Minimalist vs Maximalist Running Shoes and Achilles Tendon Loads

Sometimes I struggle to decide what to include as the title of a blog post; this time is no exception. Should I title this post: “Minimalist Running Shoes Increase the Achilles Tendon Load” or should I title it “Maximalist Running Shoes Decreases the Achilles Tendon Load“? (I played with the headline concept before, here). Either title would be appropriate as that is what this research showed:

Effects of minimalist and maximalist footwear on Achilles tendon load in recreational runners
J. Sinclair, J. Richards, H. Shore
Comparative Exercise Physiology; Published Online: October 27, 2015
The current investigation aimed to comparatively examine the effects of minimalist, maximalist and conventional footwear on Achilles tendon forces (ATF) during running. Twelve male runners (age 23.11±5.01 years, height 1.78±0.10 cm and body mass 77.13±7.89 kg) ran at 4.0 m/s in the three footwear conditions. ATF’s were calculated using Opensim software allowing the magnitudal and temporal aspects of the ATF to be quantified. Differences between footwear were examined using one-way repeated measures ANOVA. The results showed the peak ATF was significantly larger in minimalist footwear (5.97±1.38 body weight (BW)) compared to maximalist (5.07±1.42 BW). In addition it was revealed that ATF per mile was significantly larger in minimalist (492.31±157.72 BW) in comparison to both maximalist (377.31±148.06 BW) and conventional (402.71±125.51 BW) footwear. Given the relationship between high ATF and Achilles tendon degradation, the current investigation indicated that minimalist footwear may increase runners risk for Achilles tendon injury.

This study took 12 recreational runners and had them run in the New Balance 1260v2 (conventional), the Hoka One One (maximalist) and the Vibram Five Fingers (minimalist) and did some kinematic and kinetic measure to determine loads in the Achilles tendon in the different footwear conditions. The loads were higher in the minimalist shoes. There was no difference in the Achilles tendon loads between the conventional and maximalist running shoes.

The authors commented on the finding:

“This observation is clinically important regarding the etiology of Achilles tendon pathologies in runners and appears to refute the notion that minimalist footwear may unanimously reduce the incidence of chronic injury … Therefore, the findings from the current investigation indicate that minimalist footwear may place runners at a greater risk from Achilles tendon pathology”.

Nothing in the design, methods and analysis jumps out at me as being problematic. Adequate information was provided to make that judgement. This was an acute intervention and the participants were not habituated to the difference footwear conditions and some may have an issue with that.

The sample size of 12 is bound to be raised by some who do not like the results of the study (yet they would have been happy with that sample size if they liked the results), but I rarely dismiss a study based on sample size. In the above case, it was a repeated measures design in which you generally can get away with smaller sample sizes and the results were statistically significant, with the p value telling us the probability of getting the same result in the larger population. In this case, it would be unethical to use a larger group.

As always, I go where the evidence takes me until convinced otherwise…and this study tells me that minimalist shoes increase the loads in the Achilles tendon.

Sinclair, J., Richards, J., & Shore, H. (2015). Effects of minimalist and maximalist footwear on Achilles tendon load in recreational runners Comparative Exercise Physiology, 1-6 DOI: 10.3920/CEP150024

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10 Responses to Minimalist vs Maximalist Running Shoes and Achilles Tendon Loads

  1. Claire November 12, 2015 at 8:38 pm #

    Hi Craig,

    Interesting post. I was wondering whether the subjects foot strike pattern and ankle range of motion were assessed as part of the study and whether this would have any influence upon AT loading? Unfortunately I don’t have access to the full article and haven’t checked to see if you have covered this topic elsewhere (sorry).

    Another thought – the subjects in the study are all relatively young (and with only the abstract to go on, I would hazard a guess that they are all fairly fit and healthy). Would the risk of tendon injury increases with age, if increasing age correlates with increased tendon stiffness and reduced ankle dorsiflexion? The average age of the members of my running club is probably 45!

    Thanks, Claire.

    • Craig Payne November 12, 2015 at 8:41 pm #

      The research question was looking at the effects of the shoe and not foot strike pattern or other parameters; most of which are not necessarily relevant as this was a within subjects repeated measures design

  2. Tetoscana November 17, 2015 at 8:46 pm #

    Good grief. Are you serious? You’re interested in research that shows minimalist footwear increases Achilles’ tendon load?! That is the whole point of minimalist footwear – to benefit from elastic recoil. And why advocates recommend gradual adaptation to minimise the risk of injury. It seems to me you are allowing the research to take you up a cul de sac …

    • Craig Payne November 18, 2015 at 12:17 am #

      Care to show us any research that supports what you are claiming? I will stick to the evidence and not rants from cultists.

      • Tetoscana November 18, 2015 at 4:19 pm #
        Effects of Footwear and Strike Type on Running Economy
        Department of Human Evolutionary Biology, Harvard University, Cambridge, MA

        “Minimally shod runners are modestly but significantly more economical than traditionally shod runners regardless of strike type, after controlling for shoe mass and stride frequency. The likely cause of this difference is more elastic energy storage and release in the lower extremity during minimal-shoe running.”

        • Craig Payne November 18, 2015 at 5:53 pm #

          Cherry picking. What about the studies that show the opposite? Have you read those?

          • Tetoscana November 19, 2015 at 10:31 am #

            Research to show that you get more elastic recoil from a traditional or built up shoe? Please send me the references as have not found any. Thanks

          • Craig Payne November 23, 2015 at 8:24 am #

            I never said that!
            The study you quoted was not about elastic return either. They just speculated that as one possible explanation for the results they got.
            I referring to the studies that show running in minimalist shoes is less economical that traditional shoes. Have you read those? And, yes there are studies that show running in traditional shoes are also less economical than minimalist. Just as many studies show that each one is more economical. To claim that one is more economical than the other is contrary to what the evidence says. To cherry pick is intellectual dishonesty.

  3. Keith Bateman November 23, 2015 at 6:38 am #

    Great job Tetoscana – How can anyone think someone with a light shoe is a “cult” follower? – it’s normal – stupid shoe (raising the heel, adding cushioning, arch support etc) advocaters are the cult followers. Simple physics … shoes change technique (for the worse). Tetoscana me (Google my name) – we’ll send you a copy of our book – you’ll love it – and we actually ask for comments and suggestions – that’s the way good science works and why we are enhancing a second edition.

    • Craig Payne November 23, 2015 at 8:18 am #

      Easy; those fan boys who make stuff up about minimalist shoes and wish it was true behave in a cult like fashion. They also react in predictable ways when the research does not support their beliefs. That is why we need to stick to the objective science and not the belief systems associated with the “cults”.

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