Are minimalist running shoes really to blame when it comes to running injuries?
Recently I was asked to be part of a point/counterpoint discussion regarding minimalist shoes to be features in the Podiatry Today periodical. While preparing the literature to defend my position on defending minimalist shoes (as form and training patterns are far more important then shoe gear) it became clear to me that the focus of injury is moving away from foot structure to blaming shoes directly. The naysayers of minimalist shoes focus their argument on the fact that these shoes are not supportive and offer no motion control for runners. If you examine the literate published to date on minimalist shoes, not one single article compared foot structure to injury rate. In fact 100% of the literature published to date has demonstrated the injuries are secondary to overuse as a result of not transitioning to the less supportive shoe. Not one of these studies is demonstrating injury from the shoe as a result of a flat foot.
There are a lot of runners with flat feet out there who aren’t getting injured. Why? Because flat feet are nothing more then that. A flat foot is a variance of foot type which can function no differently then a “normal” or “high” arched foot. The focus on footwear has become so misconstrued that I regularly see patients with what is described as a normal arch coming to see me wearing orthotics and motion control running shoes still experiencing pain. Rarely does a physician discuss form and training patterns with a runner.
Once again, running injuries basically boil down to a few simple facts that our society has a hard time focusing on- form and training patterns. I realize than there are more variables that play a role, but we could significantly lower the yearly injury rate amongst runners if we could divert our focus away from shoes.
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About The Author
Dr. Nick Campitelli
Dr. Campitelli is a podiatrist in Akron, OH specializing in foot and ankle surgery with an interest and enthusiasm for running as well as helping runners with injuries. For the past several years he has been treating running injuries in patients by fixing their form and transitioning them to minimalist shoes. Having treated runners with all types of injuries through conservative measures with orthotics and shoe gear changes to reconstructive foot and ankle surgery, Dr. Campitelli has brought what works best and is most current to his practice as well as the Akron and Cleveland running communities.
I completely agree. Many people will find great results if they just change their form in their current shoes and can lessen their frequency of injury…but true proper form in which you are utilizing the body as it was created can never be found when muscles and tendons are limited as they are in traditional running shoes. If you look at children running barefoot out in the yard we can be reminded that we were indeed created with this ability. The form doesn’t begin to change until either 1) They are shod in traditional shoes and encourage an alternate form or 2) They STOP running and being active and allow their muscles to weaken and then later attempt to restart and think they can run a mile at a time in gym class without training at all.
The criticism of minimal shoes is laughable when one considers that many of the issues associated with running shoes that precipitated a perceived need for support and motion control arose from the fact that heel drop, flared heels and cushioning dramatically altered the normal mechanics and joint accelerations of foot strike and toe off by increasing the length of moment arms acting through the joints of the ankle complex while reducing eccentric contraction of the soleus below the threshold required for the Windlas Mechanism to deploy, problems which were reduced or absent in running flats.