Do Running Shoes Hurt Our Feet?

The world's runners spend $25 billion a year on shoes with ever more hi-tech gizmos designed to help them go faster and further ... but they could be hurting more than their wallet

AT STANFORD UNIVERSITY, California, two sales representatives from Nike were watching the athletics team practise. Part of their job was to gather feedback from the company's sponsored runners about which shoes they preferred. Unfortunately, it was proving difficult that day as the runners all seemed to prefer... nothing. "Didn't we send you enough shoes?" they asked head coach Vin Lananna

They had, he was just refusing to use them. "I can't prove this," the respected coach told them. "But I believe that when my runners train barefoot they run faster and suffer fewer injuries." Nike sponsored the Stanford team as they were the best of the very best

Needless to say, the reps were a little disturbed to hear that Lananna felt the best shoes they had to offer them were not as good as no shoes at all

When I was told this anecdote it came as no surprise

I'd spent years struggling with a variety of runningrelated injuries, each time trading up to more expensive shoes, which seemed to make no difference. I'd lost count of the amount of money I'd handed over at shops and sports-injury clinics - eventually ending with advice from my doctor to give it up and "buy a bike". And I wasn't on my own. Every year, anywhere from 65 to 80 per cent of all runners suffer an injury

No matter who you are, no matter how much you run, your odds of getting hurt are the same. It doesn't matter if you're male or female, fast or slow, pudgy or taut as a racehorse, your feet are still in the danger zone. But why? How come Roger Bannister could charge out of his Oxford lab every day, pound around a hard cinder track in thin leather slippers, not only getting faster but never getting hurt, and set a record before lunch? Then there's the secretive Tarahumara tribe, the best long-distance runners in the world. These are a people who live in basic conditions in Mexico, often in caves without running water, and run with only strips of old tyre or leather thongs strapped to the bottom of their feet. They are virtually barefoot. Come race day, the Tarahumara don't train. They don't stretch or warm up. They just stroll to the starting line, laughing and bantering, and then go for it, ultra-running for two full days, sometimes covering over 480km, non-stop

For the fun of it. One of them recently came first in a prestigious 160km race wearing nothing but a toga and sandals. He was 57 years old

When it comes to preparation, the Tarahumara prefer more of a Mardi Gras approach. In terms of diet, lifestyle and training technique, they're a track coach's nightmare. They drink like New Year's Eve is a weekly event, tossing back enough corn-based beer and homemade tequila brewed from rattlesnake corpses to floor an army. Unlike their Western counterparts, the Tarahumara don't replenish their bodies with electrolyte-rich sports drinks. They don't rebuild between workouts with protein bars; in fact, they barely eat any protein at all, living on little more than ground corn spiced up by their favourite delicacy, barbecued mouse

How come they're not crippled? I've watched them climb sheer cliffs with no visible support on nothing more than an hour's sleep and a stomach full of pinto beans. It's as if a clerical error entered the stats in the wrong columns. Shouldn't we, the ones with stateofthe-art running shoes and custom-made orthotics, have the zero casualty rate, and the Tarahumara, who run far more, on far rockier terrain, in shoes that barely qualify as shoes, be constantly hospitalised? The answer, I discovered, will make for unpalatable reading for the $25 billion trainer-manufacturing industry. It could also change runners' lives forever

Dr Daniel Lieberman, professor of biological anthropology at Harvard University, has been studying the growing injury crisis in the developed world for some time and has come to a startling conclusion: "A lot of foot and knee injuries currently plaguing us are caused by people running with shoes that actually make our feet weak, cause us to over-pronate (ankle rotation) and give us knee problems. Until 1972, when the modern athletic shoe was invented, people ran in very thin-soled shoes, had strong feet and had a much lower incidence of knee injuries." Lieberman also believes that if modern trainers never existed more people would be running. And if more people ran, fewer would be suffering from heart disease, hypertension, blocked arteries, diabetes, and other deadly ailments of the Western world

The modern running shoe was essentially invented by Nike. The company was founded in the 1970s by Phil Knight, a University of Oregon runner, and Bill Bowerman, the university's coach. Before they got together, the modern running shoe as we know it didn't exist. Runners from Jesse Owens through to Bannister all ran with backs straight, knees bent, feet scratching back under their hips. They had no choice: their only shock absorption came from the compression of their legs and their thick pad of mid-foot fat

Thumping down on their heels was not an option

Bowerman didn't actually do much running. He only started to jog a little at the age of 50, after spending time in New Zealand with Arthur Lydiard, the father of fitness running and the most influential distancerunning coach of all time. Bowerman came home a convert, and in 1966 wrote a best-selling book whose title introduced a new word and obsession to the fitnessaware public: Jogging

In between writing and coaching, Bowerman came up with the idea of sticking a hunk of rubber under the heel of his pumps. It was, he said, to stop the feet tiring and give them an edge. With the heel raised, he reasoned, gravity would push them forward ahead of the next man. Bowerman called Nike's first shoe the Cortez - after the conquistador who plundered the New World for gold and unleashed a horrific smallpox epidemic. It is an irony not wasted on his detractors

In essence, he had created a market for a product and then created the product itself

Bowerman's partner, Knight, set up a manufacturing deal in Japan and was soon selling shoes faster than they could come off the assembly line. "With the Cortez's cushioning, we were in a monopoly position probably into the Olympic year, 1972," Knight said

The rest is history. The company's annual turnover is now in excess of $17 billion and it has a major market share in over 160 countries

Running-shoe companies have had more than 30 years to perfect their designs so, logically, the injury rate must be in freefall by now. After all, Adidas has come up with a $250 shoe with a microprocessor in the sole that instantly adjusts cushioning for every stride. Asics spent $3 million and eight years (three more years than it took to create the first atomic bomb) to invent the Kinsei, a shoe that boasts "multi-angled forefoot gel pods", and a "midfoot thrust enhancer"

Each season brings an expensive new purchase for the average runner

But at least you know you'll never limp again. Or so the leading companies would have you believe

Despite all their marketing suggestions to the contrary, no manufacturer has ever invented a shoe that is any help at all in injury prevention. If anything, the injury rates have actually crept up since the 1970s Achilles tendon blowouts have seen a 10 per cent increase. (It's not only shoes that can create the problem: research in Hawaii found runners who stretched before exercise were 33 per cent more likely to get hurt.) In a paper for the British Journal Of Sports Medicine last year, Dr Craig Richards, a researcher at the University of Newcastle in NSW, revealed there are no evidence-based studies that demonstrate running shoes make you less prone to injury. Not one. It was an astonishing revelation that had been hidden for over 35 years. Dr Richards was so stunned that a $25 billion industry seemed to be based on nothing but empty promises and wishful thinking that he issued the following challenge: "Is any runningshoe company prepared to claim that wearing their distance-running shoes will decrease your risk of suffering musculoskeletal running injuries? Is any shoe manufacturer prepared to claim that wearing their running shoes will improve your distance running performance? If you are prepared to make these claims, where is your peer-reviewed data to back it up?" Dr Richards waited and even tried contacting the shoe companies. In response, he got silence

So, if running shoes don't make you go faster and don't stop you from getting hurt, then what, exactly, are you paying for? What are the benefits of all those microchips, thrust enhancers, air cushions, torsion devices and roll bars? The answer is still a mystery

And for Bowerman's old mentor, Arthur Lydiard, it all makes sense

"We used to run in canvas shoes," he said. "We didn't get plantar fasciitis (pain under the heel); we didn't pronate or supinate (land on the edge of the foot); we might have lost a bit of skin from the rough canvas when we were running marathons, but generally we didn't have foot problems. Paying several hundred dollars for the latest in hi-tech running shoes is no guarantee you'll avoid any of these injuries and can even guarantee that you will suffer from them in one form or another. Shoes that let your foot function like you're barefoot - they're the shoes for me." Soon after those two Nike sales reps reported back from Stanford, the marketing team set to work to see if it could make money from the lessons it had learned. Jeff Pisciotta, the senior researcher at Nike Sports Research Lab, assembled 20 runners on a grassy field and filmed them running barefoot. When he zoomed in, he was startled by what he found

Instead of each foot clomping down as it would in a shoe, it behaved like an animal with a mind of its own - stretching, grasping, seeking the ground with splayed toes, gliding in for a landing like a lake-bound swan. "It's beautiful to watch," Pisciotta later told me

"That made us start thinking that when you put a shoe on, it starts to take over some of the control." Pisciotta's team gathered film of every existing barefoot culture they could find. "We found pockets of people all over the globe who are still running barefoot, and what you find is that during propulsion and landing they have far more range of motion in the foot and engage more of the toe. Their feet flex, spread, splay and grip the surface, meaning you have less pronation and more distribution of pressure." Nike's response was to find a way to make money off a naked foot. It took two years of work before Pisciotta was ready to unveil his masterpiece. It was presented in TV ads that showed Kenyan runners padding along a dirt trail, swimmers curling their toes around a starting block, gymnasts, Brazilian capoeira dancers, rock climbers, wrestlers, karate masters and beach soccer players. And then comes the grand finale: we cut back to the Kenyans, whose bare feet are now sporting some kind of thin shoe. It's the new Nike Free, a shoe thinner than the old Cortez dreamt up by Bowerman in the'70s. And its slogan? "Run Barefoot." The price of this return to nature? A conservative $160. But, unlike the real thing, experts may still advise you to change them every three months

Edited extract taken from Born to Run, by Christopher McDougall. Published by Profile Books, $35

PAINFUL TRUTH 1 THE BEST SHOES AND THE WORST Runners wearing top-of-the-line trainers are 123 per cent more likely to get injured than runners in cheap ones. This was discovered as far back as 1989, according to a study led by Dr Bernard Marti, the leading preventative-medicine specialist at Switzerland's University of Bern. Dr Marti's research team analysed 4358 runners in the Bern Grand Prix, a 15.4km road race. All the runners filled out a questionnaire that detailed their training habits and footwear for the previous year; as it turned out, 45 per cent had been hurt during that time

But what surprised Dr Marti was the fact that the most common variable among the casualties wasn't training surface, running speed, weekly mileage or "competitive training motivation". It wasn't even body weight or a history of previous injury. It was the price of the shoe. Runners in shoes that cost more than $95 were more than twice as likely to get hurt as runners in shoes that cost less than $40

Follow-up studies found similar results, like the 1991 report in Medicine & Science In Sports & Exercise that found "wearers of expensive running shoes that are promoted as having additional features that protect (more cushioning, pronation correction) are injured significantly more frequently than runners wearing inexpensive shoes"

What a cruel joke: for double the price, you get double the pain. Stanford coach Vin Lananna had already spotted the same phenomenon. "I once ordered high-end shoes for the team and within two weeks we had more plantar fasciitis and Achilles problems than I'd ever seen. Ever since, I've always ordered low-end shoes. It's not because I'm cheap. It's because I'm in the business of making athletes run fast and stay healthy." PAINFUL TRUTH 2 FEET LIKE A GOOD BEATING Despite pillowy-sounding names such as "MegaBounce", all that cushioning does nothing to reduce impact. Logically, that should be obvious - the impact on your legs from running can be up to 12 times your weight, so it's preposterous to believe 1cm of rubber is going to make a difference. When it comes to sensing the softest caress or tiniest grain of sand, your toes are as finely wired as your lips and fingertips. It's these nerve endings that tell your foot how to react to the changing ground beneath, not a strip of rubber

To help prove this point, Dr Steven Robbins and Dr Edward Waked, of McGill University, Montreal, performed a series of tests on gymnasts. They found that the thicker the landing mat, the harder the gymnasts landed. Instinctively, the gymnasts were searching for stability. When they sensed a soft surface underfoot, they slapped down hard to ensure balance. Runners do the same thing. When you run in cushioned shoes, your feet are pushing through the soles in search of a hard, stable platform. "Sports shoes are too soft and thick, and should be redesigned if they are to protect humans performing sports," the researchers concluded

To add weight to their argument, acute-injury rehabilitation specialist David Smyntek carried out an experiment of his own. He had grown wary that the people telling him to trade in his favourite shoes every 450km-800km were the same people who sold them to him. But how was it, he wondered, that Arthur Newton, for instance, one of the greatest ultra-runners of all time, who broke the record for the 160km Bath-London run at the age of 51, never replaced his thin-soled canvas pumps until he'd put at least 6000km on them? So Smyntek changed tack. Whenever his shoes got thin, he kept on running. When the outside edge started to go, he swapped the right for the left and kept running. Eight km a day, every day. Once he realised he could run comfortably in broken-down, even wrong-footed shoes, he had his answer. If he wasn't using them the way they were designed, maybe that design wasn't such a big deal after all

He now only buys cheap trainers

PAINFUL TRUTH 3 HUMAN BEINGS ARE DESIGNED TO RUN WITHOUT SHOES "Barefoot running has been one of my training philosophies for years," says Gerard Hartmann, an Irish physical therapist who treats all the world's finest distance runners. For decades, Dr Hartmann has been watching the explosion of ever more structured running shoes with dismay. "Pronation has become this very bad word, but it's just the natural movement of the foot," he says

To see pronation in action, run barefoot down the driveway. On a hard surface, your feet will automatically shift to self-defence mode: you'll find yourself landing on the outside edge of your foot, then gently rolling from little toe over to big until your foot is flat

Your foot's centrepiece is the arch, the greatest weight-bearing design ever created. The harder you push down, the tighter its parts mesh. Push up from underneath and you weaken the whole structure

"Putting your feet in shoes is similar to putting them in a plaster cast," Dr Hartmann says. "If I put your leg in plaster, we'll find 40 to 60 per cent atrophy of the musculature within six weeks. Something similar happens to your feet . . . in shoes." When shoes are doing the work, tendons stiffen and muscles shrivel. "I've worked with the best Kenyan runners," Hartmann says, "and they all have marvellous elasticity in their feet. That comes from never running in shoes until you're 17."