Am I wearing the right shoe?

There is one question that is paramount in every runners mind who are experiencing symptoms:  Am I wearing the right shoe?  Recent studies, however, are beginning to reveal that this may not be the best question to ask.  Perhaps a better question might be, Am I wearing the wrong shoe? And also, Why am I having symptoms?

Shoe shoppers are often swayed by a sales person with fancy terms like stability shoe, neutral shoe or motion control shoe.  Retailers will prescribe a shoe that fits one of these categories based on a quick and dirty FPI (Foot Posture Index) test, which has a reliability rate of > 80%.  The FPI can quickly and easily determine if someone has excessive pronation to excessive supination, allowing the salesman to prescribe the shoe they think is best for their customer.

Up until this point, different styles of running shoes have been prescribed based on an individual’s need for support. The greater the likelihood of pronation, the greater amount of support would be recommended in the shoe. This logic stems from the belief that pronation is the root cause of foot pain for every runner.  Runners who required maximum support due to excessive pronation would be given a “motion control” type shoe.  Those who required good support would be prescribed a “stability” shoe.  Then there are those who didn’t need support, but needed “middle of the road” support. These would be prescribed a “cushioned/neutral” type shoe. Lastly, current running trends have led to the thinking that those who required little to no support would be given a “minimalist” shoe.

However, recent studies have started to question the idea that foot pain in runners may not be controlled by a specific shoe type.

In one study, for example, 81 female runners between the ages of 18 and 50 were evaluated using the FPI and categorized into 3 foot types: neutral, pronated and highly pronated. Despite their foot type, the participants were then randomly assigned either a neutral shoe, a stability shoe, or a motion control shoe. The participants then underwent 13 weeks of marathon training.  The results revealed that there were the most complaints of pain from those who trained in a motion control shoe.  Additionally, those with neutral feet, reported greater values of pain in the neutral shoe. Furthermore, those with pronated feet, reported greater values of pain while running in the stability shoe.  Lastly, highly pronated feet were concluded to need more study. Based on this information is might be clear that there is a wrong shoe and, that shoe type and foot type don’t always correlate.

Another study tested pronated foot types by implementing training regimens that used motion control shoes, neutral shoes and stability shoes.  So, basically, the same individuals were tested doing the same exercises with different shoe types on. Results revealed the most pain occurred when the participants wore the motion control shoes, less pain occurred while wearing stability shoes and the least pain occurred with neutral shoes.  The most alarming finding was that wearing  motion control shoes resulted in the greatest % of lost training days, regardless of foot type.

Other measures for shoe prescription have also included the height of an individual’s arch, which can be determined by reading an imprint or a fancy computerized pressure sensor. An additional study looked at 3000 US Military personnel to examine this concept.  Recruits in the experimental group wore motion-control, stability, or cushioned shoes that matched their plantar shape. These three types of shoes were given to those with a low, medium, or high foot arch, respectively. The control group received a stability shoe regardless of plantar shape. Injuries during basic training were assessed from outpatient medical records.  The conclusion was that selecting running shoes based on arch height had little influence on injury risk in military basic training.

Lastly, another study tracked 927 female runners for 1 year.  They all ran in a neutral shoe, despite the fact that a variety of foot types that ranged from highly supinated to highly pronated, were measured and recorded. The study concluded that based on the results, foot pronation was not associated with increased injury risk or pain while wearing a neutral shoe.  Motion control shoes led to increased complaints in both the highly pronated group, as well as, the highly supinated group.  Those who had highly supinated feet had the least complaints in a neutral shoe.

Based on these findings, it is apparent there really does not seem to be a “right” shoe for each runner.  The data reveals that comfort should reign supreme in shoe prescription and selection.  When we look at research that uses the FPI to measure multiple shoe types against the foot types, there is no statistical difference in regards to injury and pain. In conclusion, these results reveal the question that runners should be asking: is there a wrong shoe for me?  Some shoes will make your pain worse, but there is no guarantee that there is one out there that will keep it from happening.

As a Physical Therapist and a runner, I would submit that rather than examining foot type and shoe-wear so closely, runners should receive an Optogait evaluation. This state of the art technology can immediately identify asymmetries further up the chain in the hips and core. By using LED lights to sense inconsistencies in a person’s stride, the Optogait measures reactive forces of impact in the feet and ankles. This data can then be used to determine foot pain that is a result of deficits in strength and stability in the hips and core. Correct intervention can be determined and results achieved with this information.

Burger Rehab can perform this evaluation and prescribe the correction program for you to set you on a path of training without the risk of injury and pain. Rather than trying different shoe types to eradicate pain in your feet, we suggest determining why you have this pain in the first place.

Schedule an Optogait evaluation with Burger Rehab and get real data, in real time, and find out what is really wrong.

Larry Gray MPT

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