A shoe is provided for improving use efficiency through reduction of neuromuscular fatigue. The shoe includes an upper having a generally horizontal bottom wall. The bottom wall includes an upper surface and a lower surface. The upper comprises a forward region having a forward center of loading and a rear region having a rear center of loading. The shoe further includes a sole comprising a midsole and an outsole. The midsole comprises a suspension element, which can have a generally elongated shape. The suspension element further has a center of compression, which is generally aligned with at least one of the first and second centers of loading of the upper. The shoe can have a hinge located within the sole for providing enhanced efficiency to the user. The hinge and suspension element(s) can take various forms. The position and structure of the hinge and suspension element(s) in relation to the midsole can take various forms as well. The biomechanical action of the heel element, forefoot element and hinge can be dynamically coupled to create a highly resilient suspension system with a low rate of loading throughout the stride, thus allowing a natural, "barefoot" gait for the wearer. As a result, the wearer experiences a significant reduction in jarring impacts for any phase of the stride, a corresponding reduction in cumulative fatigue and a lower rate of chronic or traumatic injury. A method of manufacturing a suspension element for a shoe is also provided, and includes the steps of providing a die having a length, a width and a thickness, the length accommodating a plurality of suspension elements; wrapping a plurality of coated or wetted fibers around the width of the die to form the suspension elements; drying or curing the fibers to a substantially integrated form; and separating the plurality of suspension elements into independent suspension elements.