My Running Shoe Dilemma

I’m still not my 100% pre vertigo/sinusitis self but have resumed training at a slower pace. Actually, I couldn’t run faster if I tried. I can’t believe how sluggish I feel after three weeks off. I rejoined my Wednesday morning running group this morning – the first glorious day of spring. I am in awe of Pam and Leonor. They ran a marathon on Sunday 26 February and turned up for a 16km run this morning. Pam even ran yesterday and as if 16km wasn’t enough today, she headed out for more k’s when the group had finished. I practically crawled the last few kilometers. Pam and Leonor are a special breed of ultramarathon runners so a standard 42.2km marathon is a training run for them.  Something I find hard to get my head around!

So, as training resumes, I find I am still on an endless search for the perfect running shoes. Before becoming a semi serious runner I had previously been very happy with my minimalist shoes for walking and jogging (Merrells) and in fact walked all over Paris and Spain in them, sometimes 20km a day, without any problems at all. When I started running in them and building up some distance I developed bruised sore toes. Having one foot a half size bigger than the other, with a big toe that curls up, didn’t help and they were no longer comfortable. They even seemed too tight for normal walking and I think this may have had something to do with the muscles of my feet developing.

Apparently it is not unusual for feet to grow larger as the arches flatten out with age but this would happen over a longer period of time I’m sure so I prefer to think it was intrinsic foot muscle development associated with increased load! I’m sticking with that!

After a few sub optimal choices of running shoe where my feet would cramp up at the 4-5km mark, I found the Nike Free ‘Flyknit’ runners had a shape to accommodate my funny big toe (soft expandable material on top with a wide toe box) and were still lightweight but with a little more substance underfoot than my minimalist Merrells. One size up I found them very comfortable for my Parkruns and races up to 10km so I bought a second pair. I love them and thought I was set despite my left forefoot developing a mild bearable cramp at around the 15km mark. I ran the 30km Stromlo strike in them last November without even thinking about my feet. (The long billy goat climbs in 31.5 degree heat gave me other things to think about). However, my experienced Wednesday group running companions have advised me they will not be suitable for a marathon. Oh no!

Therein lies my dilemma. I have great respect for my Wednesday running companions and several have told me my Flyknits will not be suitable for a marathon. Current scientific research indicates that there is no perfect running shoe and it is best to rely on ‘the comfort filter’ when purchasing shoes.

After some consideration I have decided to listen to my experienced running companions but finding a shoe that is not too rigid and heavy but will give me that little bit more cushioning to absorb impact over greater distances without causing considerable pain and discomfort has proved an expensive exercise. I am currently trialling my fifth pair. Several close relatives and friends have been the recipients of previous unsuitable pairs. While they felt comfortable in the store and even up to 5km or so running, by 10km I would feel as if my left fore foot and right big toe were being strangled.

I still prefer my ‘Flyknits’ but am currently wearing in a pair of Brooks Glycerine 14 women’s runners that were recommended by a shop assistant in a store that did not carry that brand so I thought he was probably genuine. Of course they were more expensive than most other runners on the market and despite the research indicating price was no guide to the ‘right shoe’ – I still bought a pair. I wore them this morning and they didn’t feel too bad with just a little cramping in the left foot towards the end of my run/crawl.

Throughout my career as a physiotherapist there has been great deal of controversy in the scientific world about what constitutes ‘good running shoes’ and it seems there still is. There are even more myths and hype in the not so scientific world which makes it very difficult. After sifting through the research it seems that there is no perfect shoe or brand of shoe. Current thinking is that the most comfortable shoe is likely to be the best shoe and least likely to cause injury . This is most likely because it allows the wearer to move through their ‘preferred movement path’. In other words – we self select the most comfortable shoe for a reason. 1

This is interesting because so often, when selecting running shoes, we hear things like ‘you pronate’ or ‘you overpronate’ and therefore need a shoe with good arch support to control this. I have cringed in horror when overhearing sales assistants in running shoe stores recommending ‘motion control shoes’ because ‘you pronate’. Forcing a foot into a rigid, higher arched shoe to control ‘pronation’ and ‘reduce impact forces’ does not reduce the risk of injury but, on the contrary, more likely increases the risk. 2

The foot is meant to roll outwards or supinate (sometimes referred to anti-pronation) and then roll inwards into pronation at impact to allow the arch to flatten a little and absorb shock. Even at athletic shoe booths at sports medicine conferences I have heard ‘you’re a pronator’ you need a medial arch support to control that motion and then watched the poor unsuspecting recipient (who, being at the conference should have known better!) walk out of the sales booth with excessive supination stressing the lateral ligaments of their ankles.

Pronation is a perfectly normal combination of foot movements that occurs during foot landing while running or walking. It involves the simultaneous movements of subtalar eversion, dorsiflexion and forefoot abduction (rolling in motion of the ankle). Supination is the reverse – subtalar inversion, plantarflexion and adduction of the forefoot (rolling out motion of the ankle). These are both perfectly normal movements that allow our feet to contour over running or walking surfaces. Pronation and high impact forces have often been cited as the tyrants in running injuries but without any real high level evidence to back either view up. In fact adequate pronation and softer insoles are more likely to reduce running injuries. Shoes that are rigid and reduce the degree of normal pronation are more likely to increase injuries in runners.  This has been well demonstrated in military shoes. 1

Despite hearsay, there appears to be ‘no definitive  link between foot mechanics and running injuries’ but there is a growing body of evidence to suggest that ‘weakness of hip-stabilizing muscles leads to abnormal lower extremity mechanics and increased forces within the lower limb while running’. I personally believe this to be true and will address the issue another day. 

For more on running shoe myth busting the following articles are worth reading;

Dr. Runner’s World and Mr. Hyde

The Pronation Control Paradigm is Starting to Crumble: Review of a Study in the British Journal of Sports Medicine

 

Citations
1. Running shoes and running injuries: mythbusting and a proposal for two new paradigms “preferred movement path’ and ‘comfort filter’. BM Nigg, J Baltich, S Hoerzer, H Enders. British Journal of Sports Medicine. [Link]

2. The effect of three different levels of footwear stability on pain outcomes in women runners: a randomised control trial. Michael B Ryan, Gordan A Valiant, Kymberly McDonald, Jack E Taunton. British Journal of Sports Medicine. [Link]

3. Suspected Mechanisms in the Cause of Overuse Running Injuries. Dr Reed Ferber,  Dr Alan Hreljac, Karen D Kendall. Sports Health. [Link]

About the Author



Jennifer Kellett established Hawker Place Physiotherapy in 1991 and is the principal practitioner of the family run practice. Jenny has served the local communities of Belconnen and North Canberra with commitment and pride for over 26 years. She is a strong advocate for maintaining fitness, health and well being across all age groups and has a keen professional interest in combining Pilates with weight training for treating postmenopausal women at risk of osteoporosis.


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