Comments on: Shoes Matter: Running Shoes Can Contribute to Injury

By: Pete Larson

Pete Larson — Tue, 30 Nov -0001 00:00:00 +0000

What's interesting is that you could replace "orthotics" with "running shoes" in every instance in your response and it would be just as accurate :)

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By: Matt Phillips

Matt Phillips — Tue, 30 Nov -0001 00:00:00 +0000

Nicely written article as always Pete.
Another factor that I suggest plays an important part in trainer choice is your level of proprioception.
For people with heightened proprioception (be it through specific stability training or otherwise), stability tends to improve when no shoe is worn as the sole of your foot feeds back information to the brain, increasing agility, balance & control. For these people, it figures that a minimilistic shoe will encourage such natural feedback and allow the body to react accordingly to terrain and incline changes. However, if you have low proprioceptive skills, feedback will not be facilitated by a more minimalistic trainer, you won't be able to manage the ground strike forces, and chances are you will injure yourself.
Conclusion: Your choice of trainer will depend on your proprioceptive skills. Develop these (alongside suitable flexibility & strengthening conditioning) and you could feasibly start to benefit from your body's natural ability to handle ground forces.
I'd suggest we modify #formbeforefootwear to #proprioceptionbeforeformbeforefootwear, but I fear that would leave us little room for much else!

By: John L

John L — Tue, 30 Nov -0001 00:00:00 +0000

The statement that "shoes don't cause injuries, running does" is as meaningless as the slogan "guns don't kill people, people do". I'm pretty confident that anyone who has been running for more than a few years will tell you that running in the wrong shoe can definitely cause injuries. Sometimes after only a single run in them.

Not that the shoe itself directly inflames tendons, tears muscles or fractures bones, but the wrong shoe can cause subtle gait changes that ultimately lead to repetitive stress injuries. Traditional running shoes are a great example. The elevated heels, lack of road feel and arch supports can encourage heel striking, over-striding and long term foot weakness in some runners, eventually leading to a variety of injuries. So yes, it's form. And yes, shoes affect form.

It seems illogical that the industry would deny this. Since the whole reason cushioned, pronation controlling support shoes exist is to alter form to minimize injuries isn't it logical to assume that a shoe with the wrong features can alter form to cause them? You can't have it both ways.

By: Christopher Babb

Christopher Babb — Tue, 30 Nov -0001 00:00:00 +0000

I really like the way you are looking at this Pete. Form matters but as soon as we change the circumstances in which our body hits the ground we have to evaluate those circumstances (shoes) for possibly being the cause of injury. If we all ran barefoot then yes, form would be the predominant factor related to subsequent injuries. Once we put shoes on that all changes. I also agree that we shouldn't give shoe manufacturers a free ride but there are many other factors related to injuries that are often over looked. Diet, sleep quality, stress level, and mental attitude are just some of the things that come to mind for me. I look forward to reading more of your posts of this topic in the future.

By: Steven Sashen

Steven Sashen — Tue, 30 Nov -0001 00:00:00 +0000

In reply to packrats999.

Packrats... see http://www.nytimes.com/2011/01... for some insight into your question.

Orthotics sometimes work for some people, but even after decades of research and billions of dollars spent by consumers, there's no clear understanding of who will get benefit from what type of device.

In other words, orthotics, by some, are considered no better than a placebo (i.e. a generic Dr. Scholl's might perform no better than a custom-fitted $500 insole). And those same people resent the cost of an unreliable "solution."

There are others who have different objections (some biomechanical, some philosophical, some anecdotal) to orthotics. I'm trust that I don't have to point you to their arguments ;-)

By: Steven Sashen

Steven Sashen — Tue, 30 Nov -0001 00:00:00 +0000

The idea that you, admittedly, didn't touch upon is the one that's least recognized and, I would argue, most dangerous. At the Monfort Human Performance Lab, former USOC doc, Bill Sands, has you run in every pair of shoes you own, video taping you at 500 frames/second. When you look at your running in each different show, it's sometimes shocking to see how much your gait is affected by the shoe itself.

And there are MANY more design factors other than heel drop that make the difference.

Another realization that hits you when you see the dramatic variance that shoes make is: Orthotics are bullshit!

More specifically, it becomes clear that the same orthotic in different shoes creates a different effect. If you were going to wear orthotics (and that's a topic *I* won't touch upon here), you would need a different pair for each pair of shoes you own... and, ideally, they would need to be made based on how each shoe affects your MOVEMENT, not how you stand on the ground.

By: Dan H

Dan H — Tue, 30 Nov -0001 00:00:00 +0000

"So my point here is that although form seems to be king these days,
let’s not forget about footwear (and I haven’t even touched here on the
fact that footwear can influence form)"

This. Footwear influences how your foot lands, how it flexes and transitions, which is part of form. Some runners may be able to run in anything, but not all of us, and certainly not I.

By: longrunningfool

longrunningfool — Tue, 30 Nov -0001 00:00:00 +0000

Very good article. I just got done helping coach a junior high xc team - 4 girls, 7 boys - and we made it through the season with zero injuries.

The first day of practice we started working with the kids to try and get them into the right kind of shoes for them. I run in everything from barefoot to "performance stability" shoes depending on the type of running I do and where. We also emphasized form from the first practice- not over-striding, getting up to the mid-foot for foot strike, how to run up and down a hill properly and a dozen other little things.

The point was that we didn't focus on a single issue to prevent injury but took a global view of the process especially since most of the kids were beginning runners with no idea of good form. About half of them were in the "all knees and elbows" phase of junior high growth too which adds in almost daily adjustments for the growth spurts.

Not every child will be the next Pre or Paula but we want them to run for a lifetime and they need to enjoy it for that to happen. You can't enjoy running if you're injured.

By: packrats999

packrats999 — Tue, 30 Nov -0001 00:00:00 +0000

In reply to Steven Sashen.

Steven, It's interesting how two people can read the same article and each thinks it supports their point of view. The NYT article, to me, further reinforces the idea that orthotics are a tool just like anything else. Some don't need the tool and run barefoot. Others like myself find them useful for a specific purpose, and so on. I also agree with what Pete said about replacing the term, "orthotics" with "running shoes" and be just as accurate. You could take it even further and replace "running shoes" with "cross training" or "12 x 400m track intervals at 2000-meter race pace" for that matter. There are people who tell me that I should stop running because it will kill my knees. Just like those who argue against orthotics, they are entitled to their opinion.

By: Pete Larson

Pete Larson — Tue, 30 Nov -0001 00:00:00 +0000

In reply to longrunningfool.

Sounds like a great approach, and no injuries is fantastic!

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Pete Larson's Web Links:
My book: Tread Lightly - http://ow.ly/bdUO0
Blog: https://runblogger.com
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By: Halen Kinzel Gori

Halen Kinzel Gori — Tue, 30 Nov -0001 00:00:00 +0000

I enjoyed reading this very much and I like the neutral stance you took while writing. Shoe selection is definitely specific to each runner but having someone properly educate the runner about what they should be looking for (positive and negative) in a shoe, an overview of running shoe terminology, an educated look at their foot mechanics and tendancies, is an important piece. Hopefully, the person fitting the runner with shoes is as knowledgable and unbiased as you are and can put runners in shoes that fit their individual mechanics acurately.

By: Pete Larson

Pete Larson — Tue, 30 Nov -0001 00:00:00 +0000

In reply to Gabe.

Sounds a lot like the experience of Deacon Patrick, who I've come to know via a forum we both are active on: http://www.mindyourheadcoop.or...
He has severe vertigo but has found that he can run by going barefoot, pretty amazing!

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Pete Larson's Web Links:
My book: Tread Lightly - http://ow.ly/bdUO0
Blog: https://runblogger.com
Twitter: http://twitter.com/oblinkin
Facebook: https://www.facebook.com/Runbl...