202016Oct
Run Forrest, Run! (Part 1 of 3 – Footwear)

Run Forrest, Run! (Part 1 of 3 – Footwear)

As I pay homage to one of my favourite movies, I thought I would take this opportunity to discuss one of my favourite things: running. With marathon season upon us, I’d like to touch base with regards to a few running-related topics. So pull up a chair, grab some popcorn, and enjoy!

The first topic I will discuss is footwear. Now, before I go on, let me just say that I know this is a hot-button issue for many people and it usually sparks much heated debate. I am not here to berate any other profession or opinions or ideologies; I am simply here to discuss the information we currently have.

Let’s start by learning some of the terminology. A minimalist shoe is a shoe that is defined as having little interference between your foot and the ground while you run and allows for freer movement of the toes and foot. Experts believe these shoes may be best for runners as they mimic bare feet, thus enabling your body to adapt to running and the running surface in the way it was designed to. A maximalist or supportive/cushioned shoe is defined as a shoe that can help control foot movement and possibly alter the natural running mechanics of the body. Experts believe these shoes can decrease mechanical stress on the foot, increase stress on the skeleton, increase vertical loading rate/ground reaction force, and weaken internal foot musculature.

With all this research going back and forth, there is still much conflict in which type of running shoe is best: a minimalist or a maximalist shoe. Personally, I am a proponent of minimalism because they suit my needs perfectly and I believe nature is much smarter than I am. That being said, however, everyone is different! And so, when I discuss the topic of footwear with my patients, I always consider the following factors:

1. Comfort

Comfort is the most important factor in selecting a running shoe. It is important, however, that comfort is not defined as the sensation of softness or cushioning, but instead as the absence of pressure points that could lead to future injury. I usually suggest to patients that they obtain a shoe that does not cram the toes, is lightweight, and flexible enough to allow natural movement of the foot.

2. Running Level

Whether you are a beginner or an elite athlete, running level plays a role in shoe selection. Since a beginner is just learning the new biomechanics of running, it may be best to start with a minimalist shoe, thus allowing for more natural development of the body’s own adaptation to running impact forces.

3. Previous Injury

Maximalist shoes have been shown to decrease the amount of stress placed on the foot, thus allowing for short-term healing. Be careful though because that stress needs to go somewhere, and it’s likely to go up the chain, into the knees, hips, and possibly back. It is also important to remember to allow for optimal loading of tissues so that your foot becomes as strong as it once was.

4. Patient Goals

It is important to remember that selecting a running shoe is an individual thing. The decision should not be influenced by pop-culture, retail sales, or things your neighbours tell you. I’d suggest keeping up-to-date on the latest evidence-based research and see what rings true for you!

There is so much more that can be said about footwear and running, but at least we’ve started a dialogue. Some fascinating literature is emerging in our running world, so click on the video below to learn more!

References:

Dubois B. The Running Clinic [website] http://therunningclinic.com

Perkins KP, Hanney WJ, Rothschild CE. The risks and benefits of running barefoot or in minimalist shoes: a systematic review. Sport Health. 2014 Nov;6(6):475-80

Radzimski AO, Mündermann A, Sole G. Effect of footwear on the external knee adduction moment – a systematic review. Knee. 2012 Jun;19(3):163-75

Hall JP, Barton C, Jones PR, Morrissey D. The biomechanical differences between barefoot and shod distance running: a systematic review and preliminary meta-analysis. Sport Med. 2013 Dec;43(12):1335-53

Swart NM, van Linschoten R, Bierma-Zeinstra SM, van Middelkoop M. The additional effect of orthotic devices on exercise therapy for patients with patellofemoral pain syndrome: a systematic review. Br J Sports Med. 2012 June;46(8):570-7

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