. Thanks again for all your advice, and great website! Sarah.

  9. Peter

    Is it common for the ankle pain to not go away, or take a very long time to? I definitely did TMTS barefoot running, but I have since stopped all running and it’s been over two weeks now. The pain isn’t severe, but it just doesn’t seem to want to go away! Should I be RICEing until the pain is gone?
    Thanks and thanks for this site – it’s very informative!

    • Absolutely RICE!! If something is very persistent, I might even recommend using a supportive shoe temporarily so that everything has time to rest and recover. Supportive shoes will “do the work for you” which is ok for recovery for injured tissues, but not so good permanently because those same tissues will weaken. If the pain persists, I would go see a physical therapist as there may be some chronic inflammation or damaged tissue that needs some assistance with healing properly. I really hope you feel better!!

  10. Peter

    Thanks so much for the reply!

    Well shoot, perhaps I’m the one prolonging it! The past week I’ve started doing some range of motion, strengthening, and stretching exercises (like the ones you have listed), plus some short walks. Is this a bad idea before the pain is completely gone?

    It’s been 3 weeks now and the pain is mostly gone, but there’s still a dull something around my ankles (wouldn’t even call it pain anymore), but it’s more pronounced when I just wake up in the morning.

    Just so anxious to get back to running – TMTS is a weakness of mine!

  11. I would do one thing at a time 🙂 Like range of motion this week, then work into gentle stretching and strengthening. Not a bad idea unless the pain is worse after. Sounds pretty typical to be a little more achey in the morning. Make sure you’re warmed up before stretching, ie walk first or ROM/ strength exercises. Let me know how it goes! TMTS is a major weakness of mine too!!

  12. Peter

    That sounds much less TMTS! I’ll give your plan a try and let you know how it goes. Thanks!

  13. Rina jha

    I am working in uranium mines due to boot bt it’s so paining nw..what should i do

  14. Phil Hayes

    Hey Leigh,

    After my exams i had 7 weeks to train for a half-marathon. I was not in the best physical condition post-exam, but i’ve been slowly training and converting to a pair of New Balance Minimus road runners. I have 3 weeks left of training, and i decided to amp up my training a little bit more to 5 mile runs. However, i’m feeling pain and a lot of pressure (no injuries, just maybe weak muscles?).

    Do you think i should keep training/running in these minimalist shoes for the half-marathon? Do i have enough time? Or should i change back to my old normal running shoes for the half marathon and change back to my minimalist shoes after that?

    Thanks!

    • Hi Phil,
      Thanks for your question! Funny enough, this is the most common question I get. Nowadays, the half marathon is one of the most popular distances to run, and most people can train up to it. The problem is, people running in traditional shoes start to get injured at this distance and then try to switch to minimalist shoes mid-training and end up even more injured from too much too soon combo with the previous injuries. Now to answer your question, I have to admit you may not like my answer, but it’s all out of love 🙂 1. 7 weeks to train for a half marathon is not very much for someone who is “not in the best physical condition.” 2. 7 weeks is a horribly short amount of time to convert to New Balance Minimus shoes while training for the same half marathon. It’s never a good idea to convert to minimalist running while trying to train for an event, I can guarantee you 100% you will get injured, that’s the going rate for everyone I’ve consulted on this issue. Yet still, it’s the most common question I get, and the most common advice I give that is ignored. I can tell you that you PROBABLY will get injured if you keep training for this half in your minimalist shoes unless you rest, and if you’re only up to 5 mile runs with three weeks left of training (or is that three weeks til the race?) then you WILL be injured if you try to increase in that amount of time. I believe you’re likely already injured, as pain and a lot of pressure is an injury, not just weakness. Pain is never a good sign. As for changing back to your old normal running shoes, that is for you to decide. Training for an event while making a lifestyle change like minimalist running is never a good option though. If you want to be a minimalist runner, I always say that you need to be a barefoot runner first, so you can perfect your technique with the feedback from your soles. THEN, think about training for that half when you’ve got your technique and your strength on board. Sorry for the bad news, but thank you for inspiring me. I think I will write a blog post about this for my next one, I can’t tell you how often I get this question! I truly wish you the best of luck and please keep me updated!!

  15. james

    Hi Leigh,
    First of all, great website.

    I’ve been running barefoot for years and this year have been increasing my training steadily (but not stupidly. i do 5 sessions a week (2 X 5k race pace, 8k steady, 5 X 1k’s, 3 X 1500m) all with warm up and down with 2 rest days. Not exactly heavy. All my running is on grass with the odd bit of trail but am use to barefoot running.

    Just recently i have felt an ache on the inside of both ankles (just below the bony bit). First on my left ankle and now more on my right. there is no swelling or bruising or pain. i have just had a three day break but still feel the ache. would it be safe to keep running?

    any advice appreciated

    James

    • Hi James!! Thanks for your question. It sounds like you have just increased your training and the posterior tibialis tendon is protesting a bit. As long as you still feel the ache, I would take it easy. I would definitely recommend increasing your strength training to keep up with the amount of running that you are hoping to do. The eccentric posterior tib tendon exercise, eccentric calf lowering, and short foot exercise listed here would be great to incorporate every day. I’d recommend starting with those and continuing to ice the area, then start out for an easy barefoot (meaning no shoes!) run and see how you feel. If it’s hurting right away, give it a couple of minutes to warm up. If it goes away, probably safe to keep running, but if it comes back, stop immediately. Ice/compression wrap after running. I hope this helps, and glad you are running bare!

  16. thanks for your post. I broke my ankle 13 years ago now (boy time flies.) And it is acting up on me. I started running in toe shoes last year. And as luck would have it I broke my toe chasing after my niece at the end of last summer. I have returned to running this summer and figured since I am starting all over that my feet would adjust to the running along with my body. After reading this post I think that my wimpy ankle is suffering from tmts. Thanks for the gold mine of stretches and exercises. I plan on checking in with my doc soon to maybe get some pt. The range of motion on my broken ankle still isn’t what it used to be and I am wondering about scar tissue growing in the wrong places. So there may be more to this than tmts as it always gives me some amount of grief but in the mean time I will incorporate a lot of these stretches and exercises to my daily routine.

    Thanks

    • You are so welcome! Thanks for stopping by, and keep me updated on your ankle! 🙂

      • So after reading this post I had stopped running and just continues with crossfit and the exercises and stretches here. I participated in my mud run with my ankle taped and felt great. My TMTS was pretty much gone but I went to the doctor to check out my ankle all the same. He agreed that was probably what had happened but took an x-ray to see how my ankle was doing from the break 13yrs ago. He was concerned with pain it gives me on a regular basis. The bad news my cartilage is getting thinner between by ankle and foot joint and I have a bone spur that digs into the top of my foot when I get a good dorsal flex. His diagnosis is that toe running vs heel running is better since is reduces the damage to my ankle joint but he did not recommend having running marathons as a goal for me. (as if he was reading thoughts in my mind) He said to look at the big picture and how long I wanted a functioning ankle. He recommended biking, swimming and elliptical running. Oh hum. On the positive note he recommended toe strike running so yay for that but now I have to totally rethink my fitness goals. I can’t argue with wanting to having usable ankles when I am 70 but I was looking forward to running a half marathon next year and maybe even a marathon some day. Running is so easy just throw some shoes on and say bye honey sees you in a bit. And more traffic than I like for biking around the house so that means a little more prep work with hitches and bike tune ups, oh hum. Anyways not really a TMTS reply but I figured I would update you on my progress or lack there of. Thanks again for helping me figure out what that new ankle pain was.

      • I’m so glad you kept me updated! It’s important to me that I hear updates from you folks, I always wonder how people are doing! I’m sorry about that ankle of yours, sometimes a true trauma like that can really affect the arthrokinematics (the way the joints move) of the injured joint, resulting in eventual breakdown. I would hope that with a forefoot landing, you can work to strengthen the area and tread lightly (literally!) If I were you, I’d be a barefoot runner (sans minimalist shoes) so that you know you’re landing as light as possible and as efficiently as possible. Please continue to update me! Best wishes to you 🙂

  17. Great post! I am a TMTS guy who is frustratedly waiting for my posterior tibalis to heal (sigh). Like everyone else, I read all the warnings about taking it slow, but enjoyed the new form so much I just way overdid it. Lesson learned.

    My question is this. How do I go about finding someone who can give me feedback on my minimalist running form? I don’t trust the guys at the shoe store after the last time I went. They watched me run and just said, “Eh, looks good to me. How about this pair with giant foamy heels?” (not a direct quote). 🙂

    As I’ve run in Vibrams, I’ve noticed different muscles getting sore in my right and left legs, with much more discomfort in my right posterior tibialis and left calf. That leads me to believe I may have a pronation problem on one side. Long story short, I’d love to have someone knowledgeable about minimalist running take a look.

    Do you know where I might start looking in my community?

  18. barryrodriguez

    Great post! I am a TMTS guy who is frustratedly waiting for my posterior tibalis to heal (sigh). Like everyone else, I read all the warnings about taking it slow, but enjoyed the new form so much I just way overdid it. Lesson learned.

    My question is this. How do I go about finding someone who can give me feedback on my minimalist running form? I don’t trust the guys at the shoe store after the last time I went. They watched me run and just said, “Eh, looks good to me. How about this pair with giant foamy heels?” (not a direct quote). 🙂

    As I’ve run in Vibrams, I’ve noticed different muscles getting sore in my right and left legs, with much more discomfort in my right posterior tibialis and left calf. That leads me to believe I may have a pronation problem on one side. Long story short, I’d love to have someone knowledgeable about minimalist running take a look.

    Do you know where I might start looking in my community?

    • Barry,
      I’m so happy you’re reading! Don’t worry, I still TMTS myself sometimes, it’s just so fun, you can’t help yourself right?? Haha, I know what you mean about finding someone for feedback, the guys at the running store love selling you the foamy heels and gel inserts. This is a unique, niche area that is in need of more educators! I don’t know where you live, but many running stores and I know REIs are putting on minimalist and barefoot running clinics. While they’re rare, barefoot running coaches do exist, as well as barefoot friendly PT’s that will do a running analysis. Where do you live? I can get on a couple of websites if you’d like to see if there’s anyone/anywhere around you that is offering any clinics or advice.

      • barryrodriguez

        Thanks! I’d really appreciate your help finding someone. I live in Indianapolis.

        Thanks again!

    • Ok Barry, I didn’t find much in the way of barefoot running coaches, but I did find a guy who hopefully can help steer you in the right direction in your community. Our friend Stuart Warden, who is a PT and director of research at IU really knows his stuff. He is at the Indianapolis campus, and he should be able to point you to someone who could potentially help you. He has presented with Daniel Lieberman of Harvard, who is basically my barefoot research hero 🙂 Stuart can be reached at this email address: stwarden@iupui.edu GOOD LUCK!

  19. Hi Leigh,

    I posted a comment on here a few months ago about a injury I was recovering from, asking whether I was making it worse running barefoot. Well, I’m pleased to say things have been going really well (until today!). I’ve built up my barefoot running really slowly, and for the last few weeks I’ve got up to 5km (25-30 mins). I’m only running barefoot a max. of 3 times per week, so I don’t think I’m over doing it. I’ve also been running in shoes (not minimalistic ones) straight after my barefoot running to keep up my distance running in order to reach marathon distance in October. But today something really strange happened. After 10 mins of barefoot running, I started having this strange ache across my toes and the top of my foot. I tried running for a few more minutes, but it got so bad, I had to hobble home. I can barely walk! It hurts most when I flex out my toes whilst pushing away from the ground. It also hurts when I put pressure on the top of my foot. I’m not sure if this is related, but two days ago I stubbed the middle toe (while walking) on the same foot I now have pain it. It was a pretty bad hit, I was still in pain up to two hours after hitting it. And out of all my toes now, it’s the one that hurts the most. I haven’t felt any pain whatsoever with walking, but perhaps 10 minutes of barefoot running pushed it over the edge? I’m really hoping this isn’t one of those injuries that’s been building for months without you realising it (like my last tendon injury) and then it puts you out for months. I’ve only just got back to a decent fitness level and will be so gutted if I’m out of running again for a long time! Have you ever come across this before? Any advice you can give would be very welcome!
    Thanks!
    Sarah.

    • Sarah, YIKES!! Sounds very painful! I hope you didn’t do anything when you stubbed your toe. I guess my question is, since it’s taken me a couple of days to answer you, how is it now? Are you icing, elevating and resting? I haven’t come across this directly, but typically if it comes on that fast it’s not a great thing. What about when you curl your toes towards the ground/pull in this direction with your hands? Let me know, but if I were you I might go see your MD for XRAY. In the meantime, lots of rest and ice. Did I say that already? 🙂 If this is a stress/trauma fracture from overdoing or stubbing your toe, (hopefully not!!) they will put you in a handsome walking boot.

      • Thanks for your reply Leigh. It’s been 5 days now, and it has improved slightly, I can now put more of my weight on my foot, but it is still difficult to walk. When I curl my toes towards the ground, it’s not that painful. I’ve found that the pain has definitely moved to underneath my foot, the ball of my foot. It’s still tender on top, but it’s underneath that seems to be the issue (only when I put weight on it, resting is fine). I went to the doctor (who looked at me like a madwoman for running barefoot). She told me to put my shoes on and go to physio. Not much help! She did say she thought I’d injured a tendon in the top of my foot though.
        I have been icing it, and resting. However, last night I put a pair of Vibrams on (I bought them months ago, but have not used them yet since I was enjoying running without anything on my feet). But with my feet in them, just walking around, the pain almost halved, it was incredible. I’ve got a physio appointment today, so hopefully they can take a proper look. The pain now feels more like very bad bruising under my foot. I will let you know what the physio says today. I have also developed quite a thick callus on the ball of my foot between my big toe and second toe. It’s much more pronounced on this foot then on the other one. I wonder if that is also causing issues somewhere under the skin?

      • Hi Leigh,
        Just an update: The physio said he’d seen this quite commonly in barefoot runners, and its the soft tissue around the bones that has become irritated. He didn’t think it was a tendon issue (like the doctor thought). He recommended some inserts – ones with a lump which sits below the ball of your foot – to help relieve the pressure. They’ve helped marginally, but I’m still having a lot of difficulty walking and the pain has now spread to my other foot too. In Holland they like to send you away with minimal treatment, so I’d really have to fight to have an x-ray, let alone an MRI. Do you think it should have healed a bit more by now though, or should I just give it more time? I’m still having to walk short distances (to work) so I cannot completely rest it. I was really hoping I would be over the worst of it by now, 10 days on :o(

  20. Rob

    Leigh,
    I’m looking for a little PT love for my arch. Where’s your office?

    • Hi Rob! I don’t typically give out personal info on my site, but if you tell me where you’re located, I can help find you an excellent PT. 🙂

      • Rob

        I work in Oxnard and I’m a newby. If you are more comfortable, you can either email your address to me or refer me to another BFR PT in this area.

      • Rob

        And just for add’l information, I’m a 62 y/o lawyer, been not enjoying running all my life, bought VFF and discovered some f-u-n which I did not think was possible and now my foot aches. Would it be easier if I got an Rx? I can also meet you or your husband at Palermo’s if that would be easier.

      • Hi Rob! You’re right, it is FUN! I am not currently working in outpatient PT which is what you would need to treat your foot. I would get a Rx from a doc, makes things a lot easier when getting into PT. We are working on direct access 🙂 Anyway, I’m going to make some calls to some local PT offices, I haven’t referred anyone to local clinics yet since I’m so new to the area. Also, I work in Thousand Oaks, so I’m more familiar with that area. I will let you know soon!

      • Hi Rob! Just wanted to let you know, I spoke with Ryan Meyers, DPT over at San Buenaventura PT in Ventura, and he seemed to be open to a barefoot runner coming in. He has a treadmill and video to look at your running, and make further suggestions. He’s also MTC which is manual therapy certified from the University of St. Augustine, which is the same school I attended. That means that he will do a thorough, hands on assessment of what is going on with you. Look him up, I think he’s going to be a good one! Also, I’ve heard great things about Paul Eddy over at Pacific Therapy, but I have no idea how open he would be to barefoot runners. Still learning all the PTs around the area since I’m so new here! If you go see anyone, please keep me updated because I need a good PT to refer to in Ventura County 🙂

  21. Hi again, just a quick update. Saw a new doctor this morning (who used to run!). He thinks he even had the same injury I have and diagnosed it as Morton’s neruoma. The nerve(s) have been damaged and are causing the pain, quite often from some kind of small growth inside the foot. He gave me an injection (some kind of cortisone) which I’m still waiting to feel the effect of (can take up to 6 hours apparently) and it will last for 2 weeks. If the pain returns after the injection wears off, he said I could be looking at anything up to 9 months off running. But if the pain doesn’t come back in two weeks, I can start building up my running again slowly, but he advised me to get much wider shoes. The barefoot running caused my feet to expand, and they are just too tight in my addidas running shoes. So they probably made everything worse (or even caused it). Right now I still have the same pain, but hopefully he’s right and in a few hours the injection will start doing its work. I just hope the recovery time is at the shorter end of the spectrum :o(

    • Sarah, I am so happy that you are being so proactive with your care! I’ve been very busy in my own practice so I’m not getting to my site as often as I want to, but I’ve been thinking about you. I’m so happy you went to see another (more appropriate) doc. You’ve driven 4 points home that I really appreciate. 1. Get professional help from a doctor or physical therapist that is a runner and open to alternative styles of running. 2. Inserts don’t usually help 🙂 They weaken the area further, create an unnatural environment for tissue that’s trying to heal. Only in some cases would I recommend one. 3. There is NO substitute for a hands on evaluation. As much as I want to help others on this site, I have no way of actually evaluating injuries, only people’s descriptions of their pain which is quite subjective. So thank you thank you for being such a good advocate for your health! 4. Running barefoot changes your feet, so a decision to do so should be a lifestyle change: ie wear wide toe box shoes to work, for play, etc to stay healthy and maintain strength while letting the foot move naturally. Otherwise your regular running shoes or high heels will smoosh your toes and metatarsals! Ouch!
      Sounds like you saw a great doc. A cortisone injection may be curative for you if it successfully flushes out the inflammation. I would not recommend getting more than one, as over time the steroid could weaken and damage soft tissue, especially the integrity of your tendons/muscle in your feet which are vital to your success with running. Please keep the updates coming and I’ll continue to think about you!!

  22. Hi Leigh,

    I heard that cortisone injections can actually do more damage than good, so I don’t plan on getting any more! I just hope this one works! I had thought I was able to keep all my inflammation at bay by taking herbal supplements every day (Rhodiola, Tumeric, fresh ginger), but it seems this one was just too much for me! Looking ahead, if I can get back to running in the next month or so (I really really hope so) I still want to carry on barefoot running (but I will cut it back a lot, and build it up more slowly) but I also want to keep up my distance running in shoes since I still have a marathon I need to complete for charity. Are there any running shoes that you can suggest with wide toe boxes that would allow me to run long distances but would give me just enough support and let me land on the forefoot easily? Thanks for all your advice!!

    • Hi Sarah, Altras in general have a pretty generous toe box, and they’re always zero drop, which I’m a fan of. Also, Stems shoes have a great toe box, and people seem to enjoy running in them, although I’ve never tried them on personally. I wear Merrell Barefoot Pace Glove to work every day, and their toe box is nice for me, but could be too narrow for some folks. I think I could probably run pretty well in the Barefoot Pace Glove, but haven’t tried for any significant distance. I hope that helps!

      • Thanks Leigh! Just one final question (sorry!). All these shoes you mention sound like minimalistic shoes, which is great, but can I suddenly start running 16, 20 km in them if I’m used to running that distance in more supportive, cushioned shoes? The furtherest I got with barefoot running was 5 k.

      • Sarah, great question! The answer is no, you could not start suddenly running longer distances in minimalist shoes. If you’ve been running in more supportive shoes and wish to have something similar for your marathon, Altras are the brand that I’d recommend. They are Zero Drop so they don’t have any change in stack height from heel to toe, so that may take a little bit of getting used to. But, they have cushioned shoes and stability shoes on their website. I think you’d probably have good luck with them, but remember, I don’t run in any cushion at all so I can’t speak from personal experience on this one. 🙂

      • Thanks a lot for the advice Leigh. I will check them out. In a normal situation, I would love to just fully embrace the barefoot running and completely cut back my running in order to focus on that only and build it up slowly, but I’ve worked so hard to raise money from family and friends to run a marathon for charity, so I kind of have to get that done first! Preferably this year if possible! But I am absolutely hooked on the feeling that barefoot running gives you, it is incredible, and I hope I can fully convert one day 🙂

  23. Haley

    Hey! Great article and I love all the stretches/exercises listed here. I’m wondering if you have any specific advice for me.

    I’ve been running in NB MInimus shoes for about 3 months now. I am up to about 5K and my avg. pace is like 25 mins/5k. The first 3k is usually OK but the last 2 I get a pretty sharp pain along the top of my foot from basically one side to the other. No ankle pain normally, and the foor pain Usually stretches out after I cool down but the last 2 runs the pain has not subsided. Any idea what this might be?

    It should be noted that in anticipation of a tough mudder event, I have been doing sand sprints and dune climbs as well, but barefoot. Not sure if that makes a difference.

    Any help would be appreciated 🙂

    -H

    • Hi Haley!
      Sounds like top of the foot pain, a barefoot runner’s worst enemy… I have a draft of a post going about top of the foot pain, but haven’t finished it yet since I am in nesting mode from just buying a house. Anyway, if the pain does not subside it sounds like you should take some time off! 3 months is a nice stretch of time, but if you recently ramped up your training with barefoot sprints (especially in sand which is a very unstable surface) this demands strong control from the muscles in your lower legs and intrinsics which are the small muscles in the feet. What I’m trying to say is that your muscles in your lower legs/feet are likely not quite strong enough yet, resulting in stress/inflammation around the long bones of the feet, or possibly the extensor tendons in the top of your foot. Try rest/ice/ballerina stretch which is a video on this page. I hope this helps and keep me updated!

  24. I’ve been wondering why my ankle is killing me after my recent 5-mile barefoot run! Great post, thanks! And I just noticed, you’re in Ventura too! 🙂 Awesome!

  25. Sarah

    Hi, I got my first pair of Vibrams 3 weeks ago. I started out just walking around with them. In the first week I ran a max of one or two minutes in them. Yet I had horrible pain mainly in my ankles and feet. Some pain in my calves and knees. I stopped using them in that first week and I’m still experiencing lots of pain. I’m not sure what’s going on. Any tips?

    • Sarah I’m so sorry I just saw your question. Horrible pain doesn’t sound good! If you’re still experiencing lots of pain I would definitely schedule an appt with MD or physical therapist. Discomfort=understandable but horrible pain is not a good thing. You likely have an injury and it needs attention. Also, if that happened after truly only running 1-2 minutes then either you’re someone who needs to build up VERY slowly or your form really needs analysis. All can be facilitated by your PT!

  26. Andy

    Thanks for this post. I have been running in minimalist shoes (New Balance Minimus Trail) for almost two years now and I’ve done a few races in them. Recently I switched to using Merrell Road Gloves and almost immediately I started experiencing inside ankle pain like you describe here. At the same time I’ve been ramping up speedwork and distance to go for a PR in an October Half Marathon.

    Well I just stumbled onto your blog after waking up in the middle of the night due to the pain (I’m icing now). I’ll try these stretches in the morning.

    (By the way, welcome to the area. I’m in Santa Barbara, just up the road from you)

    • Glad you found the page! Ah yes, ramping up speedwork and distance at the same time will do that to ya! New shoes are just the kicker. What half marathon are you doing? Any other races in the works? My husband is training for the Red Rock Marathon which is up near your neck of the woods. Maybe I’ll see you out there soon!!

      • Andy

        My wife and I are planning to do the Rock & Roll Halloween Half Marathon in LA on Oct 27. In addition I’d like to do next year’s LA Marathon. I’ve done plenty of halfs but never a full marathon. I wish your husband good luck with the Red Rock Marathon. I hadn’t heard of it before, but I just checked out the route and it sounds like a beast.

  27. Hi Leigh,

    A few months ago I posted a question as I had done quite some damage to my foot while barefoot running. (I had taken up barefoot running as a result of a tendon injury in my leg at the start of the year). I had one doctor diagnose the problem as a tendon in my foot being damaged, another doctor (who was a runner) who diagnosed it as Morton’s Neuroma, and I got two steroid shots for it, and now I have just seen a podiatrist who has told me that it’s not a Neuroma, she doesn’t know what the injury was, but thinks that I absolutely need inserts because my feet are very inflexible and the pressure is not evenly distributed (it’s mostly on the heel and outer edges). She also said I have flat feet (although the imprint of my feet when I walk looks like someone with neutral feet, with a gap on the floor where the arch rises up). The pain on the ball of my foot which I had for the first four weeks after the injury has gone (thankfully) and I can now rise up on my toes, but I now have pain along the top of the foot and underneath along the arch, especially when I twist my foot outwards. I haven’t run since the injury in July. Looking back now, I think it wasn’t smart of me to try and start barefoot running while training for my first marathon (I would run first barefoot for up to 20 mins and then put shoes on and continue for another hour). But my main question now is, what’s the deal with inserts? Orthotics? They seem so unnatural to me, and there must be other things to try first before resorting to them, but at the same time, would they help me to reach my marathon goal faster than if I try natural methods? I had raised a decent amount of money for charity, and the deal was to run a marathon, so I feel the constant pressure to run one within the next year (I have a place in the London marathon next April). Is there any advice you could offer? I guess I’m really looking for someone to tell me whether I really need inserts or not (I am pretty sure this podiatrist is biased!).She also suggested that the way my feet are (my big toe curls in and the second toe rises up above the others) they are not suitable for barefoot running. Could this also be true? Thanks so much for any help you can give. I’m not ready to give up on running just yet

  28. David

    Hi Leigh,

    You mentioned that you have one leg shorter than the other. I also have this issue which has caused ankle, hip and back problems in the past. After reading a lot about barefoot running I am wondering if my orthodics and cushy shoes have failed to help! How did you go moving to barefoot running with this problem? It is the biggest thing that has stopped me so far.

    • I do have one leg shorter! I also began wondering about my orthotics and cushy shoes…. 🙂 I moved to barefoot running by quitting the cushy-ness and orthotics cold turkey. This may sound a little dramatic, but I literally chucked my shoes out the window I was so fed up with my ankle, hip and back. The question is, how significant is your leg length discrepancy? My right leg is about 1/2 inch longer than my left. In fact, many of us have a leg length discrepancy, but sometimes it’s not clear “where it’s coming from.” But either way, it most likely won’t stop you from making a transition to barefoot running if you want to do it. My advice is to go REALLY SLOW! If you have any barefoot running specialists (podiatrists, physical therapists or even running coaches) they may be able to assist you with your transition. For me, I had to transition slower than most, because I had so much support from stability shoes and orthotics. This means starting by walking barefoot and implementing a strengthening routine for your feet daily. Additionally, taking a look at your “everyday” shoes and making some changes including zero drop soles and a wide toe box. I would strongly suggest you pick up the book “Barefoot Running” by Michael Sandler. He has a significant leg length discrepancy due to his injury, and he’s one of the best advocates for barefoot running. With proper foot strength and patience, you can be a barefoot runner, you just have to have the strong foundation (your feet) to build your house. 🙂 Please, please keep me updated and happy running!!

      • David

        Hi! Thanks for such a detailed reply. I read (and re-read) it. Against my natural tendencies, I took your advice and took it VERY slow. Just walking barefoot, though I haven’t really done the strengthening side of it. That will start today! I have been trying to recover from an ankle injury for the last 23 months and have either not run or run with pain in that time. I finally found a physio that helped and went out today for a run. In running shoes. After 300m the ankle hurt again. So I thought, “Stuff it, I’m taking these off”. It was a grass oval and a just did some short run throughs of about 25 metres. Oh. My. Goodness. It felt amazing! I wanted to keep going but actually thought to myself, “TMTS”. Yep, that was my actual thought. Walked home over some gravel (ouch!) and footpath and the feet feel a little tender but I can feel them differently than before!

        Anyway, enough of my rambling reply. Thanks for your initial reply, the leg length difference was the reason I’d been shy giving it a go but I am determined to keep at it.

  29. sam

    Great post, especially appreciate the muscle identifying, stretches with video, and the length to which you address runners having this pain that are experienced vibram users. I am the latter–ive been running (in the same pair of seeyas!) in vibrams for close to 16 months, including training to run the NYC marathon this Nov 3rd in 3 hrs. After completing my final long run (25 miles) this past Sunday, I’ve had sharp inside ankle pain only on my left foot. This same issue has been an off/on issue over last few months (along with itband on my right knee). I am applying RICE and will try out some of the stretches you suggest.
    My question which I would dearly appreciate any response, is with the NYC Marathon in about 2 weeks, what should be my strategy in dealing with this inside ankle pain? Should I cease running completely until it goes away, ensuring it doesn’t nag me on race day? Or just reduce the length of all remaining runs? Or go heavy on ice? Advice, appreciated!

    • Hi Sam!!
      I’m so happy for you getting ready to run the NYC marathon, congratulations!! I ran the Portland marathon in See Yas and do all my road running in them (when I’m wearing shoes.) Bummer on the ankle, I would definitely RICE and if not painful I would try the tibialis posterior eccentric strengthening exercise. I would really drop down on your running (stop) this week and continue with cross training but only if not painful. You’re basically set at this point for the marathon, it’s taper time anyway so resting this week will only benefit the healing process at this point. It’s likely an acute tendinitis brought on by deteriorating form from fatigue after your 25 mile run and other long runs prior. That’s a long “long” run! Yes, heavy on ice, and if you don’t have a foam roller or stick, get one! Spend your time stretching, rolling out your calves/inside calves and both IT bands, and maybe even get a good deep tissue massage later this week/weekend as long as it’s not within a week or so of your marathon. Do you do any totally barefoot running? My strategy would be to try a short barefoot run next week and see how it feels. The barefoot running should be a great form refresher to fine tune before the race. Even with the ultra thin See Yas, it’s amazing how much feedback you still miss from the ground. I can’t tell you how many times I’ve taken them off and said to myself, “Oh right! I need to lift my feet underneath me more, or oh! My cadence is too slow, pick it up.”

      • Sam

        Thanks for the very helpful and very prompt reply–I’m halfway across the world, so timezone warp my sense of the time! As I briefly mentioned, I really appreciate the way your advice above and here speaks to experienced vibram/barefoot runners that are having pains, since so many of the online forums/blogs are only directed at beginners!
        I’ve got a foam roller (I’ve been a dedicated user since IT-band got ugly 2 months ago!) and am rolling away! I dont do enough totally barefoot running–of late, only once every 2 weeks on the grass for 2 miles max.

        My “big question” in response to your remarks is, how important is it to consciously develop the proper ‘barefoot/vibram’ form? My impression had been that, within reason, barefoot running should automatically guide one to the natural form — that is, I didnt need to “focus” on landing on my front foot a certain way, since the lack of real shoe support would ensure my foot did just that. I realize that Vibrams can throw this “natural” process off some, but nonetheless, this question of to what extent do I need to consciously train myself to adapt a proper “barefoot” form is one I’d love your feedback on. (related– I’ve seen youtube videos with a guy teaching how to develop this form, but so far, ignored doing so myself!).

      • Sam,
        EXCELLENT question!! I love it. Consciously developing your barefoot form is essential to your barefoot running success and experience. You are correct in saying that barefoot running SHOULD guide one to the natural form. However, what we’ve found is that that’s not always the case. Because most of us have spent so long in shoes, we have abnormal length of our Achilles, abnormal mobility in the small joints in the foot, abnormal intrinsic strength, etc, etc. While I advocate for barefoot running FIRST before going to minimalist running, I always advocate for education before even attempting to run. Barefoot running will certainly be your proprioceptive guide (i.e. what feedback you’re getting from the ground/yikes it hurts to hit at my heel, etc.) but having a general idea of how your form should look and feel is important as well. In short, you should have a forward trunk lean (not bent forward from the waist, but a slight, full body lean from your ankles to your head or leading from your pelvis), strong abdomen, feet landing under your body on the forefoot and rolling over the big toe, knees bent on landing, lifting the feet instead of pushing off, heels lift up towards your bottom directly underneath you, quick cadence (steps per minute) aim for 180-200 steps per minute, legs spinning underneath. The “Barefoot Running” book I was telling you about has some great drills and strengthening exercises for barefoot running preparation as well.

        Also, I would encourage you to run completely barefoot on a variety of surfaces, not just grass. Even though grass is like heaven to run on, right?? 🙂 Running on a variety of surfaces will help you to understand just how soft you should land on asphault, concrete,trails, etc. If you’re on Youtube, I’d check out the Minimalist Monday channel, he has some fantastic videos up. His name is Sanatan Golden, and he works with Ray McClanahan who are barefoot running experts (PT and podiatrist) out of Portland, OR.

        I’ve found that being aware is one of the most relaxing aspects of barefoot running. It’s truly “me” time, focusing on my footsteps/form and being really engaged with my body. It sounds like your form is working VERY well for you already, so you’ll probably find that if you do a little bit of learning and reading, you’ll be able to make the minor adjustment that is irritating your foot. Then, you’ll run happy forever!

  30. Sam

    Leigh,

    I posted a comment here earlier today (last night, perhaps in Cali time) and it has not appeared yet. If it got lost in internet ether, please let me know and I’ll happily repost!

  31. Amy

    I’m a little late to the party, but here goes–I got a pair of VFFs in October of last year and bega slowly working into them, walking around the house, running errands with them, etc. I ran a few times in them prior to Christmas but didn’t do much. I started running once again at the beginning of February. Aware of the potential for injury and the need to adapt slowly, I began running a max of two days per week with a minimum of one full day between runs, covering only 1/2 mile or so. I’m a month in and my ankles are sore when I start running. They’re no bother walking around or anything, but are sore when I start running. The pain isn’t bad–dull, but not ideal.

    I’m starting from scratch as I fell off the running bandwagon a while ago, and am trying to make sure my dog gets some additional exercise. Could ankle soreness be related to transitioning too quickly to the VFFs? I think that 1/2 mile twice a week with recovery time in between would be possible.

    I hardly ever wear traditional running shoes and haven’t run in them since October. At work, I generally wear flats (either ballet flats or flat boots) and heels (no more than 3x per week) so I feel my feet are already fairly accustomed to a lack of support.

    Just curious how to figure out where to draw the line on continuing to run or taking more time off to recover.

    Thanks!

    –Amy

    • Hi Amy!
      Sorry I’m a little late to the party to respond. I’ve been taking a little time off from the blog and writing, working on some other projects for my profession. It sounds like you would need to focus on your strengthening and your range of motion prior to getting into your running 1/2 miles a couple times per week. It’s so important to realize that 1/2 mile a couple times a week is still a lot, if you’re starting from not doing a whole lot of running. Strengthening exercises would include eccentric calf lowering, posterior tibialis eccentric strengthening, short foot exercises, etc. You also need to make certain that you have enough dorsiflexion range of motion (i.e. toes towards the ceiling) which can be achieved by stretching your gastroc/soleus for a prolonged time like 1-2 minutes on a slant board or standard wall calf stretch with a bent knee and then a straight knee. It looks like I need to update some of my links here, so I will do so!!

  32. I’ve been running in Merrell barefoot shoes for years on all types of surfaces but I’ve only just started developing inner ankle pain. I can run about 6k before it starts getting intense. I can’t figure out why it’s just starting even though I’ve been running in them for years now. To be fair, I’m not a regular runner but I’ve just started training for a half marathon. Could that be a ‘too much too fast’ sort of thing? Thanks for your help!

  33. Hi, another person late to the party!

    I deal with posterior tibialis tendinitis. I over pronate quite considerably because according to my chiropractor who has been doing ART (active release technique) on my ankle for a couple months now, I also have an oddly bent foot. The foot thing is genetic causing my foot to come down onto the ground weird which then causes me to over pronate to over correct it.

    Anyway, so the ART has been helping considerable. in the past year I have dealt with a stress fracture in my tibial and TONS of physical therapy. The PT didn’t help me in the long run. My pain during runs only came back.

    My question is, is barefoot running helpful to me? My chiropractor is currently recommending very high arch insoles. I wonder if I should try barefoot running sometimes to help strengthen and change step? I really don’t want to rely on unusually tall arch supports forever. My natural arch is quite normal looking.

  34. Chase

    First off, this is my first time coming across your blog. Reading the article and some of your responses, I love your perspective and outlook on running. My question comes from a top of foot pain and ankle pain that seem to go hand in hand. I’ve been in “minimalist” shoes for two years, only seriously picking up running this year though. I ran quite several 5k’s in my altra instinct 1.5’s and wanted a longer distance shoe. A trainer was suggested… So through two shoe purchases that turned out miserable, I bought vibrams and loved them. I had done a few short barefoot runs before, and I felt fine in the vibrams, besides muscle soreness I was doing 2 mile runs in them twice a week for 3 weeks. Then one day in my altras for 2 miles. Last week I did a four mile run in my altras. Several days later, I wake up with the pain. Thinking it couldn’t be running related, I continued with my planned run. The pain isn’t severe or debilitating but it is keeping me from risking a run.

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