Adherence, motivational factors, and injury rates in runners using minimalist vs. conventional shoes: A cross-sectional study of 4719 Brazilian runners

BACKGROUND: In the early 2010s, a movement advocating a more natural running style, such as running in minimalist shoes, emerged. However, little is known about runners' adherence to these shoes, interest in them, and injury rates associated with them. OBJECTIVE: To investigate adherence, motivational factors, and injury rates associated with running in conventional and minimalist shoes. METHODS: 4719 Brazilian runners answered an online survey assessing demographic data, training habits, adherence levels, motivational factors for selecting running shoes, and running-related injuries. Associations with shoe type were assessed using chi-square (χ²) tests, and multivariable stepwise logistic regression was used to examine the association between minimalist shoe use and injury prevalence. RESULTS: Most runners were classified as conventional shoe users (78%), while 22% reported having tried minimalist shoes, primarily motivated by performance improvement (43%). Among those with experience (n = 1042), 31% were former users, while 41% and 28% were classified as occasional and habitual users, respectively. Most reported no formal guidance during the transition. Men and more experienced runners were more likely to report experience with minimalist shoes (p < 0.001). No significant association was observed between shoe type and overall injury prevalence. However, stratified multivariable analyses showed lower odds of injury among habitual users (OR = 0.72, 95% CI: 0.56, 0.93; p = 0.013) compared with conventional shoe users. CONCLUSIONS: Adherence to minimalist shoes is low, and shoe selection is associated with sex and running experience. Although overall injury prevalence did not differ between groups, adjusted analyses indicated lower odds of injury among habitual users.