Clinical Analysis of Running, Running Footwear, and Injury Prevention/Performance. The Doctor(s) of Running, using knowledge of human movement, clinical biomechanics and performance to bring you cutting edge reviews, science and knowledge.

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     The use of maximalist shoes for recovery is a common understandable thought process and logical conclusion.  However, reviewing the current evidence, one must realize that the use of maximal shoes for recovery will only apply to a certain subset of runners.  While conventional wisdom would suggest that maximal shoes would provide additional cushioning, protection and allow for muscle recovery while maintaining mileage, that does not appear to be supported by the literature.  The literature is still evolving on the subject (most evidence has surface in the last few years) but what is out there has not supported what people think maximal shoes do. 

Image from Oregon State FORCE LAB

     Maximal shoes were developed to provide additional cushioning for those participating in ultra-marathon distances.  Hoka One One was one of the first companies to successfully market this type of product, although many had attempted this before (MBT shoes for example).  This type of shoe does not have specifically defined metrics, but commonly possesses a higher than normal stack height and cushioning level.  Additional characteristics that are common but not always present include a wider last/base in order to counter to instability associated with being higher off the ground and a rockered sole to compensate for a lack of flexibility secondary to the excessive midsole height.

     While the idea of extra cushioning would seem to provide additional protection, the research has shown the opposite.  When compared to traditional running shoes, maximalist shoes have been shown to increase loading rates and variables associated with impact forces (Chan et al., 2018; Pollard et al., 2018).  This is suspected to occur secondary to a decreased joint proprioception (positional sense) from the lack of ground feel, thus potentially leading to a delayed response in muscle activation during the loading phase of gait.  This lack of proprioception is further suspected in the increased leg stiffness associated with training in maximalist shoes (Kulmala et al., 2018).
Image from Oregon State FORCE LAB

     The rockered shape was thought to improve running economy by making the individual wearer more efficient.  However, the current literature has shown no difference in oxygen consumption or measures of efficiency compared to traditional neutral shoes (Mercer et al., 2018).   Furthermore, the use of maximal shoes may also take time to adapt to (Hannigan & Pollard 2019). Thus, if one is looking to add a maximalist shoe to their equipment, long periods may be required to adapt to the new biomechanical stimulus.  Without proper adaptation and with the increased loading suggested by the above research, this may increase an individual’s injury risk rather than decrease it.  

     However, the rockered sole and additional cushioned have been demonstrated to decrease loading on the foot and ankle muscles and joints, likely due to acting as a replacement for the natural rockers of the foot (Ogsten, 2019).  Additional research on rockered soles have further suggest that they decrease load into the forefoot (Brown et al., 2004) and Achilles tendon (Sbhani et al., 2014).  This suggests that runners who predominately use an ankle or foot strategy for shock absorption or propulsion may benefit from a maximalist shoe as it may allow these tissues to recover while training continues.  However, the trade off is research demonstrating suspected increased loads into the knee joint (Sinclair et al., 2016).  While there is little to no data on injury rates in maximalist shoes compared to other types, the literature suggests that maximalist shoes simply shift the load to the hip and knee rather than eliminating it (Strang et al., 2016). 

Image from Fleet Feet
The Nike Vaporfly is considered a maximal shoe, although the ZoomX Foam and Full Length Carbon Fiber plate change some of the mechanics.  There is some evidence that this combination may decrease delayed onset muscle soreness after efforts.  A post will address this in the future.


     The current evidence does not support the thought that maximalist shoes decrease loading globally or improve efficiency for most individuals.  These types of shoes have not been shown to decrease loading rates and in some cases may increase them.  Like any new stimulus or situation, individuals must be given time to adapt to the unique biomechanical characteristics of these types of shoes.  For those that use a predominantly ankle-based strategy of running, maximalist shoes may provide a method of active recovery by reducing plantar pressures and loads on this tissues.  However, those that utilize knee and hip strategies may experience an increased load, which would not be advantageous when trying to recover.  It is important to note that no shoe can prevent injury, they simply shift the load elsewhere.  Based on the above evidence, it cannot be suggested that maximalist shoes work as recovery shoes for all individuals.  Instead, they will work well for a subset of the population but adequate adaptation time still required to maximize benefits.  

Thanks for reading!

Matthew Klein, PT DPT OCS FAAOMPT
Doctor of Physical Therapy
Board Certified Orthopedic Clinical Specialist
PhD Student APU: Rehabilitation and Movement Science
Fellow of the American Academy of Orthopedic Manual Physical Therapists

***Disclaimer: As always, my views are my own.  My website should not and does not serve as a replacement for seeking professional medical care.  I have not evaluated you in person, am not aware of your injury history and personal biomechanics, thus am not responsible for any injury that you may incur from the performance of the above.  I have not prescribed any of the above exercises to you and thus again am not responsible for any injury that may occur from the performance of the above.  This website is meant for educational purposes only.  If you are currently injured or concerned about an injury, please see your local physical therapist.  However, if you are in the LA area, I am currently taking clients for running evaluations. 

REFERENCES


Brown, D., Wertsch, J., Harris, G., Klein, J., Janisse, D. (2004).  Effect of rocker soles on plantar pressure.  Archives of Physical Medicine and Rehabilitation, 85(1): 81-86.

Chan, Z. Y., Au, I. P., Lau, F. O., Ching, E. C., Zhang, J. H., & Cheung, R. T. (2018). Does maximalist footwear lower impact loading during level ground and downhill running? European Journal of Sport Science, 18(8), 1083-1089.

Hannigan, J. J., & Pollard, C. D. (2019). A 6-Week Transition to Maximal Running Shoes Does Not Change Running Biomechanics. The American Journal of Sports Medicine, 47(4), 968-973.

Kulmala, J. P., Kosonen, J., Nurminen, J., & Avela, J. (2018). Running in highly cushioned shoes increases leg stiffness and amplifies impact loading. Scientific Reports, 8(1), 17496.

Mercer, M. A., Stone, T. M., Young, J. C., & Mercer, J. A. (2018). Running Economy While Running in Shoes Categorized as Maximal Cushioning. International journal of exercise science, 11(2), 1031.
Ogston, J. K. (2019). Comparison of in-shoe plantar loading forces between minimalist and maximalist cushion running shoes. Footwear Science, 11(1), 55-61.

Pollard, C. D., Ter Har, J. A., Hannigan, J. J., & Norcross, M. F. (2018). Influence of maximal running shoes on biomechanics before and after a 5K run. Orthopaedic Journal of Sports Medicine, 6(6), 2325967118775720.

Sinclair, J., Richards, J., Selfe, J., Fau-Goodwin, J., & Shore, H. (2016). The influence of minimalist and maximalist footwear on patellofemoral kinetics during running. Journal of Applied Biomechanics, 32(4), 359-364.

Sobhani, S., Bredeweg, S., Dekker, R., Kluitenberg, B., Heuvel, E., Hijmans, J., Postema, K.  (2014).  Rocker shoe, minimalist shoe and standard running shoe: A comparison of running economy.  Journal of Science and Medicine in Sport, 17(3): 312-316.


Strang, J., DeAvilla, M., Pope, C., Silver, J., Tallon, A., Conti, C., & Pollard, C. (2016). THE INFLUENCE OF MAXIMAL RUNNING SHOES ON LOWER EXTREMITY BIOMECHANICS IN RECREATIONAL RUNNERS. International Journal of Exercise Science: Conference Proceedings: 8(4): 43.

The above post and all writings are my own and property of Matthew Klein PT DPT OCS FAAOMPT. This is part of a larger series of work for my PhD. Reproduction of this work without explicit permission will result in full pursuit by the law for copyright violation.

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