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* Even though the cushioning of the Hokas is far softer than other shoes, the thickness makes them quite stiff. This reduces the natural flexing of the foot, but it also puts extra stress on some areas of your foot. The skin on the back of the heel has more friction and the tendons under where the laces are tied have more pressure. I've found that lacing the Hokas loosely limits the tendon stress, and my [[Blister Prevention and Socks| favored sock combination]] mitigates the [[Blister Prevention| friction]].
* I've found my running form tends to degrade while running in the Hokas rather than my [[Modified Nike Free]]. When I swap back, it takes a few miles for my form to recover. I've also noticed that my [[Cadence]] is lower in the Hokas, but this might be due to the extra weight.
* The toe box of the Hokas is rather tight for many people, myself included. This is not a major problem, as it is easy to cut the toe box openwhich causes blisters (see below).
* I didn't like the speed lacing system that comes with the Hokas, but it's easy to replace them with traditional laces. Hoka includes alternative laces, but I found they were too slippery to stay knotted.
=Hoka Blisters=
[[File:Hoka Blisters.jpg|right|thumb|300px|An image of a runner with the distinctive Hoka blister pattern I saw at the [[2013 Umstead 100]].]]
I've seen a distinctive pattern of blisters associated with the Hokas, where the blister forms part way along the toes, normally between the big toe and the next toe along, and sometimes between the little toe and its neighbor. I saw a disproportionate number of Hoka wearing runners with this blister pattern at the Umstead 100. This can be avoided by cutting open the toe box, but far too few people do this.
=Recommendations=
My recommendation depends on what type of runner you are.