Did barefoot running knee injuries force minimalist running shoes off the market? This past month has been a tough one for barefoot running shoes. In an only in America story, the company that manufactures them was sued in a class action suit over health claims. While there were advertisements that the shoes would reduce knee injuries and shin splints, in my experience, the users of the strange looking running shoes were either evangelical in their belief that this was better for their feet or quickly dissatisfied. Perhaps with less than perfect timing, a new study was just published after the class action was settled that shows that the shoes have their pluses and minuses.
The concept behind barefoot running shoes is that by avoiding a cushy sole, our feet can react to the ground the way nature intended. That should allow the foot instrinsic muscles (the muscles that live between your toe bones) to react to those forces and stay strong. Having seen many active people with horribly atrophied foot muscles, this is an admirable goal. In addition, the quirky footwear would allow the foot to hit the ground more normally, resulting in far less bad forces being transmitted to the knee.
So does the reality match the hype? Sort of. The new study looked at 30 male recreational runners and divided them into true barefoot, barefoot shoes, and traditional running shoe groups. The runners then had their gait analyzed using a 3D analysis system. The results did show that the barefoot and minimalist barefoot running shoes did reduce forces at the knee that could otherwise lead to knee cap problems. On the other hand, they also increased forces at the Achilles tendon. While the authors thought this could lead to more Achilles injuries, I’m not so sure. The result at the foot/ankle begs the obvious question-“The forces at the Achilles were higher than what?” Meaning by comparing the result to traditional running shoes, we only know that cushy running shoes protect the Achilles better. So if you have an Achilles problem, running shoes may be better for you. However, any normal Achilles tendon will rapidly strengthen in response to the additional forces. If it doesn’t, there there are other bio mechanical problems that need to be fixed that go beyond cushy shoes. As I have said elsewhere, this is an opportunity to find a future problem early and fix it before something bad happens (like an Achilles rupture in middle age).
The upshot? Barefoot running shoes held their own pretty well in this study. It’s too bad our crazy legal system will force the manufacturers of these shoes into basically taking them off the market. For some runners who have knee problems, making the switch may have been helpful!
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About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…