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Fit To Run: The Truth about Running Shoes, Like it or Not (Part 1)

One of the most common questions I am asked by runners is “What type of shoes should I be running in?” Frequently, they assume that, somewhere, there is a perfect shoe to fit their foot type (high arches or low arches) in order to prevent the aches, pains, and injuries associated with running. I can’t blame them as this is the traditional model for footwear prescription, which is based on assumptions (not evidence!) and the dated thought processes still echoed by shoe manufacturers and shoe stores across the country.

Here is a common scenario that almost every runner has come across at some point or another. You’re in need of a new pair of shoes. You go to your local shoe store and seek advice from a sales associate regarding which shoe is best for you, especially considering your history of nagging running injuries (for purposes of this example, we’ll say Runner’s knee). They watch you walk, both with shoes off and on, and may even watch you run on the treadmill. They will look at the bottom of your shoes to get an idea of the “wear pattern”, which provides some information about your running mechanics. What are they looking for? The amount of “pronation” your foot undergoes while walking and running.

That’s right, the dreaded “p word”. Pronation essentially refers to a complex series of movements at various joints of the foot that allows the arch to drop during the running cycle. There is a common belief that people who “pronate” are not meant for running and are doomed for injury. I am here to tell you that pronation is a normal part of the running cycle and plays an important role in shock absorption and stabilization of the foot.

Anyways, back to the running store. The supposed amount of pronation that is “determined” will put you into 1 of 3 shoe categories.

  1. Neutral: shoe type for underpronators/supinators or neutral pronators
  2. Stability: shoe type for mild/moderate overpronators
  3. Motion Control: shoe type for severe overpronators

 You leave the store with a new pair of shoes after being classified into one of these groups. You are now armed with a new perspective about footwear. You continue running and, to your dismay, you still have knee pain as before.

 The troubling truth is that there is no evidence that traditional running footwear helps to either decrease injury rates or improve performance. Despite being a billion-dollar industry with nearly 50 years for new innovations and modifications (since the running boom in early 1970’s), more than 2/3 of runners will suffer a running-related injury each year.  Don’t get me wrong, I am not proposing that the running shoes are causing the injuries, rather I am saying that they do not consistently help to treat or prevent them.

Too many runners have the mindset that shoes are responsible for controlling running mechanics and preventing injury. As Jay Dicharry, renowned Sports Physical Therapist and Researcher said, “Shoes don’t stop the arch from moving and they don’t improve the timing of your muscle control. This is your job.”

That being said, there are 4 features that I look for in a running shoe that best allows your body to control running mechanics and minimize injury risk. These features are not always consistent with traditional running shoe models, however many of the major manufacturers have begun developing shoes that meet these requirements.

Stay tuned for Part 2 next week!

Anthony Moss, DPT is a Physical Therapist who specializes in the treatment of athletes. As a frequent competitor at the marathon and half marathon distance, he has a special interest in the evaluation and management of runners. He frequently utilizes slow-motion video analysis for biomechanical assessment of runners to guide rehabilitation, maximize performance, and reduce injury risk.





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