• The performance benefit is real and well measured. A 2026 review of the research found carbon-plated shoes make running more efficient by 2.6–4.2%, reduce the energy you burn by around 4%, and let you hold a quicker pace (by 0.5–0.6 km/h) before tiring.
• The injury concern is real too — but it rests on thin evidence. It began with a report of just five competitive runners who developed a stress fracture of the navicular (a small bone at the top of the arch) while using carbon-plated shoes. That is a signal, not proof.
• One finding keeps coming up: the heel rolls inwards more. Two separate studies found this happens more in these shoes — the same pattern seen in runners who have had navicular stress fractures.
• They stiffen your big toe joint and shift the effort further up your leg. Restricting the toe joint is how the shoe makes you faster, but the load has to go somewhere — studies show more demand at the knee, and less cushioning of impact once you get tired.
• For recreational runners the picture is more reassuring. In 30 recreational runners, carbon-plated shoes made running more efficient with no increase in the measures linked to injury — and an ordinary cushioned trainer actually put more impact force through the legs.
• Carbon insoles do nothing. The review found no benefit to speed or effort from slip-in carbon-fibre insoles, unlike plates built into the shoe.
• The real risk is how you switch to them, not the shoe itself. Going from nothing to long runs in a stiff plated shoe is where problems start.

Five years ago these were elite racing shoes. They are now in every parkrun, and they will be under a lot of Christmas trees. The question I am asked most often by running patients is whether the thing that made them faster is also what is making their foot hurt.

“Advanced footwear technology” (often called “super shoes”) combines two things: a thick, very springy foam midsole, and a stiff carbon-fibre plate running through it. The plate stiffens the shoe from heel to toe, which limits how much your big toe joint bends as you push off and helps the foam return energy.

The benefits are among the best measured in sports science. A 2026 review that pooled 14 studies found:¹

A separate trial of 30 recreational runners confirmed this directly: in carbon-plated shoes, runners needed less oxygen (around 1.8 mL/kg/min less) and had a heart rate roughly 5 beats per minute lower than in both a foam-only shoe and a standard trainer.⁶

So the shoes work. The question is what else they do.

In 2023, a group of sports medicine clinicians published a report describing five highly competitive runners who had developed stress injuries of the navicular bone while using carbon-plated footwear,² alongside an opinion piece in the British Journal of Sports Medicine raising wider concerns.³

It is important to be clear about what that is and is not. Five cases, reported because clinicians noticed a pattern, with no comparison group, and no way of knowing how many runners wore the shoes without any problem. It cannot tell you the shoes caused the injuries. What it did do was prompt people to look properly — and research into how runners move in these shoes has since found some consistent things.

The heel rolls in more

This is the finding that recurs. In 23 elite distance runners tested across neutral, foam-only and carbon-plated shoes, the heel rolled inwards further (rearfoot eversion) in the plated shoe than in a standard neutral one.⁴ An independent study of competitive runners in Nike Vaporfly NEXT% against a minimal, thin-soled shoe found the same thing — and noted that this extra inward roll is also seen in runners with a history of navicular stress fracture.⁵

The elite study’s own conclusion is worth summarising: several movement patterns linked to bone stress injury did increase, the changes were small, but these could add up over many miles.

Your big toe joint is deliberately restricted

The plate stiffens the shoe so the toe joint bends less. That is not a side effect — it is how the shoe works. But the strain on your body does not disappear; it moves elsewhere.

The Vaporfly study found the ankle bent less and did less work as runners pushed off, which explains the efficiency gain — alongside more strain on the muscles at the front of the knee, which the authors flagged as a new finding that could offset some of the benefit.⁵ Researchers call this “distal restriction, proximal compensation”: restrict the foot, and the knee and hip take up the slack.⁷

Fatigue changes the picture

A study testing runners when fresh and when tired found carbon-plated shoes limited big toe movement throughout, while tiredness made the ankle roll inwards more and made impact forces hit the leg more sharply. The type of shoe made a difference: ordinary shoes without a plate absorbed shock better once runners were tired.⁷

That is a practical point. Your last few miles are where your running form starts to slip and injuries happen, and it is exactly where the shoe appears to protect you least.

Set against all that, several things point the other way.

In recreational runners, the forces on the body did not get worse. The 30-runner trial measured how sharply impact hits the leg, how much each step brakes you, how long your foot stays on the ground, and how much your hips dip. Carbon-plated shoes improved efficiency without making any of these worse. The conventional cushioned trainer in that study sent much sharper impact forces through the leg than either modern shoe.⁶

The effects differ a great deal between people and between models. A study of 22 amateur triathletes across four different carbon shoe models found the jolt travelling up the shin bone varied by model, differed between men and women, and varied a lot from person to person — while the balance between left and right legs was unchanged.⁸

Not all plates are equal. Computer modelling shows the plate’s design matters. A plate positioned low in the sole slightly reduced strain on the long bones of the forefoot (the metatarsals), while one placed high — just under the insole — increased it by up to 12.9%.¹⁰ A curved plate reduced peak pressure under the ball of the foot by 5.5–12.6% compared with a flat one.⁹ You cannot tell any of this from the outside of the shoe.

Very thick, maximalist cushioning may be the bigger problem. The same review found these soft, thick soles increased the impact force by 10.7% and how sharply it hits by 12.3% — larger numbers than anything reported for plates.¹

Carbon insoles are not the same thing. The review found slip-in carbon-fibre insoles made no meaningful difference to speed or effort.¹ If you are considering buying a carbon insole to put in an ordinary shoe, the evidence does not support it.

For most people, yes — with some discipline about how.

• Do not race in a shoe you have not trained in. The most common pattern I see is someone who has run a whole training block in ordinary trainers, then puts plated shoes on for the first time on race day. That is the worst version of the transition.
• Build up gradually. The clinicians who first raised concerns recommended exactly this.² Start with one short, easy run, and build over several weeks.
• Do not do all your running in them. Rotate. Use them for faster training sessions and races; use something else for easy miles and long runs. This is also kinder to your wallet, since the foam wears out.
• Take pain in the middle of your foot seriously. Vague aching on the top of the arch that comes on with running and settles with rest is the classic warning sign of a navicular stress injury. It is often dismissed for weeks. If you have this, stop running and get it assessed — a normal X-ray does not rule it out.
• Be more cautious if you have had a bone stress injury before, you are increasing mileage, you have low bone density (thinner, weaker bones) or a history of an eating disorder or under-eating for your training, you are returning after a break from running, or you are running on tired legs.

If you are a runner with foot pain that is not settling — particularly aching across the midfoot — it is worth having properly assessed rather than training through. A weight-bearing CT scan (a 3D scan taken while you stand) is often useful where X-rays look normal but your symptoms suggest a problem.

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