Feature Article:::...

Running shoes an investment in health of foot

By: Greg Cross, PT

Running-related injuries are among the most common reasons for primary-care sports visits. The proper type of shoe can make a big difference in prevention of running-related problems.

Multiple studies have demonstrated that well-designed and properly fitted running shoes reduce the number of overuse injuries, yet about 40 percent to 70 percent of the more than 30 million American runners develop injuries each year.

During the normal gait cycle of running, the foot allows the leg and hip to accept vertical impact forces when the heel strikes the ground. The foot must then dissipate these forces, equally, across the mid-foot to the toes.

If a runner has an abnormality in his or her foot motion (usually referred to as excessive supination or pronation) then it can throw the smooth gait mechanism “out of whack.”

This can lead to problems such as pain and soreness in the back, hip, knee or foot. If it becomes excessive, it can lead to multiple types of problems. Common running injuries that can occur are Achilles tendonitis, plantar fasciitis, posterior tibialis tendinitis (commonly referred to as shin splints), anterior knee pain and stress fractures.

Therefore, the selection of the correct type of running shoe can be very important when it comes to the prevention of common running-related discomforts or injuries.

The “general anatomy” of the running shoe is made up of four components: the upper, the midsole, the last and the outsole.

UPPER: The main parts of the upper are the toe box, tongue, midsole, lacing system and the heel counter. The upper is usually constructed from a combination of lightweight nylon mesh and synthetic materials that are flexible and breathable, but also durable for daily wear.

MIDSOLE: Most of the cushion, stability and motion control is provided by the midsole (the most important part of the running shoe) Midsole materials vary from company to company but are usually composed of ethyl vinyl acetate (EVA) and polyurethanes. Some companies use air or gel units for shock absorption. Midsole components offer different densities of materials that help control or allow motion depending on the foot type of a runner.

LAST: The last refers to the shoe’s curvature (best observed from looking at the bottom of the shoe) There are three main last types: Curved last for high arch foot, Semi curved last for the neutral type of foot (moderate arch) and straight last, for the low arched foot.

OUTSOLE: The part of the shoe that contacts the ground is called the outsole. It is usually made of carbon rubber, blown rubber or a combination of both materials. The outsole usually far outlasts the midsole lifespan.

Running shoes are also divided into four main categories: stability shoe, motion control shoe, cushioned shoe and lightweight shoe.

Stability shoes have a combination of cushioning and medial support. They generally have a semi-curved last and provide extra support for runners who overpronate. They are usually best-suited for the runner who has medium to low arches.

Motion-control shoes are the most rigid support of all the running shoes. They are primarily designed for the heavier runner with a very flat foot that overpronates. They have a straight last and offer maximum support.

Cushioned shoes have the most flexibility. They have a curved last and are geared toward the runner with a high arched foot. (Don’t let the word be misleading in that all running shoes have a certain amount of cushioning.)

Lightweight shoes are designed for people who have neutral arches and do a lot of fast-paced training. Most joggers and runners don’t need this type of shoe.

Generally, shoes should be replaced every 400 to 600 miles. Even new shoes that have not been worn for one or two years should be replaced since they can lose some of their shock-absorbing capabilities depending on where and the temperature they were stored.

Running shoe tips

Buy shoes that are appropriate for your foot type. Don’t buy them because of the color, look, friend recommendation or cost. If you plan on running regularly then your shoes are your best and biggest investment.

Always be fitted for running shoes in the evening. Feet are larger at the end of the day. There should be a half inch between the longest toe and the end of the toe box.

Wear the type of socks you normally wear to run in when trying on shoes for a proper fit.

If you wear shoe inserts (arch supports or orthotics) bring them along when trying on new shoes.

Take a test run at the store before purchasing to make sure they feel good and fit correctly.

If they don’t feel good then don’t buy them. Running shoes do not need to be “broken in” to be comfortable.

Wear running shoes only for running. Wearing them for work and other sports may cause a break down in the cushioning or control of the shoe.

Don’t wash running shoes in the clothes washer. This will deform their shape.

Exposure to excessive heat will degrade the components of the shoe. Let them dry naturally after becoming wet.

The most expensive shoes are not necessarily the best shoe for you. Most good running shoes will cost between $70 and $120.

If you are experiencing pain or soreness with running, please consult your family physician. If indicated, she or he may refer you to a physical therapist knowledgeable about running injuries for a proper musculoskeletal examination and a treadmill gait evaluation.

A proper step-by-step examination and running shoe prescription may help you to return to pain-free running or assist in preventing further complication or injury.

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Greg Cross, PT, is the director of outpatient rehabilitation at Wellmont Holston Valley Hospital.