Barefoot vs. Cushioned: Which Women's Running Shoe Is Better for Your Joints?
- Skye Sunderland
- 1 day ago
- 12 min read
Are cushioned running shoes really better for your joints? The science says... maybe not.
Between 37% and 56% of recreational runners are injured every year.Ā Despite decades of technological advances in running shoes, those numbers have barely changed.
Yet walk into almost any running store and you'll hear the same advice:
"If you want to protect your joints, buy the shoe with the most cushioning."
It sounds logical.
More foam = more shock absorption = healthier knees.
Except... that's not actually what the evidence shows.
And before you come at meāno, I'm not about to recommend those ugly "clown shoes" we've all seen online. I completely understand that aesthetics matter, especially for women! The good news is that barefoot footwear has come a long way, and I have done the research, so you don't have to... so I'll share some genuinely stylish, feminine options later in this article.
In 2025, a scoping review analysed 106 studiesĀ investigating ways to prevent running injuries. After screening more than 3,700 papers, the researchers reached an important conclusion: no single interventionāincluding footwearāconsistently reduced injury risk on its own.Ā Instead, the best outcomes occurred when footwear was combined with strength training, gait retraining, appropriate load management, recovery and education.
In other words, shoes matterābut they aren't the magic solution many companies would have us believe.
Despite decades of thicker midsoles, softer foams and increasingly cushioned shoes, running-related injuries have remained stubbornly high. If maximal cushioning was the answer, we should have seen injury rates decline.
We haven't.
So, what does the research actually tell us?
What Does the Research Say About Barefoot Running Shoes?
A 2026 study published in Footwear ScienceĀ directly compared minimal, traditional and maximal running shoesĀ to determine how different midsole stack heights influence joint loading during running. Unlike many footwear studies that compare only two shoe types, this study examined all three conditions in the same group of 27 healthy runners, using an eight-camera 3D motion capture systemĀ and embedded force platesĀ to accurately measure movement and loading through the hip, knee and ankle.
The researchers specifically measured quadriceps force, patellofemoral joint reaction force, patellofemoral joint stress, and the amount of work performed at the ankle and knee jointsĀ during each running trial.
Compared with both traditional and maximal shoes, minimal shoes produced:
Lower quadriceps force
Lower patellofemoral joint reaction force
Lower patellofemoral joint stress
Lower positive, negative and overall knee joint work
Importantly,Ā while loading at the knee decreased, the minimalist shoe increased negative work at the ankle, suggesting that the mechanical demands were redistributed from the knee towards the foot and ankle complex. In other words, the forces weren't eliminatedāthey were simply absorbed by different tissues.
The researchers concluded that midsole stack height significantly influences patellofemoral joint loading and the way mechanical work is shared between the knee and ankle during running.Ā Rather than simply absorbingĀ impact, the amount of foam under the foot appears to influence where and howĀ your body absorbs mechanical load.
That is a particularly important finding because patellofemoral pain syndrome ("runner's knee") is one of the most common running-related injuries, especially in women.Ā Reducing stress on the patellofemoral joint may therefore have important implications for runners prone to anterior knee pain, although long-term injury studies are still needed.
But Doesn't Foam Absorb Impact?
This is where the evidence becomes particularly interesting.
One of the most common arguments for highly cushioned shoes is that the extra foam must reduce the impact travelling through your body. After all, if the shoe feels softer, surely your joints experience less force?
A 2018 study published in the American Journal of Sports MedicineĀ by Pollard and colleaguesĀ investigated how maximal cushioned running shoes influenced biomechanics in 15 female runnersĀ before and after completing a 5 km run. Using three-dimensional motion analysis and force plates, the researchers compared maximal shoes with traditional neutral running shoes.
Despite having substantially more cushioning, the maximal shoes produced:
Higher impact peaks
Higher vertical loading rates
both before and after the 5 km run.
This finding is important because higher loading rates have repeatedly been associated with an increased risk of running-related injuries, particularly overuse injuries affecting the lower limb. The authors suggested that runners transitioning to maximal shoes may initially experience greater impact loadingĀ than when running in traditional neutral footwear.
In other words, a shoe that feelsĀ softer doesn't necessarily reduce the forces your body experiences. Instead, additional cushioning may alter running mechanics in ways that increase certain loading characteristics.
Stability: The Overlooked Problem
The Reyes & Hannigan Study demonstrated that shoe stack height changes how forces are distributed through the lower limbs.
The next logical question is:
Does increasing stack height also change the way we run?
A 2025 study by Kettner and colleaguesĀ investigated this by comparing running shoes with three different stack heights:
Low:Ā 27 mm
Medium:Ā 35 mm
High:Ā 50 mm
Seventeen experienced runners completed treadmill running at both 10 km/h and 15 km/h, while researchers used a sophisticated 3D motion capture systemĀ to analyse running mechanics, joint motion and dynamic stability.
Compared with the lower stack heights, the 50 mm shoe consistently altered running mechanics.Ā Specifically, runners demonstrated:
Longer ground contact time relative to each stride.
Greater vertical oscillation of the body's centre of mass.
Longer periods of foot eversion during stance.
Reduced local dynamic stability at the hip.
These findings suggest that increasing stack height doesn't simply change comfortāit also alters running mechanics and dynamic stability.
Perhaps the most concerning finding was the reduction in dynamic hip stabilityĀ with the highest stack height. Since the hip plays a critical role in controlling the body's centre of mass during running, reduced stability may increase the amount of compensatory movement throughout the lower limb.
The researchers also observed that runners wearing the highest stack shoes took slightly longer, lower-frequency strides at faster running speeds, further demonstrating that stack height influences running technique rather than simply changing comfort.
Although this study did not directly measure joint loading or injury rates, the authors concluded that the biomechanical changes observed with the highest stack height may have important implications for both injury risk and running performance.Ā In other words, more cushioning isn't necessarily betterāparticularly if it begins to compromise stability.
Think about standing on a thick gym mat instead of solid ground. The softer surface feels more comfortable, but it's also less stable. Your muscles have to work harder to control your balance because the ground beneath you is constantly compressing.
Running in highly cushioned shoes may create a similar challenge. The extra foam doesn't simply absorb forceāit changes how your foot interacts with the ground, altering stability, movement patterns and the way forces are managed throughout the lower limb.
If thicker midsoles can change joint loading, increase impact loading in some situations and alter stability, the next logical question is why?
The answer lies in the remarkable design of the human foot.
Why Barefoot Running Shoes Change Foot Biomechanics
One of the biggest misconceptions about minimalist footwear is that the argument is simply, "natural is always better."
It isn't.
The stronger argument is based on foot function, sensory feedback and biomechanics.
The human foot contains 26 bones, 33 joints and more than 100 muscles, tendons and ligaments, making it one of the most complex structures in the body. The sole of the foot is also packed with thousands of specialised nerve endings, called mechanoreceptors, which continuously provide the brain with information about:
Pressure
Surface stiffness
Balance
Foot position
Timing of ground contact
This constant stream of sensory information allows the nervous system to make rapid adjustments with every step, helping coordinate the ankle, knee and hip to maintain efficient movement and stability.
When several centimetres of compliant foam are placed between the foot and the ground, that sensory input can be altered. Rather than simply cushioning the landing, the shoe changes how the foot interacts with the ground, which can influence foot strike, leg stiffness, knee mechanics and overall running strategy.
In other words, a running shoe doesn't just change what you feel beneath your feetāit can change how you move.
1. Minimalist Footwear Can Strengthen the Foot
Like every other muscle in the body, the muscles of the foot become stronger when they're challenged.
An RCT found that runners who transitioned to minimalist footwear developed larger intrinsic foot muscles and greater foot strengthĀ over time. These muscles play an important role in supporting the arch, maintaining balance and helping transfer force during walking and running.
While stronger feet don't guarantee fewer injuries, they do increase the foot's capacity to perform the job it was designed to do, rather than relying primarily on the shoe for support.
2. Footwear Can Shape Foot Structure
Research comparing habitually barefoot and habitually shod populations has consistently shown that people who spend most of their lives barefoot typically have:
Wider forefeet
Greater natural toe splay
Stronger foot musculature
Lower rates of certain foot deformities, including hallux valgus (bunions)
This doesn't mean everyone should stop wearing shoes. Rather, it highlights that the footwear we wear over many years can influence how our feet develop and function. A wide toe box allows the toes to spread naturally, improving stability and giving the foot the space to move as it was designed.
3. Minimalist Shoes Don't Remove ForceāThey Redistribute It
One criticism often directed at minimalist footwear is that it places greater demand on the feet and calves.
That's trueāand the research supports it.
As the Reyes and Hannigan (2026)Ā study demonstrated, minimalist shoes reduced loading at the knee while increasing the work performed by the ankle-foot complex. The forces didn't disappear; they were simply redistributed.
Rather than asking the knee to absorb as much of the impact, minimalist footwear encourages the foot, calf muscles and Achilles tendon to play a greater role in absorbing and returning force. For runners with strong, well-conditioned lower legs, this may be advantageous. However, for runners who have spent years in highly cushioned shoes, these tissues are often deconditioned and need time to adapt.
Which brings us to perhaps the most important part of this conversation: how to transition safely.
How to Transition to Barefoot Running Shoes Safely
This is where I often disagree with people.
I am notĀ saying:
"Throw away your cushioned shoes and run 10 km barefoot tomorrow."
That is one of the quickest ways to develop calf strains, Achilles tendinopathy, plantar foot pain or metatarsal stress injuries.
If you've spent years running in highly cushioned shoes, your body has adapted to that environment. Your calves have likely been doing less work, your Achilles tendon has adapted to lower loading demands, and the small stabilising muscles in your feet may not have been challenged to their full capacity.
Minimalist shoes don't suddenly become dangerousāthey simply ask your body to do more of the work it was designed to do.
Like any training adaptation, your muscles, tendons and bones need time to remodel. Give them that time, and they'll become stronger. Rush the process, and they'll often let you know.
The transition should always be gradual.
A Practical 16-Week Transition
There isn't a perfect transition timeline, but for most runners, 12ā16 weeksĀ allows the foot, calf and Achilles tendon to progressively adapt to the increased workload.
Phase | What to do |
Weeks 1ā3 | Wear minimalist shoes for walking only (20ā60 minutes per day). |
Weeks 4ā6 | Introduce 5ā10 minutes of easy running with your barefoot shoes after your normal run. |
Weeks 7ā9 | Increase minimalist running to 15ā20 minutes if symptom-free. |
Weeks 10ā12 | Complete approximately 25ā50% of your weekly running volume in minimalist shoes. |
Weeks 13ā16 | Gradually increase volume by around 10ā20% each week as tolerated. |
Progress isn't measured by how quickly you can wear the shoesāit's measured by how well your tissues tolerate the increased demand.
If your calves, Achilles or feet remain excessively sore for several days, slow down before progressing again.
Non-Negotiables During the Transition
Changing your shoes without strengthening your feet is a missed opportunity.
To help your body adapt, I'd recommend incorporating:
Heavy straight-leg calf raises
Bent-knee calf raises (to target the soleus)
Short-foot exercises
Toe splay drills
Single-leg balance work
Ankle mobility exercises
Gradual training load progression
Think of barefoot running shoes as changing the way your body trains. Just as you wouldn't expect to lift heavier weights without progressively building strength, you shouldn't expect your feet and lower legs to immediately tolerate a completely new loading pattern.
Is It Worth the Transition?
For many runners, I believe the answer is yesāparticularly if your goal is long-term health rather than simply making today's run feel softer.
The objective isn't just to survive your next 5 km.
It's to maintain:
Strong feet
Healthy tendons
Bone density
Good balance
Proprioception
Knee resilience
through your 40s, 50s, 60s and beyond.
A shoe can provide temporary comfort.
It cannot replace strong tissues.
The Barefoot Shoes I'd Actually Recommend
One of the biggest reasons people avoid barefoot shoes is simple:
They think they look terrible.
And honestly... some of them do.
The good news is that wide toe zero drop footwear has come a long way over the past few years, and there are now several brands making shoes that are both functional and genuinely good-looking.
My personal favourite is the Leguano Amalfi.
It's a simple white lace light-weight sneaker that looks more like a stylish everyday sneaker than a traditional barefoot shoe. I'm currently on my third pair, and they're the shoes I wear most often when travelling because they're lightweight, comfortable and versatile enough to wear almost anywhere.
For running, these are the brands I'd recommend:
Best overall
Excellent ground feel, a generous toe box and exceptional flexibility. Once you've adapted, these are hard to beat.
Xero Nexus Knit or HFS II
Best for transitioning
A fantastic first minimalist running shoe that feels slightly more forgiving while still allowing natural foot function. Available in white, black, dark blue, pink, light blue, and silver lining (a pretty beige pink!).
For experienced minimalist runners
Extremely flexible with a very thin sole, providing excellent sensory feedback once your feet have adapted.
My everyday favourite
Not designed as a dedicated running shoe, but one of the nicest-looking barefoot shoes available. If you've been put off minimalist footwear because of the aesthetics, these are unbelievably pretty and are well worth a look for everyday women's footwear while your feet adapt.
If You're Coming from Traditional "Sponge" Shoes...
This would be my progression:
Leguano AmalfiĀ ā the prettiest transition.
Xero HFS IIĀ ā the easiest transition.
Vivobarefoot Primus LiteĀ ā my preferred long-term minimalist running shoe.
Merrell Vapor Glove 6Ā ā once you're fully adapted and if you become addicted!
Remember, the goal isn't to buy the thinnest shoe you can find.
The goal is to choose a shoe that matches where your body is today, while gradually building the strength and capacity to rely less on cushioning and more on your own tissues over time.
A Message Specifically for Women
As a women's health educator, this is the part that concerns me most.
When we talk about running shoes, the conversation is almost always about preventing today's injuries. But as women, we need to think much further ahead than that. Our musculoskeletal system changes dramatically throughout life, particularly during perimenopause and menopause, when declining oestrogen begins to influence bone density, collagen production, muscle mass and connective tissue health. The choices we make in our 20s, 30s and 40s don't just affect how we run todayāthey influence how well we move decades from now.
Women are already at greater risk of several musculoskeletal conditions than men, including:
Patellofemoral pain syndrome (runner's knee)
ACL injuries
Hip instability
Stress fractures
Osteopenia and osteoporosis
Sarcopenia (age-related muscle loss)
Chronic hip, knee and lower back pain
What concerns me is that many women are told to avoid impact and simply buy more cushioning to "protect" their joints. While cushioning may improve comfort for some runners, the current evidence doesn't support the idea that more foam automatically means healthier joints or fewer injuries. As we've seen throughout this article, increasing stack height changes running biomechanics, can reduce stability and doesn't necessarily reduce the forces travelling through the body.
Our bodies don't become stronger by avoiding loadāthey become stronger by adapting to it.
Bone is living tissue that responds to mechanical stress by increasing bone formation. Muscles become stronger when they're challenged. Tendons, ligaments and other connective tissues remodel in response to progressive loading, while the nervous system relies on sensory feedback from the feet to continually refine movement and maintain stability.
This becomes even more important as women age. During perimenopause and menopause, the natural decline in oestrogen accelerates bone loss, reduces collagen production and contributes to losses in both muscle mass and strength. Preserving strong feet, healthy movement patterns and tissue capacity today may help reduce the risk of falls, fractures and chronic musculoskeletal pain later in life.
That's why I don't believe the question should simply be, "Which shoe feels the most comfortable?"
I think the better question is:
"Which shoe helps me build the strongest, healthiest body for the next 30 years?"
Because a shoe can certainly provide temporary comfort.
It can't build stronger bones.
It can't prevent sarcopenia.
It can't strengthen your connective tissue.
And it certainly can't replace the function of strong, capable feet.
That's something only your body can do.
If you remember one sentence from this article, let it be this:
Comfort is not the same thing as biomechanical protection.
Current evidence suggests that, compared with highly cushioned maximal shoes, minimalist footwear may:
Reduce patellofemoral joint stress.
Reduce knee joint work.
Improve sensory feedback.
Increase intrinsic foot muscle strength.
Promote more natural running mechanics.
The trade-off is that they place greater demand on the foot, calf and Achilles tendonāwhich is precisely why a gradual, progressive transition is essential.
So when someone tells me,
"Buy the thickest shoe you can find to protect your joints,"
my response is simple:
Show me the evidence.
Because right now, the strongest evidence we have points towards a different conclusion.
A resilient runner isn't built from a bigger sponge.
She's built from stronger feet, healthier movement, and tissues that have been given the opportunity to adapt.
If you enjoyed this article and want more evidence-based content on women's health, strength training, hormones, biomechanics and longevity, subscribe to my newsletter below. Every article is written to help you understand the science, cut through the myths, and make informed decisions about your healthāfor today, and for decades to come.
Key References
Reyes KE, Hannigan JJ. Footwear Science. 2026.
Kettner C, Stetter B, Stein T. The effects of running shoe stack height on running style and stability. 2025.
Pollard CD et al. Am J Sports Med. 2018.
Ridge ST et al. Medicine & Science in Sports & Exercise. 2019.
Holowka NB et al. Nature. 2021.
Lieberman DE et al. Nature. 2010.
Hamill J et al. Journal of Biomechanics. 2011.
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