How To Reduce Running Injuries: Stop Running With Shoes On Pavement
Running continues to be a high-risk activity. Some estimates say 50% of runners are injured every year. Whatever the rate, it is high and has been high for several decades. Even with the influx of minimal shoes over the last 10 years, running injuries remain common.
Why would such a natural human activity like running have such a high injury rate? The key word here is "natural". Humans did not evolve to run down roads wearing thick shoes. Humans evolved running barefoot on natural surfaces.
The first step would be to consider the role of shoes. There have been two recent studies (here and here) that have shown that any shoes, even ultra-minimal shoes, have an adverse affect on stride mechanics. Instead of helping people run better, it appears shoes are contributing to injury.
The basic problem has been known for decades and is detailed on Steven Robbins' website. When you cover the bottom of the foot with a shoe, you are blocking receptors on the plantar surface of the foot. His research clearly shows that this has consistent negative effects on gait.
Therefore, any type of shoes, even minimal ones, will have a detrimental
effect on running mechanics. This may not be what people want to hear,
but it is the truth. [And don't wait for Runner's World or the like to tell
you this, as much of the running industry is built on selling shoes.]
The other issue is the running surface. Research shows that running on asphalt or concrete increases forces to the body (here and here). Just as humans evolved to run barefoot, they also evolved to run on natural surfaces such as dirt and grass.
Since neither thicker nor thinner shoes have decreased the rate of running injuries over several decades, then maybe it's time to try the obvious solution: avoid running with shoes on pavement.
I realize that most of the races are on paved surfaces. However, roads were made for cars, not for running. Up until 100 years ago, virtually all running took place on natural surfaces. From an historical as well as an evolutionary viewpoint, running on roads is not the norm.
Barefoot running can be done on trails and athletic fields. Many barefoot proponents advocate running on paved surfaces, though I disagree with this. Running barefoot on hard surfaces is supposed to improve your form, yet I've found no research to support this hypothesis. As noted above, running on modern surfaces increases forces to the body.
Running barefoot on natural surfaces is the "gold standard" for injury-free running, as Steven Robbins puts it. Anything else increases injury risk.
One final note: while this type of running may exclude road races, many areas have trail races that can be run barefoot. The bigger issue would be encouraging the organizers of road races to move them to natural surfaces. If the goal is to put on an event that enhances health, then races should be conducted on natural surfaces.