Dr. Mark Cucuzzella’s Reply to Jeff Galloway’s Views on Minimalist Running Shoes and Injuries: Thoughts From a Minimalist Shoe Store Owner

With all his books, coaching experience, training methods, racing achievements, and Ironman-like durability with just over a half-century of miles on his legs, Jeff Galloway is a respected fixture in the running community. And along with many other runners, I’m a subscriber to his email newsletter.

But his take on minimalist running shoes in his most recent newsletter is not one that I share. Here’s what he wrote:

“Many runners who own one of the minimal and exotic shoes that have popped up on today’s market will tell you that these shoes have solved their running problems. I hear the other side of this issue, about every day, from those who have been injured (often severely) by using these products or by running barefooted. Many have to stop running for 4 to 6 months. Thousands have reported significant problems.

I’ve seen this fad come and go 5 times during my 52 years of running. Something will come out in the media about minimal support/barefooted running, and thousands will try it. About a third of those who try it run for short distances and like the tingle of the feet so they run more. Without support, the distance or the surface of the run will often cause an injury–including a number of serious ones such as stress fractures. Each fad cycle ends when those injured tell other runners about their experience–so that very few want to put themselves at risk.

Minimal shoe/barefooted running has its place if the foot can handle it: Short runs when running on a safe surface can give the foot a bit more strength and develop a lighter touch. Unfortunately, there are lots of risks on most running surfaces: pieces of glass, medal or rock–hidden below even the most groomed grass surfaces. There are also lots of surface irregularities that can produce serious trauma injuries in one step.

Today’s shoes have decades of orthopedic research behind them and can protect the foot from most of the problems due to running surface. Go to a store with trained and experienced staff members, like my Phidippides stores in Atlanta, and get the best advice.”

Here’s my reply to Jeff:

I am curious about the runners who are showing up everyday claiming to have been injured as a result of minimalist shoes. Over a year ago in Shepherdstown, West Virginia, I opened the first footwear store in the nation purely devoted to minimalism and sold no shoes with traditional elevated heels. Two Rivers Treadswas only the first store of its kind. There are now six new stores in the country who have embraced minimalism – and all are partners with the Natural Running Center (http://naturalrunningcenter.com/), where I am also its executive director. All of these stores are completely aligned with the education message of teaching good form, prescribing more functional footwear, and the progressive adaptation to more natural running.

At Two Rivers Treads, we just don’t sell shoes; we have a discussion with each and every customer regarding their running, injuries, goals, and some simple and clear instruction on how to reduce impact loads on their joints. We have sold over 3,000 pairs of shoes in a year and only five customers at most have returned with an injury and blamed the shoe. This is far less than Galloway’s daily experience. Are the injured runners just going to the doctor instead of back to us? I doubt it as we would be the first place they would return to if they felt it were the shoes. Do I have scientific data for all this….no, we are a small business.

Maybe we are doing something different when we sell minimal shoes. So just what are we doing? The following educational information is included on our store walls and handouts.

Let’s first define how we interpret minimalisma minimalist shoe, the risks, and the gradual progress.

What is Minimalism?

— Free the foot to develop naturally

— Look for the least amount of shoe you can safely wear now

— Work toward reducing the amount of shoe necessary through strengthening the foot and improving your stride

— Running is a natural movement of the body, rather than an unnatural act that requires artificial support to perform safely

— Embraces the notion that the beefier the shoe, the more a runner’s natural stride is inhibited

What is a Minimalist Shoe?

— Complements natural foot function

— Heel to toe drop is very low

— Material under the foot is thin….allowing maximum ground feel

— Upper is Soft and Flexible

— Light Weight and Flexible

Effects of a Modern Running Shoe?

— Impairs your natural bounce

— Promotes heel striking

— Alters your natural lever (heel lift)

— Creates unstable base

— Causes loss of sensory input

— Causes skin atrophy

— Creates unhelpful movement memory

What are the Risks of Minimalism?

— Foot is NOT guided into running stride

— Feet need to do some of the work and need to get strong

— If form is incorrect and you are not strong in the right places you may develop soreness….so listen to your body and progress gradually

How to go Minimal?

— Take it slow at first

— Add distance gradually

— The more minimal the shoe the more adaptation it will take

— Progress through the stages of Shoes from Neutral/Transition to Minimalist to Barefoot Style

— Do some barefoot running and walking

For early adapters who are weak in their foot and hip stabilizers a minimal shoe may be what we call a “neutral –transition shoe”, such as a Newton Isaac or Altra Intuition.

Now how do we define shoes? This too is on our store walls, and the shoes are displayed this way in the Natural Running Center Shoe review sectionhttp://naturalrunningcenter.com/naturalrunningcenter-shoereviews/

Barefoot-Style Shoe

— Your feet “feel” the ground

— Thinnest layer of protection between foot and ground

— Heel and toes are level

— Land on the midfoot/forefoot

— Lightweight

Minimalist Running

— Some cushiony comfort

— Little to no heel-to-toe drop

— Enhanced ground feel

— Soft, flexible shoe moves with feet

— Ideal for all surfaces– road, trail, track


— Similar protection to most running shoes but without elevated heel

— Little to no heel-to-toe area drop

— Foot is in natural position

— Encourages midfoot/forefoot landing

— Ideal “starter” shoe for transitioning runners to minimalist/barefoot-style

The real folks making this happen in a small community such as Shepherdstown are my lead employees, aka the Shoe Guys, Tom Shantz and James Munnis. Tom and James lend some practical and philosophical advice on the topic.

Here’s Tom: “We give verbal warnings to all minimalist shoe buyers. I have been adapting for a little over a year now. It’s a slow process. What I have found that works best is to have two pair of shoes. One that is ‘flat’, zero drop, and one that has a drop of 5mm. One should transition into the 5mm shoe first. It should take approximately 2 weeks. The zero-drop shoe should take you approximately three months to transition into. Once you have transitioned into both shoes you should continue to slowly increase your distance in the zero-drop shoe. The 10% week rule is out the window. Try 1% increase in the zero-drop shoe. For a younger runner who has been in racing flats the transition is much shorter.”

Now here’s James: “It’s still funny to me how three million years of evolution is still considered a fad by some folks. Nobody who has ever followed our advice on gradual transition has ever been injured from the act of running completely barefoot, or in minimalist shoes. Many do have the usual fatigue and discomfort over a period of up to a year or so trying to undo the weakness and atrophy of the most excellent foot that has been caused by horrible traditional footwear for everyday wear and for running. Mother Nature has given us a foot that is very endurable and survivable, despite our very recent efforts to screw it up with the many ridiculous features of a traditional running shoe. Would anyone please tell me one single reason to elevate a human heel above the forefoot for anything, or to interfere with our natural suspension system with arch support, and especially for running?”

So there you have it: Two Rivers Treads’ Shoe Guys have spoken. And as their informal comments reflect, it is not about the shoe, but the education. An example of one of the fun educational sessions hosted by our store is the recentNatural Running Roundup with Chris McDougall on the home page of the Natural Running Center.

Here’s to healthier running,

Dr. Mark Cucuzzella


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