Why Aren't Shoes Preventing Running Injuries?

Barefoot running shoes and shoes with extra cushioning seek to protect runners—but despite all the new technology, running injuries are no less common than they were 30 years ago.
Timothy Takemoto/flickr

It’s the hope of many a runner: Lace up a new pair of brightly colored running shoes and feel the aches and pains of running melt away. But despite the bold colors and additions of gels, foams, air pockets, and arch supports, more than 50 percent of runners still get injured in a given year, a rate virtually identical to that of 30 years ago. Running has been (perhaps unfairly) saddled with the perception that it’s to blame for arthritis and general orthopedic wear and tear, but the sport is linked with an injury rate that might make the NFL seem reasonable.

Many assume though, thanks to the not so subtle prodding of marketing, that expensive running shoes can reduce this chance of injury. This expectation was highlighted with news that Vibram, the company at the forefront of the barefoot running movement, recently settled a multi-million dollar lawsuit that alleged the company misled shoe buyers into believing that their popular minimalist footwear could reduce injury.  

However, it’s difficult to judge the supposed failure of modern shoe technology to reduce injury rate without first considering that the characteristics of the “average” runner has changed greatly since the introduction of the modern running shoe. In the past 30 years running has changed from something done by trained runners who competed for sport, to an activity that is enjoyed by the masses. According to the Sports and Fitness Industry Association, almost 30 million people in the U.S. ran at least 50 times in 2012. And those numbers are increasing.

Making matters more difficult, studies have identified many confounding factors that predict running-related injuries. Certain running injuries are more common in females, in males, in the young, in the old, those that weigh too much, those that weigh too little, and, well, injuries are also more common in those that have already been injured. Confused yet? It’s a wonder anyone makes it back home after a jog in the park.

But can we really blame these injuries on the shoes runners are wearing? Blaming your running shoes for injuries seems somewhat akin to faulting golf clubs for a bogey. In fact, says Brian Metzler, editor in chief of the running magazine Competitor, “The notion that running shoes can prevent injury is fallacy.” To blame it all on shoes, you ignore other, more likely contributors to running’s high injury rate, namely training errors and new people who come to the sport from a non-running background. Metzler asserts there are those within the running shoe industry that maintain that advancements in shoe technology have prevented the rate of injury from rising even higher.

But it doesn’t take a sports scientist to realize that the case for running as a high-risk activity lies with the repetitive impact of every stride. Every joint, bone, muscle, and tendon from the feet to the lower back experiences an impact of up to five times the person’s body weight and so far, attempts to stifle that energy by changing what is laced to the foot hasn’t resulted in reduced injury. However, the belief that injury risk is solely defined by how hard and how many times the foot hits the ground is fundamentally flawed. Rather, the manner in which the body’s muscles and nervous system respond to this impact is a critical determinant of stress to the body. After all, the running stride is a wonderfully individualistic and intricate melding of foot, ankle, knee, hip, and upper body motion. Trying to control injury risk must always contend both with the complexity of the running stride and its inherent individuality in every runner.

Nike’s introduction of gas-filled membranes in the sole of the Tailwind that is often cited as the launching point of the traditional running shoe and until recently, the design of this modern running shoe was varied by changing the rigidity and arch support of the shoe.  Advances in the cushioning material of the shoe, not necessarily the design itself, were the measuring stick for innovation.

“Part of the problem” says Jay Dicharry, a physical therapist and expert in biomechanical analysis, “is the shoe industry as a whole does a really horrible job of matching footwear to feet…All the methods used to fit feet to shoes don’t really hold up as valid ways to classify runners and to match shoes.”

The book Born to Run fueled a second wave of runners, one that believed that runners had been duped by the shoe industry into wearing a shoe that interrupted millions of years of evolution, forcing runners into a running style that actually caused more problems than it fixed. Riding a surge of testimonials and popular media, sales of minimalist shoes increased 300 percent in 2012, compared with a 19 percent increase in traditional running shoe sales in that same year.

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Ian McMahan is a writer and sports-medicine professional based in San Francisco.

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