By Catherine Duncan
What’s the latest on running shoes? Minimalist? Super cushion? Stability or motion control? How much drop? In recent years, there has been a significant amount of interest and research related to shoes and the impact on injuries. The end result seems to point to “get the ones that are comfortable!” But with so many choices, where do you start? My answer would be that it depends on several factors: mileage you do with them, the surface you run on, your foot structure, your overall alignment, and your running mechanics.
A few years ago, data from the running labs suggested that minimalist shoes with little or no cushioning seemed to improve running mechanics by promoting increased ankle, knee, and hip flexion. Now, it seems, there is evidence that suggests that in spite of that, having some cushioning reduces ground reaction force, the force that if excessive, often leads to overuse and impact/stress related injuries. Therefore, many runners who spend their time primarily on hard roads and sidewalks may need to consider shoes with some cushioning, particularly if running long distances. As we age, the fat pads on the bottom of our feet can get thin, reducing the built-in cushion. Runners with rigid feet have limited shock absorption from their feet. Again, best to consider a shoe that has at least some cushion. If your mileage is primarily on soft surface or trails, you may be able to get away with a less bulky shoe.
Consider your foot shape and the last of the shoe. They should match. Step in a puddle or pan of water, then step on a dry sidewalk or paper towel. Bisect your foot from heel to toe. Then, look at the bottom of a shoe and do the same thing with your eyes. The curve of your foot and the curve of the shoe should be pretty similar. Generally speaking, the more mobile your foot, the straighter it is. Be sure the shoe you choose matches your alignment. If not, you will find your foot “spills over” the edge of the shoe. This will not be comfortable for long runs.
Running mechanics are the most tricky to analyze yourself. Have your favorite physical therapist, athletic trainer, or well trained running shop shoe fitter look at you stand, walk and run. Running shoes can NEVER improve mechanical problems that are caused by muscle imbalances. Trying to fix excessive pronation caused by a weak hip, for example, by wearing shoe inserts or using a stability shoe is like waging a dog by the tail. It doesn’t work.
The current theory is that the shoe you wear should not (and really cannot effectively) alter your mechanics. At the end of the day, the shoe you wear should fit well and be comfortable. We are each unique, and with all of the choices now available, there is probably a perfect (or nearly so) shoe out there for you! Lucky enough to have 2-3 pairs that feel great and fit well? Pick the color or price that you like the best and off you go!
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Catherine Duncan, PT, SCS, ATC, is a Physical Therapist and Board Certified Sports Specialist at ATI Physical Therapy (formerly Proaxis and Balanced Physical Therapy) in Carrboro NC. She enjoys playing soccer, running, cycling, swimming, and just about any activity outdoors with her husband, two boys, and their happy dog.
