When we look at buying a new pair of running shoes it is not as simple as it seems.
The way a shoe is built, and the cushioning of the shoe plays a role not only in absorbing the shock generated when landing on the foot, but also in how the shoe will assist in lifting the foot off the ground. Although some companies advertise otherwise, no shoe can completely ‘take away shock’ or ‘offload joints’ or allow you to be ‘injury free’. However, finding shoes that are comfortable and suit your biomechanics and foot posture can help reduce the risk of injury, make it easier to run and help improve performance.
In the past we were prescribed shoes according to our foot type which was somewhat simplistically assessed on someone standing still. More recently we have started to assess a person’s mechanics running on a treadmill with video analysis. This has enabled us to more accurately address running style and mechanics and therefore prescribe shoes more appropriately. If you have a high arch or a rigid foot type, which supposedly has less capability for shock absorption, it was thought that you needed a more cushioned type of shoe. For those who have more pronated (flat) feet, motion-control shoes were recommended to reduce the frequency of pronation related injuries like Achilles’ tendon pain, anterior knee pain and plantar fasciitis. If you have “perfect” biomechanics, you would be prescribed a neutral shoe. It was thought that this would help prevent the injuries that presumably arose from these foot types.
I do need to ask the question at this point, what is “perfect?”. We have no actual definition or specific idea of how much pronation or under-pronation is optimal or normal. We need to rather assess how the person functions within their available range while also considering the research in a way that allows us to adjust it practically without being too rigid. Through this multifaceted approach, we can get an idea of which shoes will work best for the individual.
There are some basic principles
1.Don’t make large , sudden changes to your shoe type. Large changes from supportive to minimalist shoes result in significant loading onto structures that aren’t used to it which can result in injury. Running is so repetitive that even a little variability in shoe type can make a huge difference as the same structures are repeatedly loaded. Therefore, it is very important to gradually transition to a different shoe type to lower the risk of overuse injuries like tendinopathies.
2.Go lighter if possible, but that involves removing support features. Again, slow transitioning is important. Whilst lighter shoes are associated with better running efficiency, each individual will find the shoe weight which is optimal for them.
3.Does the shoe improve your running economy or performance, if not why are you changing? ‘Don’t fix what isn’t broken.’
4.What are your goals with different shoes? If it’s reducing pain, then consider different shoes. Loading can play a role here as shoes can influence your pain based on which structures in the body they load. Take, for example, heel-to-toe drop. This refers to the height of the back of the heel in relation to the height of the front of the sole. Whether you are a heel striker, a midfoot striker or a forefoot striker will affect which type of heel drop is best for you. Usually, forefoot strikers need the least amount of drop and heel strikers tend to prefer more cushioning with a higher heel to toe drop. Lower heel to toe drop shoes will makes the calves work much harder, meaning a lack of strength and range of motion may cause common seen injuries to the knee, ITB and Achilles tendon. While higher heel to toe drop shoes tend to load structures higher up like the hip and the front of the knee. A transition from higher to lower, if that is your preference, must be made slowly and progressively to allow your tissues to adapt. This way, a change in shoes can help to reduce pain and prevent overuse injuries, while allowing your training to continue. Once again, this depends on where and what your injury is.
The shoe selection science is not clear cut, so individual goals are more important- shoes are not a priority but part of the puzzle. Remember also that there is good evidence showing us that comfort and how we feel in a shoe is a good indicator of whether the shoe will be appropriate. Above all, don’t forget that when we look at injury rates and performance, training volume, load and running mechanics are vital. Most injuries occur because of flaws in managing training loads.
And that’s where we come in.
Physiotherapists are trained to assess your running style and biomechanics and can also analyse the factors which caused your pain in the first place. Through this, we can recognize non-optimal movement patterns that could be causing pain or predisposing you to injury. A combination of education in movement patterns, specific exercise programs to address the inefficiency, and finding a pair of shoes that support your goals can make running feel easier and more efficient.
Response to a different shoe is very individual, variable, and unpredictable. This makes it difficult to have set rules for finding the optimal shoe, and having the support and expertise of a physiotherapist can make this task easier be very helpful.
Feel free to reach out to us at JBS Physio for advice on shoes, or to have running and biomechanical analysis to make running fun and effective!! Train don’t strain….
