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* Some runners are concerned that a rigid heel counter may irritate the Achilles tendon. I found no research to support or refute this concern, but personally I see it as relatively unlikely. I suspect that irritation of the Achilles tendon by a shoe is more likely to be due to the extreme rear of the upper coming up to high, or curving inwards to cup around the heel too far. Note that pain in this area could also be due to the irritation of the bursa, rather than the tendon (retrocalcaneal bursitis).
=Minimalist & Barefoot Running=
Most research looks at factors that might be related to injury risk, rather than injury rates directly. I found no studies The one study so far that evaluated compared barefoot or /minimalist running and injury rates found broadly similar injury rates. So while This suggests that minimalist or barefoot and minimalist running tends to have lower impact, it's unclear if this will have any bearing on neither increases nor reduces the risk of injury rates. Of greater concern is However, there remains some compelling evidence that the transition to barefoot or minimalist footwear is correlated with higher injury rates, especially stress fractures in the foot.* A study comparing 107 barefoot runners with 94 shod controls found similar injury rates<ref name="Altman-2016"/>. The barefoot runners had fewer injuries per runner, but ran less miles, so the injury rate (injuries per mile) was similar. ** The barefoot runners ran 75% of their mileage barefoot and the remainder in minimal shoes, characterized by no arch support, no reinforced heel counter and no midsole. (That's a pretty good definition of a minimalist shoe.) The barefoot runners had been barefoot for an average of 1.7 years, and 63% began running barefoot 6–12 months before the study. That's a reasonably good adaptation period and should avoid any injuries related to the transition, ** The study attempted to ensure the two groups were similar, but there are far more men in the barefoot group (88%) than the shod group (73%). ** The runners' average mileage was 25 miles/week in the shod group and 15 miles in the barefoot group. (The study required a minimum of 10 miles/week.) ** There were 346 running related injuries, just under half of them clinically diagnosed. There were significantly more injuries per runner for the shod runners, but when the injury rate is normalized by the mileage the barefoot runners have a non-significantly higher injury rate.<br/>[[File:Altman-2016-Rates.jpg|center|thumb|300px|Injury rates per runner and normalized to mileage.]]** The barefoot runners had more foot injuries, but fewer injures elsewhere, most noticeably in the hip.<br/>[[File:Altman-2016-Injuries.jpg|center|thumb|300px|Location if injuries for both groups. It's important to note this is given as the number of injuries, not the percentage normalized which is a little misleading as there are more shod runners than barefoot.]]** The barefoot runners had far more injuries to the sole of the foot (plantar surface), mostly cuts. ** Shod runners may have had far more plantar fasciitis. (This re-enforces my belief that arch supports contribute to plantar fasciitis.)
* A review of 23 studies found moderate evidence for higher [[Cadence]] and lower impact, but noted a lack of high quality evidence<ref name="PerkinsHanney2014"/>. Examples include:
** Barefoot running can produce reduce impact forces compared with cushioned shoes<ref name="Divert-2005"/>
<ref name="Fredericson-2006">M. Fredericson, F. Jennings, C. Beaulieu, GO. Matheson, Stress fractures in athletes., Top Magn Reson Imaging, volume 17, issue 5, pages 309-25, Oct 2006, doi [http://dx.doi.org/10.1097/RMR.0b013e3180421c8c 10.1097/RMR.0b013e3180421c8c], PMID [http://www.ncbi.nlm.nih.gov/pubmed/17414993 17414993]</ref>
<ref name="Jorgensen1990">U. Jorgensen, Body load in heel-strike running: The effect of a firm heel counter, The American Journal of Sports Medicine, volume 18, issue 2, 1990, pages 177–181, ISSN [http://www.worldcat.org/issn/0363-5465 0363-5465], doi [http://dx.doi.org/10.1177/036354659001800211 10.1177/036354659001800211]</ref>
<ref name="Altman-2016">AR. Altman, IS. Davis, Prospective comparison of running injuries between shod and barefoot runners., Br J Sports Med, volume 50, issue 8, pages 476-80, Apr 2016, doi [http://dx.doi.org/10.1136/bjsports-2014-094482 10.1136/bjsports-2014-094482], PMID [http://www.ncbi.nlm.nih.gov/pubmed/26130697 26130697]</ref>
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[[Category:Science]]
[[Category:Injury]]