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Last Updated: 14.06.23

Irene Davis, Ph.D.: Evolution of the Foot, Running Injuries, and Minimalist Shoes

Irene Davis, Director of Spaulding National Running Center at Harvard Medical School, discusses how her research on biomechanics and clinical work with running injuries shape her views on body alignment and foot health. She explores the role of modern footwear in running-​​related injuries and advocates for minimalist shoes to address biomechanical issues effectively.

Key Takeaways

High level takeaways from the episode.

Human feet evolved for walking and running

  • Transition from walking man (stereopithecus) to running man (Homo erectus)
  • Development of longitudinal arch, larger joint surfaces, and longer Achilles tendon

Running for 2 million years

  • Brains getting bigger, needed meat, outrun prey for endurance
  • Humans not fast runners, but good endurance runners

First footwear found in Fort Rock, Oregon, dated 10,000 years old

  • Made of sagebrush bark, flat surface with straps
  • Purpose: protect the bottom surface of the foot from the elements

Human feet develop calluses for protection

  • Going barefoot can lead to protective calluses on the bottom of the foot

Early Olympic athletes in marathons wore minimal footwear.

Running boom in the 1970s led to more people running, many of whom were not as fit as previous runners

  • Resulted in an increase in running injuries, such as Achilles problems
  • Led to the addition of a heel lift in running shoes

Nike consulted sports podiatrists to address the rise in running injuries

  • Determined that injuries were related to too much impact and too much motion
  • Led to the development of motion control and cushioning shoes
  • Motion control shoes: stiff heel counter, stiffer material on the inside of the midsole, plastic support reinforcements, and more arch support to prevent the foot from rolling in
  • Cushioning shoes: designed for people with high arches who need more cushioning
  • Studies have shown that removing arch support strengthens foot muscles
  • Cushioning may cause people to hit harder due to protection and mass effect
  • Lack of data on foot strike patterns before cushioned shoes, but it is believed that humans evolved to land on the balls of their feet
  • Steeper slope of impact peak in heel striking is associated with a greater rate of loading, which is related to running-​​related injuries
  • Overweight teenagers should not start with running, but rather build strength and motor control first
  • Obese individuals can run without pain if they run on the ball of their foot

    • Softens the landing and reduces impact


    • Forefoot strike should be done in minimal shoes
    • Rearfoot strike should have cushioning under the heel

    Minimalist shoes

    • No elevation of heel and no cushion or support
    • Wider toe box allows for spreading of toes, enhancing foot function

    Feet are the only points of contact with the ground, like tires on a race car

    • Cramming feet into narrow shoes with less contact to the ground is like reducing tire grip and stability

    Strengthening glute medius can help alleviate IT band pain.

    Retrospective study on Harvard track team found forefoot strikers had half the injuries of rearfoot strikers.

    Modern footwear increases torques on feet

    • Unclear if this causes problems, but it’s beyond what we’re adapted for

    Encourage minimalist footwear and natural movement from birth

    • Avoid sitting in chairs, promote squatting and standing

    Encourage multi-​​sport athletes instead of single-​​sport specialization

    • Reduces burnout and injury rates

    Implement physical education in schools daily

    • Calisthenics, push-​​ups, sit-​​ups, monkey bars, etc.


    Transitioning from orthotics to minimal shoes



    We recommend using this distillation as a supplemental resource to the source material.

    • Irene Davis, Ph.D.: Evolution of the foot, running injuries, and minimalist shoes

      Attia The Drive #128

      Irene Davis, Director of Spaulding National Running Center at Harvard, researches biomechanics and foot health in relation to running and modern footwear.

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