How do you choose the best running shoe for you ? It seems a simple enough question and there appears to be a lot of science out there reviewing running shoes and different running styles. But is it good science or just good media hype/marketing?
During my research, which was much larger than the few articles that I have mentioned, two main factors seem to appear consistently in reviews of biomechanics and running shoe design, Pronation and Impact Forces. Certainly all runners are probably aware of the chilling term, the pronator.
Pronation - rolling of the foot after impact to move weight onto the big toe side of the foot.
Importantly some people do it more than others causing rotational stresses on the lower limb, but when we look at studies, do pronators suffer more injuries than their more neutral running counterparts? After doing just that I would have to say It seems not.
In a review of 927 subjects with “moderate” levels of pronation and subjects with a more natural gait pattern, there was no difference between those studied and general injury rates (3). This is a good sample size and does open the question “does correcting moderate pronation matter and how much correction can a good pair of running shoes offer”. One review cited in Nigg etal (2), notes that on review of orthotic devices, little biomechanical change was noted and any perceived benefit from such devices could be due to better muscle control rather than structural control around the foot and ankle. So if these devices don't control pronation, which is why we are buying them, and pronators don't tend to have more injuries, should this remain a significant factor in the purchase of your next runners?
Impact Forces – the forces felt when the foot first contacts the ground whilst running. Impact forces are controlled with cushioning in the running world.
There is a huge array of special materials and combinations of these materials to help decrease the impact forces that we experience when running. But how important is this? Several studies have noted (2) that we adapt our running style according to different surfaces/shoes. As this environment changes due to factors such as different running surfaces or even shoe wear, we tend to adapt our running styles so that we control the impact forces in the lower limb to limit any increases in objective “peak impact forces”. This makes sense when you consider barefoot running. These runners adapt their style to control the impact forces by the application of a mid/forefoot landing pattern so that the immediate instantaneous impact force at foot strike is ameliorated by landing on the more flexible forefoot rather than the heel bone.
So we're starting to get the picture. If we don't need to worry too much about pronation and specific support structure/cushioning, what is important? Nigg et al (2) suggest that the best way to purchase runners is to put them on in the shop and walk around a bit. He theorises that we have a “preferred movement path” and that we can best choose our own shoes by allowing comfort to decide (“the comfort filter”). Nigg et al (2) refer to a study of military recruits that found a 53% reduction in injuries to those wearing a “comfortable” insole versus those wearing a more rigid or uncomfortable insole. One comment in a forum which I reviewed, described this by saying that we as animals search for a shoe which provides metabolic efficiency, suggesting a shoe which suits our very specific/individual structure and movement pattern. This statement describes Niggs suggestion/paradigms quite eloquently, basically this means that the shoe we," the runner ", assess as most comfortable allows us to move more efficiently and effectively with our individually specific movement pattern.
So when are your runners worn out? Personally mine are occasionally given early retirement to commence life as garden shoes, but based on what we have discussed, it would seem that when they are no longer comfortable it is time for a change.
There are always counter arguments and huge debate in the running world about every aspect of this activity from clothing, to energy supplements and running styles. This blog is by no means exhaustive but I hope that it does help to clarify some of the confusion and help with your next purchase of runnners. Take any good advice, but consider in the context of this discussion. Shoes with good reviews probably are good for you too, but make sure that they are comfortable as well.
In my next blog I will be reviewing some more specific considerations for runners/walkers including patellofemoral pain, the rocker shoe and arthritis as a start point.
NB - This blog mainly is for the consideration of runners with fairly neutral to moderate foot variances. The article by Sarah Berry in the Sydney Morning Herald (1) has some good advice for specific runners and brands that you may consider in your search.
1-Why your running shoe is not worth the money- SMH Sarah Berry 2015 : http://www.smh.com.au/lifestyle/diet-and-fitness/why-your-running-shoe-is-not-worth-the-money-20150922-gjsb1a.html
2-Running shoes and running injuries: mythbusting and a proposal for two new paradigms: 'preferred movement path' and 'comfort filter'; BJSM – british Journal of Sports medicine 2015 Nigg BM etal
3-Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1 year prospective cohort study: BJSM – 2013 Nielsen et al http://bjsm.bmj.com/content/48/6/440.short
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Jason is the Leichhardt Physiotherapy's practice principal and has been practicing as a physiotherapist for over 16 years