According to Lopes et al. the most common injuries in recreational runners are 1. medial tibial stress syndrome (shin splints), 2. Achilles Injury and 3. Plantar Fasciitis.
The notion that cushioned running shoes causes injury springs from remarkable observations about habitual barefoot runners who don’t heel strike and never had a running related injury.
Now, the recognized therapeutic implications of barefoot running has come in-handy for habitual shod heel strike runners who struggle with injury.
3 Common Injuries Caused by Cushioned Running Shoes
Slowly, but surely, scientists are learning more about the detrimental effects of the cushioned running shoe. Most notably, it has been finally accepted that cushioned running shoes has caused runners to take on a maladaptive running style, the heel strike running style (shown below), which contributes to the common running related injuries.
One newer study even urged shod heel strike runners to transition to pure minimalist or barefoot running to avoid the adverse biomechanical effects of cushioned running shoes.
But let’s examine how cushioned running shoes contribute to the common running related injuries listed above.
The current study suggested that the landing phase in heel strike running is the main cause of shin splints.
Cushioned heeled running shoes leads to a dorsiflexed ankle at touchdown. This is how the heel manages to strike the ground first. Ankle dorsiflexion at touchdown results in repetitive contractions of the posterior tibial, soleus and/or the flexor digitorum longus muscles thereby increasing tibial stress and inflammation.
Also, the landing phase in heel strike running is more forceful compared to that of forefoot running. The vertical ground reaction force is much higher in magnitude in a heel strike landing which attributes to inefficient capacity for bone remodelling. That is, at the physiological level the reparative processes cannot keep up with the repetitive stress induced by heel strike.
Again, the excessive loading from heel strike induced by cushioned running shoes is thought to cause Achilles injury. The heel strike-transient paired with a high vertical ground reaction force results in repetitive stimuli that overloads the Achilles beyond its physiological tolerance thereby causing degeneration.
Moreover, Knobloch et al. found that running on soft plantar surfaces increased the risk of Achilles injuries because softer plantar surfaces compromised balance, resulting in excessive push-off.
Studies indicate that foot strength naturally wanes with long-term use of cushioned running shoes. Fading foot strength caused by cushioned running shoes triggers plantar fasciitis, a degenerative process of the plantar fascia.
A weak plantar fascia succumbs to injury during heel strike running because the plantar fascia must be strong enough to transmit the heel strike-transient. Because the resiliency and absorbability of the plantar fascia is in a weakened state, thanks to cushioning running shoes, prolonged exposure to the heel strike-transient increases the susceptibility of plantar fasciitis.
The Take Home Message
Despite the encouraging outcomes of barefoot running with a forefoot strike, most joggers cannot seem to let go of their cushioned running shoes!
Barefoot running or pure minimalist running are the most effective strategies for improving neural control of motor behavior. This is why habitual barefoot and pure minimalist shod runners are less likely to fall victim to these common running related injuries.
More From Run Forefoot:
Beck BR, Osternig LR. Medial tibial stress syndrome: the location of muscles in the leg in relation to symptoms. J Bone Joint Surg Am 1994 Jul; 76 (7): 1057-61.
Craig DI. Medial tibial stress syndrome: evidence-based prevention. J Athl Train 2008 May-Jun; 43 (3): 316-8.
Gallant et al. A theoretical perspective on running-related injuries. J Am Pod Med Assoc, 2014; 104(2): 211-220.
Garth Jr WP, Miller ST. Evaluation of claw toe deformity, weakness of the foot intrinsics, and posteromedial shin pain. Am J Sports Med 1989 Nov-Dec; 17 (6): 821-7.
Knobloch K, Yoon U, Vogt PM. Acute and overuse injuries correlated to hours of training in master running athletes. Foot Ankle Int 2008 Jul; 29 (7): 671-6.
Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature 2010 Jan; 463 (7280): 531-5.
Lopes et al. What are the main running-related musculoskeletal injuries? A systematic review. Sports Med, 2012; 42(10):891-905.
Michael RH, Holder LE. The soleus syndrome: a cause of medial tibial stress (shin splints). Am J Sports Med 1985 Mar-Apr; 13 (2): 87-94.
Moen MH, Tol JL, Weir A, et al. Medial tibial stress syndrome: a critical review. Sports Med 2009; 39 (7):523-46.
BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
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