Recognizing the Potential for Bone Stress Injuries After Using Carbon Fiber Plate Footwear

Case series of five patients using the footwear signal the need to evaluate any potential risk

Millions of endurance runners use footwear that has an embedded carbon fiber plate (CFP) in the midsole. While the performance benefits that carbon fiber plate footwear offers have been well documented, little has been published about running injuries related to use of this footwear. In a current opinion piece published today in the journal Sports Medicine, authors describe five cases in which runners using carbon fiber plate footwear sustained bone stress injuries.

“While I understand the excitement, we need to consider how to prevent injuries when athletes adopt this new footwear,” said lead author Adam Tenforde, MD, physician in Mass General Brigham’s Sports Medicine program and medical director of the Spaulding National Running Center. “We hope this current opinion helps to guide better recognition of potential medical issues related to CFP footwear, appropriate use of this new technology, and how to advance methods to safely use these shoes.”

In their publication, Tenforde and colleagues describe five patient cases, including junior elite track and field athletes in Europe and two athletes in their mid-30s who competed in endurance events in North America. All five experienced foot pain after using carbon fiber plate footwear and were later diagnosed with navicular bone stress injuries (BSI).

“Recognizing possible associations of navicular BSI in runners presenting with vague midfoot or ankle pain who use CFP footwear may be important to identify this high-risk injury,” the authors write.