Although very few overuse running injuries have an established root cause, the fact that over 80% of these injuries occur at or below the knee suggests that there may be some common mechanisms. The capacity to prevent such injuries is currently limited, with training advice and footwear prescription forming the mainstays. Thus, the prescription of the correct running shoe is considered a crucial and highly valued skill. In a study in which runners were randomized to receive a neutral, stability or motion control running shoe, it was reported that prescribing motion control shoes incorrectly, without proper justification or rationale, could actually cause injuries. So what is the best way to help you choose the proper shoe?
First, let’s discuss the different categories of footwear. Overall, there are three categories of footwear: neutral, stability, and motion control. A neutral running shoe is designed to provide cushioning and less foot control as compared to its motion control counterpart. A stability shoe has some component of foot pronation control material and that material is generally placed near the middle or arch of the shoe. A motion control shoe typically has a significant amount of pronation control material and often has some type of non-deformable material, such as a plastic plug, placed on the back-outside edge of the shoe.
Next, let’s dispel a few myths based on the research that our lab has conducted and from labs around the world. The first myth is that if you are a heavier person, you need a more supportive shoe. Wrong. Your weight has nothing to do with how you foot functions mechanically. Second myth: an injury suggests you need a more controlling shoe. Wrong and hopefully I’ve already made my point based on the research already discussed. Finally, one of my favorite myths is that if you have an orthotic device (or a shoe insert) you automatically need a neutral shoe. Wrong. Orthotics come in all shapes and sizes and must be matched to the correct shoe based on a sound method.
Any method used to properly match up the proper shoe to each runner is generally based on either optimizing performance or reducing the potential for injury. So make sure you are shopping for shoes for the right reason. Second, it’s important to understand that previous research has involved very simplistic methods for trying to correctly match footwear with each person. For example, using a single video camera and video taping you walking or running on a treadmill has no scientific validity. Many research studies, dating back to 1995, have reported up to 200% error when trying to measure biomechanical foot angles using a single camera as compared to the gold standard of 3D motion capture. Two of our recent research studies verify these findings and demonstrates a 20%-140% over-estimation in foot pronation angle when using a single camera. So don’t be fooled by stores that advertise “high-tech” approaches to shoe fitting by videotaping you on a treadmill. So what should you look for?
You should look for a footwear store that uses comprehensive approach to determine the correct shoe for you. Many factors should be taken into consideration: standing posture, biomechanical movement patterns, functional movement tests (i.e. the lunge), wear patterns on your current shoes, and how comfortable you find your current shoes. All of those pieces should be put together to formulate a decision about what type of shoe will be best for you.
Finally, based on the most current research, the best approach to finding the correct shoe is actually how comfortable you find the shoe to be. As it states within the Foot Health Assessment for Runners Quiz “If your shoes don’t fit your feet properly, you’re more likely to get a running injury.” There are some good research studies strongly suggesting that the more comfortable you perceive a shoe to be, the better your overall biomechanical movement pattern will be; regardless of the type – neutral, stability, or motion control. The first such study was conducted by a lab just down the hallway from mine at the University of Calgary: the world famous Human Performance Laboratory. Several studies have followed and all suggest that you should trust your instincts and find a shoe that feels good. I always suggest that you let the shoe store employee guide you to the correct type, using a comprehensive analysis, and then you should choose the most comfortable shoe.
Dr. Reed Ferber Ph.D., ATC
Director – Running Injury Clinic
Associate Professor, Faculty of Kinesiology, University of Calgary
The Running Injury Clinic is a world-leader in running-related research. Please visit our website at www.runninginjuryclinic.com for research concerning running injury prevention and treatment.