Research presented at the Annual Meeting of the American Academy of Orthopedic Surgeons (March 19, 2013) and to be published next month (Journal of Strength & Conditioning Research, April 2013) shows that running shoes with thick heels can slow you down. They may also increase your chances of injuring yourself.
Adolescent competitive track athletes ran on a treadmill
in heavily padded-at-the-heel sneakers, track shoes or barefoot,
at four different speeds.
CHANGING FOOTWEAR CHANGES LANDING: Wearing cushioned heel
sneakers caused the runners to land on their heel 70 percent of
the time at all speeds. Wearing track shoes caused them to land
on their heels less than 35 percent of the time. Running
barefoot, they landed on their heels less than 30 percent of the
time. Shoes with cushioned heels caused runners to land on their
heels, while wearing track shoes or no shoes at all caused a
forefoot or mid-foot landing.
HARM FROM HEEL STRIKE: Barefoot runners tend to land on
their mid-foot or forefoot. Cushioned heels on running shoes
tempt runners to take longer strides, so they land on their heels
and smack the ground with a much greater force.
Landing on your heel causes the force of your heel
striking the ground to be transmitted with more direct and greater
force to your hips and knees. Running in flat-soled shoes that
promote a forefoot strike transmits less foot-strike force up your
leg to your back and helps to prevent hip and knee damage.
One study reports that running barefoot, in and of
itself, is neither good nor bad. The key is to decrease the force
of your foot hitting the ground. Running barefoot encourages you
to take a shorter stride and hit the ground with less force
(Journal of Strength and Conditioning Research, 2012; 26 (8):
WHY RUNNERS ARE INJURED SO FREQUENTLY: Harvard University
evolutionary biologist Dan Lieberman claims that modern running
shoes may explain why fifty percent of serious runners are injured
at least once a year. He also believes that people with joint
replacements of their lower extremities should not run (Nature,
LANDING ON YOUR HEELS: Modern running shoes have features
that cause runners to land on their heels with forces of at least
three times body weight at six-minute mile pace. The faster a
runner runs, the greater the force, which causes stress
fractures of the feet and lower legs, shin splints, tears in the
fascia on the bottom of the feet, knee and hip pain, tendon and
joint damage and more.
LANDING ON YOUR FOREFOOT: Hitting the ground with the heel
first generates tremendous force because it stops the foot
suddenly and temporarily. On the other hand, landing on the front
of the foot allows the foot to keep on moving as the heel is
lowered toward the ground to distribute the forces throughout the
entire lower leg. For example, drop a pen on the tip of one end.
It hits with tremendous force because it stops when it hits the
ground and then falls forward. However if the pen were dropped on
the side of one end, it would hit the ground with much less force
because after hitting on the side of one end, the force would be
distributed as the pen falls backward to the other end.
EXCESSIVE PRONATION: In the 1960s doctors thought that the
high frequency of running injuries was caused by excessive
pronation, a rolling inward of the foot after the heel strikes the
ground. They felt that the foot rolled inward toward the arch to
dissipate the tremendous heel strike forces.
This, in turn, caused the lower leg to twist inward and
they blamed the frequent running injuries on the inward twisting
motion of the leg after heel strike. They invented running shoes
with special arch supports called orthotics to limit inward
rolling and built running shoes with thick heels to cushion some
of the shock of the heel hitting the ground. These features
increase the likelihood that runners land on their heels. Today
the standard treatment for many running injuries is special
orthotics and padded heels to help heal running injuries. I have
written about and prescribed these features for many of my
patients with running injuries.
LESS FORCE WITH FOREFOOT LANDING: Dr. Lieberman felt that
if the runners ran barefoot, they would be less likely to land on
their heels and therefore would not need to wear shoes with padded
heels and orthotics. He has shown in elegant experiments that
landing on the front part of the foot reduces the force of the
foot strike very significantly.
However, he has no data to show that running injuries
can be prevented by running barefoot. He has shown only that
modern running shoes tend to encourage a runner to land on his
heels, and that heel strike generates more force than front foot
strike. Also, many roads have stones and cut glass that can
cause injuries, and most runners have such thin skin on the bottom
of their feet that they couldn't possibly run barefoot or in thin
TODAY DOCTORS STILL PRESCRIBE ORTHOTICS: Most sports
medicine doctors treat many running injuries with running shoes
with orthotics and thick heels. Now we have running shoes with
very thin soles and minimal heels (such as Vibram Five Fingers or
Dunlop Volley). Indeed, Vibram supported Dr. Lieberman's studies.