Running and Training shoes..... how to find your best fit

As we start to approach Spring the days are growing longer, the motivation to get outside is returning, and the runners are getting dusted off for some seasonal activity. This is typically a time when we as Physio's see a spike in soft tissue injuries due to increased running and ill-fitting footwear.

Runners aren’t just runners. Unfortunately, we cannot just pick them off the shelf based on style or colour 😕. Each brand has an array of models to cater for different demands and foot types, and this Blog is here to help you learn a little more about that. Read on to learn more about runners and what you can do to minimise your risk of purchasing the wrong pair for your feet.

Did you know that there are runners that are designed for different activities? Let’s go through the key styles of runners on the market today.

• Traditional running shoes are designed for sagittal plane movement. What this means, is activities that involve a forward and/or backwards motion– like running and walking. They provide very little support or stability for side to side movements so are not great for court based sports and they are generally highly cushioned making them less suitable for activities that require stability such as lifting weights.

• Cross trainers on the contrary, provide lateral support for activities that involve side to side movement for example netball, squash, and tennis. These shoes are also firmer on the outer sole to provide durability and are therefore not suitable for longer runs/walks. These are often marketed to specific sports demands, such as Netburners / tennis / court shoes.

• Weightlifting / Cross-fit Trainers: These shoes are specifically designed for lifting weights / strength training that have a flat/hard sole to provide stability with activities such as squatting or deadlifting. Other shoes that can double as lifting shoes include converse, vans or other hard based flat lace up shoes. Alternatively, if you’ve been cleared by your physio, weight training in bare feet can also have additional benefits to the strength of your intrinsic foot muscles and can be more advantageous than lifting in your highly cushioned runners. This type of flat soled shoe also enables better stability from the ground up, enabling better drive and generation of force during your compound movements.

Selecting your footwear based on the demands of your feet will ensure your feet and joints stay happy whilst minimising unnecessary stress during activity. We often see injuries present into the Physio clinic because of incorrect shoe choices - for example:

• Wearing running shoes to play tennis/netball can increase the likelihood of an ankle sprain.

• Wearing Crossfit /lifting shoes to do repeat/volume running can lead to strain/tendon injuries in the lower limbs.

Once you’ve figured out the type of runner you need for your activity, let’s take a closer look at what key features make up a running shoe.

Outsole: The type of rubber used on the outer surface of a runner - it dictates both the ‘softness’ and the durability of the base of the shoe

Toe box + Shoe Width: The shape of the toe box is an important consideration when fitting a pair of runners. You ever heard of the expression “you can’t fit a square peg inside a round hole”? This visual is important for the shape of the forefoot when buying new shoes. Ensure the shape of the front of the shoe approximately follows the shape of your toes as per diagram reference above.

This is especially important for long distance runners/walkers where blisters, corns, black toe nails, bunions or tingling/pins and needles (neuroma) are common issues with poor fitting footwear.

Support structures: Often made from a harder density material that is designed to stop your foot and ankle from excessively rolling inward (over pronation) or outward (supination) during your gait cycle.

• Medial arch support: depending on where your ankle and foot begins to roll in during your gait cycle, the support on the inside of the shoe will either be focused at the heel for pronation at initial contact or through the arch of the shoe for mid foot over pronation. This is designed to enable your foot, ankle, knees, hips and pelvis to be aligned during activity and reduce excessive forces applied, preventing potential pain and injury.
  

• Lateral support: aim is to soften the blunt force of landing laterally whilst guiding the foot back into a more neutral alignment for foot types that roll outwards or that have very high/stiff arches.
  

Heel support/heel counter: often a plastic support structure that is either in built into the interior of the heel or anchored on the outside of the heel of the shoe to secure the heel and Achilles into the shoe and promote correct alignment when the heel contacts the ground at heel strike. Several new styles of shoes have adopted a softer, more sock-like heel counter - these will have very little support and can lead to excessive rear-foot motion.

Cushion system: A layer of softer density material that is located within the midsole of the shoe. Most runners have heel cushioning, but not all models will have cushioning that extends to the ball of the foot.

• Depending on the flexibility of the foot, not everyone requires the maximum amount of cushioning.

• A more flexible foot that tends to roll inwards will have good ability to absorb shock/forces and will require more stability features within a shoe.

• A neutral to supinating foot type that has more rigid tendencies is less flexible and often requires less support mechanisms and more force absorption properties and benefits from additional cushioning features within the forefoot of the shoe, in addition to the heel.

• Rocker bottoms - traditionally most running shoes had an essentially flat base with a slight curve up at the toe. More recently many brands have started to incorporate a rocker/curved base on their shoes. This rocker base is designed to promote propulsion and improve running efficiency. This type of shoe can be very helpful for people with reduced mobility in the ankle, foot or toes and people with heel pain or achilles issues.

• Carbon plates - a newer technology in running shoes, the addition of a carbon plate is designed to increase efficiency and propulsion by absorbing impact energy, storing it in the carbon plate and then releasing it at end of the gait cycle to improve propulsive forces. Studies have shown a 2-4% improvement in running efficiency and up to 4% improvement in speed. But unless you are already running at a high level or a fast pace you are unlikely to see a significant benefit from carbon plated shoes and the hefty price tag that comes with this new technology might not make they the best choice.

Shape of the last

If you were to trace around the edge of the shoe, this outline gives you the shape of the last of the shoe. Depending on how much contact area your foot has with the ground will help to determine what shape last you require in your runner.

If you were to walk over concrete with wet feet, what do your footprints look like? This in its simplest form will help you to identity the shape of your foot that requires shoe contact to the ground when exercising.

How do you know what features are most important for you? Let’s have a quick look over the most common foot types we see, and which features are most important for each.

Excessive pronation:

• Key features of foot: tendency to roll inwards when walking/running. Arch can be flatter or flexible meaning it may appear neutral but collapse inwards when weight-bearing.

• Goal: motion control

• Key shoe features: medial arch support, midfoot support, heel support

Neutral:

• Key features of foot include natural resting arch, even weight bearing through gait cycle – no excessive rolling inwards or outwards

• Goal: cushioning +/- stability

Excessive supination:

• Key features of foot include but not limited to high instep, rigid / high resting tone in arch and toes, tendency to strike outside of heel/midfoot with gait

• Goal: cushioning +/- flexibility

  
  

Want to make sure your current runners fit okay? Give these tips below a try to identify if your current shoes are helping or hindering your foot health/comfort:

• Do you have ½ a thumb nail length between your longest toe and the edge of the shoe when your weight is on your foot?

• Is your foot sitting within the footbed of the shoe comfortable? Can your toes wriggle around easily?

• Does the shape of your toes match the shape of the front of the shoe you are wearing?

• Does your heel feel secure in the back of your shoe when you lift your heel off the ground or is it slipping?

• Is there any areas of rubbing or pressure across your foot or toes?

• Can you see the inside of the shoe when you are standing and look down, or do your ankles stop you from being able to see your shoe?

How often should I really need to replace them?

Did you know that running shoes are only designed to last around 800km? Depending on brands the recommended replacement range is between 500-1000km. How often you need to replace your runners will depend on many factors such as your individual running style, body weight, the surface you run on, how many k’s you’re covering per week and what else you do in your runners (ie - do you also walk the dog or stand in your runners all day for work?)

Even if you take extra good care of the outside of your shoes and think they’re in excellent condition beyond this mileage, the support structures within the shoes are only designed to withstand the above distances.

What this means is that the interior scaffolding of the shoe is likely compressed and is no longer supporting your foot the way it should or originally did. The general rule of thumb if you’re moderately active, is to replace your runners at least once or twice annually to reduce risk of pain or injury.

Be mindful, there are a couple of other factors that can prematurely wear your running shoes out:

1) lifting heavy weights in your runners, as this compresses the cushion system making them compress quicker

2) if you like to wash your shoes in the washing machine, this accelerates the breakdown of the interior scaffolding of the shoe.

Changing between styles of running shoes - are there any factors to consider?

With so many shoes on the market and such a variety of choice it is inevitable that you will end up with a different style from time to time. Even as the same style brings out new models there can be significant changes to the shoe design. Depending on what shoe type you are buying there are a few key things to consider especially for distance runners:

• Heel drop or differential - the height difference between the heel and front of the shoe. This can vary widely from 0mm - 16mm across different brands. Higher heel drops tends to reduce load on the heel and achilles but will shift the weight forwards into the knees, whereas the lower drops will increased achilles loading. Most distance runners will choose something around a 10mm drop. Ideally when changing shoes try and avoid a change in heel drop of more than 2mm as there can be a significant change in loading patterns and hence injury risk.

• Stack height - this is different to the heel drop. Stack height refers to the amount of material between your foot and the ground - in other words the cushioning. Stack height affects how the shoe feels underfoot. As with heel drop there is a huge variation in stack height between different brands and models of shoes varying from "barefoot" shoes at 3-5mm through to ultra-cushioned (or maximalist) shoes at up to 50mm. Stack height can vary between the heel and the mid-fore foot of the shoe and this difference is the Heel drop as discussed above. Ultimately the stack height you choose will come down to personal comfort but here are a few things to consider:

  • Lower stack heights will usually be a much more flexible shoe offering little to no support and a lot of ground feel (meaning you feel every rock!). These minimalist or barefoot shoes take a long time to adjust to if you haven't used them before and are best suited to a mid- forefoot strike pattern

  • Maximalist or ultra-cushioned shoes are best suited to heel strikers. They can have less flex through the midfoot (hence the use of the rocker bottom in a lots of styles) and they can also have a lot of instability from a side- to side perspective so if you have a large amount of pronation or supination on foot strike these style of shoes can lead to overuse injuries in the lower limb. They are particularly unsuitable for change of direction running sports.

• Foot strike pattern - were you aware that different shoes suit different strike patterns? While there is no "ideal" foot strike pattern, identifying where you land on your foot can help in choosing the best shoe for you. Keep in mind that where you land on your foot when walking is not necessarily where you land when running so ideally a running based assessment is recommended. As a general rule the minimalist or barefoot styles of shoes are only for forefoot strikers, the maximalist shoes are best for heel strikers and the regular shoes that sit in between are suitable for any heel strike pattern. Try and avoid swapping between vastly different shoe types as it can change where you load through your foot and in turn affect injury risk. (For example when barefoot running first became widely popular and we saw a large number of natural heel strikes rapidly change to a mid-forefoot strike pattern we saw a huge increase in achilles tendon and calf injuries presenting into the Physio clinic)

  
  

How can a health professional help you?

Having a health professional, such as a physiotherapist or podiatrist, assess your gait will help you select the best footwear for your needs. This includes:

• Looking at how you’re walking/running through gait analyses

• Assessing your ankle and foot flexibility

• Assessing where exactly you need support to aid in lower limb alignment

• Assessing the shape of your foot and where you tend to place pressure to prevent risk of blisters and calluses

• Making sure you’re wearing the correct size and width for your foot

• Exploring your medical history and identifying other risks of poorly fitting footwear, for example, diabetes and peripheral neuropathies

• Exploring other factors that cause changes in feet, including pregnancy, age and injuries

  
  

In addition to the above, your physiotherapist will also assess the strength and capacity of both the muscles within the foot, arch and calf complex to provide you with some exercises that will enable you to continue to stay healthy, active and pain free.

What to bring to an assessment?

• Be sure to bring all your current pairs of runners with you so your physiotherapist can assess the wear pattern on your shoes – this tells us a lot about your feet!

• Wear comfy clothes, as we may do a walking or running assessment with you!

After all of that information, the biggest take home message: the most important feature of a runner is that they are COMFORTABLE for you. So, whilst the above information might be helpful in building your understanding of what to look for in a runner, it is still most important they feel comfortable for you for the type of activity you are performing.

The gold standard recommendation is still to seek professional advice for assessment and advice when looking to buy new runners. Having expert assessment and knowledge in the area will help guide you in the right direction for your perfect fit which will ultimately lead to your most comfortable fit. Advice can also be provided for foot and lower limb strengthening to aid in improved performance and reduced risk of injury.

Evolved Physio is a vibrant and welcoming Physio clinic located in Kincumber on the NSW Central Coast. Offering a comprehensive physiotherapy assessment of all lower limb or running related injuries, treadmill gait analysis and personalised treatment and advice, all provided by an experienced Physiotherapist.

Images accessed via: http://images.google.com.au