Transitioning to Minimal Footwear: a Systematic Review of Methods and Future Clinical Recommendations

Joe P Warne, Allison H Gruber, Joe P Warne, Allison H Gruber

Abstract

Background: Recent interest in barefoot running has led to the development of minimalist running shoes that are popular in distance runners. A careful transition to these shoes has been suggested and examined in the literature. However, no guidelines based on systematic evidence have been presented. The purpose of this review is to systematically examine the methods employed in the literature to transition to minimal footwear (MFW), as well as the outcomes to these studies in distance runners. In addition, MFW transition guidelines for future clinical practice will be presented based on observations from this review.

Methods: A systematic database search was employed using PubMed online as the primary database. Twenty papers were included in the final review.

Results: All studies implemented a prospective transition design to MFW with a detail of this transition provided, which increased MFW exposure up to an average of 60% (30-100%) at completion. Only 8/20 studies included injury prevention exercises, and 9/20 included gait retraining. The main outcomes of this transition included limited positive evidence of transitioning into MFW for running economy (n = 4 studies) and muscle development (n = 5). The injury incidence comparing running during the MFW transition (17.9 injuries per 100 participants) to matched participants in conventional running shoes (13.4 injuries per 100) appears equivocal (p = 0.219; effect size phi (φ) = 0.06 [very small]). Finally, several important recommendations for clinical practice and future research have been presented.

Conclusions: It is hoped that this paper will present important first steps in unifying the process of transitioning to MFW, both for academic and clinical use.

Conflict of interest statement

Author’s Information

None supplied.

Ethics Approval and Consent to Participate

Not applicable.

Consent for Publication

Not applicable.

Competing Interests

Joe Warne and Allison Gruber declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
PRISMA study selection flow chart for the review. The relevant, non-duplicate citations were screened and included in the review if (1) the methods included individuals with previous running experience, of which their experience level was clearly reported; (2) the study prescribed specific details for transitioning to minimal footwear including the proposed exposure to minimal shoes; (3) the study included the use of “true minimal” shoes, based on the published definition; and (4) the study was longitudinal and prospective
Fig. 2
Fig. 2
A simple example of how one might structure the initial stages of a MFW transition. Note that it is not intended that a MFW transition takes place over just 4 weeks
Fig. 3
Fig. 3
An example of the two common prescription methods for MFW exposure (distance vs. time). On the left, it is apparent that athletes running a high training volume (100 km/week) would require a full 20 km of running in MFW to meet the criteria which would present a possibly dangerous exposure. On the right, however, an athlete running just 10 km/week would find themselves running almost entirely in MFW if asked to run 20 min in this footwear, which might also be dangerous, given their low running exposure initially. Therefore, a mixed method is suggested

References

    1. Running USA . 2014 state of the sport—part II: running industry report. 2014.
    1. Kluitenberg B, van Middelkoop M, Diercks R, van der Worp H. What are the differences in injury proportions between different populations of runners? A systematic review and meta-analysis. Sport Med. 2015;45:1143–1161. doi: 10.1007/s40279-015-0331-x.
    1. Hryvniak D, Dicharry J, Wilder R. Barefoot running survey: evidence from the field. J Sport Heal Sci. 2014;3:131–136. doi: 10.1016/j.jshs.2014.03.008.
    1. Rothschild CE. Primitive running. J Strength Cond Res. 2012;26:2021–2026. doi: 10.1519/JSC.0b013e31823a3c54.
    1. Gallant JL, Pierrynowski MR. A theoretical perspective on running-related injuries. J Am Podiatr Med Assoc. 2014;104:211–220. doi: 10.7547/0003-0538-104.2.211.
    1. Lieberman DE, Venkadesan M, Werbel WA, Daoud AI, D’Andrea S, Davis IS, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010;463:531–535. doi: 10.1038/nature08723.
    1. Warne JP, Kilduff SM, Gregan BC, Nevill AM, Moran KA, Warrington GD. A 4-week instructed minimalist running transition and gait-retraining changes plantar pressure and force. Scand J Med Sci Sports. 2014;24:964–973. doi: 10.1111/sms.12121.
    1. Warne JP, Smyth BP, Fagan JO, Hone ME, Richter C, Nevill AM, et al. Kinetic changes during a six-week minimal footwear and gait-retraining intervention in runners. J Sports Sci. 2016:1–9. [cited 2016 Oct 25] Available from: .
    1. Willson JD, Bjorhus JS, Williams DSB, Butler RJ, Porcari JP, Kernozek TW. Short-term changes in running mechanics and foot strike pattern after introduction to minimalistic footwear. PM R. 2014;6:34–43. doi: 10.1016/j.pmrj.2013.08.602.
    1. Fuller JT, Bellenger CR, Thewlis D, Tsiros MD, Buckley JD. The effect of footwear on running performance and running economy in distance runners. Sport Med. 2015;45:411–422. doi: 10.1007/s40279-014-0283-6.
    1. Johnson AW, Myrer JW, Mitchell UH, Hunter I, Ridge ST. The effects of a transition to minimalist shoe running on intrinsic foot muscle size. Int J Sports Med. 2016;37:154–158.
    1. Davis IS. The re-emergence of the minimal running shoe. J Orthop Sport Phys Ther. 2014;44:775–784. doi: 10.2519/jospt.2014.5521.
    1. Rothschild C. Running barefoot or in minimalist shoes: Evidence or Conjecture? Strength Cond J. 2012;34:8–17. doi: 10.1519/SSC.0b013e318241b15e.
    1. Lieberman DE. What we can learn about running from barefoot running: An Evolutionary Medical Perspective. Exerc Sport Sci Rev. 2012;40:63–72. doi: 10.1097/JES.0b013e31824ab210.
    1. Diebal AR, Gregory R, Alitz C, Gerber JP. Forefoot running improves pain and disability associated with chronic exertional compartment syndrome. Am J Sports Med. 2012;40:1060–1067. doi: 10.1177/0363546512439182.
    1. Hobara H, Kato E, Kobayashi Y, Ogata T. Sex differences in relationship between passive ankle stiffness and leg stiffness during hopping. J Biomech. 2012;45:2750–2754. doi: 10.1016/j.jbiomech.2012.09.008.
    1. Bramble DM, Lieberman DE. Endurance running and the evolution of Homo. Nature. 2004;432:345–352. doi: 10.1038/nature03052.
    1. Guthold R, Ono T, Strong KL, Chatterji S, Morabia A. Worldwide variability in physical inactivity: a 51-country survey. Am J Prev Med. 2008;34:486–494. doi: 10.1016/j.amepre.2008.02.013.
    1. Esculier J-F, Dubois B, Dionne CE, Leblond J, Roy J-S, Gent R, et al. A consensus definition and rating scale for minimalist shoes. J Foot Ankle Res. 2015;8:42. doi: 10.1186/s13047-015-0094-5.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264–269. doi: 10.7326/0003-4819-151-4-200908180-00135.
    1. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52:377–384. doi: 10.1136/jech.52.6.377.
    1. Almeida MO, Davis IS, Lopes AD. Biomechanical differences of foot strike patterns during running: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2015;45:1–40. doi: 10.2519/jospt.2015.6019.
    1. Hall JPL, Barton C, Jones PR, Morrissey D. The biomechanical differences between barefoot and shod distance running: a systematic review and preliminary meta-analysis. Sport Med. 2013;43:1335–1353. doi: 10.1007/s40279-013-0084-3.
    1. Ridge ST, Johnson AW, Mitchell UH, Hunter I, Robinson E, Rich BSE, et al. Foot bone marrow edema after a 10-wk transition to minimalist running shoes. Med Sci Sports Exerc. 2013;45:1363–1368. doi: 10.1249/MSS.0b013e3182874769.
    1. Ridge ST, Standifird T, Rivera J, Johnson AW, Mitchell U, Hunter I. The effect of training in minimalist running shoes on running economy. J Sports Sci Med. 2015;14:643–647.
    1. Campitelli NA, Spencer SA, Bernhard K, Heard K, Kidon A. Effect of Vibram FiveFingers minimalist shoes on the abductor hallucis muscle. J Am Podiatr Med Assoc. 2016;106:344–351. doi: 10.7547/14-084.
    1. Chen TL-W, Sze LKY, Davis IS, RTH C. Effects of training in minimalist shoes on the intrinsic and extrinsic foot muscle volume. Clin Biomech. 2016;36:8–13. doi: 10.1016/j.clinbiomech.2016.05.010.
    1. McCarthy C, Fleming N, Donne B, Blanksby B. 12 weeks of simulated barefoot running changes foot-strike patterns in female runners. Int J Sports Med. 2014; 35:443–4450. [cited 2016 Jun 23] Available from: .
    1. Miller EE, Whitcome KK, Norton HL, Dyer RE. The effect of minimal shoes on arch structure and intrinsic foot muscle strength. J Sport Heal Sci. 2014;3:74–85. doi: 10.1016/j.jshs.2014.03.011.
    1. Dubois B, Esculier J-F, Frémont P, Moore L, Richards C. Effects of minimalist and traditional running shoes on injury rates: a pilot randomised controlled trial. Footwear Sci. 2015;7:159–164. doi: 10.1080/19424280.2015.1049300.
    1. Ryan M, Elashi M, Newsham-West R, Taunton J. Examining injury risk and pain perception in runners using minimalist footwear. Br J Sports Med. 2014;48:1257–1262. doi: 10.1136/bjsports-2012-092061.
    1. Warne JP, Moran KA, Warrington GD. Eight weeks gait retraining in minimalist footwear has no effect on running economy. Hum Mov Sci. 2015;42:183–192. doi: 10.1016/j.humov.2015.05.005.
    1. Fuller JT, Thewlis D, Buckley JD, Brown NAT, Hamill J, Tsiros MD. Body mass and weekly training distance influence the pain and injuries experienced by runners using minimalist shoes. Am J Sports Med. 2017;45(5):1162–1170. [cited 2017 Feb 20] Available from: .
    1. Bellar D, Judge LW. Effect of training in minimalist footwear on oxygen consumption during walking and running. Biol Sport. 2015;32:149–154. doi: 10.5604/20831862.1144417.
    1. Khowailed IA, Petrofsky J, Lohman E, Daher N. Six weeks habituation of simulated barefoot running induces neuromuscular adaptations and changes in foot strike patterns in female runners. Med Sci Monit. 2015;21:2021–2030. doi: 10.12659/MSM.893518.
    1. Moore IS, Pitt W, Nunns M, Dixon S. Effects of a seven-week minimalist footwear transition programme on footstrike modality, pressure variables and loading rates. Footwear Sci. 2014;7:17–29. doi: 10.1080/19424280.2014.971352.
    1. Joseph MF, Histen K, Arntsen J, L’hereux L, Defeo C, Lockwood D, et al. Achilles tendon adaptation during transition to a minimalist running style. J Sport Rehabil. 2016:1–17. [cited 2017 Feb 20] Available from: .
    1. Warne JP, Warrington GD. Four-week habituation to simulated barefoot running improves running economy when compared with shod running. Scand J Med Sci Sports. 2014;24:563–568. doi: 10.1111/sms.12032.
    1. Azevedo AP d S, Nóbrega C, Amadio AC, Serrão JC, Azevedo AP d S, Nóbrega C, et al. Adherence to six months of instructed minimalist and barefoot running training. Rev Bras Med do Esporte. 2016;22:182–185. doi: 10.1590/1517-869220162203152987.
    1. Dubois B, Esculier J-F, Frémont P, Moore L, Richards C. Effects of minimalist and traditional running shoes on injury rates: a pilot randomised controlled trial. 10.1080/19424280.2015.1049300. Taylor & Francis; 2015.
    1. Bellar D, Judge LW. Effect of training in minimalist footwear on oxygen consumption during walking and running. Biol Sport. 2015;32:149–154. doi: 10.5604/20831862.1144417.
    1. Giandolini M, Horvais N, Farges Y, Samozino P, Morin JB. Impact reduction through long-term intervention in recreational runners: Midfoot strike pattern versus low-drop/low-heel height footwear. Eur J Appl Physiol. 2013;113:2077–2090. doi: 10.1007/s00421-013-2634-7.
    1. Sale DG. Neural adaptation to resistance training. Med Sci Sports Exerc. 1988;20:S135–S145. doi: 10.1249/00005768-198810001-00009.
    1. Hart PM, Smith DR. Preventing running injuries through barefoot activity. JOPERD J Phys Educ Recreat Danc. 2008:50–3. Available from: .
    1. Robbins S, Gouw GJ, McClaran J, Waked E. Protective sensation of the plantar aspect of the foot. Foot Ankle. 1993;14:347–352. doi: 10.1177/107110079301400608.
    1. Rothschild C. Running barefoot or in minimalist shoes. Strength Cond J. 2012;34:8–17. doi: 10.1519/SSC.0b013e318241b15e.
    1. Buist I, Bredeweg SW, van Mechelen W, Lemmink KAPM, Pepping G-J, Diercks RL. No effect of a graded training program on the number of running-related injuries in novice runners: a randomized controlled trial. Am J Sports Med. 2008;36:33–39. doi: 10.1177/0363546507307505.
    1. Oestergaard Nielsen R, Buist I, Sørensen H, Lind M, Rasmussen S. Training errors and running related injuries: a systematic review. Int J Sports Phys Ther. 2012;7:58–75.
    1. Van Gent RN, Siem D, Van Middeloop M, Van Os AG, Bierma-Zeinstra SMA, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Sport en Geneeskd. 2007;40:16–29.
    1. Salzler MJ, Bluman EM, Noonan S, Chiodo CP, de Asla RJ. Injuries observed in minimalist runners. Foot Ankle Int. 2012;33:262–266. doi: 10.3113/FAI.2012.0262.
    1. Salzler MJ, Kirwan HJ, Scarborough DM, Walker JT, Guarino AJ, Berkson EM. Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity. Phys Sportsmed. 2016;44:373–379. doi: 10.1080/00913847.2016.1238282.
    1. Divert C, Baur H, Mornieux G, Mayer F, Belli A. Stiffness adaptations in shod running. J Appl Biomech. 2005;21:311–321. doi: 10.1123/jab.21.4.311.
    1. Malisoux L, Ramesh J, Mann R, Seil R, Urhausen A, Theisen D. Can parallel use of different running shoes decrease running-related injury risk? Scand J Med Sci Sport. 2015;25:110–115. doi: 10.1111/sms.12154.
    1. Paquette MR, Milner CE, Melcher DA. Foot contact angle variability during a prolonged run with relation to injury history and habitual foot strike pattern. Scand J Med Sci Sports. 2016; [cited 2016 Oct 25];n/a-n/a. Available from: .
    1. Barrett R, Noordegraaf MV, Morrison S. Gender differences in the variability of lower extremity kinematics during treadmill locomotion. J Mot Behav. 2008;40:62–70. doi: 10.3200/JMBR.40.1.62-70.
    1. Hamill J, van Emmerick R, Heiderscheit B, Li L. A dynamic systems approach to lower extremity running injuries. Clin Biomech. 1999;14:297–308. doi: 10.1016/S0268-0033(98)90092-4.
    1. Heiderscheit B, Hamill J, van Emmerik R. Variability of stride characteristics and joint coordination among individuals with unilateral patellofemoral pain. J Appl Biomech. 2002;18:110–121. doi: 10.1123/jab.18.2.110.
    1. Dufek JS, Mercer J a, Teramoto K, Mangus BC, Freedman J a. Impact attenuation and variability during running in females: a lifespan investigation. J Sport Rehabil. 2008;17:230–242. doi: 10.1123/jsr.17.3.230.
    1. van Mechelen W. Running injuries. A review of the epidemiological literature. Sports Med. 1992;14:320–335. doi: 10.2165/00007256-199214050-00004.
    1. Hamill J, Palmer C, Van Emmerik REA. Coordinative variability and overuse injury. Sports Med Arthrosc Rehabil Ther Technol. 2012;4:–45. [cited 2016 Oct 25] Available from: .
    1. Hamill J, van Emmerik REA, Heiderscheit BC, Li L. A dynamical systems approach to lower extremity running injuries. Clin Biomech. 1999;14:297–308. doi: 10.1016/S0268-0033(98)90092-4.
    1. Jung D-Y, Kim M-H, Koh E-K, Kwon O-Y, Cynn H-S, Lee W-H. A comparison in the muscle activity of the abductor hallucis and the medial longitudinal arch angle during toe curl and short foot exercises. Phys Ther Sport. 2011;12:30–35. doi: 10.1016/j.ptsp.2010.08.001.
    1. Olsen O-E, Myklebust G, Engebretsen L, Holme I, Bahr R. Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial. BMJ. 2005;330:449. doi: 10.1136/bmj.38330.632801.8F.
    1. Tenforde AS, Sayres LC, McCurdy ML, Collado H, Sainani KL, Fredericson M. Overuse injuries in high school runners: lifetime prevalence and prevention strategies. PM R. 2011;3:125–131. doi: 10.1016/j.pmrj.2010.09.009.
    1. Johnston CAM, Taunton JE, Lloyd-Smith DR, DC MK. Preventing running injuries. Practical approach for family doctors. Can Fam Physician. 2003;49:1101–1109.
    1. Williams DS, McClay IS, Manal KT. Lower extremity mechanics in runners with a converted forefoot strike pattern. J Appl Biomech. 2000:210–8.
    1. Crowell HP, Davis IS. Gait retraining to reduce lower extremity loading in runners. Clin Biomech (Bristol, Avon) 2011;26:78–83. doi: 10.1016/j.clinbiomech.2010.09.003.
    1. Shih Y, Lin KL, Shiang TY. Is the foot striking pattern more important than barefoot or shod conditions in running? Gait Posture. 2013;38:490–494. doi: 10.1016/j.gaitpost.2013.01.030.
    1. De Wit B, De Clercq D, Aerts P. Biomechanical analysis of the stance phase during barefoot and shod running. J Biomech. 2000;33:269–278. doi: 10.1016/S0021-9290(99)00192-X.
    1. Kulmala JP, Avela J, Pasanen K, Parkkari J. Forefoot strikers exhibit lower running-induced knee loading than rearfoot strikers. Med Sci Sports Exerc. 2013;45:2306–2313. doi: 10.1249/MSS.0b013e31829efcf7.
    1. Diebal a R, Gregory R, Alitz C, Gerber JP. Forefoot running improves pain and disability associated with chronic exertional compartment syndrome. Am J Sports Med. 2012;40:1060–1067. doi: 10.1177/0363546512439182.
    1. Roper JL, Dufek JS, Mermier CM. Gait retraining with foot strike patterns as management for patellofemoral pain syndrome: a brief review. Int J Sport Sci. 2014;4:181–187.
    1. Hobara H, Sato T, Sakaguchi M, Sato T, Nakazawa K. Step frequency and lower extremity loading during running. Int J Sports Med. 2012;33:310–313. doi: 10.1055/s-0031-1291232.
    1. Lenhart RL, Thelen DG, Wille CM, Chumanov ES, Heiderscheit BC. Increasing running step rate reduces patellofemoral joint forces. Med Sci Sports Exerc. 2014;46:557–564. doi: 10.1249/MSS.0b013e3182a78c3a.
    1. Heiderscheit BC, Chumanov ES, Michalski MP, Wille CM, Ryan MB. Effects of step rate manipulation on joint mechanics during running. Med Sci Sports Exerc. 2011;43:296–302. doi: 10.1249/MSS.0b013e3181ebedf4.
    1. Goss DL, Gross MT. A review of mechanics and injury trends among various running styles. US Army Med Dep J. 2012:62–71. Available from: .
    1. Arendse RE, Noakes TD, Azevedo LB, Romanov N, Schwellnus MP, Fletcher G. Reduced eccentric loading of the knee with the pose running method. Med Sci Sports Exerc. 2004;36:272–277. doi: 10.1249/01.MSS.0000113684.61351.B0.
    1. Dallam GM, Wilber RL, Jadelis K, Fletcher G, Romanov N. Effect of a global alteration of running technique on kinematics and economy. J Sports Sci. 2005;23:757–764. doi: 10.1080/02640410400022003.
    1. Napier C, Cochrane CK, Taunton JE, Hunt MA. Gait modifications to change lower extremity gait biomechanics in runners: a systematic review. Br J Sports Med. 2015;49:1382–1388. doi: 10.1136/bjsports-2014-094393.
    1. Wrisberg CA. Sport skill instruction for coaches. Human Kinetics. 2007;9:127–36. ISBN-13:9780736039871.
    1. Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med. 2011;45:691–696. doi: 10.1136/bjsm.2009.069112.
    1. Willy RW, Scholz JP, Davis IS. Mirror gait retraining for the treatment of patellofemoral pain in female runners. Clin Biomech. 2012;27:1045–1051. doi: 10.1016/j.clinbiomech.2012.07.011.
    1. Fletcher JR, Esau SP, Macintosh BR. Economy of running: beyond the measurement of oxygen uptake. J Appl Physiol. 2009;107:1918–1922. doi: 10.1152/japplphysiol.00307.2009.
    1. Gruber AH, Umberger BR, Braun B, Hamill J. Economy and rate of carbohydrate oxidation during running with rearfoot and forefoot strike patterns. J Appl Physiol. 2013;115:194–201. doi: 10.1152/japplphysiol.01437.2012.
    1. Cavanagh PR, Williams KR. The effect of stride length variation on oxygen uptake during distance running. Med Sci Sports Exerc. 1982;14:30–35. doi: 10.1249/00005768-198201000-00006.
    1. Tseh W, Caputo JL, Morgan DW. Influence of gait manipulation on running economy in female distance runners. J Sport Sci Med. 2008;7:91–95.
    1. Cauthon DJ, Langer P, Coniglione TC. Minimalist shoe injuries: three case reports. Foot (Edinb) 2013;23:100–103. doi: 10.1016/j.foot.2013.03.001.
    1. Giuliani J, Masini B, Alitz C, Owens LBD. Barefoot-simulating footwear associated with metatarsal stress injury in 2 runners. Orthopedics. 2011;34:e320–e323.
    1. Altman AR, Davis IS. Prospective comparison of running injuries between shod and barefoot runners. Br J Sports Med. 2015:1–6. Available from: .
    1. Ferber R, Davis IM, Williams DS. Gender differences in lower extremity mechanics during running. Clin Biomech. 2003;18:350–357. doi: 10.1016/S0268-0033(03)00025-1.
    1. Davis IS. The re-emergence of the minimal running shoe. J Orthop Sports Phys Ther. 2014;44:775–784. doi: 10.2519/jospt.2014.5521.
    1. Zadpoor AA, Nikooyan AA. The relationship between lower-extremity stress fractures and the ground reaction force: a systematic review. Clin Biomech. 2011;26:23–28. doi: 10.1016/j.clinbiomech.2010.08.005.
    1. Tonoli DC, Cumps E, Aerts I, Verhagen E, Meeusen R. Incidence, risk factors and prevention of running related injuries in long-distance running: a systematic review. Sport Geneeskd. 2010:12–8.
    1. Yeung EW, Yeung SS. A systematic review of interventions to prevent lower limb soft tissue running injuries. Br J Sport Med. 2001;35:383–389. doi: 10.1136/bjsm.35.6.383.
    1. Chuter V, Janse de Jonge XAK. Proximal and distal contributions to lower extremity injury: a review of the literature. Gait Posture. 2012;36:7–15. doi: 10.1016/j.gaitpost.2012.02.001.
    1. Murphy DF, Connolly DJ, Beynnon BD. Risk factors for lower extremity injury: a review of the literature. Br J Sports Med. 2003;37:13–29. doi: 10.1136/bjsm.37.1.13.
    1. van der Worp MP, ten Haaf DSM, van Cingel R, de Wijer A, Nijhuis-van der Sanden MWG, Staal JB. Injuries in runners; a systematic review on risk factors and sex differences. PLoS One. 2015;10:e0114937. doi: 10.1371/journal.pone.0114937.
    1. Hulme A, Nielsen RO, Timpka T, Verhagen E, Finch C. Risk and protective factors for middle- and long-distance running-related injury. Sport Med. 2016:1–18. [cited 2016 Nov 1] Available from: .
    1. Braunstein B, Arampatzis A, Eysel P, Brüggemann GP. Footwear affects the gearing at the ankle and knee joints during running. J Biomech. 2010;43:2120–2125. doi: 10.1016/j.jbiomech.2010.04.001.
    1. Almonroeder T, Willson JD, Kernozek TW. The effect of foot strike pattern on Achilles tendon load during running. Ann Biomed Eng. 2013;41:1758–1766. doi: 10.1007/s10439-013-0819-1.
    1. Bonacci J, Saunders PU, Hicks A, Rantalainen T, Vicenzino BGT, Spratford W. Running in a minimalist and lightweight shoe is not the same as running barefoot: a biomechanical study. Br J Sports Med. 2013;47:387–392. doi: 10.1136/bjsports-2012-091837.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe