Bad news on the effects of thick cushion heeled running shoes on injury prevention continues to pile up. Now, a growing body of evidence is challenging the belief that these shoes (below) are safe for runners.
Past reports have shown that cushion heeled running shoes alter biomechanics, balance, and joint function, which in turn increases vulnerability to fatigue and injury during running.
Long-term wear of thick cushion heeled running shoes also results in unfavorable changes to the muscular architecture of the foot, which may factor into chronic discomfort and injury.
Even more compelling, Robbins et al. reported that thick cushion heeled running shoes blocks sensory input from the feet, resulting in perceptual illusions of impact during running. The result: injury via flawed biomechanics, such as heel strike.
The researchers concluded that thick cushioned running shoes resulted in perceptual illusions whereby perceived impact was lower than actual impact, which led to inadequate impact-moderating behavior and subsequent injury. Because under-heel cushioning masks the feel of impact, heel strike runners think they are running safe, despite generating an impact 3-times their body weight (Lieberman et al. 2010). Indeed, this perceptual illusion –typified by shoe cushioning–connects heel strike running to injury.
More Isn’t More
Runners need to be careful not to assume that more cushioning equals more protection.
The emergence of running-related injuries bears a relationship with shoe cushion thickness –the thicker the cushion, the higher the chance of injury.
From an evolutionary perspective, humans are capable of running injury-free because the human foot is especially well-suited to deflect high impact.
Throughout our evolutionary history, humans ran barefoot and had a particular advantage in safe-landing strategies through the use of a forefoot strike (Lieberman et al. 2010). Take away one’s forefoot striking capability, and little by little the injuries accumulate because we haven’t evolved strategies to compensate for this deficit. Put another way, humans haven’t evolved compensatory mechanisms to allow less impact when heel striking.
The Take Home Message
Switching to minimalist footwear — a more flexible, barefoot-feeling shoe– or running barefoot will not only improve foot strength, but strengthens muscle memory strategies that improve foot-ground interactions and keeps the feet fully functional.
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References:
Franz, JR. et al. (2012). Metabolic cost of running barefoot versus shoe: is lighter better?
Gefen et al. (2002). Analysis of muscular fatigue and foot stability during high-heeled gait. Gait and Posture 15, 56-63.
Ker et al. (1987). The spring in the arch of the human foot.
Michael et al. (2013). Examining the potential role of minimalist footwear for the prevention of proximal lower-extremity injuries.
Robbins, SE., and Gouw, GJ. (1991). Athletic footwear: unsafe due to perceptual illusions.
Wegener et al. (2011). Effect of children’s shoes on gait: a systematic review and meta-analysis
Bretta Riches
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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