Minimalist Running Shoes: Why They Aren't for Everyone
By Michelle Orsi Shafiro, DPT, OCS, CSCS
Doctor of Physical Therapy, Orthopedic Certified Specialist
Performance Physical Therapy
It has been a few years now since everyone started running out (no pun intended) to get their copy of Born to Run and pick up some Vibrams. Chances are you know a few people, or you yourself thought minimalist or barefoot running would put an end to your running injuries. For some runners it does work and they can be grateful that it was as easy as changing their footwear. For those that struggle with minimalist running, you are not alone, and there are reasons why.
The theory behind minimalist running is sound, and comes down to form. Minimalist running shoes provide little to no cushioning for the foot and some are merely a barrier between your foot and the ground. One of the reasons behind this is to steer runners away from heel striking. Those that land on their mid or forefoot absorb more shock through their muscles vs. heel strikers who may be transferring all that load to their joints. Heel striking is thought to be very inefficient, however this is an area that is a focus of a lot of recent research and is up for debate. That is a whole different topic for another day. Along the same lines, minimalist running is thought to increase the strength of your foot and ankle musculature. Because your foot is not supported as it may be in other running sneakers you must rely on the muscles in your foot and ankle to absorb shock and generate more power to propel you forward.
Proponents of the minimalist and barefoot running movements say that we were not built to be wearing cushioned shoes and landing on our heel when running. They argue that more cushioned and supportive shoes have led people to heel strike. The logical solution would be to eliminate the support and cushion and people will instinctively no longer land on their heel. The problem is that this does not always happen, despite how much it sounds like it may hurt to land on your heels with no cushioning. Whether people have evolved to become heel strikers with weaker feet due to modern footwear or not, studies have found anywhere from 72-94% of runners are heel strikers. There are two ways to address this- wear sneakers with more cushion in the heel, or change the way you run.
When you become a forefoot striker you still have to absorb the same amount of force as someone who is a heel striker, you just do it differently. Heel strikers absorb about 16% more force through their knees than forefoot strikers, and forefoot strikers absorb 20% more force through their achilles tendon and ankle compared to heel strikers. This can become problematic for someone who is used to a cushioned shoe, heel striking, and doesn’t have the achilles or calf strength to deal with that sort of load. Jumping right into minimalist shoes can then result in calf soreness, tightness or Achilles tendinitis, assuming that you change the way you run. That is why it is important if you do switch shoe types, to wean yourself into the new sneakers. Some go as far to say that you should do foot and ankle strengthening prior to switching to minimalist running shoes to aide in the transition. Give your body a chance to adjust to the change in forces to reduce your risk of injury.
Lets say you don’t change the way you land when you switch to minimalist shoes, what happens then? First, to better understand this we will have to review a little foot biomechanics. Pronation is the foot’s way of absorbing shock upon impact when running and walking. Pronation usually is looked upon as a bad thing, in excess it can be but it also is very helpful; people who do not pronate are at a higher risk of stress fractures. Supination refers to the arch being built up; this is what allows us to generate forces and power through our feet for push off.
If an “excessive pronator” were to switch to minimalist shoes the amount of stress on the muscles that control pronation would be significantly increased. The most common injury as a result of this is tendonitis, in either the achilles or posterior tibialis muscle. People with excessive pronation are also at risk for knee pain, ITB syndrome and hip pain. On the other end of the spectrum if an “excessive supinator” were to switch to minimalist shoes their problems would be more related to lack of shock absorption. These people are at a higher risk for stress fractures particularly the 5th metatarsal but also can have problems higher up the chain in the knee and hip.
Making the switch to minimalist shoes is not for everyone. When thinking about changing your footwear I challenge you to really think about why you want to make the switch. If you have suffered injuries in the past take an inventory of what your injuries were, go to a running store with knowledgeable staff and have them watch you walk and run. Fleet Feet has a great system for assessing the proper shoe for you, and their staff has a good understanding of injuries and will be able to guide you. Certain injuries can occur from not enough or too much support and it helps to have a professional help you discern which category you fall in. If you want to give minimalist sneakers a try because it seems to be the popular shoe right now, you need to decide if it’s worth risking possible injury. Remember, if you do give minimalist sneakers a try, the key is form not just the shoes, and wean yourself into your new sneakers to allow your body to adjust.