Written by Kim Brown, PT, DPT
The question you all wished you knew the answer to. What type of running shoe is best for YOU? It is a question elite runners and recreational runners strive to answer. Will the shoe prevent injuries from occurring, will it make you faster? Or how about this, do you find that you fall in love with a certain brand and style of running shoe and then you purchase 16 pair? Ok, maybe that is slightly exaggerated. Or is it? I know you have all been in that boat. A year later your beloved shoe is “improved”? It looks different, it feels funny, it’s just not the same. You search endlessly for hours online trying to find another pair, but end up having to trial a new brand anyways.
With COVID and the onslaught of online shopping you have taken to the web to find new shoes. Without having the ability to try on a pair of shoes or speak with a store employee to see what they think is best, how do you know what to look for? TV and online ads point to minimalist while other ads point to cushion and stability. What works best?
After delving into the latest research, it has been quite the eye-opener. With much disbelief, shoe prescription is not linked to evidence-based research and is NOT shown to be related to running related injuries (RRI) (2,4). In fact, there is more thought in that choosing the running shoe that feels the best and most comfortable may in fact reduce your injury risk (2,3). This mind-blowing concept may or may not be well accepted, but take a look at the following articles.
The common conclusion is that there is no significant difference in RRIs based on the stiffness of the midsole, the drop in the shoe, or minimalist shoes (5). Wanting to find out what a typical community running shop would say to a customer I dove deeper and reached out to Andrea Cote. Andrea has been fitting shoes to runners for years and has done a wonderful job helping out injured and non-injured runners. Andrea explained:
“Sometimes it is the shoe but most of the time it’s training errors. I guess the advice I would give is for the person to try some neutral shoes on and go by fit and feel first. A neutral shoe will allow your foot to do what it wants while offering protection. This way if they need more support they could introduce an insert if they are pronating mild to moderately. I think getting away from a shoe that is extremely corrective is a good idea for most, not all. They can be heavy and hard, but some people need that. Shoes with a wider base also add a lot more stability laterally too. It is also important that people understand more expensive doesn’t always mean better for you, however I would stay away from the lower priced shoes in department stores as the midsole is not as good. “
Further research shows extrinsic factors appear to be more influential on injury including: BMI, mean session intensity (i.e. how fast you are performing your workouts), amount of mileage per week based on your current training habits, stretching or lack thereof, sleep, cross training, and nutrition (5).
An extrinsic factor that I feel is important and directly related to footwear is proper training for the shoe that you do decide to purchase. What do I mean by that? Let’s say you decide to go minimalist. You purchase a shoe that has a 3mmor even a 0mm drop. But the shoes you had prior to this new purchase had a 6-10mm drop. The more minimalist shoe is going to change your current running mechanics in that it is going to force other muscle groups to work harder, in this case your calves. If you do not slowly break these shoes in and allow your body to adapt to the new drop the increase in calf contraction will start to lead to injury. Injuries can include plantar fasciitis, achilles tendonitis, and even stress fractures. In this example most people would initially assume that the shoe caused the injury when in fact poor training habits caused the injury (1). Knowing the importance of proper training with stretching, strength training, logging healthy mileage week to week and not jumping from one extreme to another are very important factors in managing injury. This includes knowing and understanding how to utilize your shoes as a tool. If you use a tool the wrong way, your results may not be what you are looking for.
So, sit back for a minute. Are you getting sucked into the marketing vortex and making purchases based on what you think you need? Pretty colors and wanderlust graphics in magazines and online ads can persuade you either direction. There are still discrepancies in the research that need to be looked at, but right now it appears to be running shoe type isn’t directly related to injury. Finding comfort in your shoe is crucial.
Helpful Links:
Brooks offers a guide that can start you on the right path of finding the best shoe for you. Take a look at their online shoe finder at:
Remember, small businesses are currently open that love helping you find that perfect shoe. They are taking precautions and keeping everyone safe in the process.
ONE PT recommends:
References:
1)Grier T, Canham-Chervak M, Bushman T, Anderson M, North W, Jones BH. Minimalist Running Shoes and Injury Risk Among United States Army Soldiers. The American Journal of Sports Medicine. 2016;44(6):1439-1446. doi:10.1177/0363546516630926
2)Napier C, Willy RW
Logical fallacies in the running shoe debate: let the evidence guide prescription
British Journal of Sports Medicine 2018;52:1552-1553.
3)Nigg B, Baltich J, Hoerzer S,et al
Running shoes and running injuries: myth busting and a proposal for two new paradigms: ‘preferred movement path’ and ‘comfort filter’
British Journal of Sports Medicine 2015;49:1290-1294.
4)Richards CE, Magin PJ, Callister R
Is your prescription of distance running shoes evidence-based?
British Journal of SportsMedicine 2009;43:159-162.
5)Theisen D, Malisoux L, Genin J,et al
Influence of midsole hardness of standard cushioned shoes on running-related injury risk
British Journal of Sports Medicine 2014;48:371-376.