Barefoot Running Injuries... Broken Toes

During my latest barefoot/ minimalist shoe running workshop at Crossfit Grand Rapids, we had a lengthy discussion regarding barefoot running injuries.  I classify injuries in two categories: beginner "transitioning" injuries and injuries resulting from a lack of protection.  

The "transitioning" injuries involve the "top of the foot" injuries, Achilles/calf injuries, and blisters.  The "lack of protection " injuries involve puncture wounds, heat and cold injuries, blunt-force injuries, and maybe blisters.  I cover the topic of injuries on my website here.

Yesterday, Shelly experienced her first minimalist shoe injury... a broken toe.  We were running on an unfamiliar trail.  The trail was fairly technical as it was littered with large rocks, gravel, and many roots.  The trail was used primarily for mountain bikers.  Like most bike trails in the area, the terrain is rugged for runners in general and barefoot runners in particular.  

I was running barefoot and encountered several sections that required me to slow to a 14 minute/mile pace to traverse.  Shelly was wearing her Vibram KSOs. 

I was running behind her as I was tired from a crosstraining workout and five mile run I did earlier in the morning.  About a half mile into the run, she stumbled, took a few more steps, and stopped.  Immediately I knew something was wrong.  Shelly never stops.

I asked her what happened.  She said she caught the pinky toe of her right foot on a root and it bent laterally.  Her silence was the best indicator that it was pretty serious.  She started walking, then tried running.  Her obvious limp and grimace betrayed her attempts to play it cool. 

We stopped and examined the toe.  It was red an swelling; it did not look good.  

We were still about a half mile to a mile from our car, so we decided to keep moving.  Shelly put the KSO back on and tried running.  It was too painful.  She tried walking.  Again, it was too painful.  In typical Shelly fashion, she took off the shoes, walked a few steps, then took off her socks.  She ran the rest of the loop barefoot (one mile) with the broken toe. 

It is doing better today and will likely only sideline her for a few days.  She has a freakishly high pain tolerance, so she will probably push through any pain when she begins running again.  

The point of the story- barefoot or minimalist shoe running does present some dangers.  I broke a toe in 2007 in the middle of a 50 miler.  It happens.  When weighing the decision to run barefoot, realize it is not without risk.  Personally, I think the benefits FAR outweigh the risks, but the risks are real.

In Other News

I am currently reading The Barefoot Book by Dr. Daniel Howell.  While it is not specific to barefoot running, it is the perfect companion to the barefoot running books currently on the market.  I will give a full review soon, and will be holding a contest to give a copy away to one of my readers. 

Even More News

The second edition of The Barefoot Running Book is nearing completion.  I will be sharing the details as soon as possible, maybe immediately after Burning River next weekend.  It includes many new sections, a rewritten introduction, pictures, and contributions from many of the leaders in our field.  

I am planning on making it available via pre-order at a discount if there appears to be enough interest. 

Barefoot Runners are Stupid...

Okay, maybe we're not stupid.  But sometimes we make bad decisions.  Sometimes we allow our inner-competitiveness and/or stubbornness to lead us into poor decisions.  This is my curse.

Sometimes us barefoot runners give an illusion of invincibility.  We often tout our resilience to common running injuries.  Truth is, we may avoid some injuries, but a new range of issues arise.  Abrasion injuries are one such curse.  My current demon- the chronically-injured big toe on my right foot.

On New Year's Eve, I ran a four mile race on wet asphalt in sub-freezing temperatures.  I'm a bit competitive in these shorter road races, so I pushed hard.  I was happy with my finish time, but developed a blister on both big toes that appeared to be quite deep.  I ran a six mile race the next day wearing Vibrams without incident.  Since there was little pain, I more or less forgot about the blisters.

Fast forward about a month.  On an especially warm late January day, I went for a winter trail run with some running friends.  The temperature was flirting with the freezing point, so I decided to go barefoot.  I also decided to run with Rick, the fastest of the group.  About half way through the run on icy, crusty snow, I noticed what could best be described as a dull pain emanating from both big toes.  Even though I was carrying my Vibrams in my hydration Pack, I decided to continue on.  At the six mile mark, Rick stopped to retrieve his coat from behind a bush.  We were stationary for perhaps 30 seconds.  When I took the next step, I was shocked to see a pool of blood about the size of a small pizza.

The dead skin that had covered the blisters had torn away leaving a very fragile, paper-thin layer of new skin.  The icy shards of ice had punctured several holes in the left toe.  The right wasn't as fortunate.  All that remained of the bottom of the right toe was what appeared to be the fat layer under the dermis.  Is that even possible?  At any rate, it hurt like Hell.

I still avoided the Vibrams based on the logic that the snow would help curb the bleeding.  The last two miles were spent gingerly running to avoid excessive pressure on my hamburger-like big toes.  When we arrived at our cars, I immediately applied a few Wendy's napkins affixed with discount duct tape.

The rest of the crew arrived; we exchanged small talk.  They commented that it looked as if a gun-shot victim had been running the trails.  I started feeling dizzy.  I'm sure it was the result of the pain, but I couldn't help but wonder how much blood I was losing.

I averaged about five miles per week over the next few weeks as the toes healed.  I have been able to slowly increase mileage in shoes.  Luckily I've been reviewing shoes, so I had a convenient excuse to indulge in their protectiveness.  At some point, I had to take the plunge and work on building barefoot miles on asphalt to prepare for Mind the Ducks, a 12 hour ultramarathon run on a 1/2 mile asphalt loop.

This last weekend, I managed six barefoot miles on asphalt without problem. Pace was about 9:30/mile.  I had some time to kill two days ago, so I decided to do a quick four mile run barefoot on asphalt.  The weather was wonderful... the road had a few hills... I couldn't resist the temptation to test myself.  I averaged slightly under a 7:20/mile pace.  The result- two hot spots and a few tiny cuts on my still-fragile right big toe.

I just don't learn.  I assumed the feet would be fine, so I went for an anticipated three mile barefoot run on a leaf-covered trail yesterday.  I made it about 1.5 miles before pain caused me to stop.  The cuts were significantly worse.  I taped the toe, wore my EVOs, and ran for another three.

Now my quandary... I am running the Irish Jig 5k in East Grand Rapids this Saturday.  If I go barefoot, I will have to go very slow.  If I wear Vibrams or EVOs, I may be able to come close to setting a 5k PR.  Running barefoot will be more enjoyable; running in shoes will satisfy my inner-competitiveness.  Running barefoot will help condition my feet for Mind the Ducks, but increase the change of further injuring the toe.  Wearing the shoes will do nothing to prep for MTD, but will eliminate the chance of injury.  Did I mention I hate running in shoes?

What would you do?