Sigh, a fanatic.
Just like the previous condescending sarcasm about ancient humans, this is totally unhelpful to the discussion.
I’m by no means a “fanatic” (though I admit I do enjoy walking, hiking, and sometimes running barefoot or wearing “minimalist” shoes like thin leather moccasins or vibrams). Personally, I couldn’t care less what shoes someone else decides to wear.
It’s fine to present evidence, and then make careful logical arguments clearly supported by the evidence. It’s also fine to present personal opinions, anecdotes, and beliefs, as long as it’s clear that’s what they are. I just hate
FUD. When people take limited evidence (such as for instance, Vibram’s lawsuit settlement or this BJSM paper) and try to spin it as proof about much broader questions, using a confident tone of voice to shore up weak arguments and flimsy evidence, I find it annoying.
I’m similarly annoyed when people make FUD-ish claims about keyboard ergonomics, electronic gadgets, political systems, or whatever else.
Look, the fact is that unless you are an infant who has never worn any shoes, transitioning from normal to minimalist shoes is a necessary and inevitable process if you wish to use minimalist ones. If that process is dangerous and painful, as it is, then this is an important issue and is highly relevant to any discussion of the benefits/drawbacks of said shoes.
Yes, transitioning carefully and safely is important. That’s why I just said so multiple times in my previous posts.
... But they didn’t really study various ways of transitioning, or the concept of transitioning in general. They gave a relatively small number of people a (IMO extremely aggressive) preset transition schedule to keep, without as far as I can tell any advice or training or literature, and then measured the results across two types of shoes and one control type (the control was similar to their existing shoes). All this proves is that that specific transition regime caused more pain than not transitioning, and maybe a few injuries. Okay, fine. That opens up a bunch of questions for future research (like what the injury rate looks like with different types of transitions schedules, etc.), but doesn’t really prove anything more general about the merits of one type of shoe.
Note that the participants in that study were exclusively those with neutral or mild pronation; so in other words, those with moderate or pronounced pronation were excluded; so in other words the study exclusively selected from people who had the least requirement for supportive shoes and who would be the least likely to experience injuries from barefoot styles. I don't know why they made this choice,
Quoting from the paper itself, “Each participant’s foot posture index (FPI) was documented and only individuals with feet categorised as ‘neutral’, ‘supinated’ or ‘pronated’ according to the guidelines by Redmond et al. were included in this study; foot postures at the extremes listed as ‘highly pronated’ or ‘highly supinated’ were excluded.”
They don’t explicitly say this, but my guess is that they excluded people with extreme foot postures because they were already studying a very small sample population, and didn’t want to have to deal with too many extra confounding variables.
Of course, some other counfounding variables weren’t addressed: “Additional data regarding concurrent sport participation was not recorded and may have influenced the outcomes”
* * *
Anyway, let’s take a look at what the paper actually reports:
They analyzed 99 participants (they started with more but a few dropped out): 32 wearing regular running shoes, 32 wearing “partial minimalist” shoes (Nike Free), 35 wearing “full minimalist” shoes (Vibram Bikila). They had them do 12 weeks of training leading up to a 10k race, starting with 160 minutes of running in the first week (~4 runs x 40 minutes) up through a peak of 215 minutes of running in week 10 (~4 runs x 60 minutes), before a couple weeks of taper, and had people ease in “slowly” starting at running 20% in the new shoes at the first week up to 60% the last week.
They measured cumulative “injury events”, where “injury event” = “three consecutive missed run workouts secondary to running-related pain”.
Of the 35 Bikila wearers,
7 were injured during the 12 weeks: 2 at wk 2, 1 at wk 4, 1 at wk 6, 2 at wk 9, and 1 at wk 12
Of the 32 “normal shoe” wearers,
4 were injured, at weeks 3, 4, 10, and 11, respectively.
This difference is not statistically significant at the
p=0.05 level. (Something they show in their chart but never state explicitly in the paper, which is kind of weird)
Of the 32 Nike Free wearers,
12 were injured, a difference from the control group which is statistically significant at the
p=0.05 level.
Additionally, they measured the foot and ankle disability index (FADI), and found that the mean FADI score dropped for all three groups, from ~98 at the start for all three down to ~92 for the Bikila group, ~93.5 for the regular shoes group, and ~95 for the Nike Free group. None of the group differences are statistically significant.
They also had people rate their pain:
- “For the VAS pain scales, comparison of the pain scores over the 12-week period report little difference. Only in VAS for shin/calf pain did participants wearing full minimalist footwear report significantly (p<0.01) greater pain than both other footwear groups.”
- “there was no increase in foot pain reported in the participants in the full minimalist footwear group”
- “runners in full minimalist footwear condition reported greater calf and shin pain throughout the 12-week period. This finding was not unexpected given the likelihood that some of the runners in the full minimalist footwear condition adopted a forefoot strike pattern that could have resulted in greater (and unaccustomed) loading of the Achilles tendon and triceps surae musculature secondary to a larger ankle dorsiflexion moment immediately following touchdown.”
I really don’t think this study proves anything like what you’re implying from it. In particular, when totally changing running form, I don’t think some shin pain is at all surprising. I and several other people I know who run in vibrams or running barefoot also experienced some muscle soreness or pain when first starting out, something which goes away after your muscles get used to the new form, and which doesn’t inherently lead to injuries if you’re careful.... which is exactly why I’d recommend anyone doing such a transition take it slow and take the rest of the day off whenever they feel any pain.