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Does Barefoot Running Protect Us From Injury?

According to “Born To Run” enthusiasts, running with conventional running shoes weaken our feet, and cushioned running shoes are in part responsible for the more than 50 percent annual injury rate present in modern runners. In theory, minimalist shoes will strengthen our toes and arches, keeping us strong and injury-free.

Unfortunately, new research suggests that for the average athlete, wearing minimalist shoes may actually increase the risk of injury. In a 2012 study published in Medicine and Science in Sports and Exercise, researchers from Brigham Young University noted that 10 out of 19 runners transitioning into the minimalist Vibram FiveFingers shoes became injured (Fig. 2), compared to only one of the 17 runners in the control group wearing conventional running shoes (5). This is consistent research published in the December 2013 issue of the British Journal of Sports Medicine, in which 103 runners were randomly assigned to wear neutral running shoes (Nike Pegasus 28), partial minimalist (Nike Free 3.0 V2), or full minimalist shoes (Vibram FiveFingers Bikila).

At the end of a 12-week training program, the runners wearing the partial and full minimalist shoes were 2-3 times more likely to be injured than the runners wearing the neutral Nike Pegasus shoes (6).

Critics of this research state that the studies weren’t long enough for the feet to adapt to the stresses of running in minimalist shoes. The fact is that many runners may be unable to adapt to the stresses of minimalist shoes, no matter how long the training time is. As noted by the paleoanthropologists Trinkaus and Shang (7), the toes of our early ancestors were significantly wider than the toes of modern humans (Fig. 2). Because strong toes protect our forefeet from trauma by distributing pressure over a broader area, the narrow toes present in most modern humans are less able to protect us from impact forces associated with prolonged barefoot activity. No amount of training will make the bones in your toes wider.

RELATED: The Barefoot Running Injury Epidemic

Another factor to consider is that because most of us grew up wearing shoes, we are more likely to possess narrow forefeet. Studies of lifelong barefoot populations prove that the forefeet of lifelong barefoot populations are 16 percent wider than the forefeet of lifelong shod populations (8). Apparently, the stresses associated with barefoot activity cause the forefoot to develop with wider, stronger bones. Because the overwhelming majority of us grew up wearing shoes, we need to protect our narrower forefeet with cushioned midsoles.

Although the notion that we developed our huge brains because of our ability to run long distance in the hot savannah sun makes for an interesting story, current research suggests that rather than being born to run, we were really born to walk. Instead of exposing our feet to the dangerous forces associated with barefoot running, we should protect our naturally narrow forefeet and thin toes with protective running shoes possessing adequate midsole cushioning. It doesn’t take a lot of cushioning because even 10 millimeters of midsole cushioning has been shown to increase the storage and return of energy (9), and reduce the potential for injury (5, 6).

References

1. Bramble D, Lieberman D. Endurance running and the evolution of Homo. Nature. 2004;432:345-352.
2. Berna F, Goldberg P, Horwitz L, et al. Microstratigraphic evidence of in situ fire in the Acheulean strata of Wonderwerk Cave, Northern Cape province, South Africa. Proceedings of the National Academy of Sciences. April 2, 2012.
3. Pickering T, Bunn H. The endurance running hypothesis and hunting and scavenging in savanna woodlands. J Human Evolution. 2007;53:434-438.
4. Biewener A, Farley C, Roberts T, Temaner M. Muscle mechanical advantage of human walking and running: implications for energy cost. J Appl Physiol. 20-2274.
5. Ridge S, Johnson A, Mitchell U, et al. Foot bone marrow edema after 10-week transition to minimalist running shoes. Med Sci Sports & Exerc, 2013. Publishished Ahead of Print. DOI: 10.1249/MSS.0b0769.
6. Ryan M, Elashi M, Newsham-West R, Taunton J. Examining injury risk and pain perception in runners using minimalist footwear. Br J Sports Med; Published Online First 19 December 2013.
7. Trinkaus E, Shang H. Anatomical evidence for the antiquity of human footwear: Tianyuan and Sunghir. J Archeol Sci. 20-1933.
8. D’Aout K, Pataky T, DeClerq D, Aerts P. The effects of habitual footwear use:foot shape and function in native barefoot walkers. Footwear Science. 2009;Vol. 1, No. 2, June, 81–94.
9. Tung K, Franz J, Kram R. A test of the metabolic cost of cushioning hypothesis in barefoot and shod running. American Society of Biomechanics Annual Meeting. Gainesville, FL. August 2012.



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