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Hub S. Pot
July 26, 2018

Man impressed by big wave.

Lower extremity injuries have been consistently problematic for runners regardless of footwear. Taunton reported that over a 13-week training period. 

30% of runners incurred a running-related injury, most commonly patellofemoral pain, iliotibial band friction syndrome, and plantar fasciitis. Since the inception of the cushioned running shoe, its fundamental purpose has been to protect the foot in an effort to reduce running-related injuries. Despite significant advances in shoe technology over the past 50 years, the rate of sustaining a running-related injury has remained relatively stable.11

Numerous variations of running shoes have been developed to accommodate different types of runners, running styles, and running conditions. Footwear manufacturers have modified the basic components of their running shoe models to accommodate these differences, including midsole cushioning and heel-toe drop. Historically, running shoes fell into 1 of 3 cushioning classifications: (1) neutral, (2) stability, and (3) motion control. In general, individuals with a high amount of pronation were directed to a motion control shoe, those with a moderate amount of pronation were directed to a stability shoe, and those with a minimal amount of pronation, or individuals who supinated, were directed to a neutral shoe. Up until the past 7 years, traditional running shoes tended to have a heel-toe drop, which refers to the difference between the heel elevation and forefoot elevation of the midsole, of greater than 10 mm.

In 2009, the minimalist shoe, defined by very little cushioning and heel drop, became popular among runners.4 Popularity of these shoes spiked largely because their benefits were espoused by shoe manufacturers and authors of popular-press books,12 who claimed that a lack of cushioning would reduce injuries by promoting a more natural forefoot-strike pattern.10 However, popularity of minimal shoes has declined, largely due to research suggesting that adopting a forefoot-strike pattern does not decrease injury risk, improve running economy, or reduce the impact peak or loading rate of the vertical ground-reaction force.6 Research continues to examine how transitioning from a traditional shoe to a minimal shoe influences running style, lower extremity biomechanics, and risk for injury.7,15,19

At about the same time that minimal shoe popularity was rising, a company called Hoka One One introduced a highly cushioned “maximal” running shoe, a stark contrast to the minimal shoe. Currently, there is no academic definition of a maximal shoe, but in industry, the defining feature is increased cushioning of the midsole. Since 2010, maximal shoes have slowly gained popularity, with more than 20 variations of maximal running shoes now on the market.

Conceptually, this increase in cushioning is thought to improve shock attenuation and reduce the risk of injury. Anecdotally, runners have expressed in the popular press that maximal running shoes reduce or eliminate running-related pains that often appear several miles into their run. However, despite increased popularity of maximal shoes in the marketplace, no research to date has investigated the effect of a maximal shoe on biomechanical variables associated with injury, including the loading rate and impact peak of the vertical ground-reaction force2,13,14 and peak eversion of the rearfoot.14 Therefore, the primary purpose of this study was to examine the effect of a maximal running shoe versus a neutral running shoe on lower extremity running biomechanics before and after a 5-km (5K) run. We hypothesized that the maximal shoe would result in lower vertical impact peak and loading rates, but there would be no change in peak ankle eversion, compared with a neutral shoe. We also hypothesized that the impact peak and loading rate would increase after the 5K run in the traditional neutral shoe but not in the maximal shoe.

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