Tuesday, April 17, 2012

Running Injuries and Minimalist Shoes

I used to run a lot.  In fact, for about seven years I ran competitively (not ever really winning, but also not totally losing; I was usually near the bottom of the top third).  I ran because I enjoyed being in shape, and it kept me in shape for all the other activities I enjoyed doing, like rock climbing and backpacking.  Probably the most addicting thing about running for me was how good I felt when my body was in shape.

Well, I moved to Europe for a couple years, stopped running, and life was fine.  When I got back to the States, I decided I needed to take up running again.  The problem was, as soon as I started running, my knees started to ache.  Over time, the pain became so severe that I could barely walk.  I had no idea what the problem was.  When I biked, my knees felt fine, but as soon as I'd start to run, the pain would come back.  It was so frustrating.  So, for a few years I relied solely on biking and hiking to keep my cardio up.

I was talking to my boss one day about running (this is while I was working at a gear shop).  My old boss is an incredible runner.  He runs multiple ultra marathons each year (and occasionally wins).  Well, I was complaining to him about how much I missed running and how it was so frustrating to have this knee pain.  He convinced me to go trail running with him the next day after work.  He said that he would bet my knee pain is related to my running form, and if I were to change the way I run, the pain would go away.  I assured him that I run no differently now than I did years ago and I didn't have any pain then, just now.  He said that he would coach me on my form a little and see if the pain would go away.

So, the next day we went out and ran six miles together on the trails.  The whole time he was giving me pointers on how to run.  The biggest thing he taught me was to not land on my heels, but to shorten and quicken my stride and land on the balls of my feet.  It was awkward at first, but I trusted him.  By the time we got done with our run, my calves were so sore that I was hobbling around the parking lot.  Also, by the end of the run he had convinced me to sign up for a trail marathon that was coming up in about four months.  I wasn't sure I'd be able to do the race because of my knees, but they didn't seem to hurt much after our run, so I went for it.

A side note on running technique:  When you run barefoot, your body tends to automatically want to run properly, naturally.  It doesn't allow you to heel strike.  Instead, you land on the balls of your feet, with your knees bent.  Overstriding and heel striking is simply too painful without shoes on.  When you land on the balls of your feet with your knees bent, the impact is absorbed by the muscles of your legs and by the muscles in the arch of the foot, the way the body is designed to do it.  If you run with a heel strike, you land with your leg straight, not bent.  That means that all of the impact force when you land is sent to the joints in your knees and lower back.  There is no shock absorbing mechanism in your knees or lower back (no, your meniscus doesn't count).

I started running on the trails about four days a week, focusing on the new form that my boss had taught me.  Within about two weeks of running with this new form, my knee pain was gone.  Totally gone.  I was really enjoying running again, and within about three weeks I was doing 12-16 mile trail runs on a regular basis.

About two months later, a different ailment surfaced.  This time, every time I would land on an uneven surface with the balls of my feet, I would get excruciating shooting pains up my foot.  I'd dealt with plantar fascitis (which this was) in the past by not running, but I'd already signed up for this marathon, so that wasn't an option.

I talked to my boss and he explained that traditional running shoes can often lead to foot problems, such as plantar fascitis, because they are too narrow in the forefoot and they don't allow the toes and forefoot to splay properly.  Also, after running miles in a shoe, the foam packs out a little bit, packing down more at the center of the shoe, under the ball of the foot than on the outsides of the shoe.  This is due to the way the shoe is made and because the majority of one's bodyweight is centered on that point of the shoe.  That means that after months of running, the footbed of one's shoe, under the ball of the foot, is concave.  This forces the bones of the foot to push together, not allowing the foot to work properly and often inflaming the tissues in the bottom of the foot.  Therefore, traditional running shoes may have been causing more pain than they were helping.  My boss suggested running on grass without shoes every once in a while to strengthen my feet and allow my feet to work properly.  I did this and the pain started to subside, but very slowly.

By the time the marathon came around, I was excited to get it over with.  I was sick of having foot pain (which was still there, but not nearly as intensely as before) and knew I needed new shoes.  I ran the race, enjoyed the first 25 miles of it, and then started to cramp for the last three miles or so.  This marathon was slightly longer than the normal 26.2.  When I got to the finish line, my friend (previously my boss) was waiting for me to welcome me in.  He ended up taking first in that race.  He then introduced me to a few of his friends, one of which was Golden Harper, the founder of Altra Running shoes.  Altra was in its prototype stages back then.

My previous boss, Brian Beckstead, left that gear shop to help his friend start the company Altra.  They had been working for years and years learning about the foot, working in running stores, altering their own shoes (cutting a 12mm wedge out of the heel of their shoes), and ultimately designing new shoes that are supposed to allow your foot to work naturally.  While Brian was my boss, he showed me a prototype of their new shoes.  They looked radically different than the trail runners we sold at our store.  First of all, they were shaped like a foot; narrow in the heel and VERY wide in the forefoot and didn't come to a point at the toe.  Second, they were built on a zero-drop last (Altra coined the term "zero drop").  This means that the forefoot and the heel are exactly the same height off the ground.  Most other shoes have a 12mm drop (sometimes more) from heel to toe, which makes it very difficult (almost impossible) to run without landing on the heel.

It took another year or so for Altra to make its debut and start selling shoes.  They were a small company at first and couldn't keep up with demands.  Within weeks they were sold out of shoes.  A few months later they had some more, but they sold out again before I could get my hands on some.  Finally, Icon Fitness bought Altra and started funding the company, allowing them to make enough shoes to keep up with the demand.  Last November my wife bought me a pair of Altra Instinct running shoes for my birthday.  They didn't have the Lone Peak in stock at that time and I thought I may be doing more road running during the winter than trail.

I hadn't done much running between that marathon and November because all my running shoes hurt my feet and I was enjoying biking and climbing too much.  But getting the new shoes was a little more motivation for me to get after it again.  I have been running off and on since November and I am happy to say that my foot and knee pain is gone.  The only discomfort I have is in my calves when I haven't run for a while and then overdo it.

With all that said, the next post will be a review on the best running shoe I have ever used (and I've used a lot of them), the Altra Instinct.

A note on minimalist shoes and proper running technique: Because of my background I am convinced that the trend toward minimalist/barefoot running is a step in the right direction.  I know a lot of people believe in barefoot running.  I think it's great, but I personally am not man enough to do it.  I like having the protection of shoes when I run, but I don't like shoes to work against my body and cause injuries and discomfort.  So, you won't find me running marathons in Vibram Five Fingers or Altra Adams, but you will find me preaching zero-drop shoes and proper/natural running technique.  I know there are varying opinions about what proper technique is.  To define what I consider proper or natural technique, take off your shoes and run for a couple hundred yards.  It is pretty much impossible to land on your heels.  In fact, it hurts a lot to land on your heels.  Your body naturally lands on the balls of the feet and uses your leg muscles, bent knees, and the arches of your feet to absorb the impact.  That's what I consider natural or proper running form.


  1. Greg,

    Good post with good timing. I have been contemplating the barefoot/minimalist running shoe thing for the last 5 and half weeks after I injured my left foot during some speed/sprint work in my Vibram FFs (I had been running in them for a while). My foot has gotten substantially better but trying to run yesterday (in Scarpa Sparks) finally convinced me I needed see the doctor. Long story short, I may have stress fractured my foot--we'll see the what the x-ray finds. No running for at least 4 weeks.

    Anyway, last spring I had knee pain in my left knee (IBS I think based on the symptoms) until I too, changed my running technique to natural style from heel striking (which I'd done all my life--I'm 33 yrs old). That's why I ran only in FFs. Now that I've hurt myself again, I am going the "minimalist shoe with support" route--ala, Scarpa Sparks to see how that works out for me. Now you've got me curious about the Altra Instincts. :)


  2. JP, thanks for reading and for the comment. My knee problems sound similar to what you were experiencing. It was on the outside of the knee, IT band/LCL area. I'm not sure what it was but the problems went away with the new running style. My foot problems, however, didn't go away with the changed style. They got worse, until I started running in the Instincts. Now my feet feel great. Love the shoe! Definitely worth checking out.