Five Finger Footwear Reduces Knee and Back Pain in Runners

Knee pain is a major drag in running. So is back pain. But, can you image suffering both knee and back pain when running? Sadly, the painful duo is not a rarity in joggers. In fact, a lot joggers have these problems.

If you are running in cushioned heeled running shoes, you might want to stop that because to protect your knees and lower back, you need to avoid heel strike and instead, land on your forefoot. A really smart way to begin forefoot running is by wearing flatter, lighter, less cushioned running shoes. For example, the Vibram FiveFingers were found to reduce knee and back pain by helping runners land more safely on their foot.

Vibram FiveFingers Reduces Knee and Back Pain in Runners
Vibram Five Fingers Bikila, a barefoot-inspired shoe for runners.

Vibram Bikila Found to Reduce Knee and Back Pain in Runners

A study by Ryan et al., (2013) found that runners who ran in the Vibram Five Fingers Bikila reported less knee and back pain compared to runners who ran in the Nike Pegasus 28, a neutral shoe, and the Nike Free.

The finding allows runners to gain a new understanding of the simple and profound question: are cushioned running shoes safe?

Apparently not, as the study also found that runners who ran in the Nike free, which is a cushioned ‘minimalist’ shoe, had a 192% relative risk of injury compared to runners in the Nike Pegasus 28 and the Vibram Five Fingers Bikila.

The researchers concluded that minimalist shoes with cushioning is associated with a higher likelihood of knee and back pain than barefoot-inspired shoes like the Vibram Five Fingers Bikila.


The Vibram Five Fingers play a pivotal role in the architectural dictum: form follows function, meaning that in the context of running, function dictates form. If function is constrained or limited, form breaks down.

The Vibram Five Fingers closely reflect barefoot conditions where the feet are required to function on their own without the aid of external support such as medial posted insoles and heel counters. Moreover, the ultra-thin outsole of the Vibrams enhances proprioception of the foot which dictates and controls global biomechanics.

This is how the Vibram Five Fingers allows the feet to retain optimal function which equates to stronger feet, stronger limbs, and better biomechanical control, allowing the body to move more efficiently during running. Hence, form follows function.

Even though the Nike Free’s (shown below) are considered as a minimalist shoe, they are still well cushioned than the Vibrams.

Nike Free Found to Cause Knee and Back Pain

Because cushioned running shoes hinder proprioception, such shoes act as a very tight constraint on foot function, causing a reduction in muscle activation thereby a reduction in function which in turn, causes form to breakdown. The shortcomings of weak feet include poor biomechanics and discomfort during running.

Experts are now recognizing barefoot running shoes like the Vibram Five Fingers Bikila as a way out of suffering pain at the knee, hip, pelvis, and lower back while running.

More on Barefoot Running Shoes:


Ryan, M., Elashi,M., Newshan-West and Taunton, J. Examining the potential role of minimalist footwear for the prevention of proximal lower-extremity injuries. Footwear science, 2013; 5(1): S31.

Bretta Riches

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

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.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!

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