Toe Box Shape of Running Shoes Affects In-Shoe Foot Displacement and Deformation: A Randomized Crossover Study

Long-distance running is popular but associated with a high risk of injuries, particularly toe-related injuries. Limited research has focused on preventive measures, prompting exploration into the efficacy of raised toe box running shoes. This study aimed to investigate the effect of running shoes with raised toe boxes on preventing toe injuries caused by distance running. A randomized crossover design involved 25 male marathon runners (height: 1.70 ± 0.02 m, weight: 62.6 + 4.5 kg) wearing both raised toe box (extended by 8 mm along the vertical axis and 3 mm along the sagittal axis) and regular toe box running shoes. Ground reaction force (GRF), in-shoe displacement, and degree of toe deformation (based on the distance change between the toe and the metatarsal head) were collected. Wearing raised toe box shoes resulted in a significant reduction in vertical ( = 0.001) and antero-posterior ( = 0.015) ground reaction forces during the loading phase, with a notable increase in vertical ground reaction force during the toe-off phase ( < 0.001). In-shoe displacement showed significant decreased movement in the forefoot medial ( < 0.001) and rearfoot (medial: < 0.001, lateral: < 0.001) and significant increased displacement in the midfoot (medial: = 0.002, lateral: < 0.001). Impact severity on the hallux significantly decreased ( < 0.001), while impact on the small toes showed no significant reduction ( = 0.067). Raised toe box running shoes offer an effective means of reducing toe injuries caused by long-distance running.