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We are often asked to comment on which shoes may be most suitable for a patient. While that answer is up for debate, an important step to answering that question is understanding what is available out there. Here we will briefly outline some of the characteristics of different categories of running shoes that you may encounter.
1.) Minimalistic shoes – attempt to approximate barefoot running
- Reduced/minimal cushioning
- thin soles, no heel lift (traditional shoes have 10-14mm heel lift)
- no arch support
- wide metatarsal area/toe box
- very flexible, generally very light
- Vibram Five Fingers.
- Merrell Barefoot
- New Balance Minimus
- Nike Free
2.) Maximalist shoes – attempt to maximize cushioning and protection of foot
- Thick cushioning
- Rigid sole
- Slightly reduced heel lift compared to regular shoes
- Wide base
- Lightweight for its size
- Hoka One One
- Merrell All Out Peak
- Mizuno Wave Sky
- Skechers GOrun Ultra R
- New Balance Fresh Foam 980 Boracay
3.) Zero-drop shoes – footwear where the heel is at the same height as the ball of the foot
- Often overlaps with minimalistic shoes
- Variable structure, but the emphasis is that there is zero heel lift
- Altra Torin 3.0
- Merrell Vapor Glove 2
- Nike Flex Fury 2
- Vibram FiveFingers Bikila
There are many studies out there looking into the pros and cons of each type of shoewear and whether they are effective in reducing running injuries. The jury is still out but hopefully, this will cast some light on what your patients may be talking about!
Jim Niu MD, CCFP
Sport and Exercise Medicine Fellow, University of Ottawa
Advisor Dr. Taryn Taylor BKin, MSc, MD, CCFP (SEM), Dip Sport Med
Article: Prospective comparison of running injuries between shod and barefoot runners (Altman ER, et al., Br J Sports Med doi:10.1136/bjsports-2014-094482)
Written by : Geneviève Rochette Gratton , MD, CCFP, Fellow in Sport & Exercise Medicine at University of Ottawa
Advisor: Dr. Taryn Taylor, BKIN, MSC, MD, CCFP (SEM), Dip Sport & Exercise Medicine
There is a lot of controversy surrounding barefoot running. For one thing, it can be associated with an increase incident of injury when the progressive transition from shod to barefoot running is not done adequately. The prospective study by Altman and Davis looks at the incidence and rate of injuries between the two forms of running in the long term, once the transition has been correctly made.
One major finding between the two types of running is that barefoot is associated with forefoot strike, compared to rearfoot strike with shod running which could influence the nature of the injuries seen in both. Forefoot strike is accompanied by shorter stride length and lower hip abduction. Moreover, it decreases the vertical load. Barefoot running provides more sensory input which may not only be protective for metatarsal overloading, but increases ankle joint position sense and arch musculature.
As to be expected, more plantar surface injuries (cuts, bruises and blisters) were observe with barefoot running. This could be alleviated by wearing minimal footwear, still maintaining the benefit from barefoot running.
Overall, the study showed fewer injuries but also less mileage with the barefoot runners. The injury rate, when normalized to mileage, was similar in both groups. While the frequency of foot injuries (metatarsal stress fractures/syndromes etc…) was similar in both running styles, injuries to other body parts seemed to be lower with barefoot running. This was particularly true at the hip, knee and ankle joints. These results are encouraging with respect to the future of barefoot running.