25 Sep How to choose the correct running shoe?
With so many different types, brands and models of running shoes it can be a difficult task choosing the correct shoe that suits your foot function to help prevent overuse injuries. Throw in brand marketing, shoe store sales staff, footwear professionals, magazines, books, internet blogs, running friends and coaches all offering their opinion and experiences it can get even more confusing!
If we look at some of the research on running shoes and injury prevention there are two interesting facts that are summarised in a review by Nigg et al (2015).
- The frequency of running injuries has not changed in 40 years (Nigg et al, 2015).
- There is little evidence for pronation and impact forces as risk factors despite being considered primary predictors of running injuries (Nigg et al, 2015).
This is despite the apparent advancement of stability technology, cushioning and durability of footwear. Also despite our increased knowledge through the use of slow motion video analysis, force measurements and other scientific aids that should provide us with meaningful data to guide us in helping reduce overuse injuries.
As a Podiatrist working in an evidence based profession this can make referring our patients for certain running shoes sometimes hard to justify.
However….. we still need to have an approach or method for referring. The fact of matter is that runners need something under their feet to protect from the high ground reaction forces from hard surfaces most of us decide to run on as well as objects that could cause damage e.g. rocks, sticks and glass. Also if you are going to be paying a couple of hundred dollars for a pair of running shoes then having clear guidelines in terms of support and stability will give you more confidence that your selection was the right one…….even if the research does lean towards basically saying that it does not matter what you run in!
The following are the factors, in no particular order that I take into consideration when referring patients for running shoes.
- Foot function through the different phases of the gait cycle e.g. mild, moderate, excessive pronation, neutral or excessive supination during mid-stance
- Patient biomechanical restrictions e.g. restricted ankle dorsiflexion range
- Patient Injury history
- Running experience
- Patient conditioning
- Patient past experiences with running shoes
- The research related to injury prevention and running shoes
- Patient goals e.g. distances, frequency, events
Once I have taken a detailed history I can then implement my knowledge about different running shoe features to match a runner to up to THREE DIFFERENT RUNNING SHOES that I would like them to use con-currently if possible especially if their weekly kilometres are building to 20+km.
By rotating your shoes they will not only last longer but you will be gaining the perceived strength benefits of your foot moving differently depending on the features of the shoes. Not to mention it is a little more FUN and EXCITING to feel out different running shoes to break the often laborious task of running training!
The following are examples of running shoe features I consider when referring:
- Dual density mid-sole i.e. firmer foam along the medial side of the mid-sole to reduce excessive pronation
- Midsole material e.g. Ethylene-vinyl acetate most common
- Stack height i.e. the thickness of the midsole
- Heel pitch or heel drop e.g. 12mm vs 10mm vs 8mm vs 4mm vs 0mm
- Fore-foot stiffness e.g. traditional breaking where toes bend vs Rocker or meta-rocker
- Toe-box width
When to use what shoe can be a little more difficult to decide and it is best to consult a running experienced Podiatrist or Physiotherapist especially if you are new to running or you are returning to running after a prolonged period off.
Lastly it is extremely important to understand that running shoes alone will not prevent injury. Having your running technique assessed by a trained professional as well as setting up a suitable strength and flexibility program is of prime importance. Following an appropriate running program matched to your running experience and current fitness will also reduce the risk of over-training and therefore injury.
Once you have all this in place then you will not only enjoy your running more but be more confident of preventing overuse injuries. Happy running!
Nigg B, Baltich J, Hoerzer S, et al Running shoes and running injuries: mythbusting and a proposal for two new paradigms: ‘preferred movement path’ and ‘comfort filter’ Br J Sports Med 2015;49:1290-1294.