Cushionism is a Faulty Belief System

by Jim Hixson and Bill Katovsky

As most readers who are already familiar with the Natural Running Center know, we have run several articles critical of running with “more shoe,” which in recent years has meant maximalist or hyper-cushioned shoes. We certainly don’t profit from our stance, especially since it’s difficult to find other sites that are equally suspicious of maximalist running shoes, but our mandate remains simple: we attempt to improve the lives of runners everywhere, both now and in the future.

Cushionism is based on the mistaken notion that the hard surfaces of the modern world, especially roads and sidewalks, require runners to wear special athletic shoes with substantial padding to protect their feet and joints from the jarring effects of shock. Unfortunately our bodies work much more efficiently when we have less cushioning, not more.

Although it might sound counter-intuitive, runners who choose to wear thickly padded shoes on the road or trail as a way of reducing shock and avoiding discomfort are making a mistake, because cushioning alters the speed and quality of the information the body receives through the sensory system, an important subsystem of the nervous system, which enables the body to sense its environment. In fact, unless an individual can receive, process, and respond to outside stimuli efficiently, it cannot avoid pain and discomfort or seek pleasure and comfort. In this case, instead of protecting a runner’s body, extra cushioning works directly against the efforts of the sensory system to protect the body from shock and prevents the runner from recognizing the discomfort caused by running with poor technique.

Despite the recent surge in popularity of running shoes with thick, cushioned midsoles and the slick advertisements that try to persuade readers that running without extra cushioning will ultimately and surely lead to a body wracked with injuries, the history of Cushionism is quite short. In fact, extra cushioning is one of the four characteristics of modern running shoes that did not even exist until the 1970s and early 1980s; the others being an elevated cushioned heel, medial support, and stiff sole. These features are all related to one another and were originally intended to lessen the incidence of foot and leg injuries by reducing shock emanating from the shoe repeatedly hitting the ground.

Although serious runners were already wearing specialized shoes for training and competition, the first mass-produced running shoes were introduced by Adidas, Puma, and Tiger (ASICS) in the late 1940s and 1950s.  These models were all very simple, featuring minimal cushioning, flexible soles, and very low (or no) heels.  It should be noted that almost all runners at this time were athletes, and most participated in running as a serious sport, rather than for recreational or social activity.

For a variety of reasons the early 1970s saw a sharp increase in the number of runners and a change in the general character of these men and women.  Most of these converts, who were known as “joggers” ran to improve their fitness, lose weight, or for social reasons.  Unfortunately running is a physical activity that requires athletic ability, both to succeed and to run safely and efficiently.  Many new runners lacked the ability of experience to run properly and injuries became more common.

Although runners had become injured before the development of modern running shoes, the incidence and severity of injuries had usually been related to sharp increases in frequency, duration, or intensity –all variables common to athletic activities.  The injuries affecting the new runners were also affected by the manipulation of these variables, but were also strongly influenced by poor running technique, a shortcoming not usually associated with runners who were athletes.

Running shoe companies began to seek ways to reduce the rate of running-related injuries by altering the shoe design. Nike, when it was still called Blue Ribbon Sports, sold shoes under a licensing agreement with Onitsuka or Tiger shoes.  Three years before he came up with the waffle sole, Bill Bowerman introduced a small wedge into the popular Cortez model. Made from dual-density foam, the wedge provided additional cushioning support and shock absorption. The inclusion of a slight heel-raising wedge resulted from Bowerman’s understanding that it would help coax a runner forward and reduce the strain placed on the Achilles tendon.

Little did Bowerman or anyone know at the time that this small wedge would one day take on a massively metastasizing life all of its own and influence running shoe design for years to come. And yet, the rate of running injuries has stayed the same for nearly a half century.  Unfortunately the main cause of injuries — poor running technique — has never been adequately addressed.  For example, since runners were running on hard surfaces, it was thought that excessive shock was a main cause of running-related injuries; thus,  soft cushioning, like the Bowerman wedge, was added to reduce shock. Years later, when this theory was actually tested, it failed.

Consider another characteristic of modern running shoes: medial support. Individuals naturally pronate when they run (or walk), since this is an important component of shock attenuation, but it sometimes looks unusual; so, it was assumed (without scientific support) that pronation was linked to injuries and a firm midsole with medial support was added to running shoes.

When there was a steady increase in the incidence of Achilles injuries, the heel became even more elevated, even though this feature changed the position and placement of the foot upon impact, leading to detrimental changes along the entire kinetic chain.

By 1973, the newly formed Nike, despite being involved in a litigious battle with Tiger, became a serious player in running shoes, garnering 20 percent of the training flat market. Adidas fought back by introducing a heel counter. And in the following year, Brooks Shoe Company came up with a special foam-like polymer compound called EVA (ethylene vinyl acetate) that was lighter and a better shock absorber than rubber. The new Brooks Villanova used EVA for its midsole and heel wedge. In a short time, EVA became a fixture in most running shoes for the burgeoning recreational running market.

When Runner’s World conducted its annual shoe survey in 1977, the top twenty-five shoes, according to Peter Cavanagh’s “The Running Shoe Book,” had a raised “Achilles tendon protector at the heel and all but four had flared heels {for rearfoot control}. It was clear that many manufacturers were moving toward a consensus of design.”

It was not until the late 1990s when footwear researchers began to question the assumptions regarding the benefits of a bigger and more built-up shoe. In a widely publicized 1999 study, Dr. Steven Robbins, a biomechanics expert at the McGill University Centre for Studies in Aging at Montreal, discovered that expensive running shoes weren’t worth the money and might even increase the risk of injury. Dr. Robbins found that overly thick soles caused a loss of balance. “It’s a myth that thick soles offer the most protection,” he told reporters.

Subsequent studies by other researchers confirmed Robbins’s findings. Runners in thick-soled shoes were more than twice as likely to suffer injuries as runners in thin soles. Robbins even went on to suggest that athletic shoes should be classified as “safety hazards” rather than “protective devices.”

Almost all these studies were published in peer-reviewed journals; and they can be found online. One feels duped by shoe companies and (non-NRC) running stores while reading these studies. Christopher McDougall was one of the first critics to raise objections toward thick-soled, heel-striking running shoes. He considered “running shoes {as} the most destructive force to ever hit the human foot.”

Cushioning is indeed a main culprit here. As a belief system, Cushionism is really part of a larger mindset that underlies the attitude shoe companies and most (non-NRC) running stores have towards running. The underlying assumption of this view is never mentioned to the customer, or even discussed privately: running in the modern world is unnatural for humans and they must be provided with special assistance in order to run safely. Of course, that view is silly, although if it were true, then running should be avoided, not enabled by wearing shoes that alter the way the body responds to repetitive foot impact.

Cushioning is especially problematic because it changes the quality of sensory information at its source—where and when the foot strikes the ground. The interference with sensory perception has negative effects all along the kinetic chain. When you consider the number of times a runner’s feet hit the ground during a typical run, it is understandable how altered foot strike and perception can be a cause of many of the most common running-related injuries: patellofemoral pain, iliotibial band pain, shin splints, and plantar fasciitis.

At its core, Cushionism is faith-based: that a beefier, more cushioned shoe will reduce running injuries. Meanwhile, the large shoe companies and most running stores embrace cushioning as a way to make running safer and more enjoyable. Until footwear companies re-realize that shoes are only necessary to protect the sole of the foot from surfaces that are too rough, hot, or cold, the incidence and severity of running-related injuries will remain the same.

Will this transition back to more minimal shoes happen any time soon? The answer is probably “no,” because shoe companies already experimented with minimalist design for several years, then pulled the plug because runners were still getting injured, although possibly at lower rates and in different areas of the foot and leg. It wasn’t the fault of the shoe so much as it was once again due to improper running technique, which had been corrupted by years of wearing modern running shoes. Old habits are hard to break and it takes time, patience, and commitment to making basic changes.