When Athletes Get Injured, ‘Is It The Shoes?’

Back in the late ‘80s or early ‘90s, Michael Jordan and Spike Lee teamed up to make a commercial for Nike. It was basically titled, “Is it the shoes?” The salient point of the commercial was that Nike’s Air Jordan shoes would help you to jump higher and farther, “Just like Mike.”

Now we know that is not true, at least of those shoes at the time. There were some other shoes as well during the ‘90s, like the Katapult shoes seen on Seinfeld, that made the claim that they could help you jump higher. They were essentially platform shoes with no heel. The claim was that constant tension on your Achilles complex would set the tendon up to help you jump higher. These shoes didn’t work either, as at least one study showed.¹ These shoes also caused a rash of Achilles tendon problems, which were likely good for business for many orthopedists and podiatrists.

Nike has a new shoe out, the Nike Vaporfly 4%, which the company claims will help you decrease your race times by about 4 percent. There are two different papers out on this that do verify this claim. One of the papers was sponsored by Nike, and one was not.^2,3 I can vouch for Nike’s marketing success of these shoes because I’ve worked the last four or five years at the main podiatry tent at the Chicago Marathon. That tent is just past the finish line of the marathon and I will say that at least 40 percent or more of the runners who finish in under three to three-and-a-half hours are wearing these Nike shoes.

These Vaporfly 4% shoes have a carbon fiber plate in them and a heel to toe drop, or pitch, of 10 mm, Nike claims. It looks higher than 10 mm, but 10 mm is what Nike states. The shoe has minimal flexion at the metatarsophalangeal joint’s aspect of the shoe, so the company built in an aggressive forefoot rocker to make up for that. If you’ve ever worn or seen others wear Dansko clogs or shoes, you know those shoes or clogs have a similar construction, just without the carbon fiber flex plate.

When Vaporfly 4% shoes first came out a few years ago, I posted to my social media sites that they would likely cause some injuries in the plantar fascia and Achilles if patients overused them. A couple of Nike’s most prominent marathon athletes have indeed had recent issues in that general area of their feet and ankles.

Now, I’m not stating this was without a doubt the cause of these Nike athletes’ injuries or chronic problems. We all know athletic injuries in marathon athletes can have multifactorial causes. All I’m saying is, be aware of these shoes and how they are built to function. If you have athletes who are showing the signs of symptoms that I suggested above, and they are wearing shoes like this exclusively, you might ask them to back off on those shoes for awhile during their treatment and rehab period.

The construction of athletic shoes can and will cause problems for athletes. In the next few DPM Blog posts I’ll go into a little more detail on this so you will see. Till next month, cheers!

References

1. Cook SD, Schultz G, Omey ML, et al. Development of lower leg strength and flexibility with the strength shoe. Am J Sports Med. 1993;21(3):445-8.
2. Hoogkamer W, Kipp S, Frank JH, et al. A comparison of the energetic cost of running in marathon racing shoes. Sports Med. 2018;48(4):1009-1019.
3. Barnes KR, Kilding AE. A randomized crossover study investigating the running economy of highly-trained male and female distance runners in marathon racing shoes versus track spikes. Sports Med. 2018; epub Oct 29.