With all the marketing hype around, you might be forgiven for thinking that footwear is the key to preventing running injuries. Especially now, with most runners at least aware of the “barefoot” craze, it’s becoming harder to know what is the right shoe. The old advice around finding the right shoe for a particular foot-type is slowly being tested, and the trend is towards a more lightweight, minimalistic running shoe.
This phenomenon is partly due to Chris McDougall’s book, that I’m sure a lot of you have read or at least know about, and to a study published in the British Journal of Sports Medicine last year. There will likely many more studies popping up in the next couple of years discussing these findings.
The current trend to a barefoot running style is sweeping the world like wildfire, based on McDougall’s bestselling book “Born to Run”. In the book, he describes an Indian tribe in Mexico who run hundreds of kilometres per week, without shoes, and without the same degree of injury that seems to plague us mere mortals!
The problem with this shift to barefoot or minimalist shoe-running is that many runners will have adapted to their large, heavy and supportive running shoes and the style of running that these shoes promote (namely a heel strike and overstride). This change in running style won’t be appropriate for everyone, and if attempted, should be done slowly over a period of time.
One study by Ryan et al., showed matching the “correct” shoe to a foot type had no effect on injury rates in a group of 81 female runners. In fact, those that received the “correct” shoe were slightly more likely to get injured. I think it’s important not to take this conclusion too far, as the study had a small sample size and there were some major limitations. It does, however, give some credence to the view that we need to reassess the way we sports medicine professionals approach prescribing running footwear.
While a bit un-scientific, maintaining consistency of footwear and selecting a shoe based on comfort is probably our best bet at present. For example, a study on 206 military personnel, who were allowed to select a foot insert based on their feelings of comfort, showed a significant reduction in injury rates, even though the inserts often had no association with their “foot type” or what would normally have been considered the appropriate insert for their foot.
Anyway, regardless of all this hype, a far more important issue than footwear is how you manipulate your training variables. Some studies have suggested that up to 80% of overuse running injuries are attributable to training errors. How you build your training up—including mileage, terrain, speed, and frequency—is the most important single consideration in avoiding a running injury. Regardless of what shoes you wear, how you run, how tight your hamstrings are or how poor your core control, the body needs to adapt to new loads. If you haven’t run much before, or you’re ramping up in preparation for an event, how you choose to do this will be the major factor in determining success or injury.
The 3 keys to avoiding injuries:
- Plan your event preparation, including the training variables of mileage, terrain, speed, frequency and, of course, the rate of increase in each of these areas. Discuss your plan with a sports medicine professional as well as a good running coach.
- If you’re unsure on the footwear issue, discuss it with a professional. At present, research evidence suggests that you select a shoe that is comfortable for you, rather than one that has been “prescribed”. The way I address this is to give you a few options and suggest you go for a run around the store and select the one that feels the most comfortable. Some good running stores will allow you to run on the treadmill in the store to ‘try’ them out.
- Have a good biomechanical assessment. It’s a small investment in the overall scheme of things and will allow you to deal with pre-existing issues and risks, and help to prevent further problems.
…and it really is preventing an injury that is the key. Once an overuse running injury has occurred, it’s much harder to fix the problem and get you back on track.
“The 3-month check up is probably the most critical point in preparing for an event. Identifying problems at this stage gives us the time and opportunity to fix the issue before it takes you out of training or results in a serious injury.”
The key elements of the 3-month check-up are:
- Discuss previous history of injury and any current niggles
- Assess weaknesses and areas of potential overuse injury
- Discuss your training plan and current fitness level
- Discuss your footwear
- Assess running mechanics using video analysis
- Establish a plan to avoid any potential injuries
References available upon request