Running shoes and running injuries. In Science meets sports: When statistics are more than numbers. (Book Chapter)

It is a popular belief that the relationship between running footwear and running injuries is direct and causal. This idea is wrong and has been nurtured by the running shoe industry ever since the appearance of the modern running shoe. Still, the latter may well influence the relationship between training load and injury occurrence, thus acting as an effect-measure modifier of running training patterns on injury rather than a direct cause of injury itself. Some recent, well-designed intervention studies using injury as their main outcome variable have provided preliminary results that suggest a relationship between specific shoe features and injury risk. However, these findings mainly apply to certain subgroups of runners, and some stem from secondary analyses that still need confirmation. Shoe prescription guidelines are not scientifically justified in the face of the currently limited evidence base, so caution is warranted against simplistic explanations and erroneous “common sense”.