ATC 358: Minimalist Footwear For Knee Pain Relief and Boosted Economy – Current Research Findings and And How To Safely Transition To Reduce Risk, Plus: A Fit-For-Life Game Plan To Race Everything From 100m to Marathon

October 20, 2023

Intro Banter

  • Lucho’s NH Ragnar recap

Brian asks:

A Weird(?) Goal + ‘Do Anything Fitness’ 

Hi! I’ve been listening to endurance planet since (I think) 2015 when I started getting into distance running. I peaked and burned out on running in 2019/2020 when I ran my fastest times and the work I was putting in was… just felt too much work. I ran a 3:09 marathon in pouring, 80-degree rain, a 1:25 half marathon 2 weeks earlier and a few months later ran an 18 minute 5k and a 5:16 mile (without too much speed-specific training). But, it just stopped being fun. For durability: I got up to 70 miles a week in marathon training and loved it, I did a ½ iron in 2017 with 10-16 hours a week of training with no issues. No injuries at all.

I still love running, but mostly just 3-4x a week for 3-4 miles for enjoyment. I supplement it with a bit of swimming, biking, and lifting but without a plan; mostly intuitively for whatever my body wants that day.

Not related to the goal but absolutely my #1 priority is to build and maintain what I call “do anything” fitness. I love the idea of being able to jump into training for a triathlon, ocean swim, paddleboard race, or something else endurance-y and having a great base so I don’t have to spend a lot of time getting ready to train. This also includes a little durability to jump into something totally new (just an example, but something like playing tennis or soccer randomly even if I’ve never played) without risking injury.

So, to my weird goal: I’d like to make a really good attempt to run my best in every running event from the 400m to the marathon in 1 year (400, 800, 1600, 5k, 10k, 13.1, 26.2). This doesn’t really mean PR because I don’t really want to put that pressure on myself, I want it to be fun. But, I want to feel like I made a really good attempt. I started running as a 26 year old (35 now) and went right for the marathon, so I’ve never done speed stuff besides the marathon-style speedwork (which for me was usually 400 repeats at the shortest).

The 2 goals sort of align bc I’m also someone that loves the slow-and-steady running and weight training (I do love hammering on the bike and swim though, not sure why). I sometimes love pushing 100m sprints in the backyard or doing burpees, but those days are few and far between. I realize that part of having “do anything” fitness means developing and maintaining some of those explosive or fast-twitch muscles, and having a more-concrete goal will help motivate me.

So, any advice on how to start building that “do anything” fitness, use the winter to prepare for an April start date for training for the “Year of All Races”, how to sequence the year (e.g., do I start short then train for long? The other way? A mix-up? I truly have no idea), and how to balance that (if possible) with the relaxed/intuitive training I’ve enjoyed lately (not necessary but a cherry on top).

For background: I am a 35 year-old male; 5’10” and 165lb (during running PRs I got down to 150-155 but it wasnt a sustainable weight). I have a home gym with a treadmill, bike trainer, free-weights, home-made TRX system, squat rack + Olympic bar. Despite that I don’t know if I could even squat my own weight (I don’t really do 1 rep maxes ever bc Im more concerned about injury than knowing what those #s are, but I could be wrong about that; it could be a good metric) and I can do maybe 8 pullups in a row and probably max out at 30 straight pushups… so strength is a weakness for me. Despite that I have no history of injury. I work from home with a non-demanding job (very much 9-5 and I take an hour for lunch with my wife every day), so time isn’t a major issue. I live in the northeast US so winter isn’t great for speedwork but I’m not against it.

thanks again for all  your help, I absolutely love the podcast; it’s one of the few constants in my life in the last 10 years 🙂

FOLLOWUP: Apologies! I also meant to include the 100 & 200; all the “endurance” events according to Lucho!

What the coaches say:

  • Listen in for Lucho’s advice!


Research Review:

Minimalist Footwear For Runners—A Systematic Review of 23 Studies

  • “The main findings were
    • (a) the use of MF induces improvements in stride frequency and running economy in long distance events and allows a reduction in support time (i.e., foot support) during 5km distance races;
    • (b) for biomechanical factors, MF can be useful to induce some benefits in the running cycle: greater ranges of ankle motion, increased stride frequency, and forefoot striking predominance as well as a reduction in knee stiffness; and
    • (c) although the use of the MF does not reduce the impact forces in the meta- tarsus or ankle, it may reduce knee impact, indicating the interest in its use during rehabilitation processes.”
  • Criteria?
    • MF = shoe with a highly flexible sole and upper that weighs 200 g or less, has a heel stack height of 20 mm or less, and a heel–toe differential of 7 mm or less (5). 
    • Comments on shoes used in these studies and the “more extreme” minimalist shoes used.
  • More details on findings:
    • Running economy and stride frequency increased for long distance runs.
      • “Because MF has shown a great predominance of landing with midfoot and forefoot (11,21,31), the use of MF has been shown to influence changes in the footprint. In addition, MF is more suitable than conventional footwear to enhance stride frequency (31,32). Hence, MF has demonstrated its benefits for improving the running economy and, subsequently, running performance.”
    • Improves forefoot strike and decreases heel striking.
    • Minimalist footwear has been shown to reduce impact forces at the knee joint but not necessary ankle, or foot.
    • Decrease in O2 consumption with MF.
    • Best for fast races? Minimalist footwear have the greatest impact on running economy and performance at fast paces.
    • Greater dorsiflexion and plantar flexion = ankle ROM (but this comes with risks!).
      • However, MF may increase injury risk at the ankle and tarsus according to research.
    • Overall – if you are looking to increase SF and forefoot strike use MF in your tool box
    • Furthermore, MF has demonstrated its influence on athletes’ injury incidence (14). For example, Hryvniak et al. (15), found that 69% of the participants reported an improvement in their previous knee, ankle, hip, and lower back injuries when using MF.
  • Lighter shoes make a difference! Heavier shoes decrease economy:
    • for every 100g that was added to the shoe weight, the athlete decreased their running economy by 1.11%. 2016 study ref
  • What are the risks of MF?
    • The transition into wearing MF matters. Don’t go too fast.
    • One study showed: 86% of the participants suffered injuries in the conventional/Five fingers transition.
    • Potential for:
      • Flexor hallucis brevis stiffness.
      • The loads with MF were higher in the metatarsal and ankle joints; however, they were lower in the knee joint.
    • “Higher initial loading rate and plantar pressures may increase injury in this footwear condition in the early stages [8, 36]. This hypothesis requires further investigation as there is currently no high-level evidence of increased injuries in this period.”
    • “Unless high-level evidence emerges, we have no reason to believe that the injury rates are any higher either during a transition to MFW or habitually wearing MFW when compared to running in CRS. There may be specific differences in injury trends amongst groups, such as increased foot injuries in the MFW group [89], but not in the rate of injury.”
    • But overall MF can lend to stronger feet so if careful in the transition period, these potential issue may be mitigated in the long run?
  • Making the transition safely!
    • Article mention: Transitioning to Minimal Footwear: a Systematic Review of Methods and Future Clinical Recommendations (2017).
    • The authors suggest that a transition period of no less than 4–8 weeks should be used because of general muscular adaptation to training, taking this period of time [43].
    • “Given what has been observed with increases in bone marrow edema when running initially in MFW, we suggest that the initial overall running volume is decreased in the region of 10–20% in the first 2 weeks (Fig. 2), in order to reduce the risk of this bony injury from unfamiliar repetitive loading. This suggestion is based on consistent evidence that training volume is related to running injury risk [48, 49].”
    • “Given the dramatic change in the demand of the foot structure and musculature with MFW use, a period of preparation could include some light walking and every day, non-uniform loading whilst wearing MFW or going barefoot may be of benefit before any running activity is begun [44–46]. In addition, foot muscle size may be important for transitioning safely [11].”
    • “However, there are currently no studies that have evaluated whether this preparatory phase has any influence on overall injury incidence compared with a group that does not undergo a preparatory phase.”



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