Running Shoes: Is there a preferred type of shoe?
The right footwear can make all the difference to a runner. Often, footwear can play a role in running injuries, which is why it is important we address footwear for running.
Over the years, there has been a lot of debate and mixed reviews over minimalist vs conventional shoes for runners. One thing that research tends to agree on, is that the individual response to footwear varies significantly. What this means is, there is no one footwear that is right for everyone. It all depends on the individual based on multiple factors, including:
- Running technique
- Running environment (e.g. ground, slope, long vs short distance)
- Foot biomechanics
- Motor control of the lower limbs
- Strength and mobility of around the hips, knees and ankles
Esculier et al (2015) wrote an article outlining “The Minimalist Index”. The Minimalist Index contains five sections and provides a score from 0 - 100. The lower the score, the more supportive the shoe is. The higher the score, the more minimalist the shoe is. It provides us with a great tool to determine the amount of support an individual requires in their shoe to provide them with the optimal running performance.
The Minimalist Index is broken up into 5 sections, each scored out of 5:
Section 1: Weight of the Shoe
Section 2: Stack height
Section 3: Heel-to-toe drop (i.e. height difference between the rear and front of the shoe)
Section 4: Stability features of the shoe
Section 5: Longitudinal and torsional flexibility
What has the research shown?
Range of Motion When comparing conventional footwear to barefoot running, there was an increase in ankle and knee bend during running with the use of conventional footwear (Nigg et al, 2017). This is also supported by studies showing these increased range of motion to be associated with higher heel-to-toe drop when comparing minimal and conventional shoes (Malisoux et al, 2016).
Load Placed on the knee joint and calf-achilles complex The heel-to-toe drop has also been associated with the load placed on the knee and achilles. The lower the heel-to-toe drop, the less load placed on the knee and more load places on the achilles (Esculier et al, 2017). Another study by Firming et al (2017) reported increased stress placed on the metatarsal bones (i.e. bones of the foot) with minimal shoes. They noticed that there was increased bone marrow oedema (i.e. bone inflammation) and stress fractures associated with transition into minimalist shoes.
Risk on injury Overall, there was no strong consensus in the studies to suggest a correlation between heel-to-toe drop or mid-sole hardness/cushioning, and injury risk. However, the studies suggest increase risk of injury with transitioning into minimalist shoes by up to 86% (Salzler et al, 2016).
What does this mean for you?
As mentioned before, one of the greatest risks to injury with running footwear is sudden, significant changes to the footwear used. This is because the increase in change of footwear will result in increased changes to the kinematics of the individual’s running. Nigg et al (2017) suggested subtle changes to footwear to stay within the preferred movement pattern of your body. Changes will depend on the individual, which can be guided by assessment with your Physiotherapist, but use of the transitioning footwear should be no greater than approximately 5% or 1.7km per week (Fuller et al, 2017) and this should be gradual progress along the minimalist index (Esculier et al).
So, how can we determine what shoe is best for you? We would begin by discussing what symptoms you get with running. From there, an assessment will provide us with a diagnosis of your injury. We will then assess your running shoes, your foot biomechanics, strength and mobility of your hips/knees/ankles, and running technique. We will then have all the information we need to determine what type of features in a footwear would be optimal for you and can provide the information using The Minimalist Index.
In conclusion, there is limited evidence to support barefoot running or minimalist shoes compared with conventional shoes for injury risk and performance. However, there is evidence to support increase risk of injury related to transitioning into minimalist shoes.
It is suggested that you speak to your Physiotherapist about your concerns with your running footwear. They will be able to assess any injuries or symptoms you have, assess your running biomechanics and associated mobility and strength, then come up with a plan with you on the optimal footwear for you and/or safest way to transition.
Click here to book in with one of our experienced Physiotherapists to assess your footwear and provide further insight of the optimal support for your footwear.
Reference:
Esculier et al. (2015), A consensus definition and rating scale for minimalist shoes