by Nicholas A Campitelli

–I recently lectured at the Andrews Institute for Orthopaedic and Sports Medicine on “New Paradigms in Endurance Sport.” At the Florida conference, it was an honor to be in the presence of one of the greatest contemporary educators on running, like Mark Cucuzzella, M.D., a nationally known lecturer and instructor on running form as well as a two-time winner of the Air Force Marathon, and of course, co-founder of the Natural Running Center.

We lectured to 50 participants who ranged from physicians and physical therapists to coaches and personal trainers. The course focused on proper running form, nutrition and running injuries. Dr. Cucuzzella began the course discussing training patterns that help our bodies adapt to the demands placed upon them without becoming injured. We reviewed the well-known Lydiard training principles that have enabled runners to break the four-minute mile and allowed others to continue a fast pace during marathon.

The most fascinating aspect of the conference was how little time we spent discussing footwear. Dr. Cucuzzella, who owns the Two Rivers Treads shoe store in Shepardstown, WV, led a review of the evolution of running shoes through the past 40 years.

Running shoes have long had a cushioned heel and rigid support throughout the rearfoot and midfoot despite a lack of any evidence-based research showing this reduced injury or even helped runners become faster.

Dr. Cucuzzella used this information to lead the discussion into the next segment on running form in which he demonstrated the importance of proper mechanics over the need to wear shoes. The runners can initially learn this proper form by going barefoot to ensure that a shoe will not hinder their ability to feel the ground and disrupt the proprioceptive feedback that is crucial to developing more efficient running form.

The feedback from the participants at the conference was outstanding. There were many who showed up in their traditional running shoes. They received information from course directors on how to run with minimalist shoes and there was an increased understanding that having the proper running form greatly outweighs any combination of shoes and orthotics to prevent or reduce injury.

The course also featured an extensive review of running training patterns over the last 60 to 70 years. It is very eye-opening when you look at the history of long distance and endurance runners, and see how they were training and what was on their feet. Reviewing the history of what some of the fastest runners have worn as their shoes throughout the years helps us to realize what little, if any, importance that shoes have on running.

On May 6, 1954, Roger Bannister became the first person to break the four-minute mile. He was obviously not wearing motion-control running shoes because they didn’t exist back then. Later that same year, Australia’s John Landy again broke the four-minute mark and New Zealand’s Peter Snell broke that mark in 1962. Again, they wore no high-tech cushioned shoe. Today, Hicham El Guerrouj of Morocco holds the record for the mile at 3:43. Of course, he was wearing minimalist shoes known as racing flats.

The naysayers of minimalist shoes and barefoot running use the argument that today’s elite athletes may be racing in a flat or minimalist shoe, but they are doing their training runs in motion-control or cushioned shoes. Bannister and Snell were following the Lydiard method of training, which had them running up to 100 miles a week and sometimes even more. What were they wearing? They wore leather shoes that had no support, cushion or heel. In other words, they were minimalist shoes.

Regardless of what today’s record holders or those trying to break those records are training in, they appear to be performing best in minimalist shoes or racing flats. Even the elite marathoners are racing in minimalist shoes or racing flats. Meb Keflezighi, an Olympic silver marathon medalist, wears the GOrun minimalist shoe (Skechers). He came in fourth in the 2012 London Olympic marathon.

So, is there any benefit to training in a motion-control shoe? Injury prevention obviously is the number one response from most individuals. This answer does nothing more than open the floodgates for more questions. Why did the runners from the 1950s and 1960s not get injured putting in 100 miles a week in a non-supportive shoe? They trained in the same or similar shoe that they raced in.

What explains the injuries such as plantar fasciitis that we are seeing in today’s runners who are wearing cushioned supportive shoes with heels? Olympic marathoner Ryan Hall admitted to having plantar fasciitis while training for the Olympic Games in London this past May. He races in a flat shoe but trains in cushioned supportive shoes that are indeed motion control shoes, although ASICS will not refer to them as having “motion control.” For all intents and purposes, they are traditional running shoes.

The point of the matter is that runners should be focused on “how to run” and not what shoe they are wearing. However, in my opinion, the shoe only needs to consist of a relatively thin rubber sole with no support or cushion, and definitely not a heel.

A version of this essay originally appeared in Podiatry Today.