Technological advances in elite marathon performance

Running Shoes of the Postmodern Footwear Era: A Narrative Overview of Advanced Footwear Technology

The modern era of running shoes began in the 1960s with the introduction of simple polymer midsole foams, and it ended in the late 2010s with the introduction of advanced footwear technology (AFT). AFT is characterized by highly compliant, resilient, and lightweight foams with embedded, rigid, longitudinal architecture. This footwear complex improves a runner's efficiency, and it introduced a step change in running performance. Purpose: This review serves to examine the current state of knowledge around AFT-what it is and what we know about its ingredients, what benefits it confers to runners, and what may or may not mediate that benefit. We also discuss the emerging science around AFT being introduced to track-racing spikes and how it is currently regulated in sporting contexts. Conclusions: AFT has changed running as a sport. The construction of AFT is grossly understood, but the nature of the interacting elements is not. The magnitude of the enhancement of a runner's economy and performance has been characterized and modeled, but the nuanced factors that mediate those responses have not. With these knowns and unknowns, we conclude the review by providing a collection of best practices for footwear researchers, advice for runners interested in AFT, and a list of pertinent items for further investigation.

The Influence of "Super-Shoes" and Foot Strike Pattern on Metabolic Cost and Joint Mechanics in Competitive Female Runners

PURPOSE

The objective of this study is to assess the influence of "super-shoes" on metabolic cost and joint mechanics in competitive female runners and to understand how foot strike pattern may influence the footwear effects.

METHODS

Eighteen competitive female runners ran four 5-min bouts on a force instrumented treadmill at 12.9 km·h -1 in 1) Nike Vaporfly Next% 2™ (SUPER) and 2) Nike Pegasus 38™ (CON) in a randomized and mirrored order.

RESULTS

Metabolic power was improved by 4.2% ( P < 0.001; d = 0.43) and metatarsophalangeal (MTP) negative work ( P < 0.001; d = 1.22), ankle negative work ( P = 0.001; d = 0.67), and ankle positive work ( P < 0.001; d = 0.97) were all smaller when running in SUPER compared with CON. There was no correlation between foot strike pattern and the between-shoe (CON to SUPER) percentage change for metabolic power ( r = 0.093, P = 0.715).

CONCLUSIONS

Metabolic power improved by 4.2% in "super-shoes" (but only by ~3.2% if controlling for shoe mass differences) in this cohort of competitive female runners, which is a smaller improvement than previously observed in men. The reduced mechanical demand at the MTP and ankle in "super-shoes" are consistent with previous literature and may explain or contribute to the metabolic improvements observed in "super-shoes"; however, foot strike pattern was not a moderating factor for the metabolic improvements of "super-shoes." Future studies should directly compare the metabolic response among different types of "super-shoes" between men and women.

Comparative Effects of Advanced Footwear Technology in Track Spikes and Road-Racing Shoes on Running Economy

PURPOSE

Determine the effects of advanced footwear technology (AFT) in track spikes and road-racing shoes on running economy (RE).

METHODS

Four racing shoes (3 AFT and 1 control) and 3 track spikes (2 AFT and 1 control) were tested in 9 male distance runners on 2 visits. Shoes were tested in a random sequence over 5-minute trials on visit 1 (7 trials at 16 km·h-1; 5-min rest between trials) and in the reverse/mirrored order on visit 2. Metabolic data were collected and averaged across visits.

RESULTS

There were significant differences across footwear conditions for oxygen consumption (F = 13.046; P < .001) and energy expenditure (F = 14.710; P < .001). Oxygen consumption (in milliliters per kilogram per minute) in both the first AFT spike (49.1 [1.7]; P < .001; dz = 2.1) and the other AFT spike (49.3 [1.7]; P < .001; dz = 1.7) was significantly lower than the control spike (50.2 [1.6]), which represented a 2.1% (1.0%) and 1.8% (1.0%) improvement in RE, respectively, for the AFT spikes. When comparing the subjects' most economic shoe by oxygen consumption (49.0 [1.5]) against their most economic spike (49.0 [1.8]), there were no statistical differences (P = .82). Similar statistical conclusions were made when comparing energy expenditure (in watts per kilogram).

CONCLUSIONS

AFT track spikes improved RE ∼2% relative to a traditional spike. Despite their heavier mass, AFT shoes resulted in similar RE as AFT spikes. This could make the AFT shoe an attractive option for longer track races, particularly in National Collegiate Athletic Association and high school athletics, where there are no stack-height rules.

Effects of technological running shoes versus barefoot running on the intrinsic foot muscles, ankle mobility, and dynamic control: a novel cross-sectional research

BACKGROUND

Technological running shoes have become increasingly popular, leading to improvements in performance. However, their long-term effects on foot musculature and joint mobility have not been thoroughly studied.

OBJECTIVE

To compare the activation of the intrinsic foot muscles between runners wearing technological footwear and barefoot runners. Secondary objectives included assessing ankle dorsiflexion (DF) range of motion (ROM) and dynamic postural control in both groups.

METHODS

A cross-sectional study was conducted involving 22 technological footwear runners and 22 barefoot runners. Ultrasonography was used to measure the thickness of the plantar fascia (PF) and the quadratus plantae (QP), abductor digiti minimus (ADM), abductor hallucis (AH), and flexor hallucis longus (FHL) muscles. Ankle mobility and dynamic postural control were also recorded.

RESULTS

Ultrasonography measurements showed statistically significant differences for PF thickness (mean difference [MD]: -0.10 cm; 95% CI: -0.13, -0.05 cm), QP cross-sectional area (CSA) (MD: -0.45 cm2; 95% CI: -0.77, -0.12 cm2), ADM CSA (MD: -0.49 cm2; 95% CI: -0.70, -0.17 cm2), and FHL thickness (MD: 0.82 cm; 95% CI: 0.53, 1.09 cm), with all measurements being lower in the group wearing technological footwear compared to the barefoot runners. Ankle DF ROM was also significantly greater for the barefoot runners (MD: -5.1°; 95% CI: -8.6, -1.7°).

CONCLUSIONS

These findings suggest potential implications for the foot musculature and ankle mobility in runners using technological footwear.

Relationship Between Advanced Footwear Technology Longitudinal Bending Stiffness and Energy Cost of Running

INTRODUCTION/PURPOSE

Shoe longitudinal bending stiffness (LBS) is often considered to influence running economy (RE) and thus, running performance. However, previous results are mixed and LBS levels have not been studied in advanced footwear technology (AFT). The purpose of this study was to evaluate the effects of increased LBS from curved carbon fiber plates embedded within an AFT midsole compared to a traditional running shoe on RE and spatiotemporal parameters.

METHODS

Twenty-one male trained runners completed three times 4 min at 13 km/h with two experimental shoe models with a curved carbon fiber plate embedded in an AFT midsole with different LBS values (Stiff: 35.5 N/mm and Stiffest: 43.1 N/mm), and a Control condition (no carbon fiber plate: 20.1 N/mm). We measured energy cost of running (W/kg) and spatiotemporal parameters in one visit.

RESULTS

RE improved for the Stiff shoe condition (15.71 ± 0.95 W/kg; p < 0.001; n2 = 0.374) compared to the Control condition (16.13 ± 1.08 W/kg; 2.56%) and Stiffest condition (16.03 ± 1.19 W/kg; 1.98%). However, we found no significant differences between the Stiffest and Control conditions. Moreover, there were no spatiotemporal differences between shoe conditions.

CONCLUSION

Changes in LBS in AFT influences RE suggesting that moderately stiff shoes have the most effective LBS to improve RE in AFT compared to very stiff shoes and traditional, flexible shoe conditions while running at 13 km/h.

The Fallacy of Single Trials: The Need for Multiple Trials in Assessing Running Economy Responses in Advanced Footwear Technology

In the quest to uncover the underlying mechanisms responsible for the performance-enhancing benefits imparted by advanced footwear technology (AFT), footwear researchers are employing an individual-level approach. In doing so, they hope to unveil individual-specific responses to AFT otherwise masked by a group-level approach. Classifying an individual's response on the basis of running economy (RE) is a logical strategy given that the intended purpose of AFT is to enhance performance; however, caution should be taken when doing so. Metabolic measurement devices are far from perfect, and given the known errors associated with metabolic measurements we would like to reiterate a suggestion first made 40 years ago: when seeking to quantify the interindividual variability of improvement in RE associated with running in AFT, the best practice is to rely on a minimum of two same-day measurements of RE.

Technologically advanced running shoes reduce oxygen cost and cumulative tibial loading per kilometer in recreational female and male runners

Technologically advanced running shoes (TARS) improve performance compared to classical running shoes (CRS). Improved race performance has been attributed to metabolic savings in male runners, but it remains unclear if these same benefits are experienced among females and in recreational runners. The mechanisms behind these benefits are still not fully understood despite the need for optimisation, and their influence on injury mechanisms has not been explored. Here we combined biomechanical, physiological, and modelling approaches to analyse joint mechanics, oxygen uptake, and tibial load in nineteen male and female recreational runners running with CRS and TARS at their individual lactate threshold speed (12.4 ± 1.9 km/h). Oxygen uptake was 3.0 ± 1.5% lower in TARS than in CRS. Ankle dorsiflexion, joint moment and joint power were reduced in TARS compared to CRS at various phases of stance including midstance, while knee joint mechanics were mostly similar throughout. There were no significant differences for tibial bending moment during the stance phase but cumulative tibial damage per kilometre was 12 ± 9% lower in TARS compared to CRS. Our results suggest that running with TARS reduces oxygen cost in recreational female and male runners, which may partly be explained by differences in lower limb joint mechanics. The lower cumulative tibial bone load with TARS may allow runners to run longer distances in this type of shoe compared to CRS.

Can the recent sex-specific evolutions in elite running performances be attributed to advanced footwear technology?

Recent improvements in elite running performances across all distances have been largely attributed to the introduction of advanced footwear technology (AFT), which features a curved and stiff plate working synergistically with a new generation of midsole foams demonstrating enhanced resilience and compliance. These recent improvements appear to be considerably more pronounced in women's events, highlighted by improvements in road racing world records by an average of 3.7% (range: 2.6%-5.2%) compared to mean progressions of 1.5% (range: 1.3%-1.9%) in the same men's events. Although there is a growing body of research investigating the mechanisms underpinning running performance enhancements derived from AFT, there remains no explanation for potential sex-based differences in their benefits. We overview the currently available evidence and highlight why the recent direction of AFT research provides a barrier to progress by focusing primarily on male athletes. We subsequently provide our perspective on why women may be benefiting from the new generation of shoes more than men, suggest potential mechanisms leading to hypotheses that need to be further investigated in upcoming studies, and finally propose that factors outside of footwear innovation may have concurrently driven the recently observed performance evolutions.

The effect of advanced footwear technology on elite male marathon race speed

PURPOSE

The aim of this study was to explore the ergogenic effect of advanced footwear technology (AFT) upon world-class male marathon running speed.

METHOD

A retrospective analysis of 99 world-class male marathon runners' performances between 2012 and 2021 was undertaken, providing a sample size of 971 performances, split into two footwear groups: AFT (n = 299) and traditional (n = 672). Additionally, details regarding the year of the marathon performance and racecourse were extracted. A mixed model for repeated measures (MMRM) analysis were undertaken identifying athlete (Wald Z = 2.821; p = .005) and course (Wald Z = 4.111; p < 0.001) as significant contributors to the variance in marathon running speed and as such were included as random factors with footwear type set as a fixed factor.

RESULTS

World-class male marathon running speeds were significantly faster (p < 0.001) when running in AFT (5.441 m.s-1) when compared with traditional shoes (5.386 m.s-1) with a mean difference of 0.055 m.s-1 (95% CI 0.039-0.071 m.s-1), translating to an improvement in marathon speed of 1.0% or a 79 s improvement in marathon race time.

CONCLUSION

Our findings demonstrate an improvement in world-class male marathon running speed of 1% when running in AFT, a near identical degree of improvement to the male marathon world record ran in AFT. Whilst a 1% improvement in marathon running times associated with AFT is smaller than previously predicted utilizing laboratory-based models, this still reflects a significant degree of improvement at the elite level.

Does Advanced Footwear Technology Improve Track and Road Racing Performance? An Explorative Analysis Based on the 100 Best Yearly Performances in the World Between 2010 and 2022

Advanced footwear technology (AFT) is currently being debated in sports. There is a direct evidence that distance running in AFT improves running economy. In addition, there is indirect evidence from competition performance for improved running performance from using AFTs in middle- and long-distance running and sprinting events. However, the extent to which world-class performance is affected across the full range of track and road racing events between genders has not been systematically analyzed. This study examined publicly available performance datasets of annual best track and road performances for evidence of potential systematic performance effects following the introduction of AFT. The analysis was based on the 100 best performances per year for men and women in outdoor events from 2010 to 2022, provided by the world governing body of athletics (World Athletics). We found evidence of progressing improvements in track and road running performances after the introduction of AFT for road races in 2016 and AFT for track racing in 2019. This evidence is more pronounced for distances longer than 1500 m in women and longer than 5000 m in men. Women seem to benefit more from AFT in distance running events than men. For the sprint events (100 m to 400 m hurdles), the peak performance gains in 2021 and 2022 compared to the pre-AFT period ranged from 0.6 to 1.1% and from 0.4 to 0.7% for women and men, respectively. For middle-distance events (400 m to 3000 m steeplechase), peak performance gains ranged from 0.6 to 1.9% and from 0.6 to 0.7% for women and men, respectively. For distances from 5000 m to the marathon, performance gains ranged from 2.2% to 3.5% and 0.7% to 1.4% for women and men, respectively. While the observational study design limits causal inference, this study provides a database on potential systematic performance effects after introducing advanced shoes/spikes in track and road running events in world-class athletes. Further research is needed to examine the underlying mechanisms and, in particular, potential gender differences in the performance effects of AFT.

Well-trained Endurance Runners' Foot Contact Patterns: Barefoot vs. Shod Condition

We aimed to investigate the initial foot contact and contact time in experienced endurance runners at individualized speeds, in running shoes and barefoot. Forty-eight participants (33.71±7.49 y, 70.94±8.65 kg, 175.07±7.03 cm, maximum aerobic speed 18.41±1.54 km.h-1) were distributed into three groups according to athletic performance: highly-trained runners, middle-trained runners, and control group. An incremental running test until exhaustion was performed for assessing maximum aerobic speed. After≥24 h of recovery participants randomly walked and ran, barefoot and in running shoes, over a pressure plate at ~4.7 km.h-1 and 85% of the maximum aerobic speed, respectively. They wore the same model of running shoes with homogeneous lacing pattern. A rearfoot strike was performed by 68.8% and 77.1% of participants when running barefoot and in running shoes, respectively. Considering the tendency to develop a rearfoot strike was lower in the barefoot condition, runners with higher performance may benefit from training in minimalist running shoes because their foot contact pattern could tend towards a non-rearfoot strike. Our results suggest that initial foot contact and contact time are related to running performance and may also be influenced by running shoes.

Influence of Running Shoe Longitudinal Bending Stiffness on Running Economy and Performance in Trained and National Level Runners

INTRODUCTION/PURPOSE

Previous results about shoe longitudinal bending stiffness (LBS) and running economy (RE) show high variability. This study aimed to assess the effects of shoes with increased LBS on RE and performance in trained and national runners.

METHODS

Twenty-eight male runners were divided into two groups according to their 10-km performance times (trained, 38-45 min and national runners, <34 min). Subjects ran 2 × 3 min (at 9 and 13 km·h -1 for trained, and 13 and 17 km·h -1 for national runners) with an experimental shoe with carbon fiber plate to increase the LBS (Increased LBS) and a control shoe (without carbon fiber plate). We measured energy cost of running (W·kg -1 ) and spatiotemporal parameters in visit one and participants performed a 3000 m time trial (TT) in two successive visits.

RESULTS

Increased LBS improved RE in the trained group at slow (11.41 ± 0.93 W·kg -1 vs 11.86 ± 0.93 W·kg -1 ) and fast velocity (15.89 ± 1.24 W·kg -1 vs 16.39 ± 1.24 W·kg -1 ) and only at the fast velocity in the national group (20.35 ± 1.45 W·kg -1 vs 20.78 ± 1.18 W·kg -1 ). The improvements in RE were accompanied by different changes in biomechanical variables between groups. There were a similar improvement in the 3000 m TT test in Increased LBS for trained (639 ± 59 vs 644 ± 61 s in control shoes) and national runners (569 ± 21 vs 574 ± 21 s in control shoes) with more constant pace in increased LBS compared with control shoes in both groups.

CONCLUSIONS

Increasing shoe LBS improved RE at slow and fast velocities in trained runners and only at fast velocity in national runners. However, the 3000 m TT test improved similarly in both levels of runners with increased LBS. The improvements in RE are accompanied by small modifications in running kinematics that could explain the difference between the different levels of runners.

The potential impact of advanced footwear technology on the recent evolution of elite sprint performances

Background

Elite track and field sprint performances have reached a point of stability as we near the limits of human physiology, and further significant improvements may require technological intervention. Following the widely reported performance benefits of new advanced footwear technology (AFT) in road-running events, similar innovations have since been applied to sprint spikes in hope of providing similar performance enhancing benefits. However, it is not yet clear based on current evidence whether there have been subsequent improvements in sprint performance. Therefore, the aims of this study were to establish if there have been recent year-to-year improvements in the times of the annual top 100 and top 20 athletes in the men's and women's sprint events, and to establish if there is an association between the extensive use of AFT and potential recent improvements in sprint performances.

Methods

For the years 2016-19 and 2021-2022, the season best performances of the top 100 athletes in each sprint event were extracted from the World Athletics Top lists. Independent t-tests with Holm corrections were performed using the season's best performance of the top 100 and top 20 athletes in each year to identify significant differences between years for each sprint discipline. Following the classification of shoes worn by the top 20 athletes in each event during their annual best race (AFT or non-AFT), separate linear mixed-model regressions were performed to determine the influence of AFT on performance times.

Results

For the top 100 and top 20 athletes, there were no significant differences year-to-year in any sprint event prior to the release of AFT (2016-2019). There were significant differences between AFT years (2021 or 2022) and pre-AFT years (2016-2019) in eight out of 10 events. These differences ranged from a 0.40% improvement (men's 100 m) to a 1.52% improvement (women's 400 m hurdles). In the second analysis, multiple linear mixed model regressions revealed that the use of AFT was associated with improved performance in six out of ten events, including the men's and women's 100 m, women's 200 m, men's 110 m hurdles, women's 100 m hurdles and women's 400 m hurdles (estimate range: -0.037 - 0.521, p = <0.001 - 0.021). Across both analyses, improvements were more pronounced in women's sprint events than men's sprint events.

Conclusion

Following a period of stability, there were significant improvements in most sprint events which may be partly explained by advances in footwear technology. These improvements appear to be mediated by event, sex and potentially level of athlete.

The fourth dimension: physiological resilience as an independent determinant of endurance exercise performance

Endurance exercise performance is known to be closely associated with the three physiological pillars of maximal O2 uptake (V ̇ O 2 max $\dot{V}_{{\rm O}_{2}{\rm max}}$ ), economy or efficiency during submaximal exercise, and the fractional utilisation ofV ̇ O 2 max $\dot{V}_{{\rm O}_{2}{\rm max}}$ (linked to metabolic/lactate threshold phenomena). However, while 'start line' values of these variables are collectively useful in predicting performance in endurance events such as the marathon, it is not widely appreciated that these variables are not static but are prone to significant deterioration as fatiguing endurance exercise proceeds. For example, the 'critical power' (CP), which is a composite of the highest achievable steady-state oxidative metabolic rate and efficiency (O2 cost per watt), may fall by an average of 10% following 2 h of heavy intensity cycle exercise. Even more striking is that the extent of this deterioration displays appreciable inter-individual variability, with changes in CP ranging from <1% to ∼32%. The mechanistic basis for such differences in fatigue resistance or 'physiological resilience' are not resolved. However, resilience may be important in explaining superlative endurance performance and it has implications for the physiological evaluation of athletes and the design of interventions to enhance performance. This article presents new information concerning the dynamic plasticity of the three 'traditional' physiological variables and argues that physiological resilience should be considered as an additional component, or fourth dimension, in models of endurance exercise performance.

Exercise and Experiments of Nature

In this article, we highlight the contributions of passive experiments that address important exercise-related questions in integrative physiology and medicine. Passive experiments differ from active experiments in that passive experiments involve limited or no active intervention to generate observations and test hypotheses. Experiments of nature and natural experiments are two types of passive experiments. Experiments of nature include research participants with rare genetic or acquired conditions that facilitate exploration of specific physiological mechanisms. In this way, experiments of nature are parallel to classical "knockout" animal models among human research participants. Natural experiments are gleaned from data sets that allow population-based questions to be addressed. An advantage of both types of passive experiments is that more extreme and/or prolonged exposures to physiological and behavioral stimuli are possible in humans. In this article, we discuss a number of key passive experiments that have generated foundational medical knowledge or mechanistic physiological insights related to exercise. Both natural experiments and experiments of nature will be essential to generate and test hypotheses about the limits of human adaptability to stressors like exercise. © 2023 American Physiological Society. Compr Physiol 13:4879-4907, 2023.

Variability in Running Economy of Kenyan World-Class and European Amateur Male Runners with Advanced Footwear Running Technology: Experimental and Meta-analysis Results

BACKGROUND

Advanced footwear technology improves average running economy compared with racing flats in sub-elite athletes. However, not all athletes benefit as performance changes vary from a 10% drawback to a 14% improvement. The main beneficiaries from such technologies, world-class athletes, have only been analyzed using race times.

OBJECTIVE

The aim of this study was to measure running economy on a laboratory treadmill in advanced footwear technology compared to a traditional racing flat in world-class Kenyan (mean half-marathon time: 59:30 min:s) versus European amateur runners.

METHODS

Seven world-class Kenyan and seven amateur European male runners completed a maximal oxygen uptake assessment and submaximal steady-state running economy trials in three different models of advanced footwear technology and a racing flat. To confirm our results and better understand the overall effect of new technology in running shoes, we conducted a systematic search and meta-analysis.

RESULTS

Laboratory results revealed large variability in both world-class Kenyan road runners, which ranged from a 11.3% drawback to a 11.4% benefit, and amateur Europeans, which ranged from a 9.7% benefit to a 1.1% drawback in running economy of advanced footwear technology compared to a flat. The post-hoc meta-analysis revealed an overall significant medium benefit of advanced footwear technology on running economy compared with traditional flats.

CONCLUSIONS

Variability of advanced footwear technology performance appears in both world-class and amateur runners, suggesting further testing should examine such variability to ensure validity of results and explain the cause as a more personalized approach to shoe selection might be necessary for optimal benefit.

Advancements in running shoe technology and their effects on running economy and performance - a current concepts overview

Advancements in running shoe technology over the last 5 years have sparked controversy in athletics as linked with clear running economy and performance enhancements. Early debates mainly surrounded 'super shoes' in long-distance running, but more recently, the controversy has filtered through to sprint and middle-distance running with the emergence of 'super spikes'. This Current Concepts paper provides a brief overview on the controversial topic of super shoes and super spikes. The defining features of technologically advanced shoes are a stiff plate embedded within the midsole, curved plate and midsole geometry, and lightweight, resilient, high-energy returning foam that - in combination - enhance running performance. Since the launch of the first commercially available super shoe, all world records from the 5 km to the marathon have been broken by athletes wearing super shoes or super spikes, with a similar trend observed in middle-distance running. The improvements in super shoes are around 4% for running economy and 2% for performance, and speculatively around 1% to 1.5% for super spikes. These enhancements are believed multifactorial in nature and difficult to parse, although involve longitudinal bending stiffness, the 'teeter-totter effect', the high-energy return properties of the midsole material, enhanced stack height and lightweight characteristic of shoes.

Effects of the Nike ZoomX Vaporfly Next% 2 shoe on long-interval training performance, kinematics, neuromuscular parameters, running power and fatigue

We analysed the effects of the Nike ZoomX Vaporfly (VPF) on long-interval training performance, kinematic parameters, running power and fatigue compared to a traditional running shoe. Twelve well-trained men (mean ± SD: 32.91 ± 7.50 years; 69.29 ± 7.55 kg and 172.73 ± 5.97 cm) performed two long-interval training sessions (5 × 1000 m with 90s recovery period) 7 days apart, with the VPF shoe or a traditional running shoe (CON) in random order. The countermovement jump (CMJ) height was measured before and after the training sessions and heart rate, spatiotemporal parameters, running power and leg stiffness was measured during training sessions. Running-related pain was assessed prior and post-24 h of each training session. Long-interval training performance improved 2.4% using the VPF shoe compared to CON (p = 0.009; ES = 0.482). Step length, contact time and leg stiffness were higher (p < 0.05; ES = 0.51, ES = 0.677, ES = 0.356) while flight time was lower (p < 0.001; ES = 0.756) when using VPF. Running power decreased in a similar way in both conditions throughout the training session. Vertical power was significantly higher in the VPF condition (p = 0.023, ES = 0.388). CMJ height decreased in both conditions after training (4.7 vs. 7.2%, for the VPF and control, respectively, p < 0.001; ES = 0.573). Finally, the perceived muscle pain was influenced by the shoe model condition (chi-square 5.042, P = 0.025). VPF shoes improved the long-interval training performance with similar running power, heart rate and neuromuscular fatigue, and reduced subjective perceived muscle pain compared to regular training shoes. HighlightsVPF shoe may improve long-interval training performance in trained runners with the same running power and heart rate.Lower subjective perceived muscle pain is found with VPF compared to the regular training shoes.This type of footwear may be used in high-intensity training sessions aiming to increase the training volume at higher intensities with lower associated fatigue.

Impact of advanced footwear technology on elite men's in the evolution of road race performance

Advanced footwear technology (AFT) changed footwear design concepts by using a curved carbon fibre plate in combination with new, more compliant and resilient foams. The aim of this study was (1) to examine the individual effects of AFT on the evolution of the main road events and (2) to re-assess the impact of AFT on the world's top-100 performance in men's 10k, half-marathon and marathon events. Data from the top-100 men's 10k, half-marathon and marathon performances were collected between 2015 and 2019. The shoes used by the athletes were identified in 93.1% of the cases by publicly available photographs. Runners wearing AFT had an average performance of 1671 ± 22.28 s compared to 1685 ± 18.97 s of runners not using AFT in 10k (0.83%) (p < 0.001), 3589 ± 29.79 s compared to 3607 ± 30.49 s in half-marathon (0.50%) (p < 0.001) and 7563 ± 86.10 s compared to 7637 ± 72.51 s in the marathon (0.97%) (p < 0.001). Runners wearing AFTs were faster by ~1% in the main road events compared to non-users. Individual analysis showed that ~25% of the runners did not benefit from the use of this type of footwear. The results of this study suggest that AFT has a clear positive impact on running performance in main road events.

Human performance augmentation: the importance of integrative physiological quantification

In recent years, there has been an explosion of new approaches (technological, methodological, pharmacological, etc.) designed to improve physical performance for athletes, the military and in other applications. The goal of the present discussion is to review and quantify several ways in which physiology can provide important insights about which tools may lead to improved performance (and may therefore be worth resource investment) and which tools are less likely to provide meaningful enhancement. To address these objectives, we review examples of technological solutions/approaches in terms of the magnitude of their potential (or actual) influences: transformational, moderate, ineffective or undetermined. As one example, if there were a technology which significantly increased arterial oxygen partial pressure by 10%, this would be relatively meaningless in healthy people resting at sea level, where it would have a minimal effect on arterial oxygen content. However, there might be specific situations where such an effect would be very helpful, including at high altitude or in some patient populations. We discuss the importance of quantitative evaluation of putative approaches to performance enhancement and highlight the important role of integrative physiologists in the development and critical appraisal of these approaches.

Litigation involving sports-related spinal injuries: a comprehensive review of reported legal claims in the United States in the past 70 years

BACKGROUND CONTEXT

Sports-related spinal injuries can be catastrophic in nature. Athletes competing in collision sports (eg, football) may be particularly prone to injury given the high-impact nature of these activities. Due to the oftentimes profound impact of sports-related spinal injuries on health and quality-of-life, they are also associated with a substantial risk of litigation. However, no study to date has assessed litigation risks associated with sports-related spinal injuries. A better understanding of the risk factors surrounding these legal claims may provide insights into injury prevention and other strategies to minimize litigation risks. In addition, it may allow the spine surgeon to better recognize the health, socioeconomic, and legal challenges faced by this patient population.

PURPOSE

To provide a comprehensive assessment of reported legal claims involving sports-related spinal injuries, including a comparative analysis of legal outcomes between collision and non-collision sports. To discuss strategies to prevent sports-related spinal injuries and minimize litigation risks.

STUDY DESIGN/SETTING

Retrospective review.

PATIENT SAMPLE

Athletes experiencing spinal injuries during sports.

OUTCOME MEASURES

Outcomes included verdict outcome (defendant vs. plaintiff), legal claims, injuries sustained, clinical symptoms, and award payouts.

METHODS

The legal research database Westlaw Edge (Thomson Reuters) was queried for legal claims brought in the United States from 1950 to 2021 involving sports-related spinal injuries. Verdict or settlement outcomes were collected as well as award payouts, time to case closure, case year, and case location. Demographic data, including type of sport (ie collision vs. non-collision sport) and level of play were obtained. Legal claims, spinal injuries sustained, and clinical symptoms were also extracted. Furthermore, the nature of injury, injured spinal region, and treatment pursued were collected. Descriptive statistics were reported for all cases and independent-samples t-tests and chi-square tests were used to compare differences between collision and non-collision sports.

RESULTS

Of the 840 cases identified on initial search, 78 met our criteria for in-depth analysis. This yielded 62% (n=48) defendant verdicts, 32% (n=25) plaintiff verdicts, and 6% (n=5) settlements, with a median inflation-adjusted award of $780,000 (range: $5,480-$21,585,000) for all cases. The most common legal claim was negligent supervision (n=38, 46%), followed by premises liability (n=23, 28%), and workers' compensation/no fault litigation (n=10, 12%). The most common injuries sustained were vertebral fractures (n=34, 44%) followed by disc herniation (n=14, 18%). Most cases resulted in catastrophic neurological injury (n=37, 49%), either paraplegia (n=6, 8%) or quadriplegia (n=31, 41%), followed by chronic/refractory pain (n=32, 43%). Non-collision sport cases had a higher percentage of premises liability claims (41% vs. 11%, p=.006) and alleged chronic/refractory pain (53% vs. 28%, p=.04). Conversely, collision sport cases had a higher proportion of workers' compensation/no fault litigation (23% vs. 4%, p=.03) and cases involving disc herniation (29% vs. 9%, respectively; p=.04).

CONCLUSION

Sports-related spinal injuries are associated with multiple and complex health, socioeconomic, and legal consequences, with median inflation-adjusted award payouts nearing $800,000 per case. In our cohort, the most commonly cited legal claims were negligent supervision and premises liability, emphasizing the need for prevention guidelines for safe sports practice, especially in non-professional settings. Cases involving athletes participating in non-collision sports were significantly associated with claims citing chronic/refractory pain, highlighting the importance of long-term care in severely injured athletes.

Amateur runners more influenced than elite runners by temperature and air pollution during the UK's Great North Run half marathon

The short- and long-term impacts of air pollution on human health are well documented and include cardiovascular, neurological, immune system and developmental damage. Additionally, the irritant qualities of air pollutants can cause respiratory and cardiovascular distress. This can be heightened during exercise and especially so for those with respiratory conditions such as asthma. Meteorological conditions have also been shown to adversely impact athletic performance; but research has mostly examined the impact of pollution and meteorology on marathon times or running under laboratory settings. This study focuses on the half marathon distance (13.1 miles/21.1 km) and utilises the Great North Run held in Newcastle-upon-Tyne, England, between 2006 and 2019. Local meteorological (temperature, relative humidity, heat index and wind speed) and air quality (ozone, nitrogen dioxide and PM_2.5) data is used in conjunction with finishing times of the quickest and slowest amateur participants, along with the elite field, to determine the extent to which each group is influenced in real-world conditions. Results show that increased temperatures, heat index and ozone concentrations are significantly detrimental to amateur half marathon performances. The elite field meanwhile is influenced by higher ozone concentrations. It is thought that the increased exposure time to the environmental conditions contributes to this greater decrease in performance for the slowest participants. For elite athletes that are performing closer to their maximal capacity (VO₂ max), the higher ozone concentrations likely results in respiratory irritation and decreased performance. Nitrogen dioxide and PM_2.5 pollution showed no significant relationship with finishing times. These results provide additional insight into the environmental effects on exercise, which is particularly important under the increasing effects climate change and regional air pollution. This study can be used to inform event organisation and start times for both mass participation and major elite events with the aim to reduce heat- and pollution-related incidents.

Metabolic cost of level, uphill, and downhill running in highly cushioned shoes with carbon-fiber plates

BACKGROUND

Compared to conventional racing shoes, Nike Vaporfly 4% running shoes reduce the metabolic cost of level treadmill running by 4%. The reduction is attributed to their lightweight, highly compliant, and resilient midsole foam and a midsole-embedded curved carbon-fiber plate. We investigated whether these shoes also could reduce the metabolic cost of moderate uphill (+3°) and downhill (-3°) grades. We tested the null hypothesis that, compared to conventional racing shoes, highly cushioned shoes with carbon-fiber plates would impart the same ∼4% metabolic power (W/kg) savings during uphill and downhill running as they do during level running.

METHODS

After familiarization, 16 competitive male runners performed six 5-min trials (2 shoes × 3 grades) in 2 Nike marathon racing-shoe models (Streak 6 and Vaporfly 4%) on a level, uphill (+3°), and downhill (-3°) treadmill at 13 km/h (3.61 m/s). We measured submaximal oxygen uptake and carbon dioxide production during Minutes 4-5 and calculated metabolic power (W/kg) for each shoe model and grade combination.

RESULTS

Compared to the conventional shoes (Streak 6), the metabolic power in the Vaporfly 4% shoes was 3.83% (level), 2.82% (uphill), and 2.70% (downhill) less (all p < 0.001). The percent of change in metabolic power for uphill running was less compared to level running (p = 0.04; effect size (ES) = 0.561) but was not statistically different between downhill and level running (p = 0.17; ES = 0.356).

CONCLUSION

On a running course with uphill and downhill sections, the metabolic savings and hence performance enhancement provided by Vaporfly 4% shoes would likely be slightly less overall, compared to the savings on a perfectly level race course.

Longitudinal bending stiffness does not affect running economy in Nike Vaporfly Shoes

PURPOSE

This study aimed to determine the independent effect of the curved carbon-fiber plate in the Nike Vaporfly 4% shoe on running economy and running biomechanics.

METHODS

Fifteen healthy male runners completed a metabolic protocol and a biomechanics protocol. In both protocols participants wore 2 different shoes, an intact Nike Vaporfly 4% (VF_intact) and a cut Nike Vaporfly 4% (VF_cut). The VF_cut had 6 medio-lateral cuts through the carbon-fiber plate in the forefoot to reduce the effectiveness of the plate. In the metabolic protocol, participants ran at 14 km/h for 5 min, twice with each shoe, on a force-measuring treadmill while we measured metabolic rate. In the biomechanics protocol, participants ran across a runway with embedded force plates at 14 km/h. We calculated running economy, kinetics, and lower limb joint mechanics.

RESULTS

Running economy did not significantly differ between shoe conditions (on average, 0.55% ± 1.77% (mean ± SD)) worse in the VF_cut compared to the VF_intact; 95% confidence interval (-1.44% to 0.40%). Biomechanical differences were only found in the metatarsophalangeal (MTP) joint with increased MTP dorsiflexion angle, angular velocity, and negative power in the VF_cut. Contact time was 1% longer in the VF_intact.

CONCLUSION

Cutting the carbon-fiber plate and reducing the longitudinal bending stiffness did not have a significant effect on the energy savings in the Nike Vaporfly 4%. This suggests that the plate's stiffening effect on the MTP joint plays a limited role in the reported energy savings, and instead savings are likely from a combination and interaction of the foam, geometry, and plate.

Can We Quantify the Benefits of "Super Spikes" in Track Running?

The recent and rapid developments in track spike innovation have been followed by a wave of record-breaking times and top performances. This has led many to question what role “super spikes” play in improving running performance. To date, the specific contributions of new innovations in footwear, including lightweight, resilient, and compliant midsole foam, altered geometry, and increased longitudinal bending stiffness, to track running performance are unknown. Based on current literature, we speculate about what advantages these features provide. Importantly, the effects of super spikes will vary based on several factors including the event (e.g., 100 m vs. 10,000 m) and the characteristics of the athlete wearing them. Further confounding our understanding of super spikes is the difficulty of testing them. Unlike marathon shoes, testing track spikes comes with a unique challenge of quantifying the metabolic energy demands of middle-distance running events, which are partly anaerobic. Quantifying the exact benefits from super spikes is difficult and we may need to rely on comparison of track performances pre- and post- the introduction of super spikes.

A Narrative Analysis of the Progression in the Top 100 Marathon, Half-Marathon, and 10-km Road Race Times from 2001 to 2019

PURPOSE

This study aimed to characterize and describe finishing time trends of the fastest 100 performers in the men's and women's marathon, half-marathon, and road 10-km each year from 2001 to 2019 and assess the underlying basis for recent performance improvements.

METHODS

The top 100 performers for each sex, event, and year were partitioned into four arbitrary ranking groups: 1-10, 11-25, 26-50, and 51-100. The percent improvement in mean performance time for each year beyond 2001 was calculated for each ranking group, event, and sex. Multiple linear regression was also used to determine improvement trend for each ranking group, both sexes, and all events for each 3-yr period between Olympic years.

RESULTS

In total, 11,400 performances in the marathon, half-marathon, and 10-km road races from 2001 to 2019 were analyzed. The 3-yr period preceding the original date of the Tokyo Olympics (2017-2019) accounted for 44% and 35% of the overall improvement in marathon time from 2001 to 2019 for women and men, respectively. The years 2017-2019 featured the largest average improvement of any 3-yr period and was the only period where nearly every ranking group in every event for both sexes improved.

CONCLUSIONS

The results suggest that recent world record performances are a result of overall circumstances affecting road racing (e.g., shoe technology) rather than the outstanding physiology of individual top runners, per se.

The effects of footwear midsole longitudinal bending stiffness on running economy and ground contact biomechanics: A systematic review and meta-analysis

This study aimed to address the effects of increased longitudinal bending stiffness (LBS) on running economy (RE) and running biomechanics. A systematic search on four electronic databases (Pubmed, WOS, Medline and Scopus) was conducted on 26 May 2021. Twelve studies met the inclusion criteria and were included. Standardised mean difference with 95% confidence intervals (CI) between footwear with increased LBS vs. non-increased LBS conditions and effect sizes were calculated. To assess the potential effects of moderator variables (type and length plate, increased LBS, shoe mass and running speed) on the main outcome variable (i.e. RE), subgroup analyses were performed. Increased LBS improved RE (SMD = -0.43 [95% CI -0.58, -0.28], Z = 5.60, p < 0.001) compared to non-increased LBS. Significant increases of stride length (SMD = 0.29 [95% CI 0.10, 0.49], Z = 2.93, p = 0.003) and contact time (SMD = 0.17 [95% CI 0.03, 0.31], Z = 2.32, p = 0.02) were found when LBS was increased. RE improved to a greater degree at higher running speeds with footwear with increased LBS. RE improved 3.45% with curve plate compared to no-plate condition without improvements with flat plate shoes. When shoe mass was matched between footwear with increased LBS vs. non-increased LBS conditions, RE improved (3.15%). However, when shoe mass was not controlled (experimental condition with ∼35 grams extra), a significant small improvement was found. These RE improvements appear along with an increase of stride length and contact time. Shoe mass, type of plate (flat or curve) and running speed should be taken into consideration when designing a shoe aimed at improving long-distance running performance.

Evolution of distance running shoes: performance, injuries, and rules

Over the last 50 years, the development of running shoes has been mainly focused on improving the protection and comfort of the runner and her/his foot. Although there have been tentative attempts by companies to make shoes a tool for improving athletic performance, this goal has only recently been achieved. Indeed, the year 2016 was a real turning point when Nike launched its first shoe benefiting from the advanced footwear technology. Advanced footwear technology (AFT) mostly consists of an increased sole thickness, a curved and stiff plate embedded or below the shoe midsole, and an outsole with a marked concave shape. This innovation turned to a game changer in the world of distances running performance. Indeed, between 2016 and 2019, many male and female runners broke personal best times, national records, area, and world records in distance from 5 km to the marathon. The present article aimed at describing the magnitude of these performance enhancements in distance running as well as and the possible underlying performance-enhancement mechanisms associated with the advanced footwear technology. It also reviewed the existing literature on the safety aspects of "classical" construction shoes and AFT shoes. It concluded on a possible shoe mechanical tests-based protocol to maintain fair distance running competitions while not totally preventing manufacturers to innovate, and some thoughts on the nature and goals of further studies to be conducted to assess the safety (macro- and micro-traumatic) AFT in both elite and recreational runner populations.