The Running Shoe Myth:
Do Running Shoes Prevent Knee Injuries?

The first question we must answer is, "Why do we wear shoes to begin with?"

The obvious answer is to prevent injury to our bodies. The second reason may be to improve performance in certain tasks, and general comfort is likely the third reason.

It may seem an odd question, but as knee injuries continue to climb we must ask ourselves if shoes really do keep us safer.

Clearly a shoe does prevent many common injuries to the foot, especially in our world of broken beer bottles and cigarette butts carelessly tossed from speeding cars. Neither of these things is fun to step on, nor is it fun to walk in the snow with bare feet. So I think we can agree that shoes do prevent injuries to the bottoms of the feet in general. They definitely make walking and running more comfortable in the short term.

However, constant shoe wearing does also weaken the feet, making them far more prone to this type of injury. So it’s not quite a clear cut answer.

Shoes also protect the toes from injury. Most of us have stubbed our toes before and know how much this can hurt. Closed toe shoes do a nice job of protecting the toes from slamming into objects or debris.

But, can the toes do their job when enclosed by a shoe?

The simple answer here is no, they definitely cannot. The toes are meant to flex, spread, reach, and grab. They sense the terrain and send signals to the brain to help the body cope with whatever is underfoot. Much like the tips of the fingers, the tips of the toes are very sensitive. That’s why it hurts so much when you whack them into something. It hurts when you hit your finger with a hammer or get it caught in a door, but you don’t go around wearing thimbles all day, do you? Would your hands be able to do their job if you wore hard-shelled mittens?

It’s also worth of note that when your toes and feet are confined inside a shoe, other foot problems such as painful bunions can result. So while the shoes may protect the toes from common injury, they can also cause injuries and prohibit the proper function of the toes.

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Those who are avid runners may understand concepts such as pronation and supination of the foot while running. This refers to the foot being rotated inward in the case of pronation so extra weight is on the inside of the foot, and rotated outward in the case of supination so extra weight is on the outside edge of the foot. They make special shoes and supports for each of these conditions as well as many others.

But is any of this really necessary, or are we overly concerned about foot injuries, instead of focusing on the real problems?

If you were to closely observe people who do not ever wear shoes, you would find that they can run and walk just as well and in many cases better than their shoe-wearing counterparts. There have been actual studies done, including observation with high speed cameras to see how the feet work in those not wearing shoes.

Believe it or not, our feet were designed to work without that extra buffer. Now I’m not suggesting you walk down Main Street barefoot, crunching broken glass and rusty nails with each step. But I am telling you that shoes are not natural and cause some unnatural injuries. Moreover shoes allow you to get around on feet that muscularly weak and very prone to injury when uncovered.

Some suggest that the padding in shoes could slow or prevent knee injuries. Perhaps it’s the fault of the hard pavement that we develop these knee problems? Based on the general rise in comparison with the popularity of running as a sport, it seems that some sort of technology is to blame. Should we wear our shoes and run in the grass?

That might help, but it’s not the root of the problem. What’s interesting is that this concept actually validates many points I’ve been taught in my 25 years of martial arts training. Shoes actually cause extremely bad habits in how people walk and run. These bad habits are unnatural to our current anatomy and often result in injuries.

This is not to say that a constant pounding of the feet against pavement is good for your joints, but it’s not a wholly unnatural thing for our bodies. Certainly running on software surfaces is good, and perhaps running on some sort of cushion isn’t all bad either. Here’s the trouble. Where is the cushion in your Nike Air shoes or any other high-tech tennis shoes?

The massive cushion is in the heel of the shoe, right? Why is that?

Remember all that training I mentioned? Much of it is movement and footwork training to assure that the martial artist is balanced at all times and can move rapidly from any position. The number one rule I teach my students when it comes to footwork is to never get caught on your heels. The ball of the foot should touch the ground first, never the heel. When turning, you should spin on the ball of the foot, not the heel.

Stand up and try this once. Spin around 180 degree turning on your heel. Do it again and imagine someone pushed you just slightly. How is your balance? Not so good, right? Try it again but spin on the ball of the foot and see how your balance is. It should be about ten times better from this position.

When running the body was meant to lean forward somewhat and land on the ball of the foot. In this manner the toes stretch out and check the terrain, then the flex and grip that terrain. The impact comes on the ball of the foot. The shock of the impact is absorbed by the flex of the ankle supported by the calf muscle.

If you come down on your heel where does the shock go? If you aren’t wearing shoes, just slamming your heel into the pavement is going to hurt. It will hurt so much that you will be forced to run the correct way, on the balls of your feet.

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But if you did slam you heel down there is no shock absorber. The impact goes straight through your ankle joint and then to knee joint, hip joint, and so forth until it’s fully dissipated. This allows the runner to lean back slightly while running, which is more comfortable when jogging or running slowly.

The ankle joint is likely to be locked into a straight position, so the impact here should be reasonable unless the foot rolls slightly to either side. In that case the runner usually strains, sprains, or breaks the ankle when the force transfers to it. But if the ankle is straight, the shock isn’t so bad.

The problem is when the shock of every step travels up the tibia to the knee joint. It’s like a rubber mallet pounding on the leg bone. This can cause cartilage (menisci) injuries, this is basically the padding in the knee. It could cause injuries to the ligaments that tie the bones together in the joint. The larger ligament in the front of the knee, the Anterior Cruciate Ligament (ACL), prevents the tibia (your shin bone) from moving forward and backward on the femur (the large thigh bone). This ligament is particular is susceptible to injury because of the angle of the knee when running on the heels.

I want to be clear that I’m not advocating a shoeless society. But I do think wearing shoes less often if good for everyone unless your friends and family members have smelly feet. Some companies are now starting to develop shoes that more closely mimic how the foot is meant to work.