A new biomechanics study from Mass General Brigham, published this month in PM&R, finds that the same advanced footwear technology (AFT) — the carbon-plated, high-stack super-shoes now ubiquitous across the elite road racing field — produces subtle but consistent changes in running mechanics in ways that researchers say are consistent with the loading patterns that lead to bone stress injuries. The work is one of the first lab-based looks at how AFT actually re-shapes a runner's gait in a controlled head-to-head against neutral and minimally responsive footwear.
The authors recruited 23 healthy elite distance runners — 11 women and 12 men — and ran them in three conditions on a single laboratory protocol: a neutral racing flat, a lightweight responsive-foam trainer with no carbon plate, and a carbon-plated AFT shoe with the highly cushioned foam and stiff embedded plate now standard in elite road racing. The runners performed treadmill segments at controlled paces while the lab captured three-dimensional kinematics, ground reaction forces and a panel of joint-loading variables. The methodology deliberately avoided the field-study confound of self-selected pacing: every shoe was tested at the same speed.
The study's headline finding is that AFT shoes produced significantly higher peak loading rates at the tibia and shifted joint moments at the ankle and knee in directions the wider biomechanics literature has previously associated with elevated tibial and metatarsal bone stress injury risk. Crucially, those changes happened even at controlled pace — meaning the mechanism cannot simply be explained by AFT runners running faster and harder than they would in a flat. The authors are careful not to claim direct causation of injuries from a treadmill protocol, but the loading-pattern shift they document is real and measurable.
For elite athletes, the practical implication the authors emphasise is volume management rather than abandonment. AFT shoes still produce the energy-return benefits that have powered every major elite road performance since 2017, and the paper does not argue that those benefits are not real. Instead, it makes the case that the marginal injury risk associated with the loading-pattern change is something coaches and athletes should factor into how many weekly kilometres are run in AFT versus in less-aggressive shoes. The implicit recommendation is the one many elite programmes have already adopted in practice: reserve the AFT for race-pace work and key sessions, not for daily mileage.
The paper sits alongside a March 2026 review in the British Journal of Sports Medicine that pooled six AFT biomechanics studies and reached a similar directional conclusion — and alongside the long-running observational debate about the rise in elite metatarsal and navicular bone stress injuries since 2018. None of that body of evidence yet amounts to a causal verdict against super-shoes; what is changing is that the mechanism has now been measured in a controlled lab head-to-head rather than only inferred from injury registries. Sub-elite runners spending most of their weekly mileage in AFT, the authors note, should treat the findings as a reason to ask the same volume-management questions elite athletes are already asking.