Increasing body mass increases the incidence of injury in runners using minimalist shoes

Joel Fuller, Jonathan Buckley, Dominic Thewlis, Margarita Tsiros, Nicholas Brown, Joseph Hamill

Research output: Contribution to journalMeeting abstractResearch

Abstract

Transitioning to minimalist shoes is a popular means for improving running economy amongst runners. However, there are concerns about the potential for minimalist shoes to cause injury. Purpose: To investigate the effect of transitioning to a minimalist shoe on injury incidence in runners. Methods: We used a prospective randomized controlled trial design. 61 trained, habitual rearfoot strike runners (age: 27 ± 7 years; body mass index: 23.3 ± 2.1 kg/m²; weekly distance: 26 ± 14 km) were randomly allocated to either a minimalist or control shoe. Runners had no previous experience with minimalist shoes and had no previous (<3 months) injuries. Runners gradually transitioned to their allocated shoe condition (5% weekly increase) over 26 weeks. Time to first injury was the primary outcome of interest. Running related pain intensity was measured weekly using a 100 mm visual analogue scale (VAS) with anchors no pain (0 mm) and worst pain (100 mm). Minimum clinically important difference (MCID) in pain was considered to be 10 mm. The effect of shoe type on injury incidence was analysed using multivariable logistic regression. Body mass (BM) was included as a continuous covariate. The effect of shoe type on pain was analysed using a fixed effects linear model with independent variables shoe and time. Results: 11/30 runners sustained an injury in the control shoe compared to 16/31 runners in the minimalist shoe. There was no effect of shoe (odds ratio[OR]=2.01, 95% confidence interval [CI] 0.68 to 6.28; p=0.21) or body mass (OR=0.92, 95%CI 0.82 to 1.00; p=0.08) on injury incidence. However, there was a significant shoe*BM interaction effect on injury incidence (OR=1.18, 95%CI 1.04 to 1.36; p<0.05). Runners that weighed one standard deviation (9.1 kg) more than the sample mean BM (74.8 kg) were 4.1 times more likely to get injured running in the minimalist shoe compared to the control shoe. Runners in the minimalist shoe group experienced increased low back (3 mm, 95%CI 1 to 5 mm), knee (6 mm, 95% CI 3 to 9mm), calf (5 mm, 95%CI 1 to 8 mm), shin (3 mm, 95%CI 1 to 5 mm) and ankle (4 mm, 95%CI 1 to 7 mm) pain (p<0.05) but not thigh (0 mm, 95%CI -2 to 2 mm) or foot (1 mm, 95%CI -1 to 3 mm) pain (p>0.38). All differences in pain were less than the MCID. Conclusion: Heavier runners should exercise caution when running in minimalist shoes due to an increased risk of injury.

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Shoes
Incidence
Wounds and Injuries
Body Mass Index
Randomized Controlled Trials
Pain

Cite this

Fuller, Joel ; Buckley, Jonathan ; Thewlis, Dominic ; Tsiros, Margarita ; Brown, Nicholas ; Hamill, Joseph. / Increasing body mass increases the incidence of injury in runners using minimalist shoes. In: Medicine and science in sports and exercise : volume 48(5S) supplement 1. 2016 ; Vol. 48, No. 5. pp. 168-168.
@article{95ccc12854144b15814700fd84d0e728,
title = "Increasing body mass increases the incidence of injury in runners using minimalist shoes",
abstract = "Transitioning to minimalist shoes is a popular means for improving running economy amongst runners. However, there are concerns about the potential for minimalist shoes to cause injury. Purpose: To investigate the effect of transitioning to a minimalist shoe on injury incidence in runners. Methods: We used a prospective randomized controlled trial design. 61 trained, habitual rearfoot strike runners (age: 27 ± 7 years; body mass index: 23.3 ± 2.1 kg/m²; weekly distance: 26 ± 14 km) were randomly allocated to either a minimalist or control shoe. Runners had no previous experience with minimalist shoes and had no previous (<3 months) injuries. Runners gradually transitioned to their allocated shoe condition (5{\%} weekly increase) over 26 weeks. Time to first injury was the primary outcome of interest. Running related pain intensity was measured weekly using a 100 mm visual analogue scale (VAS) with anchors no pain (0 mm) and worst pain (100 mm). Minimum clinically important difference (MCID) in pain was considered to be 10 mm. The effect of shoe type on injury incidence was analysed using multivariable logistic regression. Body mass (BM) was included as a continuous covariate. The effect of shoe type on pain was analysed using a fixed effects linear model with independent variables shoe and time. Results: 11/30 runners sustained an injury in the control shoe compared to 16/31 runners in the minimalist shoe. There was no effect of shoe (odds ratio[OR]=2.01, 95{\%} confidence interval [CI] 0.68 to 6.28; p=0.21) or body mass (OR=0.92, 95{\%}CI 0.82 to 1.00; p=0.08) on injury incidence. However, there was a significant shoe*BM interaction effect on injury incidence (OR=1.18, 95{\%}CI 1.04 to 1.36; p<0.05). Runners that weighed one standard deviation (9.1 kg) more than the sample mean BM (74.8 kg) were 4.1 times more likely to get injured running in the minimalist shoe compared to the control shoe. Runners in the minimalist shoe group experienced increased low back (3 mm, 95{\%}CI 1 to 5 mm), knee (6 mm, 95{\%} CI 3 to 9mm), calf (5 mm, 95{\%}CI 1 to 8 mm), shin (3 mm, 95{\%}CI 1 to 5 mm) and ankle (4 mm, 95{\%}CI 1 to 7 mm) pain (p<0.05) but not thigh (0 mm, 95{\%}CI -2 to 2 mm) or foot (1 mm, 95{\%}CI -1 to 3 mm) pain (p>0.38). All differences in pain were less than the MCID. Conclusion: Heavier runners should exercise caution when running in minimalist shoes due to an increased risk of injury.",
author = "Joel Fuller and Jonathan Buckley and Dominic Thewlis and Margarita Tsiros and Nicholas Brown and Joseph Hamill",
year = "2016",
doi = "10.1249/01.mss.0000485508.25899.4a",
language = "English",
volume = "48",
pages = "168--168",
journal = "Medicine and science in sports and exercise : volume 48(5S) supplement 1",
issn = "1530-0315",
publisher = "American College of Sports Medicine",
number = "5",

}

Increasing body mass increases the incidence of injury in runners using minimalist shoes. / Fuller, Joel; Buckley, Jonathan; Thewlis, Dominic; Tsiros, Margarita; Brown, Nicholas; Hamill, Joseph.

In: Medicine and science in sports and exercise : volume 48(5S) supplement 1, Vol. 48, No. 5, 2016, p. 168-168.

Research output: Contribution to journalMeeting abstractResearch

TY - JOUR

T1 - Increasing body mass increases the incidence of injury in runners using minimalist shoes

AU - Fuller, Joel

AU - Buckley, Jonathan

AU - Thewlis, Dominic

AU - Tsiros, Margarita

AU - Brown, Nicholas

AU - Hamill, Joseph

PY - 2016

Y1 - 2016

N2 - Transitioning to minimalist shoes is a popular means for improving running economy amongst runners. However, there are concerns about the potential for minimalist shoes to cause injury. Purpose: To investigate the effect of transitioning to a minimalist shoe on injury incidence in runners. Methods: We used a prospective randomized controlled trial design. 61 trained, habitual rearfoot strike runners (age: 27 ± 7 years; body mass index: 23.3 ± 2.1 kg/m²; weekly distance: 26 ± 14 km) were randomly allocated to either a minimalist or control shoe. Runners had no previous experience with minimalist shoes and had no previous (<3 months) injuries. Runners gradually transitioned to their allocated shoe condition (5% weekly increase) over 26 weeks. Time to first injury was the primary outcome of interest. Running related pain intensity was measured weekly using a 100 mm visual analogue scale (VAS) with anchors no pain (0 mm) and worst pain (100 mm). Minimum clinically important difference (MCID) in pain was considered to be 10 mm. The effect of shoe type on injury incidence was analysed using multivariable logistic regression. Body mass (BM) was included as a continuous covariate. The effect of shoe type on pain was analysed using a fixed effects linear model with independent variables shoe and time. Results: 11/30 runners sustained an injury in the control shoe compared to 16/31 runners in the minimalist shoe. There was no effect of shoe (odds ratio[OR]=2.01, 95% confidence interval [CI] 0.68 to 6.28; p=0.21) or body mass (OR=0.92, 95%CI 0.82 to 1.00; p=0.08) on injury incidence. However, there was a significant shoe*BM interaction effect on injury incidence (OR=1.18, 95%CI 1.04 to 1.36; p<0.05). Runners that weighed one standard deviation (9.1 kg) more than the sample mean BM (74.8 kg) were 4.1 times more likely to get injured running in the minimalist shoe compared to the control shoe. Runners in the minimalist shoe group experienced increased low back (3 mm, 95%CI 1 to 5 mm), knee (6 mm, 95% CI 3 to 9mm), calf (5 mm, 95%CI 1 to 8 mm), shin (3 mm, 95%CI 1 to 5 mm) and ankle (4 mm, 95%CI 1 to 7 mm) pain (p<0.05) but not thigh (0 mm, 95%CI -2 to 2 mm) or foot (1 mm, 95%CI -1 to 3 mm) pain (p>0.38). All differences in pain were less than the MCID. Conclusion: Heavier runners should exercise caution when running in minimalist shoes due to an increased risk of injury.

AB - Transitioning to minimalist shoes is a popular means for improving running economy amongst runners. However, there are concerns about the potential for minimalist shoes to cause injury. Purpose: To investigate the effect of transitioning to a minimalist shoe on injury incidence in runners. Methods: We used a prospective randomized controlled trial design. 61 trained, habitual rearfoot strike runners (age: 27 ± 7 years; body mass index: 23.3 ± 2.1 kg/m²; weekly distance: 26 ± 14 km) were randomly allocated to either a minimalist or control shoe. Runners had no previous experience with minimalist shoes and had no previous (<3 months) injuries. Runners gradually transitioned to their allocated shoe condition (5% weekly increase) over 26 weeks. Time to first injury was the primary outcome of interest. Running related pain intensity was measured weekly using a 100 mm visual analogue scale (VAS) with anchors no pain (0 mm) and worst pain (100 mm). Minimum clinically important difference (MCID) in pain was considered to be 10 mm. The effect of shoe type on injury incidence was analysed using multivariable logistic regression. Body mass (BM) was included as a continuous covariate. The effect of shoe type on pain was analysed using a fixed effects linear model with independent variables shoe and time. Results: 11/30 runners sustained an injury in the control shoe compared to 16/31 runners in the minimalist shoe. There was no effect of shoe (odds ratio[OR]=2.01, 95% confidence interval [CI] 0.68 to 6.28; p=0.21) or body mass (OR=0.92, 95%CI 0.82 to 1.00; p=0.08) on injury incidence. However, there was a significant shoe*BM interaction effect on injury incidence (OR=1.18, 95%CI 1.04 to 1.36; p<0.05). Runners that weighed one standard deviation (9.1 kg) more than the sample mean BM (74.8 kg) were 4.1 times more likely to get injured running in the minimalist shoe compared to the control shoe. Runners in the minimalist shoe group experienced increased low back (3 mm, 95%CI 1 to 5 mm), knee (6 mm, 95% CI 3 to 9mm), calf (5 mm, 95%CI 1 to 8 mm), shin (3 mm, 95%CI 1 to 5 mm) and ankle (4 mm, 95%CI 1 to 7 mm) pain (p<0.05) but not thigh (0 mm, 95%CI -2 to 2 mm) or foot (1 mm, 95%CI -1 to 3 mm) pain (p>0.38). All differences in pain were less than the MCID. Conclusion: Heavier runners should exercise caution when running in minimalist shoes due to an increased risk of injury.

U2 - 10.1249/01.mss.0000485508.25899.4a

DO - 10.1249/01.mss.0000485508.25899.4a

M3 - Meeting abstract

VL - 48

SP - 168

EP - 168

JO - Medicine and science in sports and exercise : volume 48(5S) supplement 1

T2 - Medicine and science in sports and exercise : volume 48(5S) supplement 1

JF - Medicine and science in sports and exercise : volume 48(5S) supplement 1

SN - 1530-0315

IS - 5

ER -