Why Minimalist Shoes Do Not Create Injuries
- Nicholas A Campitelli DPM FACFAS
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The lawsuit against Vibram USA was for making false claims about its footwear product FiveFingers. The website touted many benefits. In particular, Vibram USA claimed your foot can become stronger by wearing FiveFingers. In my opinion, this is a true statement although it was not scientifically proven at the time the claims were made. A 2005 study sponsored by Nike demonstrated a strength gain in the abductor hallucis muscle of the feet after subjects ran six months in the Free shoe.1 We have since seen Miller and colleagues publish a similar study on the New Balance Minimus and Merrell Barefoot Glove, also demonstrating a strength gain in the abductor hallucis.2
My colleagues and I at the Kent State University College of Podiatric Medicine also have scientific data that we collected over the past two years that we are very excited to share as well. While this is a bit too late for this legal battle, it will certainly shed some light on what happens to our feet during normal locomotion in a pair of FiveFingers.
I have been very fortunate to interact with Vibram USA. I spent a lot of time assisting the company in foot education and, with the help of Lieberman, wrote a transition protocol/running brochure for helping others transition to running in this manner.3 I was never employed by Vibram USA nor did the company influence me in any way to endorse their product. I did not sell its product and I do not represent it in anyway.
I reached out to the company five years ago when the barefoot running boom began and explained that this is a great way to protect the feet of those who are running barefoot. It allowed natural running. It was a great product to wear that no one else was making. It was to our feet what gloves are to our hands. The shoes were so simple yet people thought of them as so “weird” looking. However, by wearing them, our feet could function in the normal manner in which they were intended and yet not be considered barefoot.
What Vibram has done for the foot and running industry is truly a milestone. Some may not realize it but they helped change the way we look at running now and, more importantly for me, how we look at foot function.
I was able to resolve a 10-year-old injury, which was the result of ongoing poor biomechanics indirectly related to my motion control running shoes.4 I used FiveFingers as a tool for learning how to run. I had been running since the age of 16 and was able to run professionally at the ages of 37-39 in a 5k, half marathon and marathon. This was not because I was wearing FiveFingers but because I learned how to run.
I guess I shouldn’t say I learned how to run because that could be misleading. I realized the previous shoes I was wearing were inhibiting my ability to run naturally and were altering my gait so much that I was slowing down, placing abnormal stress on my forefoot, and living with chronic pain. Eventually, my injury resolved on its own. The stress to my forefoot diminished as I acquired a more natural gait by running in FiveFingers. As with many, it took time, months in fact. But my changes were permanent and I have been pain-free since 2010.
Addressing The Vibram Claims And Lawsuit
So did Vibram make false claims? I do not feel the company did and I will explain why. Vibram was able to break into an industry that for over 40 years made the claim that our feet needed stability, motion control and cushioning to reduce or prevent injury. This industry not only sold this philosophy to the consumer but also to physicians, who then recommended it to their patients. The industry instilled this idea that shoes need to be fitted according to foot type with respect to arch height into all shoe manufacturers and then the idea passed down to specialty running shoe stores, retail sporting good stores, Runner’s World and other periodicals as well as healthcare professionals.
For the naysayers who will respond to this post with articles and claims that there is evidence, then why has the shoe industry changed? Why has the average drop height of shoes decreased by over 20 percent? Why has the flexibility of shoes increased? Why have the majority of all high-end running shoes companies introduced minimalist shoes (New Balance Minimus, Merrell Barefoot Glove, Nike Free, Adidas Adipure, Altra Running Company, Saucony Kinvara, Brooks Pure, and Skechers GOrun and GOMeb)? If the injury rates are still as high as 70 percent in traditional running shoes, then did these companies not make false claims as well?
Are you getting it? The shoes are not the problem. It is the training patterns and the way people run that create injuries.
The traditional running shoes with high cushioned heels and motion control midsoles are severely inhibiting natural running form so badly that a high percentage of runners are getting injured. Pronation has nothing to do with overuse injuries. I can list countless articles that demonstrate this (and will do so in a later blog post).
In my opinion, Vibram made no more claims than did the rest of the industry over the past 40 years. Look how many individuals bought shoes because they had a gel pad or air in the sole. Have you ever cut open an ASICS gel shoe to see the gel pad in it? There is more cushioning in the case for my iPad. If this gel is so crucial, then consider this. ASICS sells you a shoe with gel in the heel for “X” amount of dollars and if you spend a few extra dollars, you can get gel in the forefoot too. Is the company then liable for injuries to those who could not afford a shoe with gel in both the forefoot and the heel?
Who Or What Is To Blame For Injuries?
The same goes for the Nike shoes and all shoe companies. Consider a physician who recommends running shoes to a patient and he buys the “less expensive” model from the same brand. If this patient buys the $80 shoe instead if the $180 shoe, who is responsible for the injury: the shoe company or the physician? In other words, if the $180 shoe with more motion control and stability propaganda is necessary, why do they sell the $80 shoe? Shouldn’t the shoe companies be responsible for the injuries the $80 shoes created?
In my perspective, shoes do not create stress fractures. Overuse and osteoporosis do. Running in FiveFingers does not create plantar fasciitis. Overuse and weak abductor hallucis, abductor digiti minimi and flexor hallucis brevis muscles do.
Chris McDougall’s book Born to Run has sold over a half of million copies worldwide, was in the New York Times bestseller list for over 200 consecutive weeks and Amazon called it one of the 100 books to read in a lifetime. Should we sue him as well?
As we continue to run, we will continue to have injuries. Don’t blame a shoe company for getting injured. Not relying on support or motion control shoes is what makes the foot stronger. It just so happens that Vibram came up with a product that allowed this to occur.
Thanks for reading and we cannot wait to share the results of our findings very soon.
1. Potthast W, Niehoff A, Braunstein B, et al. Changes in morphology and function of toe flexor muscles are related to training footwear. Available at www.staffs.ac.uk/isb-fw/ISBFootwear.Abstracts05/Foot52.Potthast_ChangesI... .
2. Miller EE, Whitcome KK, Lieberman DE, et al. The effect of minimal shoes on arch structure and intrinsic foot muscle strength. J Sports Health Sci. In press. Available at http://www.sciencedirect.com/science/article/pii/S2095254614000374 .
3. Available at s3.amazonaws.com/VibramFiveFingers/Barefoot_Running_Brochure_R13_062211.pdf .
4. Available at http://www.drnicksrunningblog.com/running-with-sesamoiditis-how-i-resolv... .
Editor’s note: Dr. Campitelli has disclosed that he is an unpaid Medical Advisor to Vibram USA. This blog originally appeared at http://www.drnicksrunningblog.com/ .