As physiotherapists we get asked a lot by patients with running-related problems “What is the perfect footwear for me?” or “Do you think I should change my running footwear”, or my favourite “Do you think barefoot running would suit me better?”
These aren’t straightforward questions, and people in the physiotherapy world and other professions that treat and manage running-related problems have differing opinions.
At PhysioMotion we see a lot of runners and so we try and keep up to date with the research around running, treating running conditions, and the best footwear for specific running styles. We’ve pulled together some food for thought if you’re wondering what type of trainers to buy, you’re thinking of using insoles, or toying with the idea of barefoot running.
The first thing to remember: there is no one running trainer that is perfect for everyone. You need a trainer to complement your running pattern.
According to research by Nigg et al. (2015), you should select your running shoe based on comfort, as this will improve your running economy. But this is challenged by other professionals, who are very vocal about their dislike for certain maximalist running shoes, such as Hokas. They believe a lot of cushioning causes instability in your running and slows down your cadence. As a consumer, you may also not get the most bang for your buck, as they believe that the cushion wears unevenly, which can cause more instability in your running and make it difficult to engage the muscles required to push forward.
If you are looking to change your footwear due to a recent running-related injury, always seek advice from a physiotherapist or podiatrist to find out what caused your problem as it might be more complex than just your footwear, which could be a contributing factor.
When we spoke to podiatrist Amanda Walker at Gait Lab, she told us that she normally recommends Asics, Brooks and New Balance, but suggests to patients that the trainer should ultimately feel comfortable and be suited to the activity. It’s sensible to trial a few different types and brands to see how they feel. If a trainer doesn’t feel responsive, then it’s generally not going to encourage you to use it for running.
Tom Goom, a physiotherapist based at The PhysioRooms in Brighton, specialises in running injuries. He’s got some guidelines for when you want to purchase a new pair of trainers or change the style of your trainers:
1. Avoid making a big change from the current shoe type as this increases your risk of injuries. It’s better to alter one element of your trainer slightly each time you buy a new pair. This allows your body to adapt to either more or less support.
2. Be guided by comfort and symptoms. If possible, try running in the shoes to assess comfort before buying. Most running shops have a treadmill or area that you can run around to trial the shoe.
3. If you can, consider buying a lighter shoe, as heavier shoes require more effort to run in. “Lighter” doesn’t have to mean minimalist or barefoot shoes.
Tom also has some guidance for people who tend to develop certain running-related injuries or long-term conditions, although he stresses that you always need to feel comfortable and look at your training programme and gait pattern.
So, once you have the right trainer, how long until you need to replace it if you want to avoid injury?
It’s generally recommended that you change shoes either after 350-600 miles or when your shoes lose their comfort and springiness. But research by Kong et al. (2009) found little difference in movement patterns between new shoes and very worn shoes. This could be due to your body adapting to the shoes’ wear and having the strength to maintain your running pattern.
Amanda Walker states that the need for insoles is very individual and you need to consider many factors. She often works alongside foot and ankle consultants and physiotherapists to help establish whether a patient with running-related injury requires insoles short or long term, or at all.
Patients with flat feet are sometimes provided with insoles even though they are injury free. Amanda feels this is completely unnecessary. Insoles are normally required when a person’s biomechanics are adversely affected by their feet, and this causes an injury. Insoles are incredibly effective in changing the loading pattern and reducing injury when used alongside a strengthening programme from a physiotherapist.
The jury is out on this. There are people in both camps when it comes to the question of barefoot running. But the one thing they can agree on is that it’s a personal choice. So, if you are considering changing to minimalist or barefoot running, you need to ask yourself: Why am I doing this? What is my aim in changing to minimalist or barefoot running?
Shoe weight has an impact on your ability to run quicker to a certain extent. Studies have shown that adding 100g to a shoe increases metabolic rate by 1%. But reducing weight often comes at the cost of reduced cushioning, and cushioning can also improve running economy by reducing the muscle activity required to absorb impact.
People also believe that minimalist running can help strengthen the intrinsic muscles of the foot. Amanda Walker suggests there is little evidence that running in minimalist or barefoot shoes improves intrinsic muscle strength or activation, but believes that it can encourage a shorter stride and bringing the foot back in under the body which gives you “good running form”. Her question then is, why not work on the strengthening and running drills to give good running form rather than running in a minimalist trainers?
Other sports professionals believe that barefoot running gives you sensory input that sorts out a lot of form and muscle issues naturally, enhancing your balance and control and resulting in better running patterns. Percy Cerutty, the running coach from Australia had great success in the 1950s and 60s, encouraging his team to run barefoot on beaches and sand dunes.
If you decide that you do want to transition to minimalist or barefoot running, you need to think carefully about how to do this. Studies have shown the risk of injury during the transition is high.
According to Tom Goom, it’s not clear what a safe and effective transition to minimalist shoes is. A study by Fuller et al. (2017) investigated a 6-week transition period with a 5% increase in total training time each week. They found that running-related pain and injury were higher in the transition group compared to the controls.
Amanda suggests a good calf-strengthening programme before embarking or starting with a minimalist shoe. Do it slowly with a training programme that uses the barefoot training shoes in drills first to see how your body copes. If all is going well, build distance slowly. We usually recommend an increase of no more than 10% per week.
The other way is to slowly reduce the support and cushion in your shoes over time. Research by Esculier et al. (2015) has suggested that grading shoes on a minimalist index would help people with the transition.
If you want to know more about finding the right footwear or you have a running-related injury, give us a call or email to see how we can help you make the right choice:
020 3422 6655
Read our article in Sebra News W2 on Why are feet so important?.
Esculier et al. (2015).A consensus definition and rating scale for minimalist shoes.Journal of Foot and Ankle Research.8, Article number: 42
Fuller et al. (2017) Six-week transition to minimalist shoes improves running economy and time-trial performance.J Sci Med Sport. Dec;20(12):1117-1122.
Nigg B et al.Running shoes and running injuries: mythbusting and a proposal for two new paradigms: ‘preferred movement path’ and ‘comfort filter’.British Journal of Sports Medicine 2015;49:1290-1294.