Page 110 - Journal of Special Operations Medicine - Spring 2016

his regular training shoe. The type of shoe (conventional minimalist shoes. Investigators will collect data on
or minimalist) was determined by the manufacturer’s foot strike patterns, energy cost, and other measures.
descriptions. Injuries to the Soldiers were examined in These data will be obtained at the start of the study, at
a 12-month period before the shoe examination. This 6 weeks, and at 26 weeks. Injuries will be tracked dur-
study found there was virtually no difference in injury ing the entire 26-week period. Findings from this study
rates between those wearing conventional versus mini- should add considerably to our knowledge on running
malist shoes (Figure 6, far right). mechanics and injuries related to minimalist footwear.

Although these four studies of minimalist footwear and Until better and more consistent evidence is available,
injuries appear to present somewhat confusing results, runners should pick shoes based on the recommenda-
let us take a critical look at each. Acknowledged limita- tions from the American College of Sports Medicine
34
tions of the earliest questionnaire study were mostly (ACSM). The ACSM has a two-page guide on the selec-
related to the self-reporting of information and the na- tion of running shoes. The guide is available at https://
ture of the runners recruited. The authors noted that www.acsm.org/docs/brochures/running-shoes.pdf. Also,
one of their previous studies indicated that 69% of run- the US Army has a minimalist running shoe website
ners were able to distinguish between rearfoot and fore- (http://armymedicine.mil/Pages/Minimalist-Running-
foot strike patterns. Thus, there may have been some Shoes.aspx) that contains practical information on US
mistakes in reporting foot strike patterns. The question Army–approved types of running shoes and a transition
used to obtain injury data was well stated, but injuries program for switching from conventional running shoes
were self-reported rather than obtained from medical to minimalist shoes.
records and participants may not have remembered
all injuries they experienced. Minimalist-shoe runners Acknowledgment
reported more years of running and may have been a
self-selected group. They may have better known how We thank Ryan Steelman for assistance with the figures.
to avoid injuries, whereas those with continued in-
jury problems may have ceased running and not been Disclaimer
included in the study. Finally, it was possible that the
minimalist shoe runners who were recruited were those The views expressed in this presentation are those of the
most enthusiastic to share their experiences, resulting in authors and do not necessarily reflect the official policy
a biased sample. of the Department of Defense, Department of the Army,
US Army Medical Department, or the US government.
In the Fort Carson study, it was not clear how long The use of trademark names does not imply endorse-
37
the Soldiers were using their shoes or if the injuries were ment by the US Army but is intended only to assist in the
directly related to running, since the study only exam- identification of a specific product.
ined total injury incidence in the past year. On the other
36
35
hand, the Vancouver and Brigham Young University Disclosure
studies had well-defined groups of participants and
prospectively tracked running-related injuries. Despite The authors have nothing to disclose.
these favorable study characteristics, the two studies 35,36
followed the runners for only 10–12 weeks and mini- References
malist-shoe runners were not fully adapted to the new
footwear, since participants were not performing all 1. Altman AR, Davis IS. Barefoot running: biomechanics and im-
their training in the new shoes by the end of the inves- plications for injury. Curr Sports Med Rep. 2012;11:244–250.
tigations. Nonetheless, these two prospective studies do 2. Jenkins DW, Cauthon DJ. Barefoot running claims and con-
troversies. A review of the literature. J Am Podiatr Med Soc.
suggest that injury rates are higher during the transition 2011;101:231–246.
period from conventional to minimalist shoes. In addi- 3. Esculier JF, Dubois B, Dionne CE, et al. A consensus definition
tion, there are several case series of runners who were and rating scale for minimalist shoes. J Foot Ankle Res. 2015;
38
injured during transitioning to minimalist shoes or 8:42.
switching to minimalist shoes without any transition. 39 4. Hollander K, Argubi-Wollesen A, Reer R, et al. Comparison
of minimalist footwear strategies for simulating barefoot run-
ning: a randomized crossover study. PLOS ONE. 2015;10:
Longer-term investigations are needed in which run- e0125880.
ners are followed not only during the transition pe- 5. Perl DP, Daoud AI, Lieberman DE. Effects of footwear and
riod but also for periods when they are fully adapted strike type on running economy. Med Sci Sports Exerc. 2012;
44:1335–1343.
to minimalist shoes. One ongoing project is conduct- 6. Squadrone R, Gallozzi C. Biomechanical and physiological
40
ing a 26-week, prospective, randomized controlled trial comparison of barefoot and two shod conditions in experienced
comparing individuals training in conventional versus barefoot runners. J Sports Med Phys Fitness. 2009;49:6–13.

94 Journal of Special Operations Medicine Volume 16, Edition 1/Spring 2016