November 11, 2017 Will Carroll I’ve had a pet theory for years that, as Mars Blackmon tried to tell us, it’s gotta be the shoes. There has been a significant uptick in foot and ankle injuries – especially complex injuries like Lisfranc and Jones fractures – over the last twenties years. I believe that a confluence of bigger/stronger/faster athletes and an improvement in shoes have created an unforeseen consequence. Simply put, the shoes are too good. The human body can only take so much force and adding in additional traction often has a negative physical consequence. There’s likely much more to this, but let’s keep it simple. I was watching Netflix’s Abstract, a show about design. One of the episodes focuses on Tinker Hatfield, the legendary designer from Nike who designed the iconic Air Jordans and many more. In the first scene of the documentary, Hatfield says that it’s his job to take the foot past it’s human capability. I knew it! Look, Hatfield’s doing his job and doing it well. Unforeseen consequences are just that and for many, the shoes do help. Today’s athletes are gaining precious seconds in many sports – football, soccer, track, or even the mythical 4% of the Sub2 marathon project. But at what cost? Let’s say that the shoes (and I speak here in the general sense of modern athletic shoes) make 50 percent of athletes better, make no difference in 25 percent, but in 25 percent, it increases the forces beyond what they can handle physically, creating injuries? We wouldn’t stop making the shoes or go back to Stan Smiths and Chucks just because a quarter of athletes were breaking down, would we? Of course not. The answer is to identify which percentage is which. There’s plenty of technologies, led by pressure mapping and motion capture, that could help show how much force the foot is generating and capable of handling. Yet for most athletes, they pick cleats or shoes by who pays them, how they look, or if their hero wears them. “Fit” is usually “feel”. However, gait analysis and pressure mapping is something that is distinctly specialized and not widely distributed. You won’t walk into Finish Line and see a pressure mapping system. I’d love to see more done in this area, but let’s focus on the athletes that are seeing those negative consequences of advances. Do we simply count them as a cost, or are there ways of making them better as well, or at least controlling their workload so we stave off the breakdown that we should be able to see coming? I don’t have an answer to that which works across the board. We’ll never get injuries to zero, but lowering them even a little can have an immense effect. Quantification, data projection, and a focus on using as much information as is available in any given situation is the key here. The best practice is not to shrug and leave some behind. It’s also not to hold back a technology or program that works for a large number of people. It’s to individualize. It’s your foot. It’s your data. It’s your workload. Don’t base your improvement on anyone else’s results. Make it your own, start to finish.