Are These Shoes Made for Running? Uncertainty, Complexity and Minimalist Footwear

Repost from Technoscience as if People Mattered

In almost every technoscientific controversy participants could take better account of the inescapable complexities of reality and the uncertainties of their knowledge. Unfortunately, many people suffer from significant cognitive barriers that prevent them from doing so. That is, they tend to carry the belief that their own side is in unique possession of Truth and that only their opponents are in any way biased, politically motivated or otherwise lacking in sufficient data to support their claims. This is just as clear in the case of Vibram Five Finger shoes (i.e., “toe shoes”) as it is for GMO’s and climate change. Much of humanity would be better off, however, if technological civilization responded to these contentious issues in ways more sensitive to uncertainty and complexity.

Five Fingers are the quintessential minimalist shoe, receiving much derision concerning its appearance and skepticism about its purported health benefits. Advocates of the shoes claim that its minimalist design helps runners and walkers maintain a gait similar to being barefoot while enjoying protection from abrasion. Padded shoes, in contrast, seem to encourage heel striking and thereby stronger impact forces in runners’ knees and hips. The perceived desirability of a barefoot stride is in part based on the argument that it better mimics the biomechanical motion that evolved in humans over millennia and the observation of certain cultures that pursue marathon long-distance barefoot running. Correlational data suggests that people in places that more often eschew shoes suffer less from chronic knee problems, and some recent studies find that minimalist shoes do lead to improved foot musculature and decreased heel striking.

Opponents, of course, are not merely aesthetically opposed to Five Fingers but mobilize their own sets of scientific facts and experts. Skeptics cite studies finding higher rates of injury among those transitioning to minimalist shoes than those wearing traditional footwear. Others point to “barefoot cultures” that still run with a heel striking gait. The recent settlement by Vibram with plaintiffs in a class-action lawsuit, moreover, seems to have been taken as a victory of rational minds over pseudoscience by critics who compare the company to 19th century snake oil salesmen. Yet, this settlement was not an admission that the shoes did nothing but merely that recognition that there are not yet unequivocal scientific evidence to back up the company’s claims about the purported health benefits of the shoes.

Neither of the positions, pro or con, is immediately more “scientific” than the other. Both sides use value-laden heuristics to take a position on minimalist shoes in the absence of controlled, longitudinal studies that might settle the facts of the matter. The unspoken presumption among critics of minimalist shoes is that highly padded, non-minimalist shoes are unproblematic when really they are an unexamined sociotechnical inheritance. No scientific study has justified adding raised heels, pronation control and gel pads to sneakers. Advocates of minimalist shoes and barefoot running, on the other hand, trust the heuristic of “evolved biomechanics” and “natural gait” given the lack of substantial data on footwear. They put their trust in the argument that humans ran fine for millenia without heavily padded shoes.

There is nothing inherently wrong, of course, about these value commitments. In everyday life as much as in politics, decisions must be made with incomplete information. Nevertheless, participants in debates over these decisions too frequently present themselves as in possession of a level of certainty they cannot possibly have, given that the science on what kinds of shoes humans ought to wear remains mostly undone.

At the same time, it seems unfair to leave footwear consumers in the position of having to fumble with the decision between purchasing a minimalist or non-minimalist shoe. A technological civilization sensitized to uncertainty and complexity would take a different approach to minimalist shoes than the status quo process of market-led diffusion with very little oversight or monitoring.

To begin, the burden of proof would be more appropriately distributed. Advocates of minimalist shoes are typically put in the position of having to prove the safety and desirability of them, despite the dearth of conclusive evidence whether or not contemporary running shoes are even safe. There are risks on both sides. Minimalist shoes may end up injuring those who embrace them or transition too quickly. However, if they do in fact encourage healthier biomechanics, it may be that multitudes of people have been and continue to be unnecessarily destined for knee and hip replacements by their clunky New Balances. Both minimalist and non-minimalist shoes need to be scrutinized.

Second, use of minimalist shoes should be gradually scaled-up and matched with well-funded, multipartisan monitoring. Simply deploying an innovation with potential health benefits and detriments then waiting for a consumer response and, potentially, litigation means an unnecessarily long, inefficient and costly learning process. Longitudinal studies on Five Fingers and other minimalist shoes could have begun as soon as they were developed or, even better, when companies like Nike and Reebok started adding raised heels and gel pads.

Monitoring of minimalist shoes, moreover, would need to be broad enough to take account of confounding variables introduced by cultural differences. Indeed, it is hard to compare American joggers to barefoot running Tarahumara Indians when the former have typically been wearing non-minimalist shoes for their whole lives and tend to be heavier and more sedentary. Squat toilets make for a useful analogy. Given the association of western toilets with hiatal hernias and other ills, abandoning them would seem like a good idea. However, not having grown up with them and likely being overweight or obese, many Westerners are unable to squat properly, if at all, and would risk injury using a squat toilet.

Most importantly, multi-partisan monitoring would help protect against clear conflicts of interest. The controversy over minimalist and non-minimalist shoes impacts the interests of experts and businesses. There is a burgeoning orthotics and custom running shoes industry that not only earns quite a lot of revenue in selling special footwear and inserts but also certifies only certain people as having the “correct” expertise concerning walking and running issues. They are likely to adhere to their skepticism about minimalist shoes as strongly as oil executives do on climate change, for better or worse. Although large firms are quickly introducing their own minimalist shoes designs, a large-scale shift toward them would threaten their business models: Since minimalist shoes do not have cushioning that breaks down over time, there is no need to replace them every three to six months. Likewise, Vibram itself is unlikely to fully explore the potential limitations of their products.

Finally, funds should have been set aside for potential victims. Given a long history of unintended consequences resulting from technological change, it should not have come as a surprise that a dramatic shift in footwear would produce injuries in some customers. Vibram Five Finger shoes, in this way, are little different from other innovations, such as the Toyota Prius’ electronically controlled accelerator pedal or novel medications like Vioxx. Had Vibram been forced to proactively set aside funds for potential victims, they would have been provided an incentive to more carefully study their shoes’ effects. Moreover, those ostensibly injured by the company’s product would not have to go through such a protracted and expensive legal battle to receive compensation.

Although the process I have proposed might seem strange at first, the status quo itself hardly seems reasonable. Why should companies be permitted to introduce new products with little accountability for the risks posed to consumers and no requirements to discern what risks might exist? There is no obvious reason why footwear and sporting equipment should not be treated similarly to other areas of innovation where the issues of uncertainty and complexity loom large, like nanotechnology or new pharmaceuticals. The potential risks for acute and chronic harms are just as real, and the interests of manufacturers and citizens are just as much in conflict. Are Vibram Five Finger shoes made for running? Perhaps. But without changes to the way technological civilization governs new innovations, participants in any controversy are provided with neither the means nor sufficient incentive to find the answer.