19 Jul The Running Shoe for You
Running shoes come in 3 basic support structures, 3 basic widths and 3 basic forms. Getting all three right will increase your chances of successful training and decrease your chance of injury.
3 Support Structures:
1. Cushioned: Cushioned shoes are exactly what they sound like. Their main purpose is to provide extra cushioning. Think a cozy pillow. While this might sound ideal for everyone, just imagine running on a pillow…it can be a bit ‘mushy’ for most of us.
The cushioning is at the expense of structure. Meaning the shoe is focused on the cushion and not focused on providing additional support. Thus for most people, as most people require support, a cushioned shoe is not the best choice.
In addition, average to heavier runners and long-distance slower runners also would never make this choice. The more body weight on a pillow, the more the pillow is damaged. The more time spent on the pillow the more the pillow is damaged.
The only population that may work in a cushioned shoe are lighter weight, efficient runners who have sound structural arches and feet. These are runners that weigh around 100 lbs or less, and are trained, speedier runners (think consistent sub 7 minute milers) who know correct biomechanics and whose feet are of sound biomechanical form. These runners have the normal amount of pronation in their stride and an intact arch. You will find few runners meeting this criteria, thus cushioned shoes are generally a bad choice for most runners
2. Neutral: A neutral shoe basically is designed for those runners with a more ‘normal’ foot, biomechanically speaking. This means they have the normal amount if pronation necessary for proper push off but not excessive pronation. Most runners who are not over pronators fit in this category. It has a combination of cushion and structure making it ideal for most runners.
3. Motion Control: Motion control shoes are for severe over-pronators. These are people with severely flat feet or feet that flatten during weight bearing. A motion control shoe is more structured so as to add structure to a foot that has a failing structure.
What about people who fall in between? Say you pronate more than normal but not excessively? First, let a health care professional trained in foot biomechanics be the judge of what is excessive or more than normal! If you are right in the middle, sometimes the best choice is a neutral shoe with a well-made orthotic or insert. While most over the counter inserts are not worthy, Superfeet does make a decent one for running. It’s like adding a little bump up from your neutral shoe without having to go all the way up to a motion control shoe.
In addition to this option, many running shoe companies make shoes that also fall in between neutral and motion control. Some even show a little scale so you can see where the shoe lands.
3 Basic Widths:
1. Narrow: Believe it or not, most thin runners have narrow feet. This corresponds to size AA for women and B for men. Most of us think we have big feet, or if we have a flat foot we think we need wide sneakers. In actuality the biggest problem I see in runners leading to injury is that they are running in the wrong width shoe. Narrow runners in regular size shoes can experience all kinds of calf strains, plantar fasciitis, ankle tendinitis and tibial stress fractures. Consult someone who knows best to find out if this is you. Generally thin runners or petite runners also have a narrow foot if they are not severe over-pronators, but not always.
Be aware that even though a salesman or shoe write up may say a shoe ‘runs narrow’, this is not a substitute for a narrow shoe. You must look for AA for women and B for men.
In addition keep in mind your favorite running store does not understand these nuances. They are not trained in foot structure, just have general knowledge of selling a shoe. They will have no idea about the width of shoe you should be in. Most doctors and health care providers also don’t know the difference or think there is one.
2. Normal width: For most runners who have a normal width foot, generally overweight runners as well.
3. Wide: Generally people who fall under this category have severe bunions, severe pronation, and/or are overweight. However, some very thin runners can also have bunions forcing them in wide shoes. This is rare however, as most would be a narrow bumped up to a normal width given the bunions.
3 Basic Forms:
1. Lightweight/barefoot: These shoes have very little, if any support for the foot. Unfortunately, although they became very trendy, they are generally a poor choice. Besides the most important point… that humans have evolved to needing supportive footwear (our ancestors have been wearing them for centuries), unless you are a very lightweight and biomechanically efficient professional or semi-professional runner (think good foot structure AND fast), you shouldn’t think twice. An average size runner at an average or a bit faster than average pace, especially a long distance runner, should steer clear.
2. Normal: Most regular non-lightweight traditional shoes
3. Heavy: These are shoes like Hoka’s original thickness that are on average a bit heavier and have more material than normal. They may be recommended for people with multiple foot injuries or those with severe pronation but are also generally a poor choice for the masses. Steer clear unless a running health care professional suggests one of these specifically.
Although you should never self-diagnosis which category you fall in, a good rule of thumb for whether you are in the right shoe or not would be to put on your running shoes, then note afew factors:
1. Can you comfortably separate your toes? If you can, likely the toe box is too wide and you need a narrower width shoe. The toes, arch and heel should all feel snug without cutting into the foot
2. Look at your laces. Can you barely tie them because there is no more length in the laces? Or are they tied so tight all the way up that there is little room horizontally left to right on each lace level? If either of these apply, you may be in the wrong width shoe.
3. Do you tend to get mostly ankle and foot issues like calf pain, arch pain or tibial stress fractures/tibial stress syndrome? Or do you tend to get knee pain on the outside or inside of the knee or inside of the ankle? Chances are the width or structure shoe you have chosen is wrong or could be improved.
4. When you take the shoe off is there redness on your foot anywhere that lasts more than 2 hours after the shoe comes off? If so, depending on the area of redness you may be in a shoe that is too tight. See a professional to trouble shoot.
5. With your shoe off and in standing on one leg, does your arch hit the floor or does it stand up well? Now squat down on that one leg. Does your arch hit the floor, maintain its position?
If your arch hits the floor in standing you may need a motion control shoe. If it only hits the floor when you squat on one leg, you may be neutral.
6. Do you feel like your heel lifts just a bit out of your shoe when you run/walk or feel like the heel is not snug (i.e. It can shift a little left and right in the shoe? If so, likely your shoe is too wide.
The conclusion? Don’t trust a shoe salesman, even if it is an experienced runner or coach, even if it is a reputable running store. These are not people trained in biomechanics, they know very basic information. Even in my home town of NYC, which boasts very running-centric stores, more often than not my runners come in after being sold the wrong shoes.
The grand majority of patients I see are wearing the wrong shoes. If you plan on being a runner, and definitely if you plan on long distance training, it is essential you get your feet checked. It could be the difference on whether you make it to the starting line or not!