
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:
The key elements of the 3-month check-up are:
References available upon request