The ‘Science’ of feet and footwear?

Feet and footwear: applying biological design and mismatch theory to running injuries.

“We are drowning in information but starving of wisdom” E O Wilson.

Many areas of modern ‘science’ are characterised by lack of consensus and equivocal findings, with the latest ‘understanding’ often changing on a weekly basis with the latest new piece of research. Running injury causes and cures and the effects of footwear on these is a prime example of an area lacking both context and consensus. The failure to dismiss new research findings and footwear fads that cannot be replicated and/or make no sense against undisputed scientific laws is the explanation for this confusion. In an attempt to bring clarity to those wishing to make evidence-based choices, but whom are currently drowning in information, we (Lee Saxby, a PhD student and I) recently published an opinion paper in the International Journal of Sports and Exercise Medicine.

Using old fashioned scientific reasoning i.e. making deductions from undisputed laws and first principles, the paper presents a summary of evidence supporting that while adapted for stability and shock absorption in running, both the structure and function of the human foot can be compromised by modern, narrow, stiff and heavily cushioned footwear. The paper presents evidence that the loss of biologically normal foot structure and function caused by the design features of modern footwear is an unrecognised cause of running-related injury.

The key points of the paper are:
1. Humans are adapted for endurance running, but injury rates are high.
2. A mismatch between evolved structure and function of the foot, and design features of modern footwear could explain the high injury rate in endurance running.
3. The design features of modern footwear can deform foot structure and impair foot function. The loss of structure and function could explain many common running injuries.

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