Where is the evidence in favour of distance running shoes? What does Nike say?

Amongst many health professionals and enthusiasts there is a reluctance to accept barefoot running. I’m totally open with people having alternative opinions as long as it’s based on logic. If, for example, people feel that they have not come across enough evidence or proof to suggest that we should be barefoot that’s OK. But to then turn around and tell people to run in shoes is entirely hypocritical.

Why? Because there is no evidence for running in shoes with thick soles, pronation control and elevated heels! I can make this claim because Dr Craig Richards,a physiotherapy and researcher currently working as a ‘Footwear Researcher’ in the Human Performance Laboratory at the University of Newcastle, carried out a systematic review of the prescription of distance running shoes in the British Journal of Sports Medicine. i.e. what he wanted to know was: is there any evidence for modern distance running shoes (defined as shoes that control pronation, the amount the foot rolls in or out, and have an elevated cushioned heel)?

In order to try and answer his question he searched through journal databases, which have papers from as far back as the 1950s right through to the current day (paper was published in March 2008). In short the paper concludes that it found ZERO clinical trials that assessed the effect of these shoes on injuries, running performance or the general well being/health of runners (Richards et al 2008). Richards goes on to say that shoes must be thought of as ‘unproven technology‘, which ‘have the potential to cause further harm‘, and that the prescription of distance running shoes ‘is not evidence-based‘ (Richards et al 2008, p162).

So there you have it. There is no proof in running in shoes with arch support and nice gel cushioned heels. That alone should tell you that you don’t need to run in expensive shoes. It’s so ingrained in us that to get the best out of everything (ourselves included) we need to spend money. I think one of the major limitations of barefoot running is that its free! This is why we now have all the major shoe companies trying to sell us something that we already have. I take great enjoyment in recommending these Nike advertisements:

Nike Free Barefoot

Nike Free Scribble Men

Commerical Nike Free

Nike Commercial in New YorK

How good are they? I find these hysterical and yet it’s so embarrassing. They’re rubbing it in our faces and making millions from it. Nike undoubtedly has enormous resources for R and D. And what do they come up with? THE BAREFOOT! They show it off, tell us how great it is and then cover it up! If there was evidence for their shoes, the limitless R and D dollars would have undoubtedly revealed it by now. Don’t you think?

p.s reference for Dr Richards article:
C E Richards, P J Magin and R Callister. 2008. Is your prescription of distance running shoes evidence-based?,
Br J Sports Med 2009 43: 159-162 originally published online April 18, 2008 (doi:10.1136/bjsm.2008.046680)

By Sam

BM in Sport and Exercise and BA in International studies (German Major) completed at the University of Technology, Sydney.
Master of Physiotherapy at the University of Sydney.

Interests: I am an exercise enthusiast full stop! I play or have played football, tennis, basketball and dabbled in waterpolo and underwater rugby! Recent sporting interests are cycling and barefoot running! I also love watching all codes of football/rugby.

Physiotherapy: Due to my interests in sport and health I am fascinated in human movement and physiology. In addition to musculoskelatal physiotherapy I’m also interested in neurological (stroke, brain injury and spinal cord injury rehab), and cardiopulmonary (heart and lung function and rehabilitation) physiotherapy:

7 Comments

  1. Genki - April 9, 2011, 4:43 pm Reply

    Very cheeky of Nike! I wonder when the first law suit will appear – McDonalds style!

    I will confess that I did start my barefoot running journey by transitioning to Nike Free from Asic Gel Kayano (first with my orthotic inserts and then without), combined with some short distance barefoot runs to try and toughen up my feet (once around the block was often far enough for my princess feet!).

    Initially I loved the Nike Free and found them to be very light and flexible and I felt my feet and calves having to work much harder to support me, which is the point right. However, as my foot musculature developed and my arches began to lift more (I was going barefoot as much as possible) I soon felt that they provided too much support and I have now pretty much ditched them. Now I run solely (pardon the pun) barefoot or in my Vibram Five Finger which I just love!

    The turning point for me was that once I started running full time in my NF I would commence my run in these but still have to work hard at my posture and technique to keep my niggling ITB pain and hip pain (from an old labrum tear) at bay. I felt pretty happy that I could ‘control’ this as long as I was concentrating on every step and maintaining good postural alignment (I am a Pilates instructor and try to follow the Chirunning principles so I obsess about this sort of stuff). About a third of a way through my runs I would usually take my shoes off and run barefoot for a while (sand/grass/pavement/road…..loving it all, the sensations on the feet are incredible!) and then put my shoes back on about a km or two from home when the skin on my feet could take no more. I noticed that during the barefoot segment of my runs I felt much more free (ironically freer than the Nike Free) and relaxed so that I didn’t have to concentrate much on my technique at all.

    Surprisingly, I started to see a pattern in those last few kms where the niggling feelings that I associated with my tightening ITB and hip problems started creeping in only once I had put my shoes back on. Was my running technique changing so much between the Nike Free and being completely barefoot? Obviously there was a correlation here so I decided to try the VFF so that I could continue to run longer distances without my poor feet wearing down and test that it wasn’t just fatigue causing me problems at the end of the run.

    Needless to say my running is better than ever and virtually pain free. My ITB problems seem to have completely resolved (I do attribute this to lots of postural work in Pilates too but the barefoot posture certainly forces me into a better posture) and I can feel my hip flexors are strengthening and releasing which is a very liberating feeling.

    I certainly feel that the Nike Free was an important stepping stone for my transition to barefoot running but it was not a sustainable solutions for me as it did alter my step. The foot has an incredibly ingenous design that should be allowed to do what it is designed to do. I am a true barefoot believer now!

    As a Pilates instructor I am pretty much barefoot all day (with no weird stares…lucky me) but if I can’t be barefoot I love the VFF and more recently I am very keen to try the CMUK (see http://www.cmuk.com.au) as a more fashionable walking/running options. If anyone is interested I’ll let you know how the CMUK feel and perform….they look super cool!

    • Sam - April 10, 2011, 4:29 pm Reply

      Hey Genki,

      The transition process, which you have described from you Asics to barefoot running is great! It is very similar to what I would suggest to someone who wants to make the transition to barefoot running.

      I think the majority of shoes that are branding themselves as barefoot shoes make for great transitional shoes. I feel though that the sole of the Nike Free and the toe spring (the front of the shoes the curves up) are major flaws in the shoe design. The heel is built up too high, meaning that your heel is above your foot and keeps your calves (planter flexors) in a shortened position (as if walking on your toes) and contributes to tightness in the Achilles region. If you look at your foot when you’re standing without shoes on you will notice that your toes rest flat on the floor. Thus having a shoe that curves up the front puts your toes in a hyperextended position (toes flexed up towards the roof). This results in putting increased tension through the plantar fascia and weakens the arch of the foot. As you mention they also provide too much arch support (blocks the natural motion of the foot). The shape of the sole also curves, which again is an entirely unnatural foot shape.

      From what I have seen I think the Terra Plana Evo barefoot shoe, the Merrell barefoot range, the CMUK shoes you linked to, or quite simply a dunlop volley provide better transitional shoes that can help you move towards running barefoot, in vibrams or maybe in a pair of Zem’s. Personally I feel vibrams themselves are a transitional shoe towards barefooting or a great alternative when the terrain is just too rugged.

      Again you really hit the nail on the head when you explained the thought process that is required to run safely/efficiently in running shoes. It’s simply too painful to run with bad technique when you’re barefoot, which means you have more time to let your mind wonder and enjoy your surroundings as you run!

      Your injuries unfortunately are very common in the running population and a lot of people will require treatment for these injuries in addition to moving to barefoot running. You’re lucky you have such great knowledge about stability and core strength from your pilates background and were able to attack your injuries from both above and below the troubles. I will certainly be quick to advise people to ‘run from the guts’, which requires great pelvic stability and motor control. There are some amazingly good dynamic exercises that can be done on the pilates reformers which address these issues specifically (no doubt you know them all very well!).

      Have you found many runners coming to your clinic with running injuries?

      • Sam - April 10, 2011, 4:29 pm Reply

        P.s excellent pun

  2. Genki - April 10, 2011, 7:09 pm Reply

    Hi Sam,

    Thanks for your great advice and for sharing your knowledge. I completely agree with everything you say about the Nike Free, it is a brazen statement by Nike to associate them with barefoot running or even as a minimalist shoe but I got what I needed out of them and enjoyed them for a few months.

    I did try and go with a more minimalist shoe (an Asics Martial Arts – perhaps more fashion than function, but it was all I had and they do have a flat sole and more flexibility than I was used to) when I first started my barefoot journey about 12 months ago, but honestly my calves were killing me and I found I could only run about once a week (1-3km) with 4-5 days recovery needed. I guess the Free just gave my calves that little bit of a break to get over that first hurdle so that I could start lengthening through the Soleus and Achilles before going totally flat/bare.

    The toe lift in the Free, as you say, is definitely noticeable. It really interfered with the sensations and functions of my toes. Once I kicked off the shoes and began running on grass I really felt my toes working which was, and still is, a truly blissful experience!

    One of the most valuable experiences for me as I was getting back into running was understanding the biomechanics and functional potential of my feet and toes. I owe this mostly to Bruce Hilderbrand of ‘Balance Control Pilates’ in Melbourne (see http://www.balancecontrolpilates.com/franklinmethod/topics/) who runs the Franklin Method workshops in Australia. I did several workshops with Bruce as this method is highly complimentary to the Pilates method. The two workshops that stood out for me were ‘Walking Wisdom, Running Rhythm’ and ‘Jump for your Life’. I highly recommend you experience these for yourself Sam, even as a Physiotherapist I am certain you will be deeply impressed with what you experience and learn from these workshops. Bruce is an awesome presenter and a very knowledgeable practitioner of the Franklin and Pilates methods. He is somewhat of a rock star in his field (although very down to earth and humble) working with elite athletes (AFL footballers, Olympic athletes etc.) as well as being the strength and conditioning coach for the Australian Ballet (now those guys need strong, healthy feet!).

    In these two workshops Bruce gives a great presentation on the role of the feet, ankles, legs, hips, pelvis and spine in jumping and running actions with a focus on using the natural biomechanics of these structures, enhanced with imagery, to create effective spring, shock absorption and stability. This was the first time I had actually thought about my toes or the arches of my feet as having any function at all other than to just sort of keep me upright and connect me with the ground. I am somewhat embarrassed by my ignorance but after almost 20 years in orthotics with highly supportive shoes I had lost that neuromuscular connection and support of my feet!

    Anyway, getting back to the point, this was my motivation in getting the VFF because I didn’t want to neglect my toes anymore, I wanted the freedom to use them independently and to benefit from their incredible design and function once my calves and ankle were a bit stronger, I am not sure if I could have handled them from the very beginning due to the calf length/strength issues.

    I know this has been a long response already but if you will forgive me I’d like to add a little more in the hope that by sharing what I experienced others might benefit too.

    When I first came across the concept of BFR I had already been suffering in excess of 10 years with hip pain and 6-7 years of ITB syndrome. I was already in orthotics due to shin splints in my early 20s (mysteriously started after purchasing and running in a pair of chunky Converse back in the 90s, I simply had no idea of the association back then but in hind site it seems obvious) and these were just not helping me. I went to several physios (and don’t take this personally Sam, I think you are on the ball!) who simply told me to stretch my hip flexors and roll my ITB. I even went to a renowned Sydney Sports Medicine doctor who offered to irreversibly slice a wedge out of my ITB so that it would no longer rub on the lateral condyle of the femur and gave me a GTN patch to place over the painful area in my hip to increase perfusion (???). I worked as a Paramedic at the time (and a personal trainer before that) so I like to think that I have a reasonable anatomical and physiological understanding of the body but neither of these treatment options seemed logically feasible to me.

    Needless to say I pretty much gave up and took about 6 years rest until I discovered Pilates! Finally I found a great physio who was able to diagnose my hip pain as a labrum tear (confirmed by MRI) and put me back on the path to recovery. She was able to explain why I had developed these injuries and how I could improve them (dare I say cure them) without drugs, surgery or simply rolling (ITB) and resting. Let me sum it up for other readers (Sam you would already appreciate this), 1. postural alignment, 2. core strength and 3. muscle balance. No other form of exercise or movement therapy has these collective goals or works as effectively to create awareness in movement and posture to create a better biomechanically functioning body. Combine it with the mind:body connection of using visualisation and imagery for neuromuscular facilitation and correct muscle recruitment patterning and you have a very powerful technique for rehabilitation and strength and conditioning.

    I loved Pilates so much for how it had changed my life (I was almost crippled by my injuries with 10 years of chronic pain!) that I quit my Paramedic job and started training to become a Pilates instructor. I now run my own studio and see the results every single day of people improving and even overcoming their injuries to lead active, pain free lives, whether that be to just get around doing daily activities or competing in elite level sports.

    I feel very sad that when I was receiving early treatment for my injuries nobody spoke to me about my running technique (chronic heal striker in overly supported shoes) or my posture in general (anterior pelvic tilt with internal rotation of hip, same for about 80% of population, mine was probably exacerbated over time with loss core strength, poor foot structure/strength and dysfunctional compensatory muscle patterns from my accumulative injuries). I feel that 10 years past by wasted and worse, I was probably doing more damage to myself with every new attempt to run. This was just my experience and by no means will it be exactly the same for all. My advice is do lots of research, get someone to assess your posture, identify and build up your weak areas, release the tension in your tight areas (both through Pilates) and take a conservative approach to transitioning to BFR and you will be rewarded! Clinical (physio) or traditional studio style Pilates, either one it does not matter as long as you have a knowledgeable, experienced instructor who is focused and attentive. Mat Pilates at the gym is great but make sure you have a good foundation in Pilates through one of the above first before doing these types of classes otherwise you may be wasting your time and doing (further) damage to yourself.

    And in answer to your question Sam, yes I do get runners coming to my studio as well as a lot of cyclist who suffer from back pain as well as ankle, knee and hip injuries. I see a lot of the same sort of problems, weak glutes in particular glute med., weak adductors & external rotators of the hip, very tight and dominant quads, TFL and ITB, and dysfunctionally weak but tight poas. Core, and I am talking about transverse abdominus and pelvic floor, are chronically weak with bracing of Rectus Abdominus mistaken for a strong core. I try to create a lot of awareness in people of their toes, feet and ankles too, Pilates has many great exercises and techniques for these areas and is especially helpful in relieving plantar fascitis and helping to create better ankle, knee, hip alignment to resolve other foot and lower leg injuries.

    I am not a physio so my clients are usually non-acute and many start Pilates for core strength and as an alternative to other forms of exercise. Many have long given up on their running/skiing/cycling/gym workouts etc. due to chronic injuries and they see Pilates as a gentler form of exercise. They are always very excited when they begin to experience significant changes in their body, experience less pain and have a greater awareness of the strength and potential range of their body. It is always a bit of a shock to them too when they realise that Pilates is a more of a challenging workout than they have ever experienced before, yet they can leave the studio feeling stretched, mobile and invigorated.

    Anyway I hope this hasn’t bored anyone, my passionate rant should end here. Happy running!

    • Sam - April 20, 2011, 6:35 pm Reply

      Hey Genki,

      I can understand where you are coming from in terms of the calf pain in minimalist shoes. Its most certainly an issue that will be experienced by most people when they transition to minimalist/barefoot running. The best way manage this is to start really slowly. By that I mean running around the block on the first run. Then in following runs look at little increments until the calves (and feet!) have adapted. A good little trick is to practice running backwards (for about 10-15 steps) intermittently through your runs. This can help to eccentrically strengthen through calves and gives a bit of a dynamic stretch as you go!

      Thanks for sharing your knowledge with us. We really encourage people to share their experiences with all of us. That is certainly on the key things we want to get out of this website! Hopefully it won’t be too much longer until we have a forum up and running!

      I’m glad you were happy to think outside of the square in terms of your injuries. The surgery sounds like a dreadful option to me. I have have seen however that there is reasonably good evidence for the GTN patches on tendon injuries (i.e achillies or tennis elbow). Thank god for the physio who was on the ball enough to detect your labrum tear (ouch!!!)!

      I think for runners who have experiences running injuries that when they seek treatment they shop around to find physio’s who have a particular interest in running. There are many complex issues that need to be taken into consideration for what is a seemingly easy task! In terms of rehab and conditioning the body for running your pilates sounds fantastic!

      Once again thanks for sharing your experiences with us!

      • Genki - April 21, 2011, 1:46 pm Reply

        It is interesting that you should mention the backwards running. A friend was telling me just today about a man who ran a whole marathon backwards! I know this is not what you are suggesting but if some people out there think that Barefoot Running is crazy then they should check out ‘Backwards Bud’ (http://www.usatoday.com/news/health/2006-05-25-backwards-running_x.htm).

        Apparently there is a whole movement out there for ‘Retro Running’ (http://www.backward-running-backward.com/) although I don’t see any of them doing it barefoot. I guess the advantages would also be that you would have less chance of stubbing a toe….lol.

        • Sam - April 21, 2011, 6:03 pm Reply

          Haha how did you discover this? I wonder how the neck feels after a backwards marathon?

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