Are running shoes causing injuries?

Tell that to Tony Fletcher, who runs ultramarathons (any distance greater than a marathon) in minimalist shoes when he isn’t writing or performing his duties as the Vice President of the Onteora Board of Education. Fletcher began training and competing in Vibrams shortly after Born To Run’s publication. He found that he ran faster and was more conscious of the terrain in precarious races such as the Escarpment Trail Run, a 30K trek through the Catskill Mountains. “I started looking at my Asics and sort of saying, you know what, I don’t love you anymore.” He eventually incorporated barefoot exercises into his training routine.

Local swimmer-turned-Ironman Joseph McGrath began running in earnest only after reading McDougall’s book. He essentially taught himself to run in minimalist shoes, and loved them. When he decided to compete in triathalons, he added biking to his routine and upped his mileage in all three events. He soon experienced knee pain and realized he had a choice to make. “I liked the philosophy behind minimalist shoes so much, but it came to either getting another pair of shoes or not running.” Professional triathalon coach Mark H. Wilson also gave minimalist shoes a try, and came to a similar conclusion. They were “just too minimal for what I was preparing for at the time [the Survival of the Shawangunks triathalon]… every stone I stepped on hurt like hell.” Both athletes felt the demands of their training regimen and the intensity of their races necessitated more forgiving footwear.

My own experience also yielded mixed results. I ran in a pair of Merrell Trail Gloves almost every day for six months, mostly on trails, and my technique adapted to the forefoot strike common in barefoot runners and arguably easier on the feet. My endurance doubled and I dropped half a shoe-size, suggesting I had built up my arches—encouraging, since I had always been flat-footed. Plus I felt great. At least for me, there were very real, very evident benefits to training in minimalist shoes.

However, as the intensity of my runs continued to increase, I developed ankle pain, particularly when running on the road (they are, after all, Trail Gloves). Nevertheless, in mid-July I wore my Trail Gloves in the Gardiner 5K, which features a predominantly asphalt course. I finished well, but spent the next two days sitting to keep weight off my aching ankles. It was from this reclined position that I ordered a pair of thick, airy Saucony Kinvaras.

There as many variables as there are runners; body structure and mechanics, weight, shoe, terrain, speed and distance, to name a few. “There’s not a right or wrong, there’s what’s right for that person,” says Dr. Toback. Everybody’s feet are different, as are their lifestyles and goals. These are all factors to take into account when purchasing a shoe.

Perhaps it is best to think about minimalist shoes or running barefoot as simply another option, like motion control and stability shoes, suitable for certain foot types, or cleats and hiking boots, designed for specific terrain. For a lighter, mechanically-sound individual looking to traverse softer terrain, they may be a good investment. Buying the shoes does not necessitate buying into the fad, nor does it preclude owning another type of shoe as well.

No shoe can magically ward off all injury, and not all injuries are due to shoes; even barefoot Pieterse and Bikila suffered debilitating injuries at some point in their career.

“Oh yes, I’ve had plenty,” muses Axelrod. “Almost every runner has gone through one injury or another. Some are luckier than others and manage to go with less injuries, and some have more than others.”

“A good rule of thumb,” says Dr. Tumen, is to “Stay under 20 miles a week.”

I was incredulous. “Twenty miles? That’s seems spare.”

“Yes,” He chuckled. “But those are the people who run injury free.”

Since running any of the several marathons in which Dr. Tumen has competed means running 26.2 miles in one day, it is clear that he, like most runners, does not always follow medical advice—even when that advice is his own.

The practice of distance running could not exist if it conformed to Western medical wisdom. The sport is as much a battle with human limitations as other competitors or any clock, and it is as psychological as it is physical. All the evidence in the world may not change a runner’s mind once it is set on something, be it a finish line, the top of a mountain, or a pair of shoes. It is their greatest virtue, though sometimes it may also be their biggest vice.