I haven’t had much time to devote to this blog recently but I do have some thoughts I would like to pass along this AM on running shoes.  As you can imagine, I get tons of questions each day on what type of shoe patients should be wearing on their feet whether its for running or simply for day to day activities.  Our society is so focused on what we put on our feet it is almost ridiculous.  Ridiculous in a sense that we have ignored the health of these amazing appendages only to ruin them by listening to society.  Call it what you want, but the ones who are telling us what to wear on our feet are the same ones who are selling them to us and capitalizing on the success of the shoe.  As an example, if the Nike Pegasus was such a fix all shoe for injury, why has it changed in construction and style over the last 20 years?   Haven’t you ever heard of those runners who find a shoe that is so perfect that they buy 10 pairs of them to store away in their closet because they know the manufacture is probably going to change the shoe so drastically that it will not feel the same to their feet.  The crazy thing about this is the runner is probably right.  They have intuitively figured out what is working for them, and does not want to put the body through a transition period again to adapt to a new shoe.  A new shoe in a sense that the design will change so much the foot will respond differently in it.  So why are shoes changing so much?? Why have they changed so much in the past 40 years?  That’s just how the industry works.  The past 40 years of shoe construction is just a blink of the eye in respect to how long we have been running.  For those who say barefoot running or minimalist shoe running is a fad, I can easily say the opposite and with such certainty that it would be hard to prove me wrong.  In other words, running shoes have become and are a fad.  We do not need them to run.  Well, running shoes that is as we have become to know them.  We only need something to protect our feet from the environment if we choose to.  Meaning if we are running on stones or areas that may damage the skin on our feet.  Or if we want to run a bit faster as in a race and need some cushioning.   But we don’t need motion control and our feet have not evolved in any sense to need motion control.   Some say our feet weren’t meant to run on concrete or asphalt.  True, but what does concrete or asphalt have to do with motion control? If pronation of the foot is our body’s innate way to absorb shock, then why do we inhibit it on hard surfaces with a motion control shoe? All we really need to run on asphalt or concrete is a little bit of cushion. Right?  Also, I guess the hard clay baked ground our ancestors ran on was much softer then asphalt?  Or maybe the peer reviewed literature that existed at that time said it was much safer to run on the baked clay if you didn’t have flat feet.  That was a joke. For those who argue the concrete is harder then asphalt, you are correct.  But, in the whole scheme of things does it really matter?  Would it make a difference if I struck your foot with a hammer made out of concrete or asphalt?  Probably not.

Lets get back to shoes.  What’s with the maximalist shoes that are being made today.  Are they the answer?  Here is my attempt to explain why these shoes are becoming popular.  Regardless of what most people think or will say, the running shoe industry is driven by our society, not by research or peer reviewed literature.  Steve Jobs had a great way of making this point well understood.  He was criticized very heavily for not putting flash on the iPad by many journalists in the tech world.  He responded to this by explaining his reasons for not doing so, but then described how the public drives what Apple does.  Meaning, if people didn’t like the iPad because it did not contain flash, then they wouldn’t buy it.  At the time he said this, people were buying more iPads than Apple could produce.  Consumer driven.  The same is happening in the running shoe industry.  Lets look specifically at the Hoka One One maximalist running shoe.  It was introduced at a time when many people were running learning about minimalist shoes and also buying minimalist shoes.  There was no scientific research done to design this Hoka One One shoe the way it was.   We simply had a start up company say, “lets put a whole bunch of cushion in a shoe that’s softer then what most stability control running shoes use, and make it almost as light as them”.  People tried it on and liked it.  Instant gratification.  It was introduced to the trail runners.   They liked it so they bought them.   They told their friends in the trail running sub culture and more and more were sold.  Was there any evidence based research?  None.   In fact, with any running shoe that is created, the evidence based literature only follows after the shoe is created and then put out into the public for runners to wear.

So, to summarize, the manufactures make them and the public tries them on.  If they like the way they feel,  they buy them.  If they don’t, they don’t buy them.   The more the public likes them, the more the manufactures make.  The research then follows after the shoe is introduced.  So for all you research based scientists who base your decisions on the literature being produced, it’s only as good as what the public wants to wear.  Is there any research that is done before a shoe is made?  Possibly, but it has little to do with running or injury.

For all those who ask,  “what’s the deal with these over cushioned maximalist shoes?” I  say,  go and ask the people wearing them because they’re the ones driving the creation of them.

Dr. Nick