by Dr. Nick Campitelli.

Julie is all smiles, and rightly so. She just finished her first marathon --and pain-free.

The debate continues amongst medical professionals, podiatrists, runners, and the media as to “Should we be running with supportive shoes with motion control?” For years the norm has been to support the arch with a custom or rigid orthotic to prevent overuse injury. This device was added to a cushioned running shoe that was designed to control or stop motion to joints of the foot.

The question has arisen lately, “Does the foot really need all this support?”
The short answer is no.

Meet Julie — a 35-year old runner with flat feet and valgus knees that was being treated with custom orthotics and ASICS motion-control shoes. She has been running this way for over 10 years and had chronic low back pain and occasionally knee pain. The symptoms were attributed to running with her biomechanical deformity which she was told she will eventually lead to more severe problems to her knees.

Julie came to my office, looking for help. I am pleased to report that Julie became yet another of the many patients, or rather “success story,” whom I have transitioned into minimalist running shoes while abandoning their motion-control shoes and custom orthotics.

Six months ago, Julie ditched the orthotics and gradually transitioned out of her motion-control shoes into a minimalist shoe. Our game plan was to gradually reduce the time in her orthotics with each run until she was running all her runs without them. She began following my protocol of starting her runs in  minimalist shoes and then switching back to her traditional running shoes for the remaining run. This was done incrementally using a 10% increase in duration in the minimalist shoes. At the same time, she began a 14-week Hal Higdon beginner marathon training program.

Julie's feet.

The results?

Initially, there was the typical transitioning soreness to her calf muscles and feet which eventually went away, She began running in the New Balance Minimus trail shoe with a 4mm drop and eventually switched to the new Minimus Zero, and then select runs in Vibram FiveFingers, the Bikila model. After three months of running, her knee pain resolved. She no longer had low back pain and even stopped stretching her hamstrings daily as it was no longer necessary because her back pain was gone.

Julie's shoes.

And her first marathon? She completed the 26.2- mile race in 4:17:18 — and in 83-degree weather!. No foot pain, no shin pain, no knee pain, no back pain. Most importantly, with no artificial support. How great is that?

Dr. Nick Campitelli is a board-certified podiatrist, specializing in foot and ankle surgery. He is also on the NRC Advisory Board. This essay originally appeared here.