Are running shoes causing injuries?

(Photo by ezioman)

The argument Chris McDougall proffers in his best-seller Born To Run seems self-evident; for hundreds of thousands of years our ancestors regularly ran longer distances than many of us commute today, and they did it without shoes and largely without the injuries ubiquitous among modern Nike-clad runners. Thus the makers of bloated modern footwear must be the arch nemeses of the bare human foot, which evolution has equipped with all it could ever need for any type of terrain or variety of performance.

While the foundation of the argument may be sound, the conclusions McDougall draws are grossly oversimplified. That is not to suggest his book is without merit, nor that there are not benefits to be had by running barefoot. However, there are a few things to consider before running without shoes or in a pair of the thin, lightweight minimalist shoes that flooded the market after the book’s publication.

“We live in a concrete world,” says Dr. Douglas F. Tumen, a podiatrist with Hudson Valley Foot Associates, himself an avid runner who has tried minimalist shoes and read McDougall’s book. “Everybody here is running on hard surfaces, and the [minimalist] shoes don’t give any shock absorption, they don’t give any motion control.” Bare feet never adapted to asphalt. While a justification for cushioned shoes in and of itself, the hard manmade surface encourages carelessness and lax form, because of its evenness rocky, root-strewn wilderness, as well as faster running, which increases the force of impact. Race conditions only exacerbate these factors, while padded running shoes might mitigate them.

While there are notable instances of extremely successful barefoot runners, like Abebe Bikila—who ran a barefoot 2:23:14 marathon to win in the 1964 Olympics—and Zola Pieterse, two-time consecutive winner of the 5,000-meter in the World Cross Country Championships, most of them are from countries and cultures vastly different from our own. Bikila and Pieterse both hailed from Africa, albeit vastly different regions.

“We can’t just compare ourselves [to runners from other countries and cultures],” says Kingston podiatrist Dr. Tracey G. Toback. He cites anatomy, heredity, and adaptation as deciding factors. Where our ancestors, like Bikila and Pieterse, ran barefoot from childhood, most of us walk with shoes, like our parents and their parents, etc. Natural selection has not favored bare feet for a few thousand years.

In fact, Dr. Tumen has seen more injuries due to minimalist shoes. “There’s a lot of people that read the book, went out and got the shoes, and a lot of people who ended up in my office.” Ironic, considering the health benefits typically lauded alongside thin-soled shoes.

A class action lawsuit was recently filed against Vibram over claims that “‘scientific research’ shows that their expensive FiveFingers… will provide ‘all the health benefits of barefoot running’ to anyone who runs in them….Defendants’ health benefit claims are deceptive because FiveFingers are not proven to provide any of the health benefits beyond what conventional running shoes provide.”

The lawsuit also takes issue with the fundamental notion that running barefoot is itself somehow universally healthy, citing the American Podiatric Medical Association’s position that, “While anecdotal evidence and testimonials proliferate on the Internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects of this practice (their emphasis).”

Proponents of minimalist running attribute the same lack of evidence to the claims of major shoe companies like Puma, whom the British Broadcasting Company recently called out on unsupported claims that their shoes “minimise injury, optimise comfort and maximise speed.” Puma made no reply.

Runners are divided

It is as difficult to generalize about minimalist running as it is easy to be goaded onto either side of the argument, since both seem paradoxically to offer compelling evidence or no evidence at all. Runners are as divided as the rest of us.

Some, like Keith Axelrod, president of the Mid-Hudson Road Runners Club, prefer to stick with what they know. “I’ve run in the same style of Asics for the last six or seven years,” he says. After reading articles and talking to other runners, he remains unconvinced of the efficacy of minimalist shoes. “It’s kind of an esoteric thing in my mind… I don’t think because somebody’s doing it in the next five years, you’ll see millions of people doing it.”