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Tuesday, March 04, 2008

Running shoes: Solution or the problem?

Running shoes and running injuries: Do the shoes actually cause the injuries?

After a couple of posts on doping, a bit of a change of theme for today, as we look at running shoes and injuries. This post was inspired by a link I was sent by one of our regular readers (thanks John - the link is further down the page, incidentally) and it's a really great article, a real conversation starter, so it follows on nicely from our great discussion after the previous post on lifetime bans for dope cheats. Thanks to everyone for their input on that one, let's see how this one goes.

The other reason to post links is because we've both been incredibly tied down with other work just lately, so in true academic fashion, we'll borrow from the excellent work that already exists and just steer the discussion and the traffic in that direction! Having initially thought that it was Albert Einstein who said that he had "stood on the shoulder of giants", one of our readers pointed out that it was in fact Isaac Newton! To save face, I will however point out that Einstein did quote Newton by saying this later in his own life, which of course only reinforces the idea that in science, don't say something in a new way when someone has already said it perfectly for you! And so we borrow that concept today and refer to a great article on running shoes and injuries...

The running shoe debate: An old topic revisted

To date, we have not really tackled the running shoe subject directly here at The Science of Sport, but it has come up incidentally in previous posts.

For example, it came up in the first post on our series on the Pose Running technique, where it was pointed out that ever since the "boom" in the running shoe industry about 30 years ago, the percentage of runners who get injured each year has remained pretty much the same.

So despite technological advances and developments in the industry, injury incidences have remained largely unchanged. Shoe companies make many promises, such as:

"Anti-pronation devices limit movement of the foot, reducing the risk of injury in overpronators", or "Forefoot and rearfoot cushioning devices reduce impact and the risk of injury"

Yet there's little reason to believe that this is true. The latest studies suggest that anything between 40% and 70% of runners are injured every year. And fascinatingly, in 1989, a study found that runners who ran in shoes costing more than $95 actually were twice as likely to get injured than runners who ran in shoes costing only $40! That was even after correcting for training and racing mileage! Of course, it's impossible to conclude that "expensive shoes CAUSE injury", because there are other factors that can't be accounted for. And one might argue that the typical runner of 2008 is quite different from the runners of the 1970's, who tended to be lightweight, biomechanically very different athletes. So maybe the fact that the injury rates are the same is actually a positive for the shoe industry? But let's pursue it a little further...

Points of differentiation and running shoe research

And what is more, the companies very rarely make their research available for all to see. Even if they did, you can pretty much guarantee that the research (which would be funded by the company, remember) would show "conclusively" that the shoe positively influences biomechanics, cushioning and hence reduces injury risk. The cynics among us would challenge the research on the grounds that they company could hardly spend money on scientific research and conclude that their latest selling point on the new models DOESN'T make a difference!

And in order to understand the full extent of the issue, you have to appreciate what is relatively obvious from a marketing point of view - all shoe makers are doing their utmost to differentiate their shoes and get their "share of wallet" in what is a very competitive, very lucrative (billions of dollars), but very cluttered market. The result of this search for a "point of differentiation" has thrown up a dizzying number of gimmicks and gadgets - every company has their solution, their distinctive features, often with the same function as competitors', yet it's still called "cutting edge technology".

A great article on running shoes

For a great article on the shoe industry, right the way from the Pharoahs of Egypt, through the Middle Ages and then onto the modern shoe industry, here is a great article on running shoes:

Athletic Footwear and Running Injuries

The article is pretty long, but worth the read. For the latest information and some real thought-provoking writing, I'd recommend Part II, about a quarter of the way down the page, which focuses on running injuries and how the shoes have failed to alter the injury rates.

Another site that may well develop into something in the future has been set up by a research in Australia, Dr Craig Richards - it's called "Barefoot versus the shoe"

He actually contacted us recently, in connection with some other articles here (fatigue, Pose), and we discovered the blog then. The posting frequency is relatively low, but it's worth reading simply to see what the shoe companies say in response to Dr Richards when he challenges them for their research. Hopefully in the future, he'll post more regularly and keep exposing the industry where it needs to be exposed.

Is barefoot running the way to go?

On the note of Dr Richards' blog title (Barefoot versus the shoe), the argument is growing that running barefoot is the natural and hence the "correct" way to run. And I know of many podiatrists who are gradually shifting their thinking in this direction - if any of you out there are podiatrists, please feel free to weigh in on the discussion. In fact, even the shoe industry has cottoned onto this idea - think Nike Free, and the other shoes that are now being made to mimic barefoot running.

But, a word of caution here. If you're a runner who has been pounding the pavement for 20 years in a pair of shoes, suddenly switching to barefoot (assuming you can run barefoot - I would never consider it on the tarred roads of Cape Town) may be a risky move for you. Because the change in biomechanics and loading of joints, muscles and tendons threatens injury if you're not careful. So in the article, you'll see advice to run barefoot - what you may miss is the proviso that you start with "small doses", which is really important - be careful about over-compensating and injuring yourself on the other side!

Any shoe experts out there?

I suspect that everyone has an opinion on this one - I have no doubt that many of you reading this will be able to share your experience that a persistent, nagging injury suddenly cleared up when you switched shoes, and perhaps you've never looked back? Those stories are very common, and lend support to the idea that a certain shoe will help with injury risk.

Personally, I'm of the belief that an injured athlete should look at their training as the first port of call after injury. The second port of call is probably training as well, followed by things like muscle strength or flexibility imbalances, and then in fifth, have a look at your training! Seriously though, I think that one consequence of a pre-occupation with shoes and injury prevention is that it takes away the attention that should be given to training - an injury can almost always be traced to a change in training intensity or volume, and that's where I'd begin the detective work, not with shoes.

But, let's hear from anyone who has experience or knowledge. I know we have many readers who are involved in the industry, and have a great deal of technical knowledge, so do fire away!

A look into the future

So that's it as far as "standing on the shoulders of giants" goes - in the next few days, I'll hopefully get that long-awaited post on fatigue up, so join us then!



Ian said...

Let me preface my comment by saying that I'm not an expert by any stretch. I've been running consistently for over 3 years now and have gone through many different pairs of shoes.

When I began I was running in New Balance trail shoes and probably put over 1000 miles on them before someone told me that 500 was their limit. I was also wearing them to play tennis and just for general daily use so they were definitely abused. I've been a little more careful about my running shoes since then, but in my 3 years of running I have never been injured.

After 300 miles in a pair of Mizunos I began to have some minor issues with foot pain in the balls of my feet, but nothing that I would consider an injury.

In my mind (which is frequently wrong) I believe that I haven't been injured because I run with a certain biomechanical efficiency. I couldn't tell you what it is but I believe that there is something about my stride, footstrike, pronation etc. that just seems to work for me. Perhaps there was something about the Mizunos that didn't jive with it or that caused me to alter my gait, but all the other shoes I've run in (Asics, NB, Puma, Nike) have logged a lot more than the suggested number of miles.

Ian said...

Oh, and by the way, I'm so glad to see you tackling this issue. I've read that article before and I can never make up my mind which is better, barefoot running or shoe'd running.

Asher said...

Great topic!
Regarding barefoot running: Only two champion runners ever ran barefoot -- Mary Decker and Abebe Bikila. But Bikila only ran barefoot in 1960 because he had trouble obtaining proper shoes; he always ran with shoes, and in 1964 won with shoes. ONLY Decker ever competed barefoot by choice.
Scientifically, the idea that the foot was designed for running is quite unconvincing. The human foot was designed to be an all-purpose limb, to be used for running + climbing + swimming + kicking, etc. A running shoe optimizes it for exactly one of these activities, just as a flipper optimizes it for another and crampons for a third. So it makes sense that we would run faster in shoes, and in fact we do -- except for one single competitor in the last century.

Clyde said...

I'm sure someone will point out this study that found expensive shoes are a waste of money: http://www.eurekalert.org/pub_releases/2007-10/bmj-eta101007.php. But it doesn't address the longevity of shoes, which is a real issue after a couple hundred miles for heavy runners.

Clyde said...

Here's a follow-up letter to that study that raises more issues: http://bjsm.bmj.com/cgi/eletters/bjsm.2007.038844v1#1722

Anonymous said...

Thanks for tackling this issue.

Firstly, Asher, you may be referring to Zola Budd rather than Mary Decker in the famous clash. It was the former without the shoes.
My feeling is - expanding a bit further from Asher's point on the specificity of the foot- that the barefoot was ok when running on sand and grass, but as you say, on the concrete/asphalt of Cape Town or elsewhere, maybe not so.
I grew up as a barefoot running kid, and I can say that I would not have been able to run more than a couple of k's that way (not without discomfort either). On top of that I have a biomechanical (shorter leg) imbalance too.
my wife has extremely high arches, and needs not only shoes, but specific ones.
I can also 'feel' when my shoes are no longer good enough... why does my legs/feet not get used to those shoes in that condition. So the new shoe obviously does have something over the older one.
The running shoe has enabled almost "everyone" to run a reasonable amount of km's. Myself. my wife and those with worse conditions.
On top of that, over the last 30yrs it can be seen that the median times have increased in all distances. Where marathons had cut-offs at 3:30, one can now run one in 7hrs or longer. So the type of runner has to be taken into account when looking at the frequency of injuries post running shoe advancement.
Running shoes don't cause injuries themselves. Running does....and more specifically, running in 'incorrect' shoes do.
One thing I think everyone is starting to note, is that 'anti-pronation' shoes are in general used too much.

The default is most likely a neutral shoe with specific (orthotic etc) enhancements for the individual.

by7 said...

my 2 cents...

I am a pronator and in the past I have been using orthotics, support control shoes, etc, etc

The results was I always has tight calves and the gait was getting worse and worse for the lack of sensibility of the feet.

I decided to ditch orthotics and train as much as I can in lighweight trainers and using even racing flats on treadmill.
The results is that now my calves are not more tight and I feel much better control from the feet at the moment of contact from the ground.

To summarize: I agree that some cushuioning protect the feet from the pounding of running on black-top, etc. But all these motion control shoes, etc are only a rip-off and at the end would cause the problem to get worse and worse.
The feet will get weaker and weaker, together with the support muscles around the ankle.
Go gradually for lightweight trainer and you will see the difference

Liz and Peter said...

great topic!
I have been following your blog for a couple of months now but have been yet to chime in.
I am a physical therapist (physiotherapist to the Cape Towners) in Eugene, OR. A big running town for those not familiar. Also the birthplace of Nike. As a runner and as a PT who treats alot of running injuries, I can say that, except for the extreme cases of runners and shoes, it is much more likely an internal biomechanical issue behind the injury.
I always ask my patients about their shoes, look at their shoes, and watch them run in their shoes but I get a lot more information once their shoes are off and I can see what the foot,lower extremity, and trunk are doing.
For the most part, I recommend people stay in whatever shoe they like, assuming they aren't an extreme case of high arch or over pronation.
I think the running shoe industry is much like the fitness equipment industry. Yes, they are out to make money, as many of us are. Doesn't make them bad. It just means we need to be cautious consumers. Whether its the Bowflex vs the Total Gym or Nike vs New Balance; they all have their claims and "research".
In my opinion, run and enjoy yourself. If an injury comes up, and at some point they do:
1) don't change shoes unless they are old
2) cross train if you can with biking, swimming, elliptical, etc
3) Rest, ice, compression, elevation
4) get it looked at by a professional. Not one that wants to put you in an expensive pair of rigid orthotics
Thanks for the discussion, guys!

תום said...

I'm an avid reader of your blog, and I find the way you put scientific truth before anything else to be highly commendable.
In that spirit, I hope you don't find me too tiresome when I point out that the person attributed with saying he stood on the shoulders of giants or, more precisely, that "if I have seen further it is by standing on the shoulders of giants" is Isaac Newton.

Ross Tucker and Jonathan Dugas said...

Hi Carmit

Oh dear, I've been caught out - you're right! It was Isaac Newton.

I will say in my defence that I had a feeling it wasn't Einstein initially - I know he said it later, I read it in a biography on his life, but he was actually quoting Newton, and I made the mistake of attributing it directly to him!

Thanks for the email, I'll make a slight edit to the original post and admit my error!


Andrew said...

Excellent topic! I've struggled with similar questions. All I've concluded is that I just don't know what to do about shoes! It does seem that they're mostly for abrasion protection - I've done barefoot training with no problems except on asphalt - but I also learned that some shoes do cause injuries while others don't.

One question for you experts: How does running speed come into play? I've noticed that I have a wonderfully smooth stride when running fast (5K race or sprints) but it feels like I shuffle a bit when going slower. Are shoes designed for the faster speeds of sponsored elite runners?

Anonymous said...

A Case for Bare Feet, Section 3: Health. See 3.4 in particular for
the disadvantages of only training in shoes

Michael Warburton. Barefoot Running

Why Shoes Make "Normal" Gait Impossible, By William A. Rossi, D.P.M

Comment on Barefoot Running. Caroline Burge

Bare feet in Medicine

Barefoot FAQ,


Take Off Your Shoes and Walk by Simon J. Wikler D.S.C.

The Barefoot RevolutionRoy M. Wallack


Barefoot running not always good for the feet. Casey McGuire-Turcotte.

Hung-Kwong Ng said...

I have flat feet and often had shin splints. I was prescribed motion control shoes and orthotics with a wedge. It didn't help; I threw away the orthotics; I started doing one-legged balance board exercises and warming up gradually. I no longer get shin splints except when running all out on track. Recently, I had a video analysis done while running on a treadmill. I don't overpronate at all despite the flat feet. I'll purchase whatever is the Editor's Choice for stability shoes in Runners World. Almost of the shoes work out fine.

I thought I read somewhere there is not much a piece of plastic can do to slow pronation given the amount of force (several times bodyweight) that is applied.

Anonymous said...

Very interesting post. I can't help feeling that Oscar Pistorius is judged as having an "articfical advantage" (which he obviously has but that goes off topic)

But running shoe technology moves on (or so the manufacturers tell us) - at what point will shoe (or other gear) technology become an artificial advantage?

My switch from heel striker and reliant upon BIG heels to pose runner is in the link below.

Dora said...

I have been running mainly in Nike's for 3 years but recently started getting shin splints. After having a gait test it revealed I was over pronating and I was advised to try support shoes. Many people I had ran with in the past also noticed my foot pronating and advised me the same. A few days ago I bought the new support shoes. After 3 runs, I am sitting here in agony.. browsing the internet in search of answers to the question 'Can shoes which are designed to prevent injury actually CAUSE it?' I am due to do London Marathon in 3 weeks, a dream come true for me, something I have been training so hard for. Now I am heartbroken, I can't put weight on my left foot at all. The pain is unbearable. I have no doubt it was the shoes.

Anonymous said...

7 years ago I had an injury (achilles, I couldn't run anymore, I was biking in stead; then suddenly I got an idea: run barefoot; my intuition was right: the injury disappeared, I enjoy running now even more; especially the sensuous feeling with all the different faces of the earth

Unknown said...

Hi I am a podiatrist
I have just found this blog and I will read it and comment

Dennis Rehbock

Anonymous said...

I've been running marathons for 3 years. Last year I started having lots of knee issues and hip issues so I went to a PT who gave me a series of strengthening exercises. In addition, I have been experimenting with barefoot running both on and off road as well as getting into more "barely there" footwear like racing flats and vibram 5 fingers. I do all my long runs in flats and it seems to be helping me. I would love to build up to doing long runs barefoot and perhaps even racing barefoot but I am a long ways from there currently. BTW, Vanilla, your blog is too funny!

Barefoot running is liberating and fun and it seems to help to keep me injury free.


Anonymous said...

Great post! Hi, i'm a new reader in your blog. i often sprain when i'm running. i'm ever think that one cause my shoes, maybe its shape. what is your idea? thanks.

Anonymous said...

In a very belated response to Asher, You are confusing Mary Slaney with Zola Budd...Zola ran barefoot...MDS was a marquee Nike athlete...The two are often mentioned due to their infamous '84 Olympic race...

L. Wu said...

One thing I realized recently is that just as in lifting, there's a difference between training to be healthy and training for performance.

Modern running shoes can help you perform better by masking your weaknesses--unbalanced muscles, untrained tendons--which means you can run faster and for longer periods of time.

Does that mean you can run in a sustainable way, or that you will have healthy feet at the end of your runs? Heck no.

blokie said...

This topic kills me. I'm all for anything that is more natural but no one considers both sides of the "coin." Ya indigenous people run barefoot and are relatively injury free but comparing them with people of industrialized countries such as "us" is like comparing apples and oranges. We have created a concrete jungle and whomever or however you believe humans were created it is NOT natural to run on pavement and therefore I agree the use of running shoes is a necessity. So when this Doctor who started this blog does his studies on whether or not barefoot is a solution when pounding pavement as opposed to soft dirt while running through the desert he shouldn't quit his day job. The solution isn't going to be discovered by blaming the shoe companies, you have the choice of doing your own research and believing what you want to believe, much like the debate of whether god is actually "real" or just made up. If you believe shoes aren't natural but neither is running on pavement then run barefoot through the trails... its simple. Stop trying to reinvent the wheel, these companies have more money than you'll ever have to convince the majority that shoes are necessary! They'll win.

Ross Tucker and Jonathan Dugas said...

Hi Blokie

I don't know if you'll return to read this reply to your comment - I hope so.

I really would suggest that you actually read the post. It seems to me that you're writing a long comment about a post that is a figment of your imagination. I am not saying we should run barefoot. I am considering both sides of the argument, and I realize the incentive of the companies.

If you read the post, you'll see all that. Maybe then the topic wouldn't kill you. but you brought pre-conceived ideas into the post and read what you wanted to read.


Anonymous said...

Citations needed.

Rod said...

I do not believe that running long distances, especially on pavement, is natural for the human body. There is no species of primate that naturally runs long distances. Perusing a natural form for an unnatural activity is not likely to be optimal.
The design of the human body is not perfect and each body is a less than perfect implementation of that design. It is delusional to think that for most people the body will achieve optimal performance on its own.
The assertion that midsole cushioning can “fool the system into underestimating the impact” and the “system responds by landing harder in an attempt to compress the cushion and 'feel' the ground” misrepresents the mechanism the body uses to adapt and protect itself. The statement suggests that running on natural soft dirt would confuse the body more than artificial hard cement.
Antidotal evidence of individual experiences cannot be used to prove cause and effect. A scientific comparison study that isolates the effects of shoes and orthotics on running performance is required.

Unknown said...

My own experience. I am an older runner/jogger. Been so for about 30 years. I use to buy common, everyday running shoes and just plodded along just fine. About 6 years ago a shoe salesman said that maybe I should try a 'motion control' shoe since it looked as though I may over-pronate. So I did. Shortly there after I purchased another pair of shoes and since the sales person seen I was wearing motion control shoes, he sold me another pair, then another, another, and another pair. 6 years later I started having horrible lower leg pains. Went to therapy and even chiropractors. Not much helped until one day I noticed that while walking barefoot my pain was none existent. A few weeks ago I purchased a pair of 'normal' athletic shoes. My pain seem to be subsiding. And one thing,, I notice when I wear the motion control shoes I do pronate but when I wear the normal shoes I don't. I think I'll end up tossing all my motion control shoes and just go back to what I was wearing 6 years ago before this all started. Thanks.

Anonymous said...

A little antecdotal evidence in favour of "less shoe." I decided to run a marathon when I turned 50 and began running. (I had run intermittantly to get in shape for other things over the years, but had not run seriously since high school.) I went to a local running shore and the young salesperson sold me a pair of stability shoes (which I understand is what most runners use). They worked fine until I got up to runs in the 17+ mile range at which point I got severe calf cramps which took weeks to go away. After a couple of rounds of this (and missing my hoped for marathon because of it) I went to a running store with a treadmill and discovered I should have been running in neutral shoes. The switch to neutral shoes allowed me to complete my marathon (and 6 more that year) but I always seemed to have some ache or pain plaguing me. Recently while I was ramping up my training to go for another stretch of marathons, my wife bought me "Born to Run" by Chritopher McDougall and I became intrigued with the possible evolutionary reasons for running barefoot. I was inspired to buy a pair of Nike Free 3.0s as a "barefoot" shoe and later a pair of Feelmax shoes (booties is a more appropriate name for these). I now run in the Nike Frees almost all of the time and have even taken the insoles out because they began to feel too soft and had too much of an arch. I have raced a half marathon and a 5 K in these and have run up to 21 1/2 miles training in them and have suffered fewer aches and pains than in any previous time of heavy training. My feet do feel tired after long runs, and I do occasionally switch back to my conventional neutral shoes for a run or two as a break. I have run a bit in the Feelmax booties but I can't adapt to them quicky enough as I need to keep my training milage up right now. They are really much more "barefoot" than the Nikes. I do think that that the lighter shoes have forced me to change my gait somewhat to reduce impact, and I attribute my reduced aches and pains to that more than the shoes, but I do believe the stabilty shoes caused me injury (although it took long runs to bring it to the surface) and even the neutral conventional shoes covered up poor running technique to some extent. I am going to use the Nikes for my next marathon and after that hope to increase the amount of running I do in the "booties" and see how that goes. I'm hoping it continues to work for me. I stand to save a lot of money on shoes if it does and like many middle aged runners, I am looking for ways to train a little harder without injuring myself.

Anonymous said...

A nice article, but where are your references from all the quotes, facts and statistics you put in it????

Anonymous said...

In 2003, I had a severe ankle sprain (with torn ligaments) on my left ankle and could not run after this. If I ran more than 1 km, I would be in severe pain for a week. Of course, my weight went way up in the next 6 years. So in summer 2009, I decided to get back into running by educating myself about other ways I could run, and found many books on proper technique. I had no idea that there was more to running than just plodding along. I have changed my gait and shoe completely. For running form, what works for me is to use a footstrike that is about 75% or more on the forefoot and 25% or less on the heel, with the foot hitting the ground right under my hips - no forward reaching heel strikes. For the shoe, I have taken to Nike Free shoes, using first the NF5.0 for about 2 months and for the past 2 months now the NF3.0 as these "encourage" me to have the more optimal footstrike through instant feedback - short term pain if I do it wrong. I am now preparing for my first ever marathon in 1 week, having done 3 months of training including regular single day runs of 21 to 35 km with weekly runs of 100 km or more. I have had no injuries and no persistent pain, beyond what would be normal muscle and ligament aches, which are gone in 2 days. For normal walking around, I use Vibram Five Fingers to reinforce proper foot movement technique and strengthen the small muscles, ligaments, tendons of the lower leg and foot. So I think that the running shoe debate should recognize that every body is different, people train for different reasons or purposes and therefore require different "kit". Conversely, if people want to try out a very different style of footwear, it is sensible to gradually work into it over a period of months, not days. To think that you can strap on a pair of Nike Free 3.0 and go out and run a half marathon is unreasonable - if you can only benchpress 150 pounds, no one in their right mind would suggest that making a leap to a 300 pound benchpress is healthy or risk-free. Beyond developing proper technique specific to the sport, it would be prudent to work your way into the new footwear with planned and dedicated training, or you will risk injury from a lack of patience and planning, not from the running shoe itself.

Anonymous said...

I'm not a runner. But I walked the Camino (in Spain) in expensive walking shoes, I forget the brand, a German brand -- they had inflexible soles and were very hard on my foot, but I couldn't feel any stones underneath which was great. I bought them cos someone who had walked the Camino recommended them.

I developed extremely painful shin splints, and completed 650km on strong anti-inflammatories, taken every day. Midway I had to skip a stretch (three days off) due to total inability to walk. Most days I relied on my walking sticks to take the weight off my legs.

Why I'm writing this comment is this: On return, I bought the Asic running shoes my PODIATRIST had recommended before I took the walk (he had recommended them for general use, he didn't know I was doing the Camino). I also inserted the soft inner soles he made up especially for my foot, and I have not had a shin splint since! But every time I put on the inflexible walking shoes, I get instant shin splints.

I found the info on barefoot running interesting. For the final 30km of the Camino, I wore my Haviana slip slop on one foot cos I had a painful blister. I couldn't wear it on the other foot cos my arch felt like it would collapse. But I do tend to believe shoes are educating our feet to be weak. Take a look at ballet dancers -- they've been doing pretty well with just a piece of leather separating the floor from their exceptionally strong feet. (Okay, they are beset with injuries...!)

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Anonymous said...

An interesting discussion, as when I read Christopher McDougall's "Born to Run" it really stuck a note with my experience of having grown up barefoot / in sandals, and never having owned a pair of running shoes before the age of 50. When I ran my first trail-marathon it was in slip-slops and people thought I was crazy. Since then I have bought several pairs of trail-running shoes of major brands (Mizuno, Salomon, Ascis, Adidas..) and found them useful for their obvious use in mud, stony and thorny trails, but they certainly have created problems with my soles (partially collapsed front arches), toenails (lost a few), calves (tight and strained tendons). When I race now, I mostly do so in shoes, but always try to run in my Vibram 5-finger minimalist slippers or slip-slops (thongs) if there is not too much mud or variation in substracte. My feet certainly feel best when unshod. I believe people like shoes only because they are used to wearing them or that they serve an obvious protective function to the sole, but that the supportive functions are indeed deleterious to the natural motion of the foot & leg.