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Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass

Fuller, J. T., Thewlis, D., Buckley, J. D., Brown, N. A. T., Hamill, J., & Tsiros, M. D. (2017). Body Mass and Weekly Training Distance Influence the Pain and Injuries Experienced by Runners Using Minimalist Shoes. The American Journal of Sports Medicine, 363546516682497. https://doi.org/10.1177/0363546516682497


This randomized clinical trial performed in Australia investigated running injury risk in 61 male runners with a mean age of 27 years old. All participants had a rearfoot strike at the beginning of the trial and met minimum training and performance requirements. Participants were randomized to a minimalist shoe or conventional shoe group for the remainder of the study. The minimalist shoe runners were then transitioned from their conventional shoes to minimalist shoes gradually over a 26 week period. Ultimately, 31 runners were allocated to the minimalist shoe group and 30 runners were allocated to the conventional shoe group. Runners completed a visual analog scale (VAS) weekly to assess their pain levels.
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home_cover-73x98 Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass Journal Club Sports Medicine | JC   home_cover-1x1 Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass Journal Club Sports Medicine | JC   Screenshot-2017-02-04-14.12.35-300x264 Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass Journal Club Sports Medicine | JC

Linear fixed-effects model predicted differences in weekly pain between minimalist and conventional shoes relative to weekly training distance.

Key findings of minimalist vs. conventional shoes include:
  • Knee, calf, shin, and ankle pain scores were significantly higher (more self-reported pain) in the minimalist shoe group than the conventional shoe group
  • There were no differences in foot, thigh, or lower back pain scores between groups
  • For runners using minimalist shoes, the risk of injury increased with increasing body mass and with increasing training distance
  • For runners using minimalist shoes, a body mass of 85kg or more correlated with a 68% chance of injury by the end of the 26 week training period
  • For runners using minimalist shoes, a weekly training distance of more than 21.7 miles resulted in a clinically significant increase in calf pain compared to conventional shoes
  • A weekly training distance of more than 24.9 miles resulted in clinically significant increases in shin and ankle pain compared to conventional shoes
  • Runners over 187 lbs were more than 3x as likely to sustain a running injury
  • The study authors concluded that heavier runners should avoid running in minimalist shoes
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