Updates to the Running Shoe and Injury Considerations

Elite athletes continue to break new records while running shoe design evolves, diverges, and incorporates new technologies. Shoe design is grossly split between minimalist, traditional, and maximalist shoes. Each shoe has a unique design with characteristics defined by the stack height, heel height, heel-to-toe drop, arch support, cushion, weight, and resulting biomechanics. Current epidemiology of running-related injuries correlates to experience level, weekly volume, and training progression, but the literature currently suggests there are limited effects from footwear. Although biomechanical research demonstrates the effects of footwear on the mechanical forces and stressors, clinically relevant outcomes are limited. Despite a lack of conclusive evidence, runners and clinicians often still perceive footwear as a key factor for injury prevention. This narrative review highlights the need for continued research into clinical outcomes and unbiased individualized footwear recommendations based on comfort, experience, and performance goals using current best-known practices.