Question: Why do you wear pronation control shoes?
Answer: Because someone at a shoe store told you that you need them, and they were told that you need them by a shoe company rep.
The above Q&A basically describes my feelings on the topic of overpronation. You might think that you wear such shoes because you need support for your “excessive” foot movement to prevent injury, but the reality is there is scant evidence at best that these shoes accomplish this goal, or that excessive pronation is even strongly linked to increased injury risk.
Unfortunately, the pronation control paradigm has come to dominate the world of shoe fitting, and judging by the number of people asking for shoe advice on online forums who start by claiming they are an “overpronator,” it’s not a topic that seems to be dying off as rapidly as it should.
The reality is that pronation is completely normal. If you walk in a shoe store and their sole basis for choosing a shoe for you is how much your pronate and what your arch looks like, turn around and walk out the door. You’re probably just as well-off choosing a shoe at random from an on-line store. The science simply does not support this protocol (I wrote an entire chapter in my book explaining why), and in fact may contraindicate this practice. Given this, I was pleased to see a post come across my blogroll by sports podiatrist Ian Griffiths.
The post, published on the Kinetic Revolution website, describes why Griffiths thinks that “the term “overpronation” is neither accurate, descriptive nor meaningful, and should therefore be erased from modern day usage in both the lay and the medical communities.” Griffiths covers a lot of ground in his article, pointing out such interesting tidbits as the fact that with regard to pronation:
Across many studies, all of the data collected from pain free and injury free subjects and athletes shows that very few individuals actually meet the historical definition of ‘normal’.
One study examined 120 healthy individuals both non weight bearing and weight bearing. Not one subject conformed to the historical criteria of a ‘normal’ foot. Further searching through the literature shows that the majority of data collected from sampled populations suggests that the normal (average) foot position at rest is actually mildly to moderately pronated, as opposed to ‘neutral’.
Regarding injury risk due to “overpronation,” Griffiths has this to say:
It is a commonly held belief that pronation will increase the risk of lower extremity injury. However (perhaps surprisingly) this is not particularly well supported by the literature, with very few studies which actually show pronation increases injury risk. Instead, there are numerous pieces of work which have shown there is no association with foot type and injury and some research exists which even suggests that a pronated foot type is actually protective against injury.
And I love and fully agree with the conclusion regarding what to do with the term “overpronation”:
Hopefully it is now clear that this is a term which contributes nothing to our understanding – it is not definable, not reliable or valid, not diagnostic, its relationship to injury is not fully understood, and it does not dictate what the most appropriate management plan may be. It should not be replaced, it should be removed.
Griffiths feels that pronation is simply one factor to consider when dealing with an injured patient, and this is in line with my view as well. It’s one factor among many that could contribute to any given injury, and it has been given a primacy in the footwear world that it does not deserve. It would be like deciding all of a sudden that we should assign shoes to runners based on their amount of hip adduction and internal rotation because excessive amounts have been linked to increased patellofemoral pain syndrome risk – at least in this case there would be some science supporting the practice.
Anyway, I highly recommend heading over to read Griffiths full post at the Kinetic Revolution website. Hopefully the article will help to free you or your running friends and loved ones from the shackles of the pronation-control paradigm!
About Peter Larson
Pete, I find this interesting as I’m battling a mild case of PF at the moment and I’ve been told by a podiatrist that it may be because I pronate slightly (I’ve always run in neutral shoes). So I was considering a light weight shoe with a medial post (Mirage, Fastwitch etc) but articles like this make me think twice. All the literature is pretty confusing.
I had mild PF for most of last year and I run in just about every shoe you can imagine. Gone now for the most part, and seemed to dissipate when I upped my mileage significantly this summer – go figure. I also benefited from ART on my tight calves with a local chiro, and some heavy duty foam rolling sessions on my calves. I think the combo of the latter two things plus greater activity combined to solve the problem.
Not aware of any solid research suggesting that pronation is tightly linked to PF, but can’t hurt to try a different shoe I suppose – PF is notoriously difficult to pinpoint a cause.
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Pete Larson’s Web Links:
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Blog: https://runblogger.com
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Im glad to hear that you managed to run through a year with a mild case – I’m not keen on an extended break at all. I’ve had very tight calves lately so I’m hoping that is the cause and it will go away with foam rolling and physio.
Tackle the calves and see if that helps, made a big difference for me. Had some gnarly trigger points in mine.
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Another option: toe crunches to stretch the bottoms of the feet. Google “toe crunches yoga” and click on the first non-sponsored option. Try so sit like that for a minute or two and then flip your feet to give them a break. Then repeat.
Here’s a good video on PF.
link to sock-doc.com…
Galen Rupp is an extreme overpronator. But somehow he still manages to run fast. Thanks for the article!
I almost used the photo of his foot in this article!
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Thanks to share that Pete,
I’m happy to see a podiatrist pushing the reflexion further. I defend these positions since 10 years and I have a hard time with most of health professionals… it’s ingrain that pronation is a problem… especially when we sale the solution :)
I think the trend of dynamic valgus at the knee will follow exactly the same path. 1. idea we need to be straight-align 2. define a normal that doesn’t exist 3. validate with cross-sectionnal studies (correlation) 4. doing interventions … and finally having some prospective studies that NOT show a causation… and for a few people : changing there own practice.
Blaise
Thanks Blaise. Unfortunately this message still has not gotten through to the majority of runners if online forums are any indication – pronation still rules the discussion.
Sent from my iPad
Well said Pete. Local running stores should educate folks about “good form running” and fit them with minimalist shoes instead.
Drives me crazy that publications like Runners World still peddle this outdated nonsense.
Good luk in your upcoming half!
As someone who has worked in specialty running for several years, I am what would would be termed an “over-pronator”. That said, I have been running either barefoot or in minimal shoes for over two years with no ill effects related to how my foot pronates. I love working in specialty running and really enjoy working with runners. At our store, have stopped using pronation terms but still have a rather standard fitting process. As someone who feels that the focus on pronation is incorrect I find it difficult to get customers to look past the processes involved in being fit. I blame the industry more than the stores. Our store is trying to evolve beyond the traditional fit process and bring the focus on stride length, cadence, and comfort. That said, it is difficult for many customers to accept that they have more control over how they run and just want a shoe that will make them “ok.” I have seen this change significantly over the last couple of years but I believe until the shoe companies and the medical community move away from these terms it will be a slow change. I believe the change is coming and the last to accept this will most likely be the medical community.
I do my best to educate customers without being pushy. This is especially difficult with customers who come with a doctors note that says they need and ASICS 2170 or a Brooks Adrenaline. I tell them to educate themselves, with blogs like this one but many just aren’t willing to see past the process. I also teach Good Form Running and that has been a big eye opener for those that have taken the classes but that reaches a small fraction of customers.
That said, what is the best way to fit folks? Is there a true process that can be applied considering the scientific studies out there?
Woody,
Thanks for the comment, glad to hear you are moving past the old way of doing things. Sadly, not all are, including most of the stores in my local area. Is there an ideal way to fit shoes for an individual? There may be, but we don’t have a perfect method yet. There are some who I know that are working on things, and I’m hopeful we will have better methods in the not too distant future.
Although I don’t work in a shoe store, I give shoe advice all the time via this blog and over email so I more or less feel like I work in a virtual store! Pronation is generally not something I ask about unless the runner reports an injury history that suggests possible linkage to excessive pronation. Even then, I’m more concerned that a shoe is causing excessive pronation rather than the runner being an excessive pronator naturally. Some shoes can cause people to pronate more than they do when barefoot (e.g,. I got posterior tibial tendonitis from the NB MT110 which causes me to pronate excessively).
My main questions when it comes to shoe advice are 1. Forefoot fit – do they like a wide or narrow forefoot. 2. Heel-toe drop: how much is preferred. 3. Cushioning firmness: soft or firm (I think this may ultimately be one of the most important factors). 4. Flexibility: stiff or flexible. 5. Intended purpose: road, trail speedwork, distance, a combo of all. I find that most of the time this information along with an injury history lets me hone in on a few decent options to try.
Pete
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Pete Larson’s Web Links:
My book: Tread Lightly – link to ow.ly
Blog: https://runblogger.com
Twitter: link to twitter.com
Facebook: link to facebook.com…
I’ve been reading your blog for a while now, but this is my first comment. I have to say that I was basically pushed into the motion control shoe market by aggressive salespeople stating I needed a certain type of shoe because I’m flat-footed, and pronate. After getting injured several times, started researching how to prevent injury and came across this blog. I tried barefoot running on my treadmill then outdoors. Although it was painful to the bottom of my feet initially, my body adjusted. I now run barefoot, or in very minimalist shoes in the winter. My calves are now stronger than ever and I haven’t had an injury since. I’m not a scientist, or clinician of any type, just a 41 year old guy that listens to his body, and right now MY BODY tells me the following: Big Bulky Shoes+Running=Pain. Minimalist Shoes/Barefoot+Running=No pain. Pretty simple to me.
Thanks for sharing, I hear stories like this all the time! Barefoot may not be a cure-all for everyone, but it’s certainly an option and has worked wonders for some. Stories like yours are why I avoid blanket shoe fitting protocols – too much individual variation, especially when the protocol we have is not based on good science!
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Pete Larson’s Web Links:
My book: Tread Lightly – link to ow.ly
Blog: https://runblogger.com
Twitter: link to twitter.com
Facebook: link to facebook.com…
Thanks for the reply. By the way, just bought your book on Amazon today.
Thanks for buying it!
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Pete Larson’s Web Links:
My book: Tread Lightly – link to ow.ly
Blog: https://runblogger.com
Twitter: link to twitter.com
Facebook: link to facebook.com…
Another happy reader here, too! I bought it about a month ago, now my wife is starting to read it.
Thanks!
I have been meaning to ask you a question about this! I “overpronate” although I have always run in neutral shoes. My problem is that my shoes get crushed out on the inside heel very quickly. Like the pronation is squishing them and shortly they become totally slanted to the inside; feels like I’m standing on sloped ground when I wear them and from behind they are drunkenly leaning medially. My favorite shoe is the NB101 but after 200 miles: crushed and slanted. Montrail Rogue Flys only lasted 100 miles! Foam is crushed out while the tread & upper looks new. So frustrating (and expensive).
I am wearing Saucony Progrid Lite Mirage II and Montrail Mountain Masochists now, but they feel so stiff and clunky. Any ideas to help my favorite light, flexible, somewhat cushioned shoes last longer? Or new shoes to try?
Does anyone else have this problem?
Here’s my take on this. Most running shoes have a shape that does not match that of a foot. Most have a curved last, like a letter “C”. Add to that a 12mm heel drop that forces you to land on the heels, motion control shanks, orthotics and other things and you have a recipe for disaster. I know this from experience, I had flat feet (notice the past tense) and wore orthotics and supportive shoes for the best part of 40 years. Once you remove all those mechanisms that alter the foot motion, you tend to land mostly on your forefoot/midfoot. No crushing of the heel happens, no rolling in of the feet, no artificial “overpronation” caused by the shoes. Flat feet are no longer an issue and you may even develop a somewhat normal arch as many (myself included) have done. So my recommendation would be: go back to the basics. Learn to run barefoot. Later on, look for shoes with zero drop, flexible, with no support whatsoever that would prevent the foot from flexing and naturally finding the best way to land. I personally prefer Altra shoes due to the naturally shaped last (compared with the aggressive last of NB for example), but it’s just a matter of preference, whatever works for you is fine.
Gabe
Are you saying you think a midfoot strike stops pronation? I’m skeptical.
Try it, you have nothing to lose. I land mostly on the ball of my feet but a fraction of a second later I’m lightly touching the ground with my heels relaxing the calves. Landing on the forefoot takes the ankles (where you’d see the pronation as the foot rolls inward) out of the equation, and all of a sudden it doesn’t matter one bit whether you have flat feet or not. And as the arches strengthen, the “overpronation” is further diminished. Add to that the fact that the toes, especially the big one, spread out doing what they’re supposed to do which is support the foot laterally. When the toes are all scrunched together, there’s no lateral support and it only makes sense that the foot may roll inward. This is just my experience, but I’ve seen other people do the same.
I just noticed that a little further down, Pete Larson said this (scroll down to see the full comment): “I’m more concerned that a shoe is causing excessive pronation rather
than the runner being an excessive pronator naturally. Some shoes can
cause people to pronate more than they do when barefoot (e.g,. I got
posterior tibial tendonitis from the NB MT110 which causes me to pronate
excessively).”. So his experience matches mine (sorry Pete I stole part of your comment, I can’t figure out how to link directly to it).
No problem, thanks for reiterating!
Try shortening your stride and landing on your midfoot.
The MT101 is a pretty soft shoe, not sure about the Rogues. Would be interesting to see a video of your gait as it seems like you may be loading heavily on the inner margin. Ever have any knee pain on the inner side?
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Pete Larson’s Web Links:
My book: Tread Lightly – link to ow.ly
Blog: https://runblogger.com
Twitter: link to twitter.com
Facebook: link to facebook.com…
No persistent knee pain. No chronic pain at all really. This year I’ve run about five 50Ks and just ran a 50 miler (all trail). I must be loading the inner part of the shoe, I just don’t know what to do about it.
I don’t have video; can you take a decent enough video with an iPhone?
Very interesting post Pete. It is very timely for me. I have been getting some PT for a pretty bad case of platar faciitis that I think began when I started wearing the Kinvara 3. (I have been wearing the other models of the Kinvara since they first came out) The PT arranged for a Dartfish analysis this morning, where I had video from all sides while treadmill running. I will be meeting with a trainer to go over the results, but he noted in scanning the video that while my left foot lands perfectly flat, my right foot has some pretty extreme pronation. I also have a higher arch on this foot. I can see they are probably going to prescribe custom orthotics, unless they determine that there is a muscle weakness that is causing my foot to hit the ground at a fairly extreme angle. (My foot appears twisted toward the outside when I strike the ground with the very outside edge).
Guess I am wondering what your thoughts are about using a custom orthotic? Note that my right foot (the PF foot) always feels like there is a lot of space under my arch in most shoes).
I also forgot to mention that I did the test in NB 1400s (light shoe with substantial heel-toe drop). These seem to have helped the PF some, and I clearly mid-foot strike in these based on the video. They are also very nice fitting shoes for me.
Thanks again for all of the great posts…
“Question: Why do you wear pronation control shoes?
Answer: Because someone at a shoe store told you that you need them, and they were told that you need them by a shoe company rep.”
Ok New Question: Why do you wear minimal/barefoot running running?
Answer: Because someone on a blog told you that you need them, and they were told that you need them by a shoe company rep.”
In reality there’s little rigorous evidence to support the use of any specific footwear; not least because designing a trial capable of establishing cause and effect in the world of injury prevention is extremely difficult.
People have been applying the motion-control paradigm for many years now and while it may not be ideal, it hasn’t been proven less effective than the alternative (if you disagree, please post the evidence).
Shoe companies will make money out of runners no matter what shoe-fitting model you subscribe to – my advice is: we have been using these shoes for years, barefoot running is still in its infancy.
Don’t ‘throw the baby out with the bathwater’. Lets wait for some proper evidence before we make a decision on this one?
Minimalism came first, didn’t it? Where has the motion-control paradigm been proved to be more effective? This paradigm is so pervasive and has been around for years and years that we’ve all been conditioned to accepting it – without question. Most of our bodies have definitely adapted to running in “traditional” running shoes, so running in something flatter and firmer is going to feel different, probably drastically so. It won’t be for everybody’s tastes – especially at first.
If you’re running well and comfortably, don’t change and keep doing what you’re doing. But far too many people who are having problems for whatever reason, either don’t even know that there is an alternative or if they do, are often too afraid to give it a fair chance. There is a risk to transitioning because the body needs to go through an adaptive period, but many people go about in a haphazard, undisciplined way which only increases the risk of injury.
In the big timeline of things, cushioned, corrective shoes are the trendy “fad”, so to speak. The simple, minimalistic footwear has been around far longer and the new wave of “minimalist” shoes incorporate many innovations to make them more comfortable and durable than those of yesteryear. Lighter and more comfortable feel too good for me to just dismiss.and disregard.
Shoes get far too much credit and blame IMO. It’s not the car, it’s the driver. It’s not the shoes, it’s the runner. Most often, problems are avoidable and due to driver/runner error, not with the car/shoe.
Read chapter 6 of my book, it covers the entire topic and also the evidence. 4 studies have come out in the past few years showing that the pronation control paradigm is ineffective at best, and in one every overpronating runner in motion control shoes got injured. 100%. And the statement that “barefoot running is in its infancy” is ridiculous – humans have been running barefoot for millions of years, motion control has been around for about 30. And injury rates have not declined at all as a result.
Humans have quite likely been running barefoot since they first trod the African savanna a few million years ago. Archaeological evidence suggests we have also been suffering osteoarthritis just as long.
But how many tarmac roads were we running on back then? And where were the large-scale long distance running competitions held 2 million years ago?
The landscape and our lifestyles have changed beyond recognition since this period.
Musculoskeletal injuries tend to be multifactorial in nature.
To establish cause and effect requires reproducable results from well-designed, large scale trials – as I mentioned. Its easier to show that injury rates persist, but much more difficult to show whether this is actually caused by training methods, lifestyle choices (eg sedentary job), bodyweight, genetic factors, other factors, or the (probably relatively minor) effects of footwear choice.
I am aware that the evidence for the pronation-control trainer never really arrived.
But where is the rigorous empirical evidence for barefoot running being a better alternative in terms of injury-risk.
I am aware of the theoretical decrease in heel-strike with minimal footwear – this proves nothing in real-life risk of injury.
Warming up before exercise has also provided disappointing in terms of evidence for reducing injuries, despite making sense on a basic theoretical level.
I am not interested in anecdotal evidence from someone with an obvious conflict of interest (“read chapter 6 of my book”). I have worked as a musculoskeletal physiotherapist for 8 years myself so I’m perfectly capable of appraising scientific evidence for myself.
Please post your references that show barefoot running to be superior to motion-control footwear as I am interested to know if I should be actively recommending this approach to runners myself.
Did this post suggest that barefoot running is better? I must have missed that. You clearly don’t know my position on the topic. I suggested reading my book since you came to my blog and made a comment that is ignorant of my thoughts on the issue. I think you’d find that I discuss almost every issue that you bring up, and agree with you on most.
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My opinion on motion-control shoes is this – Be very careful what you try to fix. Because it may not be broken in the first place. Motion control shoes and heavily cushioned midsoles reduce sensory feedback to the feet which may lead to increased ground contact times, lower cadence and make it easier to overstride. People who run well in motion-control shoes may be well-adapted to running in them and need never consider any other kind of shoe or they may be able to run just as well in neutral/non-corrective shoes if only they tried. I believe that shoe choice is a bit of self-fulfilling prophecy. You either stick with running in your choice of shoes, make a switch to some other footwear choice or just give up running entirely.
If you have no desire to read my book and learn my position, which is far from anecdotal and is in fact based on a thorough appraisal of the scientific literature on the topic, then read Jay Dicharry’s Anatomy for Runners. He’s a PT who’s been treating injured runners for a long time in one of the best gait labs in the world. And if you want my references, they can all be found at http://www.treadlightlybook.com.
Sent from my iPad
Here’s one to get you started: link to bjsm.bmj.com…
And don’t try to make this debate about barefoot running as that as not at all the topic of discussion in this post.
Sent from my iPad
barefoot running is not in its infancy. It has been around much longer than any motion control (PECH) shoe
In my experience, there are at least two reasons that concept of overpronation is relevant for ME – long term shoe wear, and knee pain.
When I find a shoe that works well for me, i can run it until the upper falls apart (lately with all the lightweight designs, this seems to happen way too soon), but this requires that the midsole remain level laterally. Recently for me, this includes shoes like the Puma Trailfox 4, a conventional neutral trail shoe (1,750+ miles). In the past, it has included medially posted shoes like a late ’80s Converse model (4,300+ miles) and similar vintage Adidas Web Tech (3,800+ miles). What these and other long lasting shoes had in common was that the heel counters remained straight up and down as the midsoles compressed. (A side note – outsoles are not a limiting factor with my no-scuff stride.) Some (but not all…) “neutral” shoe designs that I have used will have the medial edge of the shoe be compressed more than the lateral edge with use such that the heel counters are tipped towards each other. It’s pretty clear that running in the shoes that end up like that, I’m overpronating and squashing the heck out of the medial side compared to the lateral side. Otherwise, the compression would not be uneven. Like your experience with your MT110s, this is not a good situation. For me, the lateral heel slant is about as strongly associated (just about 100%) with knee pain as is possible (the pain reverses as soon as I change into a different pair of shoes). Unlike for you, forefoot slant is less important for me than that the heel remain flat laterally – I remember that I squashed the medial forefoot and caused a permanent lateral forefoot slant in my Converses (that lasted forever and a day) within the first few runs in that shoe, but they felt great anyway. (I have also had a single pair of stability shoes [old Adidas Supernova Trail, I think] that was too much and ended up compressed laterally more than medially, and became weird to run in biomechanically – and I had to retire them early as well.) So, if a shoe is able to control overpronation for me, whether by a well designed single density neutral midsole design, or by medial posting, the difference is between a shoe that lasts a short time (as little as 8 miles to 300 miles) vs. a shoe where the upper is the limiting factor for shoe life for me. That said, I have found that ratings of stability are often useless for my biomechanics – depending on the shoe, I might severely overprontate in a ‘stability’ shoe, yet be totally neutral in a neutral shoe. The standard treadmill test, when I have tried it, seems to provide me with a lot what I want to know in this area.
So, what of the shoe (Adidas Cubato+) that lasted only one short run (8 miles) for me? Well, maybe it didn’t “last” only that long, and it was just the wrong shoe for me. I felt knee pain maybe 4 miles into the first run and had to turn around and hobble to my start. I felt knee pain whenever I tried the shoes on again, so I dumped them in the donation bin a short while later. Switching to any other shoe, all was good. I think I identified the problem as the shoe making/inducing me overpronate so severely, such that it was introducing unwanted lateral forces into the knee. This is the same thing that I noticed back in the day (’80s) when my Nike Pegasus (neutral) shoes would make my knees hurt after about 100 miles, while my other shoes were going thousands of miles. I think that Pegasus shoe was when I first made the connection of the heels tilting/medially biased midsole compression to knee pain for me. If this isn’t overpronation causing problems, I don’t know what you would call it. I didn’t have knee problems in general, and I didn’t have any knee injuries because I never continued running in a pair of shoes that caused knee pain. Like I said earlier, I just switched shoes, and the knee pain would immediately go away until i switched back. I take it that this kind of experience wasn’t described in the studies that you reference. It may be just me (though I don’t think I’m so incredibly unique), but I just wanted you to know that overpronation can induce pain in just a few short miles. If there is another explanation or biomechanical thing going on other than overpronation, I’d be semi-interested in learning about it (though i know what works for me already, so it might not change anything in practice for me.).
Haha “semi-interested”! Great!
As I mentioned on Twitter, as a wholehearted supporter of “#formbeforefootwear” I totally agree that wearing a trainer to overcome a bio-mechanic inefficiency is not a long term solution, I find the suggestion that we erase the term “over-pronation” slightly confusing…
Pronation is indeed a natural series of muscle contractions & resulting joint motion that needs to occur each time a limb(s) lands in order to decelerate the body prior to the next acceleration (supination), but if this series of contractions is not optimised, e.g. made inefficient by muscle weakness, hence causing the body to remain in the pronated decelerative state for too long, then surely this is a case of OVER-pronation and once diagnosed can be treated by adjusting (stretching / strengthening) the kinetic chain as and where necessary?
@sportinjurymatt
I don’t think the term overpronation should disappear as a clinical diagnosis, but I don’t think it’s application in shoe shops is particularly helpful, nor do I think it is consistently applied or meaningfully diagnosed in such settings.
Now that, Pete, makes perfect sense to me. In fact, you just made day. It’s the application of the terminology at fault, not the terminology. Thanks for the reply and hosting the debate.
No problem Matt, this topic always seems to stir up strong debate!
OK, I just skimmed Griffiths, and that was uninteresting to me. He said something like static measurements of pronation cannot be linked to dynamic foot function, which I have heard before, and have bought into it based on experience (girlfriend has flat feet, runs really high mileage for 20 years injury free in neutral shoes). We know that wet footprint test is useless. However, the standard treadmill test at running shops is a dynamic measurement of overpronation, right? Maybe people want to say that is useless as well, but I don’t think so based my experiment of myself. Maybe it is useless for other people.
By treadmill test, I mean with a slow motion video taken from behind the runner…
How is the treadmill test helpful to you? I think it may become important to me in shoe selection; still trying to figure it out.
A gait analysis might be worth a shot. If you are not experiencing pain, may just be that you are hard on your shoes an need to find a shoe that won’t break down so quickly. A gait analysis can reveal if there are any aspects of your running form that are causing this rapid breakdown, and might help to find you a better shoe. For example, EVA foam is more susceptible to breakdown than some other material, and a shoe that does not use EVA might be a way to deal with this. One example would be Newton shoes, but because of the lugs they can cause issues for some people, others love them. I shoe with minimal midsole would be another option. Knowing if one of these options might be suitable might be best done by having someone take a close look at how you run.
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Pete Larson’s Web Links:
My book: Tread Lightly – link to ow.ly
Blog: https://runblogger.com
Twitter: link to twitter.com
Facebook: link to facebook.com…
“skimmed Griffiths” – he said a heck of a lot more than static does not equal dynamic. Maybe a full read is worth it.
I read his post again and also three passages that you highlighted in your blog post here. I don’t think I missed anything the first time around. The first passage talks about static measurements (both non-weight bearing and weight bearing) and that the average position at rest (static) is slightly pronated. OK. I skipped my focus pretty quickly past this (my previous post’s “uninteresting”) because I have never considered static measurements to be diagnostic of pronation. How about observing the movement of pronation, since the technology to do so is easily had? I never had others such as running shop employees try to assess static pronation in me and try to draw conclusions about shoe selection from this. I’m sure it happens in running shops and maybe clinics, maybe even often – this might be interesting to other people. I’ve always understood pronation to be about dynamics, so calling a static position pronated maybe be accurate, but it seems like a diversion to me.
The next Griffiths passage that you quote, I quote part of it again here: “However (perhaps surprisingly) this is not particularly well supported by the literature, with very few studies which actually show pronation increases injury risk. Instead, there are numerous pieces of work which have shown there is no association with foot type and injury and some research exists which even suggests that a pronated foot type is actually protective against injury.” From my plan language reading of this quote, I understand it as him using “pronation” in a static sense because he talks of “foot type”, and “pronated foot type”. This implies that there are numerous studies that compare foot types, classified using static measurements, with injury, and that they don’t show a relationship or that a slightly pronated foot type is protective. There is no unambiguous mention of studies that compare dynamic measurements of pronation with injury. I don’t know if he means there are no such studies, or that he just doesn’t mention them. For all I know based on this just this passage, the “very few studies that show pronation increases injury risk” classify what is overpronation by dynamic measurements. There is not enough information to tell from the quote.
Based on the above, i don’t see that he has supported his case in his post (as written) that dynamically assessed pronation should be removed. Maybe he has read the studies that support this, but he hasn’t presented them in that post. The other conclusion that pronation is just one factor to consider in an injured runner is obvious, and I agree.
Seems to be two debates running on this topic. One here and one at the Kinetic Revolution website. As my comments had a reply over there it kind of makes sense for me to continue the debate there.
Great blog Pete. Thanks for hosting.
@sportinjurymatt.
I’m 47 and about 20 pounds overweight. About 3 years ago I started the couch to 5k program wearing Mizuno Wave Ascends that the running shoe store “recommended” after putting me a pair og “neutral” shoes and observing.me run down the street. Over time I started to develop achilles tendenosis and iced it after my.runs. I was up to a 30 min 5k and then it just got to bad and I had to stop and walk. I havent run much since then. I recently read Jay Dicharry’s book Anatomy for Runners and am ready to try easing my way into barefoot running. I have ordered Vivobarefoot Ultras and will start to try the couch to 5k program again as well as the foot and stability exercises in Jays book.
Question is there anything a older beginner should be aware of or do to be better prepared for success. My.goal is to get back to the 30 min 5k.
Thanks!
Derrel
Just be very gradual in trying new footwear and building mileage/speed. Allow the body time to rest and adapt. Jay’s book is a great resource, and the exercises he suggests make a lot of sense – need to start doing them myself!
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I would like to see your peer-reviewed research to support your hypothesis, instead of just saying what you think.
Ryan MB, Valiant GA, McDonald K, Taunton JE. 2011. The effect of three different levels of footwear
stability on pain outcomes in women runners: a randomised control trial. British Journal of Sports Medicine 45(9): 715-721.
Knapik JJ, Swedler DI, Grier TL, Hauret KG, Bullock SH, Williams KW, Darakjy SS, Lester ME, Tobler SK, Jones BH. 2009. Injury reduction effectiveness of selecting running shoes based on plantar shape. Journal of Strength and Conditioning Research 23: 685-697.
Knapik JJ, Trone DW, Swedler DI, Villasenor A, Bullock SH, Schmied E, Bockelman T, Han P, Jones BH. 2010. Injury reduction effectiveness of assigning running shoes based on plantar shape in Marine Corps basic training. The American Journal of Sports Medicine 38: 1759-1767.
Knapik JJ, Brosch LC, Venuto M, Swedler DI Bullock SH, Gaines LS, Murphy RJ, Tchandja J, Jones BH. 2010. Effect on Injuries of Assigning Shoes Based on Foot Shape in Air Force Basic Training. American Journal of Preventative Medicine 38: S197-S211.
Cowan DN, Jones BH, Robinson JR. 1993. Foot morphologic characteristics and risk of exercise-related injury. Archives of Family Medicine 2: 773-777.
Williams DS, McClay IS, Hamill J. 2001. Arch structure and injury patterns in runners. Clinical Biomechanics 16: 341-347.
Nigg BM, Cole GK, Nachbauer W. 1993. Effects of arch height of the foot on angular motion of the lower extremities in running. Journal of Biomechanics 26: 909-916.
Dicharry JM, Franz, JR, Della Croce U, Wilder RP, Riley PO, Kerrigan DC. 2009. Differences in Static and Dynamic Measures in Evaluation of Talonavicular Mobility in Gait. Journal of Orthopaedic and Sports Physical Therapy 39(8): 628-634.
Stacoff A, Nigg BM, Reinschmidt C, van den Bogert AJ, Lundberg A. 2000. Tibiocalcaneal kinematics of barefoot versus shod running. Journal of Biomechanics 33: 1387-1395.
James SL, Bates BT, Osternig LR. 1978. Injuries to runners. American Journal of Sports Medicine 6: 40-49.
Wen DY, Puffer JC, Schmalzried TP. 1998. Injuries in Runners: A Prospective Study of Alignment. Clinical Journal of Sports Medicine 8(3): 187-194.
Nigg BM. 2001. The Role of Impact Forces and Foot Pronation: A New Paradigm. Clinical Journal of Sports Medicine 11: 2-9.
Lun V, Meeuwisee WH, Stergiou P, Stefanyshyn D. 2004. Relation between running injury and static lower limb alignment in recreational runners. British Journal of Sports Medicine 38: 576-580.
Hreljac A, Marshall RN, Hume PA. 2000. Evaluation of lower extremity overuse injury potential in runners. Medicine & Science in Sport & Exercise 32(9):1635-1641.
Viitasalo JT, Kvist M. 1983. Some biomechanical aspects of the foot and ankle in athletes with and without shin splints. American Journal of Sports Medicine 11(3): 125-30.
Hinterman B, Nigg BM. 1998. Pronation in Runners: Implications for Injuries. Sports Medicine 26(3): 169-176.
Nigg BM. Biomechanics of Sports Shoes. Calgary: Topline Printing Inc., 2010.
This article and especially your comments on your own PF troubles make for interesting reading. Thanks.
P.S. Paul Welford and Nicole, I’d love to read further responses from you to the blog, did you ever get around to reading the book Paul? Were you satisfied with the peer reviewed literature Nicole?
I have been researching shoes lately because i’ve been needing new shoes for my job and the shoes i’ve been wearing, Danners I believe, have pretty much fallen apart. I’ve had them for 5 or 6 years and for 4 of those have worn them every day at my job. I work in a warehouse (light products like shirts and garden stakes and such, so nothing really heavy) and I walk every day. Over time I have noticed that the insides of the soles of my shoes are worn down considerably while the outside has worn at a regular rate.
my feet would do what I guess the overpronation term suggests but i am also flatfooted. my feet tend to hurt into the heel, the ‘arch’ and sometimes up into the ball of my feet, even after getting up out of bed. Now i don’t know if there’s a separate underlying issue there with my feet or if the state of my shoes have caused the pain in my feet but I know I need new shoes. Christmas at my job is very fast paced and lately I haven’t been able to walk as quickly through the warehouse due to the pain, it really slows me down.
basically I was wondering what advice you had on what kind of shoe to get? I have been looking into the more athletic shoes, i know everyone at my job has them and don’t seem to have any problems on the hard concrete.
I’d recommend going to a running shop and having them take a look at your feet, try a few things on and see what feels best. Even if you don’t plan to run in the shoes, you will get better help at a running shop than at a big box or mall type store. If pain is a problem then seeing a doc might make sense – podiatrist might me a good first stop.
Hi Peter,
How do you know which shoe to buy then? Just according to comfort?
Thanks
Comfort while running and fit would be the two big ones.
Perhaps you should look up Ehlers-Danlos Syndrome, Marfan and other connective tissue conditions where real medical issues cause joints to be unable to hold up to the strain of weight bearing in normal usage. Then, you could rewrite your wholesale dismissal of the pronation issue and perhaps have a more informed take on the ignorance of the poor stupid medical professionals who request support for the feet of their patients.
You’re missing the point of the article I referenced, which was written by a medical professional. His point is that overpronation is not the diagnosis, it is a symptom. In your example, the diagnosis would be any of the conditions you mentioned, and excessive pronation would be the symptom. In fitting running shoes, all too often people are “diagnosed” as being overpronators based on questionable practices and the term is used to push shoe sales.
As someone that has been athletic all of my life and flat footed I have to disagree. Shoes that assist over pronating are a must. I am now 41 and can look back through my history and see signs of progressive injuries because I did not have shoes that corrected my foot position. When I was growing up there were no over-the-counter shoes to correct my feet. In high school I started getting shin splints that were aweful to the point that I had to take breaks from athletics.
I still exercised but no where near the level I used to. In college my ankles started clicking when I walked bearfoot and trying to run regularly gave me ankle pain and more shin splints. I went to physical therapy but that offered no success.
After college my achilles tendons started getting inflamed. I was very frustrated and dealt with these issues until my 30s when I discovered shoes that corrected my pronation. I was able to run three times a week with no issues. No shin splints and achilles tendon issues.
Keep in mind that I have never been a heel striker. So, I appreciate these shoes and am glad they are here.