Barefoot runners have been hitting the pavement in ever-increasing packs in recent years thanks in part to the burgeoning popularity of minimalist shoes and books like "Born to Run," which chronicles the unique running style of the Tarahumara Indians in Mexico.

Research has shown that running barefoot or with minimalist shoes can encourage people to adopt a forefoot or midfoot-landing running style, which results in a less forceful impact as the runner's foot hits the ground. It still remains to be proven conclusively that this running style is better for a runner's health than the heel-striking gait that people in regular running shoes favor.

"We don't have any published research that's taken one group of runners going out in normal shoes and had another group run barefoot or in minimalist shoes, and then looked at the injury outcomes," University of Central Florida researcher Carey Rothschild said in a phone interview.

Rothschild's new research paper published in the Journal of Strength and Conditioning Research found that runners are primarily interested in barefoot running because they think it will help them avoid future injury - but health concerns were also the most cited reason why people were reluctant to try it out.

After surveying 785 runners, Rothschild found that around three-quarters of respondents were interested in barefoot or minimalist running. Of the 283 people that were already running barefoot or with minimalist shoes, preventing injuries was the most commonly cited reason for switching from traditional shoes.

But 54 percent of survey respondents said that that the fear of injury from barefoot running was one of the main reasons they were reluctant to take up the practice. And according to Rothschild, their fears aren't quite that unfounded.

"Despite the proposed advantages barefoot running may present, there are several disadvantages a runner must consider when abandoning running shoewear," she wrote.

Truly barefoot runners do risk wounds to the feet from harsh terrain and may suffer injury thanks to overuse of muscles, tendons and ligaments that help stabilize the foot. Forefoot striking also could be a potential source for injuries to the metatarsals - the bones in the foot located just below the phlanges, the bones of the toes.

However, 42 percent of the barefoot or minimalist runners that Rothschild surveyed reported no adverse side effects to their training. Of those that did experience problems, the most commonly identified adverse effect was increased muscle soreness in the lower leg or foot.

The survey found that 85 percent of the respondents would be willing to try out barefoot or minimalist running if they had the help of a coach, but that in reality, most respondents were relying on advice from friends or books to make the transition.

Rothschild recommends that runners looking to shed their shoes get a thorough physical examination and an assessment from a physical therapist first, so they can identify any strength or flexibility issues that could complicate their training. Learning proper running form from a coach is also key, she says.

"Just because you put on a minimalist shoe doesn't necessarily mean you're automatically going to adopt a forefoot strike," Rothschild said.

SOURCE: Rothschild, Carey. "Primitive Running: A Survey Analysis of Runners' Interest, Participation and Implementation." Journal of Strength and Conditioning Research 26: 2021-2026, August 2012.