Shoes matter, but so does technique…

*** Modified post. I’ve been able to get a hold of the original paper about transitioning to Vibram FiveFingers. So read on, or read again, for some slight changes to the text. ***

There’s been noise lately about a settlement that Vibram, the maker of the famous (or infamous, according to some) FiveFingers “shoes”, has agreed to pay to their customers.

The issue is over false claims, or so the class action lawsuit alleged, that FiveFingers prevent injuries and make muscles and tendons stronger.

A quick search on the subject will surely reveal quite a bit, but I’ve sprinkled a few links in this post, to provide more details. First, the oldest reference to the lawsuit I could find, from July 2012.

Blog item from ABC

The most recent article, in a Canadian magazine, appears to provide the conclusion of the process. Note that Vibram has agreed to pay; I’m no lawyer (I’m a scientist), so I would be willing to bet that the issue revolves around what would constitute a solid enough proof of the statements made by Vibram. I’m pretty sure no scientist would be willing to proclaim the statements are proven beyond a doubt. That’s just the way science works…

Blog in Canadian Running

But what fascinates me about this is the tone of some of the articles. Some “reporters” and bloggers clearly showed their stripes and did not hesitate to bash Vibram, minimalist shoes, and the whole barefoot running movement. It felt like a deep, quasi-religious, fighting line has been drawn. I won’t bother you with those articles; the ones in reputable running magazines were far more neutral, and carefully written, as they should be.

Some, however, did something very clumsy, unlike the main magazines: They linked the lawsuit to a piece of research pertaining to indicate that wearing FiveFingers leads a high percentage of runners to foot bone injuries. You can read the news about the report there:

Report on study in Runner’s World

Note that the study, and the lawsuit, are in no way related. But it sure is convenient as a coincidence. Especially for the makers of conventional running shoes.

Before going any further, allow me to state a few key points, just to be clear:

1. In my experience as runner and coach, it is possible to run correctly in almost any pair of shoes, be they “conventional running shoes” or “minimalist”.
2. I do not believe there is a conspiracy by running shoe manufacturers to cause harm to runners by making shoes that they know will cause injury. Even though by some accounts 70% of runners using “conventional running shoes” will get hurt at some point.
3. What I do believe is this: there is a natural tendency to want to protect your business and market share. That’s called having a vested interest in a certain situation. There is no need for any kind of conspiracy when the incentives are aligned. Companies will do what is in their best interest.
4. There is a correct way of running, and it is easily demonstrated. No matter what anyone in the running shoe industry says about each of us being different. They only try to muddle the issues, and it is very sad.
5. What has probably happened with the minimalist and barefoot movement is not an indication that the safety and benefits of those shoes have been overstated, but rather that the weakening of our bones, muscles, and tendons over the years of walking, and especially running, in shoes designed to “protect us”, has been grossly under-estimated.

Now, perhaps the lawsuit was brought about by someone “strongly encouraged” to do so by the big shoe manufacturers. And maybe the study referred to in Runner’s World was also similarly sponsored. (There are some issues about that research, so please see at the end of this post for my notes. But the main problem I’ve encountered is that the second-hand source all seem bent on using it to point nasty fingers towards Vibram and minimalist and barefoot running, whereas the research paper was pretty much simply stating that transitioning must be done slowly, and carefully.)

But, ultimately who cares? The lawsuit was settled, so let’s move on. Preferably, by continuing to run.

Full disclosure: I currently own 3 pairs of FiveFingers, and a fourth one I used to own recently “died” after a long and satisfying life. Like some of the commentators on the blog posts and articles I’ve read, if I get a refund from Vibram, I will use the money to get an extra pair of FiveFingers, and I’ll keep using them for running. I even got married in a pair of FiveFingers. I hesitate to call them shoes as to me they are more like gloves for feet. I also own Ecco’s Biom Project shoes, and Asics runners (2 pairs), which I still use at times, when running marathons and ultras, and when racing triathlons. So there.

Now allow me to finish with the main point, before I forget: The correct way to run.

It is my contention that there is such a correct way, as already stated, and that it can be done in any pair of shoes. How do I know?

Not from understanding physics (which I do) and its application to bio-mechanics, or coaching a lot of runners (which I have), or transitioning myself late in life from a heel striker to a forefoot runner (which I have, over a period of 2 years). The answer is actually much easier to understand.

Consider the animals that we are. Remove us from this modern society we’ve built, and in which, by and large, we are no longer fit in an evolutionary sense. Let’s travel to the Land Before Shoes. How did we run then? Not on our heels, that’s for sure!

Test it for yourself. Take your shoes off, and try to run, even if for just a few steps.

You’ll immediately, instinctively, switch to a forefoot striking gait, and that striking will be absorbed in large part by the arches and ankles of your feet, and the tendons and muscles of your legs. Because that’s what they have evolved to do! (Normally, I urge people to do this test on soft grass, but it is possible to heel strike on very soft ground, so be cautious, and do it on a hard but clean surface, for full effect.)

Watch young children run barefoot. You’ll immediately notice that when not taught otherwise, we all run with a forefoot striking gait.

That is the correct way to run.

It’s just that over years of under-use, over-protection, we have not developed the needed sturdiness to run that way as adults.

It takes time, much more than a few weeks, to compensate. And it can be painful. And you risk injury if you try to do too much, too soon. So it should probably only be attempted with the help of a good coach.

Yet the conclusion is inescapable: There is a correct way of running.

It just may not be the way everyone can run in this day and age. For having run too long in conventional shoes, or lacking the patience to rebuild their bodies…

In case of doubt, wear shoes, and make a run for it!

Photos by Sacha Veillette.

Notes on the original research paper by Sarah T. Ridge et al.

For those interested, and because I am a scientist first and foremost…

In terms of methodology, the design of the research was sound, as far as it went. However, I have concerns over the following items, some of which may invalidate the conclusions:

1. While selection of FiveFingers users was random (among each group of men and women, so that’s good), all runners were experienced runners. Which means they were all used to running in conventional shoes, and had not been injured (or said so) in recent past. So far, so good. Except for a bit of psychology of running: Although the runners were given instructions on how to transition, most runners who are used to running a certain distance per week have a tendency to think they know what they are doing. In a word: they feel they can do it, no matter what. The odds of the FiveFingers group actually having followed the transition plan are slim, in my estimation. And my estimation is supported by the reported fact that FiveFingers users peaked their training volume in week 4 of the study, way too early! Simply put: they probably tried to run more with the FiveFingers than they should have, got hurt, then scaled it back down, but it was too late.
2. Regarding the MRI results, which I’m told were taken with a somewhat low quality machine, the convention of what constitutes remodeling of the bones and injury is arbitrary. And perhaps a bit conservative. Being slightly less conservative, by only one level on the scale used, might change the conclusion. Interesting fact also reported in the article: the results are comparable to having sedentary people start running and doing it for 7 days straight. No one should go from 0 to seven straight days of running, but you would expect major work to begin in the bodies of those who do, and yes, some injuries to result from the abrupt change. Duh!
3. There were initially 43 participants recruited for the study. They were divided roughly equally between the FiveFingers, and the control. Which means there should have been 21 and 22 participants in each group. 19 completed the study in the FiveFingers group, so a drop of 2 or 3, whereas 17 completed in the control (a drop of 5 or 4, depending on the exact split between the groups). The numbers and specific reasons for the drops were not disclosed on a per-group basis, but we know 3 participants did not show up at the end for the MRI, 2 got injured for “unrelated reasons” during the training, 2 never returned calls (so probably did not even train, or perhaps trained and got hurt right away). Hiding what exactly happened to those participants is one way to bias results. What if there were 5 drops from the control group, and it was all because they got injured, and not at all for “unrelated reasons”? For instance, for reasons related to the conventional shoes, but not in the feet, like knees and hip problems? The picture would look very different, and actually quite comparable between the two groups.
4. Leaving aside the possibility of manipulation of the results, which I’m pretty sure the authors were not trying to do, it is worth noting what their own conclusion really said: Far from an indictment of running in FiveFingers, they indicated that transition should be done very slowly, and more slowly than prescribed at the time by the folks at Vibram. (Those guidelines, we are told in the paper, had been changed between the start of the work and the publication of the paper, by the way.) I would go even further: taking a bunch of experienced runners, who in my experience are notoriously bad at following coaches’ advice, is a recipe for disaster. When you transition to minimalist shoes, you should take a lot of time, and ideally start as if you were starting to run from scratch. Very few experienced runners are willing to hold themselves back to that extent, and that is why we get hurt. Yes, I count myself in that lot, even though it took me a long time, my adaptation is not complete yet, and I had some major pains bordering on injury.
5. The only way to get a definitive answer on this question would be to take two groups of newbie runners through a strictly controlled regimen of training. One group in each type of shoes. That would take time, but it would be better science. Of course, if you change the way you run, you will have major adaptation and risk of injury. But let’s see who, of the two groups, would actually get hurt less, and what their feet, legs, knees, and hips would look like at the end of the program. That would be interesting. Anyone has some funding available?