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Logical fallacies in the running shoe debate: let the evidence guide prescription
  1. Christopher Napier1,2,
  2. Richard W Willy3
  1. 1 Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 The UBC Run Clinic, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
  3. 3 Division of Physical Therapy and Health Sciences, University of Montana, Missoula, Montana, USA
  1. Correspondence to Dr Christopher Napier, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; chris.napier{at}

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For the past 40 years, running shoes have been prescribed on the basis of matching shoe features to foot morphology to prevent running-related injuries (RRI). Yet, traditional shoe prescription has not prevented RRIs—consider five quality randomised controlled trials (RCT) and observational cohort studies.1–5 In contrast, a recent investigation6 found that motion control shoes protected against injury in experienced runners who had pronated feet. There are likely important methodological reasons for the discrepancies between these studies, such as differing definitions of RRI and various experience levels among runners. Nonetheless, there remains a lack of conclusive evidence to support traditional shoe prescription to prevent RRIs.7

Alternative shoe prescription paradigms have emerged. While minimalist shoes have historically received the most attention from researchers, clinicians and runners, the more recent paradigms of maximalism, zero-drop shoes and choosing a shoe based on comfort appear to be gaining in popularity (see figure 1 for examples).

Figure 1

Examples of various shoe paradigms. Clockwise from top left: traditional (Brooks Epinephrine 18), minimalist (New Balance Minimus Trail 10), zero-drop (Altra Torin …

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  • CN and RWW contributed equally.

  • Contributors CN and RWW contributed equally to the writing of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.