[ D1HobbyJogger ]

There are so many shoes on the market, brands, types, and new research claiming to make you faster, support you longer, and prevent stress injuries. New Companies keep coming out daily and everyone is trying to get a foot in the Shoe industry. It is a growing and affluent market. They are designed to help absorb shock with the repeated pounding that occurs when running to help prevent stress in the lower leg, which could lead to stress injuries. 

Generally, running sneakers are grouped into 3 categories. Cushion, stability and most control.

Shoes with extra cushion are usually good for runners with a high arch, or cavus foot. Stability shoes are good for a neutral foot, and helpful to correct runners with over pronation. Control shows are great for those with hypermobile feet and ankles, are pes planus and have no arch.  

It is important to find a shoe that supports your running form because your running mechanics can also be influenced by the shoe. If the midsole is stiff, the geometry of the shoe does not fit your foot, if the heel lift is too short or high, etc. The wrong shoe can even exacerbate or lead to lower leg dysfunction. 

How can you tell if your feet are hypermobile or not? Try this sit to stand test. 

Have someone help you measure the distance between your navicular and the ground. Measure in millimeters (mm) with a tape measure and record when sitting and then again when standing. If the difference is 0-3mm, you are hypo-mobile and there is no significant difference in mobility from walking to running. If the difference is 4-6 mm from sit to stand, you are neutral, and there is no significant difference in walk or run. Finally, if the difference is 7-10 mm from sit to stand you are hypermobile and there is a slight difference in mobility from walk to run.  

This is because every time we step we are putting energy into the ground, and it is giving most of it back up to us through ground reaction force to propel us forward. 

When heel strikers run, they put all their force down into their heel, they rock forward to the middle of the foot putting pressure along the lateral border of the foot. The foot reaches max pronation just after the midstance phase of running before you need to dorsiflex at the 1st ray and big toe to be able to advance yourself forward and use that energy from the ground to push off. 

Dual density material is put in sneakers to support the foot in this phase. This is firm material on the inside of the shoe so that your foot doesn't crash into it and overpronate. 

Elevated heels have been put into shoes to prevent stress on the Achilles. The calf (gastrocnemius and soleus) is an important muscle for running. Having the heel elevated helps reduce stress on the calf and the Achilles because, in theory, it doesn't need to extend as much. But doing so also compromises the glutes ability to contract and makes you run more quad dominant. This also causes you to stay in more lumbar extension leading to back pain and hip flexion weakness. 

With barefoot running being a new up and coming craze, they get away from these ideas. It is important to work on foot stability and the intrinsic muscles in your feet to help prevent injury. Being able to contact the ground also involves neuromuscular control as you can feel different surfaces and make adjustments on how you move because of it. 

How does barefoot running change your form? 

Because your body realizes they need to dampen the impact of the ground when running, since they don’t have a shoe under them, they tend to land more plantar flexed and closer to themself with a shorter stride length and higher turnover. If you run with shoes you have more cushion and can focus on advancing farther, faster. So you land on your heels more and have a greater step length reaching farther in front of you with each step. 

Toe Boxes, the front of the shoe where your toes and metatarsals are, should fit your foot without squeezing it in. You don’t want the sides of the shoe compressing the arch. When babies are born, they don't wear shoes and their toes and transverse arch are wide.This is normal with the human body to be able to balance better. Then, we start to wear shoes that compress out feet and don’t allow them to be wide. 

Posting, is when firm, dense material is put in the medial side of the shoe to support the foot like a soft secure wall, and tell the foot where to go. This causes the ground reaction force to move medially as you rely on this post of cushion leading to more shear forces across the knee. 

Midsoles, like mentioned before, are light weight, multi density materials used to support your foot just after midstance to help with shock absorption in the phase with the most stress when loading. This reduces the chance for proprioception, a sensory phenomenon that your body has to react to when different stressors act on it. If there is too much cushion it causes the runner to land with more stiffness in their limbs and cause more instability because of less proprioceptive feedback. The materials break down with increase in volume and intensity and that is why it is recommended to replace shoes every 3-4 months or 400 miles. Evidence even shows that as the cushions decrease with time, runners modify their running patterns to maintain constant external load affecting how you run and how much force you put down.  For example, longer stance time. 

Right now, shoes are acting as a filter to reduce what your foot feels in the ground through proprioception, and what forces the ground can give to the foot. 

If you run in a shoe that is 10% stiffer, that does not necessarily mean you will start running 10% change in gait style. It could not change at all or even change by 25%. It is not a linear relationship. 

If you want to change from a high cushioned supportive shoe to a low cushion, lightweight racing shoe, you need to slowly progress. Spikes increase the ground reaction force when running which is needed for speed and power. Switching quickly from one extreme to the next can lead to pain and injuries. It has to be a smooth transition

When selecting a shoe, if the runner likes the type they’re in (motion, cushion or stability), have them stay in that shoe, or suggest other brands or models to improve comfort. Different models might have slightly different structures to fit an individual's contour of their feet. Generally, motion control shoes had the most injuries, cushion next and stability shoes had been the best at preventing injuries. Everyone is different. Some people can function well with a flat arch, others might need the support of an orthotic or stability shoe to help. But it is not necessarily about the shoe, but about how the shoe biases your running style. A lighter shoe helps allow some proprioceptive feedback from the ground, is lighter for more running efficiency but also helps reduce the energy costs needed compared to running barefoot. 

Your shoes can depend on a number of factors. Your weight, previous pathologies, the time of the day, the type of running you’re doing (5ks vs marathons), the surfaces you’re running on, the width of your foot, and the size of your foot. 

It is advised to buy shoes later in the day, because with more activity, your foot gets tired and your arch flattens and compresses so it is less likely to fit in a smaller shoe. You want your foot the be flat and not be compressed by the sides of the shoe even when it is tired and flat. 

Selecting Shoes for optimal gait 

• Minimal drop

• Firm cushioning- a little goes a long way (zero drop forces change, minimal drop allows it) 

• Light weight 

• Don't pull away from your foot (consistent feedback)

• Match to terrain / demand 

  • If symptomatic, this assumes that you are actively working with your patient to get them into this shoe.