It is argued that running shoes are necessary for the health of the human foot if an individual is doing a great deal of running, yet at the same time history tells us a different story. There is now a growing tide of evidence that suggest that the modern running shoe may in fact be the “Achilles heel” of most active runners.
The available literature on the benefits of cushion soled running shoes in decreasing the instances of injury in active runners is scant to say the least. In fact one study (Richards, Craig E. Parker, Magin. Robin, Callister.) from 2008 showed that there is no original research that shows that use of modern running shoes for health reasons is evidence based. The closest I could find was an article (Hirschmüller A, et al.) discussing the use of custom insert orthotics to aid people with running injuries. But what the study did not cover was the origin of the injuries, merely the treatment.
There are however studies starting to come out that point in the direction that perhaps running shoes are to blame for the majority of overuse injuries sustained by runners. One example is a study (Kerrigan DC, et al.)that showed that the amount of torque placed on all 3 of the lower major joints (ankle, knee, hip) was significantly greater while running in modern running shoes. While they make concessions that perhaps some other style of running shoe may give differing results, I think it’s safe to say that as long as the shoe abides by the thick heel over cushioned style it will (to a greater or lesser degree) cause the sort of force loads and shocks to the body that were evident in the research.
Though it is clear that based on the number of studies done on custom orthotic inserts that there is some value in them in terms of offering pain relief for injured runners, they fail to address the issue at hand: what is causing the pain. This issue was clearly addressed in the second paper I mentioned ( Kerrigan DC, et all). The study clearly shows that running shoes and the heel to toe running style exerts significantly greater pressure on the lower body. This kind of repeated stress can most certainly give rise to the multitude of injuries suffered by (depending on who one reads) anywhere from 45%-70% of active runners over the course of a year. The prevailing wisdom of course being that if one suffers pain while running the best solution is 1; stop running, or 2; get custom orthotics. As the study shows, orthotics are effective ways to relieve pain for a temporary time, but that then begs the question; what is it that the shoes are failing to do that gives rise to injuries that necessitate more padding inside the shoe. These shoes are already padded to the extreme so it should stand to reason that adding more padding might not fix the problem. As it turns out we evolved to use our feet as our primary source of information gathering for our body while attempting to balance ourselves (go figure). In fact one study (Robbins, S. E, Waked) found that the softer the landing surface the harder humans land on it. They theorized that the reason behind this is that when landing the human foot is looking for a solid surface on which to find purchase and thus gain balance. The softer the surface, the harder people hit in an unconscious attempt to compress the soft material into something firm that could be used by the foot to secure balance. So keeping this in mind we turn once again to the orthotic study, and one can’t help but think “is more padding what needs to be going on here?” This question is answered pretty clearly by Kerrigan, running in thick cushioned shoes causes the individual to land with much greater impact, which in turn causes significantly more stress for the rest of the body. So where does this leave us? Are people simply not meant to run long distances? One anthropology research paper says that this is not the case (Lieberman, Daniel. et all). In the paper a pretty convincing case is made for the idea that humans are evolutionarily designed for long distance running. Our ancestors would likely not have survived long had they been subject to the injury rate of modern runners. So it would seem that modern running shoes are the root of the problems facing (almost all) modern runners.
There is a growing community of individuals who advocate barefoot, or minimalist running. While these communities are claiming that there is less injury and less stress placed on the body utilizing these methods of running, the movement seems to be having a hard time gaining ground due primarily to the ingrained belief that running shoes are a necessary item for safety purposes. But a cursory examination (or an in depth one: Richards, Craig E. Parker, J, Magin. Robin, Callister.) shows that there is no evidence for this belief. So what is a runner to do if the fear of injury is present but they are unwilling to run without their beloved shoes? I think the answer is to be found in looking at form.
When an individual runs in modern cushioned heel shoes one is almost forced into the heel to toe running style that causes such stress to the body. While running barefoot (or in minimalist shoes) allows the foot to land on the edge of the forefoot slowly dropping the heel rolling across the ball and then springing off of the toes. This style of running is bio-mechanically what we evolved to do. As a result it is the least damaging way for us to run. People’s fear of broken glass and nails, the hard surface of the sidewalk, there are a multitude of reasons to look askance at running in either bare feet or in minimalist shoes. So you don’t want to get rid of your shoes? That’s fine. The knowledge gained by reading these studies can still be applied to how you run now. Adapt your style, don’t heel strike. Sure it will be harder to run in this manner when your shoes are designed to make you run in the exact opposite way you should. But there are ultra marathoners (Scott Jurek comes to mind) who run in racing flats, which while better than normal running shoes are a far cry from minimalist or bare feet. But a good portion of them remain injury free. The secret? they run in the same way someone who is running unshod would run ( see the book “Born to Run“ by Christopher McDougall.)
Injuries are almost guaranteed to occur in active runners, and orthotics seem to help reduce the pain of these injuries. But running in shoes with cushioned soles and heels seem most likely the cause of the injuries in the first place. If we take all the information available we can draw this conclusion; an awareness of style, and adaptation of form can take one significantly closer to running in a manner that will scientifically and significantly reduce the likelihood of injury.
Richards, Craig E. Parker, J, Magin. Robin, Callister. Is your Prescription of Distance Running Shoes Evidence Based? British journal of sports medicine April 18 2008
Hirschmüller A, Baur H, Müller S, Helwig P, Dickhuth HH, Mayer F. Clinical Effectiveness of Customised Sport Shoe Orthoses for Overuse Injuries in Runners- a Randomised Controlled Study. British journal of sports medicine Nov, 1, 2009
Kerrigan DC, Franz JR, Keenan GS, Dicharry J, Della Croce U, Wilder RP. The Effect of Running Shoes on Lower Extremity Joint Torques. PM&R: The Journal of Injury, Function , and Rehabilitation. Dec, 2009
S.Robbins, E.Waked. Balance and Vertical Impact in Sports: Role of Shoe Sole Materials*1 Archives of Physical Medicine and Rehabilitation, Volume 78, Issue 5, Pages 463-467
Lieberman, Daniel. Dennis, M. Bramble. David ,A. Raichlen. John, J. Shea. The First Humans-Origin and Evolution of the Genus Homo. Chapter 8; Brains Brawns and the Evolution of Human Endurance Running Capabilities.