1970's - The magic years

Prior to the introduction of antibiotics in the second quarter of the twentieth century infections accounted for most deaths and medical research was mainly directed at understanding and treating them. After just two decades of antibiotic use, human life expectancy at birth in economically advanced countries nearly doubled from near 30 years where it had been for perhaps much of human existence to near 60 years. Heart disease and cancer soon overtook infections as the major cause of death and research was re-directed to these now these more important afflictions. The “fitness boom” that commenced in the 1970's and continues presently was a mass public health movement resulting from scientific reports indicating that vigorous exercise improved myocardial infarction survival and moderated obesity, a major risk factor of coronary artery disease.

Distance running became the expression of this movement. It became possible because of a footwear design change that occurred just prior to it consisting of incorporation of large amounts of expanded polymer foam in the midsole of running shoes. This allowed foot comfort when running on pavement even in individuals with a low level of overall fitness. Advertizing of running shoes during the early years of the “running craze” consisted of honestly stating features that promoted shoe durability and comfort.

1980 -1990 – unsafe product transformed to protective device

Vast numbers of injuries followed the use running shoes based on this new design irrespective of manufacturer. This leading the public to suspect that there was an inherent flaw in the shoe design. This was further reinforced by numerous anecdotal reports indicating that injuries when running were infrequent in countries where barefoot locomotion was the norm. Also, humans required a robust foot to survive as hunter-gatherers for some 250,000 years. This health problem became so large that it could not be ignored by scientists. Solutions were approached from two distinct directions – application of presumptions of the pseudo-sciences of chiropody and podiatry by biomechanists, and traditional basic health science involving hypothesis and experimentation. Biomechanists were eager to create protective footwear, however because of their engineering rather than health science background, were incapable of contributing to a basic understanding of why humans were so frequently injured wearing these shoes. They chose to accept the available empirical notions of the pseudo-sciences which indicated that the foot is inherently delicate thus requires external protection, ignoring both lack of scientific support for these ideas nor fear of incorporating self-serving empirical notions from a group with no scientific credentials. Specifically, biomechanists never questioned the underlying assumption that the foot is inherently delicate, nor that footwear might be the cause rather than the solution of these injuries. This “original sin” of biomechanists eventually resulted in their total body of work becoming irrelevant once scientific reports indicated that the foot is inherently robust and footwear likely account for most running related injuries.

Running shoe manufacturers faced with public concern about frequent injuries when running with their shoes found it impossible to market running shoes based only on comfort and improving fitness through running as they had done previously. They now incorporated the ideas of the pseudo-sciences of chiropody and podiatry to sell running shoes to the now injury wary public. This was accomplished through creating the illusion that the problem with running injuries was not their shoe, but rather their shoes were “protective devices” that aided the inherently fragile human foot. This false advertizing was made easier because few people had contact with barefoot populations so they were unable to ascertain for themselves that injuries were infrequent  in barefoot runners.

Athletic footwear manufacturers decided to avoid direct association with podiatry and chiropody because of their poor scientific credentials. Rather they aligned themselves with biomechanists who were university based therefore more credible despite promoting the same empirical notions. Manufacturers hired biomechanists and supported applied research of biomechanists so long as they behaved as surrogates of the foot pseudo-scientists through not interfering with their deceptive advertizing campaign. Running shoes began to be falsely advertized as effective protective devices with biomechanists providing the scientific legitimacy to support their claims. From this came the unsupported and refuted ideas that thick-soft layers underfoot would protect against excessive impact during running, and excessive pronation and supination result in injuries.

Contemporaneous with entry of biomechanists into injury prevention in 1980. I began   systematic scientific research into the cause of foot injuries in runners wearing modern running shoes. Initial work was based on the notion that the foot of humans is inherently robust because it was essential to survival of H. sapiens during their 250,000 years as hunter-gatherers. By this evolutionary analysis, I hypothesized that footwear must make an inherently robust foot susceptible to injury. By 1990, my colleagues and I had published a series of scientific reports supporting the notion that tactile information emanating from SA II mechanoreceptors results in behavior that moderates impact during locomotion. Also footwear act as an interface that attenuate mechanical transients that would normally occur when locomotion is performed barefoot, thereby moderating sensory feedback resulting in excessive impact during locomotion following the neuropathic medical model. The foundation of our current understanding of running related injuries with footwear had been laid (The publications).

1990 -2000 – the age of denial

The notion that the running shoe is a protective device scientifically died by 1990 via publication (The publications) of reports from my laboratory explaining how footwear use when running causes frequent injuries from chronic excessive impact through interfering with inherent protective behavior, yet athletic footwear manufacturers continued to irresponsibly advertise products as protective devices mainly because the the misleading claims continued to sell shoes because the public was slow to become aware of these new scientific developments. Running shoe manufacturers together with their biomechanist entourage who they financially supported orchestrated a decade long futile battle to delay the advancement of science in this area (see the exchange of letters to the editor-in-chief of a scientific published in Medicine and Science in Sports and Exercise (MSSE) that appears on this website). Despite biomechanists' sometimes hysterical approach of helping footwear manufacturers decieve though claiming that the bare foot is fragile thereby needing footwear, they were eventually abandoned by the footwear manufacturers they had tried so hard to please and the number of biomechanists employed directly by footwear manufacturers collapsed. The few that remained were used simply to create a public image of a scientific approach to product design and to perform mundane tasks such as durability testing. Similarly, footwear manufacturers reduced funding of university based biomechanists. This resulted from concern of product liability claims following my 1997 report published in the British Journal of Sports Medicine entitled. “Hazard of deceptive advertizing of athletic footwear.” It indicated that advertizing footwear as protective gives users a false sense of security that induces them to land with amplified impact, thereby accounting for a greater than 200% increase in injury frequency associated with the use or more expensive running shoes that was found in Marti's earlier epidemiological report.

From 2000, running shoe manufacturers began moderating claims regarding protection against injury out of concern of legal liability risk. Advertizing of modern running shoes of traditional design now is based mainly on fashion of the brand, cosmetics and athlete endorsement, with protection still regrettably implied.

The age of living dangerously

By 2000, most athletes had lost any hope of being protected by athletic footwear, and knowledgeable individuals (mainly serious runners and experienced coaches) became convinced about the importance of barefoot locomotion in prevention of injury and rehabilitation following running injuries of shod runners. Many individuals tried running barefoot and soon realized that fears of frequent injury when barefoot promoted by biomechanists and foot pseudo-scientists were unfounded. The only resistance to more widespread barefoot activity is implicit and explicit social norms that induce individuals to wear shoes.

By 2005, claims that running shoes improve health and safety returned, but this time to sell shoes which were later called “minimalist shoes” and later “barefoot shoes.” These products were an attempt to cash in public scepticism about safety of traditional running shoes, increased  interest in barefoot running and timidity to attempt confronting social norms regarding barefoot locomotion in public. They knowingly falsely advertized these products as allowing protection inherent to the bare foot. This advertizing was obviously reckless considering the known risk between deceptive advertizing and injury in runners. Initially this misleading advertizing message was soft in that it suggested that these new products were less dangerous than traditional shoes because it simply consisted of less shoe material. Some smaller manufacturers of these thin-soled products were more bold about claims by boldly stated that the foot changes with their shoes to closely resemble the foot of barefoot runners. No manufacturer was as bold as was Vibram in making these false claims. It seems appropriate that the frequent injuries associated with use of Vibram products initiated the first class action lawsuit regarding misleading advertizing of athletic footwear, holding them responsible for frequent injuries that have been associated with their products that can be accounted for by the false sense of security produced by their advertizing claims.

Summary:

The modern running shoe first appeared approximately 1970, and was originally advertized honestly as a device that allowed everyone to maintain foot comfort while running on pavement regardless of previous fitness level. By 1980, footwear manufacturers responded to public concern of frequent injuries when running with these shoes by transforming it in the minds of users from a hazardous product to a protective device through deceptive advertizing. This was achieved by promoting self-serving empirical notions of podiatrists, chiropodists and biomechanists. By 1990, a series of reports explained why athletic footwear cause chronic overloading when running through neutralizing forces required by plantar SA II mechanoreceptors to produce behavior that moderates overloading. Manufacturers continued to deceptively advertize their products as protective devices despite this information  until a report indicated that the advertizing in and of itself can account for injuries. Athletic footwear manufacturers moderated their claims out of fear of legal liability claims.

Health claims remained modest until 2005, when mainly smaller manufacturers began recklessly   marketing “minimalist shoes” and “barefoot shoes” as safe because they do not interfere with protective mechanisms inherent in humans when they run barefoot. Frequent injuries followed from the false sense of security that this advertising created. A recent class action suit against Vibram, a manufacturer of these products that perhaps most aggressively and recklessly made these false claims, demands damages to those injured.