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The Rise and Fall of Minimalist Footwear

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Since the release of the now infamous book “Born to Run” by Christopher McDougal in 2009, barefoot running and running with minimalist footwear has experienced an unprecedented rise in popularity1. Online bloggers, brand marketing experts and self-proclaimed running experts jumped aboard the bandwagon and without adequate evidence to back up their claims, began proclaiming the benefits of barefoot running2,3,4. Barefoot and minimalist running have been advocated as a means of strengthening foot musculature and encouraging a better style of running5,6. However, it has also been associated with increased incidence of stress fractures and abrasions of the foot7.

The foundations of the arguments were based around the fact that humans historically were designed to be hunter-gatherers, running hundreds of miles barefoot without injury:

“Humans and our recent ancestors have been accomplished endurance runners for more than a million years”, Bramble and Lieberman (2004)

While these statements may be true, humans have evolved to adapt to changing environments and the vast majority of the current population are ill-conditioned for such distance running particularly barefoot.

The market leader in the minimalist category has been Vibram with their range of Five-Fingered minimalist running shoes. They boldly claimed that their footwear can:

  • Help make the foot healthier
  • Strengthen muscles in the feet and lower legs
  • Improve range of motion
  • Increase sensory reception
  • “There is ample evidence that training without shoes allows you to run faster and further with fewer injuries”

          No surprise then that when such claims were found unsubstantiated the lawsuits soon followed. In March 2012, Valerie Bezdek an American consumer of Vibram Five Fingers brought a law suit against the company and settled for over £2m8. As part of the settlement the court also ordered, “Vibram will not make…any claims that FiveFingers footwear are effective in strengthening muscles or preventing injury unless that representation is true, nonmisleading and is supported by competent and reliable scientific evidence”. While running in minimalist footwear may exhibit certain benefits, it is crucially important to ensure that you are firstly conditioned for such running and transition in a cautious manner.


          The Emergence of “Maximalist Footwear”

          A whole new classification of running shoes has emerged in more recent years which have commonly been referred to as maximalist footwear. These shoes have been designed with the intention of providing as much cushioning and shock attenuation as possible while also remaining lightweight and stable. Typically higher cushioned shoes have been the least stable; however current maximalist footwear utilizes an extra wide base and high medial borders which encapsulate the foot. This coupled with a low heel-to-toe height differential create a stable platform for the foot. A midsole rocker also facilitates excellent transition from heel-to-toe which can be particularly beneficial to athletes with poor hallux function. Similarly, some long distance runners find this rocker system as an added benefit for downhill running by reducing the need for braking. Hoka One One has led the way in this market and their range has become incredibly popular in the distance running category both on and off road. The success of this brand is evident in the apparent mimicking of their designs by major shoe brands such as Brooks and Altra in the US. Latest sales figures from the US market show the Hoka One One brand alone outselling the whole of the minimalist footwear category9.


          The Prescription Predicament!

          So with the multitude of choices available in the current market the million dollar question resurfaces, “Which shoe style is right for me?”The simplistic answer is that there is no singular style which is best for every individual. Integral biomechanical parameters should be assessed to ensure an individual is physically suited to the use of particular footwear. Initial footstrike orientation, ankle joint ROM, body mass, training surface, injury history and training goal should all be taken into consideration when prescribing footwear. For instance poor ankle dorsiflexion ROM is likely to create problems for an individual changing to minimalist footwear with low heel-to-toe height differential (ramp-angle). Similarly a low axis hyperpronating foot would likely encounter complications from running in minimalist footwear due to high ankle eversion moments. Indeed some research suggests that a rotation of a variety of footwear styles may yield the greatest possibility of remaining injury free10.


          PPL Opinion

          While there is evidently a fall in the popularity of minimalist style footwear there remains a strong market for such shoe styles. Long before the upsurge in popularity seen in the past decade, lightweight and low heeled shoes were widely worn. The hysteria created by the popular aforementioned book and the ensuing media hype merely created an unsubstantiated bias for one particular style of footwear. Thankfully this hype has long faded and a healthier balance exists in the market. While maximalist shoes are proving popular currently, there is nowhere near as much endorsement as was previously seen during the rise of minimalism. While the maximalist category has excelled in countries such as USA and Australia, it has yet to see the same growth here. We at PPL predict a strong growth in this area here in Ireland over the next couple of years.

          The variety and availability of such an array of shoes should be seen as advantageous to medical practitioners whom can utilise such options to aid patients. The same variety is not as evident in casual footwear it would seem. Increasingly, the profile for popular casual shoes seems to be flat, flexible and shallow heel cups. Unfortunately, comfort often comes secondary to fashion in the real world and so we do not expect to see any significant change to casual footwear any time soon.


          References

          1. McDougall, Christopher. Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen
          2. http://www.runbare.com/
          3. http://www.chrismcdougall.com/barefoot.html
          4. http://www.runbarefootmarathon.com/benefits-of-barefoot-running/
          5. http://www.barefootrunning.fas.harvard.edu/5BarefootRunning&TrainingTips.html
          6. Goldmann, J., Potthast, W., & Brüggemann, G. (2013). Athletic training with minimal footwear strengthens toe flexor muscles Footwear Science, 5 (1), 19-25 DOI:10.1080/19424280.2012.744361
          7. Overload injuries in barefoot/minimal footwear running: evidence from crowd sourcing. Martin Daumer​, Christine Kleinmond, Christoph Stolle, Christian Lederer, Marc Hilgers, Markus Walther
          8. http://www.runnersworld.com/general-interest/vibram-agrees-to-settle-class-action-lawsuit
          9. http://www.runresearchjunkie.com/latest-figures-and-surprise-comment-on-running-shoes-sales/
          10. Malisoux L, Ramesh J, Mann R, Seil R, Urhausen A, & Theisen D (2013). Can parallel use of different running shoes decrease running-related injury risk? Scandinavian journal of medicine & science in sports PMID: 24286345

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