March 2013

Even gradual transition to minimalist running leads to signs of stress in feet

In the moment: Sports medicine

By Emily Delzell

Investigators at Brigham Young University in Provo, UT, reported that runners who transitioned from traditional running shoes to zero-drop shoes meant to mimic barefoot running had evidence of bone marrow edema, a marker for stress on the foot, after gradual transition from conventional to minimalist shoes.

Investigators recruited 36 experienced recreational runners who underwent magnetic resonance imaging to measure bone marrow edema before and after a 10-week trial. They matched a control group of 17 runners with 19 runners who transitioned from traditional to minimalist footwear.

Bone marrow edema was not statistically different between control and minimalist running groups at baseline; after 10 weeks, however, posttraining measurements showed that minimalist runners were more likely than controls to have increases in bone marrow edema in at least one bone.

The researchers, who e-published their results in February in Medicine & Science in Sports & Exercise, concluded that runners interested in transitioning to minimalist running shoes should do so very slowly to avoid potential stress injuries.


Ridge ST, Johnson AW, Mitchell UH, et al. Foot bone marrow edema after 10-week transition to minimalist running shoes. Med Sci Sports Exerc 2013 Feb 22. [Epub ahead of print]

3 Responses to Even gradual transition to minimalist running leads to signs of stress in feet

  1. I would like to know what shoes were used for this study. If the authors have used the term “zero drop” to refer to “minimal” running shoes they have made a grievous error in nomenclature. I am suspicious that a shoe with no heel elevation would contribute to bone marrow edema while I have no doubt that “minimal” running shoe could. Zero drop refers to the ramp angle of the shoe and not the stack height, this is an enormous difference. There are several shoes with zero drop, like Altra, that have a substantial mid-sole and ample cushioning. These shoes are not the same as Vibram Five Fingers or Vivo Barefoot and should not be described as “zero drop” alone despite not having any heel elevation.

  2. Jordana Bieze Foster says:

    An excellent point. As you will see if you look up the study abstract using the citation provided above, the shoes used in the study were Vibram FiveFingers. The authors did not use the term “zero drop” in the abstract.

  3. Thanks for the clarification, Jordana. I was suspicious that there might have been some editorial licence taken.

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