Contrary to what many runners believe, finding the right shoe for you is very simple. No fancy equipment is needed. So, let’s dive in to how you can find the right shoe for you!
What the research tells us: Runners intuitively select a shoe that is comfortable and allows them to remain in their preferred movement pattern. We all move differently which is why there is no one size fits all shoe! Runners selecting a shoe that fits their specific biomechanics may automatically reduce the risk of injury because the shoe is not forcing them to move in a way that is unnatural to them. We want our shoes to allow our skeletons to move in the path that our bones prefer to move. You 100% do not have the same hip, knee, and ankle bone alignment than everyone else out there, which is why no two runners have the exact same running form. So, we want the shoe to allow us to move in a way that is comfortable and efficient for us vs trying to force our bodies to move in a way that is unnatural, and therefore less efficient.
Step 1 of finding the right shoe for you: Try on multiple pairs of shoes and walk or jog around. Pick the one that FEELS the most comfortable!
Step 2: Make sure the shoe fits
Take out the insert of your shoe and step on it. Are you able to see the sole of your shoe on both sides of your toes? This is important so that your toes do not develop calluses, blisters, or bunions, and so your toes can spread out and work properly while you run. Then make sure that you can see space in front of all your toes. This will help to avoid getting black toenails or losing toenails. These events are COMMON but not NORMAL. If you lose your toenails or get black toenails, this means that your shoes are not fitting correctly. Having enough toe space also helps to prevent your toes from curling. They don’t work well if they are curled!
Next, make sure the arch in the shoe matches your foot arch. Your shoes will feel a lot more comfortable if they match the general form of your foot.
How often should you change out your shoes?
Remember to change your shoes out every 300 to 500 miles! Shoes lose their shock absorption qualities over time, which will impact how you feel while you run and could potentially lead to you running differently.
A quick note about shoes and injuries: Perkins et al stated it perfectly by saying, “there is no single factor such as shoe design that will explain more than a fraction of RRIs (running related injuries).” Shoes are VERY unlikely to be the single cause of your injury. The most common causes of running related injuries are training errors, muscle weakness, and running form concerns.
What does the wear on your shoes mean?
First off, there is no “good” or “bad” wear on the bottom of your shoes. The wear just provides you with information regarding your foot strike and push off and whether one side is working harder than the other.
Now let’s do a major deep dive into the types of shoes and different shoe components!
Barefoot? Minimalist shoes? Max cushion? Which is better?
The short answer: There is no one shoe or type of shoe that is “better” than others (other than carbon-plate shoes, which we know makes road runners faster).
The long answer:
There is very limited evidence suggesting that barefoot or minimalist shoes lead to lower ground reaction forces. There is also no evidence demonstrating a correlation between an absence of a peak in forces at foot contact and decreased injury rates with barefoot running.
What research has demonstrated is that people who run barefoot tend to land with less dorsiflexion at the ankle, which is likely due to wanting to reduce pressure at the heel when the foot contacts the ground. For runners who wear shoes, this is not a concern since shoes are designed to help absorb ground forces, providing shock absorption at the heel. There is very limited evidence to support that barefoot running is more efficient than wearing shoes. Running efficiency not only looks at form but also the amount of oxygen used, heart rate, and rate of perceived exertion while running. So, even though running gait may change while running barefoot vs wears shoes, it does not mean that these gait changes lead to improved performance or a reduction in injury rates. According to Perkins et al. “Whether running barefoot benefits running economy and potentially improves performance is unknown.”
Now, barefoot running is not the same as wearing minimalist shoes. So, what do we know about wearing minimalist shoes? Some research supports that it can improve running economy. But, minimalist shoes also put more pressure on the forefoot and have been associated with greater bone marrow edema compared to people who wear traditional shoes. So, if you plan to switch to a minimalist shoe, do so gradually so that your bones can adapt to the extra stress.
As Perkins et al. concludes, “No definitive conclusion can be drawn on the risks or benefits to running barefoot, shod, or in minimalist shoes.”
Regarding max cushion shoes: Max cushion shoes do not influence running economy, meaning that a person running in neutral shoes will use the same amount of energy as running in max cushion shoes.
How to apply this to your running: Race EVENT and DISTANCE need to be considered when buying shoes. For example, wearing minimalist shoes during a 100 mile or longer race will likely not work for most people. During my first 100-mile race, I wore a medium cushion shoe for the first 50 miles and then a max cushion shoe for the rest of the race when my feet needed some extra help. So, there is no one-size fits all shoe for all people and your shoe preferences might change depending on race distance, type of terrain, weather conditions, etc.
Concerned with flat feet?
Flat feet or pronated foot/ankle posture
High arches or supinated foot/ankle posture
If you have flat feet, you need a stability shoe or special orthotics, right?
Incorrect!
There was an AWESOME study done by Neilsen et al. in 2013 where the researchers followed 927 novice runners for one year. They measured degree of flatness in their feet, then had all runners run in neutral shoes, and assessed who got injured after a year.
What did they find?
There was NO difference between people who had very high arches, high arches, neutral arches, flat feet, and very flat feet!
The researchers stated, “The results of the present study contradict the widespread belief that moderate foot pronation is associated with an increased risk of injury among novice runners taking up running in a neutral running shoe.” AMAZING!
Recommendations MIGHT be different for more experienced runners. There was a much smaller study performed by Malisoux et al. in 2015 looking at the injury rates in recreational runners who had supinated (high), neutral, or pronated (flat) arches and whether they were wearing a stability shoe or neutral shoe. After 6 months, they found that a stability shoe was effective with reducing the risk of injury for runners, especially those with flat feet. These two studies differed in that they used different stability shoes. More research is needed in this area to see if stability shoes (and which ones) really do anything for people with flat feet.
Side note: Flat feet are due to WEAK foot muscles vs a structural problem. Strengthen your feet to give you the best support possible vs relying on a shoe to do it for you!
Does shoe prescription work?
The short answer: No
The longer answer:
Having someone look at your feet while standing, walking, or running and then prescribing a specific shoe to you has not been demonstrated in research to help reduce the risk of injury or improve running performance.
A meta-analysis performed by Knapik at al. involved following 7,203 individuals in the military. They first classified each person’s arches as high, normal, or low (flat feet) and then had the experiment group wear shoes specific to their arch height while the control group all got the same shoe meant for neutral arch runners. What they found was there was no difference in injury rates for any of the groups. Now, military individuals do a lot more than just run, but this is a great study in that the researchers were able to control A LOT of variables that usually cannot be controlled in other studies (amount of training, other activities done other than exercise, diet, living environment, compliance with actually wearing the shoes, etc). It also includes a HUGE number of participants. It is very difficult to find studies that include over 7,000 people!
Shoe Drop
The drop in a shoe is the height difference between the heel and toe. So, a zero-drop shoe means there is no difference in cushion height between the toe and heel, while a large drop shoe means the heel is higher than the toe.
Shoe without a drop
Shoe with a drop (although a very small one)
Is drop vs no drop better? There is NO difference in injury rates between the two.
One word of caution: If you are switching to a zero-drop shoe, do so gradually. People who go from a drop to zero-drop without doing a gradual transition are more likely to experience injuries. Zero drop shoes lead to more forces from the ground being absorbed through the calf and Achilles, so this type of shoe might not be the best shoe for you if you have a history of calf or Achilles injuries.
Laces:
Runners tend to feel more supported and demonstrated reduced loading rates and pronation velocities when they wore seven eyelet shoes vs six. So, if your shoes have seven holes in them, consider lacing them all the way to the top!
Shoe stiffness:
If you take the heel of your shoe and try to bend it towards the toe, how easily are you able to do that? If it is easy, then your shoe has low stiffness. If it is hard, then your shoe has high stiffness. Some research shoes that having more forefoot bend stiffness in a shoe can improve running performance and economy, but stiffness is not associated with decreasing the risk of injury.
Shoe midsoles:
Three quick points on midsoles:
Softer midsoles (so not the amount of cushion but how SOFT the available cushion is) can help to reduce forces while landing and landing rates.
Thicker (so MORE cushion) can help with shock absorption at foot strike but might impact foot sensation. This might not be the best option for people with poor balance.
There is no difference in injury rates or type of injury between people who wear soft midsole and hard midsole shoes.
Have questions about your shoes? Send me an email so we connect! jblumentritt@physicaltherapyontherun.com
Want to learn more? Here are the articles I used to write this blog:
Nigg et al., Running shoes and running injuries: myth busting and proposal for two new paradigms: ‘Preferred movement ‘path’ and ‘comfort filter’, 2015
Nielsen et al. Foot pronation is not associated with increased injury risk in novice runners, wearing a neutral shoe: A 1-year prospective cohort study, 2014
Perkins et al., The Risk and Benefits of Running Barefoot or in Minimalist Shoes: A Systematic Review. 2014
Knapik et al., Injury-Reduction Effectiveness of Prescribing Running Shoes on the Basis of Foot Arch Height: Summary of Military Investigations. 2018.
Sun et al., Systematic Review of the Role of Footwear Construction in Running Biomechanics: implications for Running-Related Injury and Performance, 2019.
Podcasts to check out:
Science of Ultra - Barefoot running with Dr. Daniel Lieberman
Science of Ultra - Shoes and Biomechanics with John Mercer, PhD