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June 18, 2013 by TAMMY McKENZIE
Busting The Myths - You Don't Need Any Special Kind of Shoes To Start Running

Sales personnel at various specialty sport and footwear retailers are fairly convincing when they advise us that we need a specific type of shoe to assist us in our physical activity endeavors. Even many chiropractors will encourage the use of orthotics before running to mitigate what they perceive as flaws in our natural gate. The reality is, if you're healthy and plan to start running, despite any kind of tendencies to over- or underpronate, it is perfectly all right to put on a pair of completely ordinary ‘neutral’ running shoes without any special support, according to research conducted at Aarhus University.

This is the result of a study which has just been published in the British Journal of Sports Medicine under the title “Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe”.

Running shoes, decked out with the latest cushioning, motion control and arch support technologies, may not be as beneficial to your feet and joints as you might think.

Many running shoes, at least the kind currently on the market, may actually put more of a strain on your ankles and joints than if you were to run barefoot or in neutral shoes and the increased pressure could lead to knee, hip and ankle damage.

Wearing Anything Specialized On Your Feet Alters Normal Form And Function Of The Foot

A habitually shod lifestyle has consequences for the biologically normal anatomy and function of the foot.

Kristiaan D’Aout and Peter Aerts from the Biology Department at the University of Antwerp collaborated for their work on the biomechanics of barefoot walking with Dirk De Clercq (University of Gent, Belgium) and with Todd Pataky (University of Liverpool, UK).

This team made the first detailed analysis of foot function in people who have never worn shoes. For this project, they travelled to South India, where many people walk barefoot throughout life, mostly for spiritual or financial reasons.

In this way, the researchers wanted to gain an insight into the biologically normal function of the foot, which evolved for millions of years - unshod.

The research was funded by the Fund for Scientific Research - Flanders, and was based on dynamic measurements of pressure distribution under to foot sole during walking. It showed that he foot of habitual barefoot walkers differs, both in shape and in function, from that of habitually shod peers.

Barefooters have a relatively wide forefoot and manage at better distributing pressures over the entire surface of the foot sole, resulting in lower (and most likely favourable) peak pressures. As such, the fundamental scientific results are also important for clinicians and for the design of quality footwear, which should not hamper the foot’s biologically normal function.

But you don't have to go barefoot while running. Neutral shoes will do just fine.

Healthy runners monitored for 12 months

Researchers have followed 927 healthy novice runners with different pronation types for a full year. All study participants received the same model of neutral running shoe, regardless of whether they had neutral foot pronation or not. During the study period, 252 people suffered an injury, and the runners ran a total of 163,401 km.

“We have now compared runners with neutral foot pronation with the runners who pronate to varying degrees, and our findings suggest that overpronating runners do not have a higher risk of injury than anyone else,” says physiotherapist and PhD student Rasmus Nielsen from Aarhus University, who has conducted the study together with a team of researchers from Aarhus University, Aarhus University Hospital, Aalborg University Hospital and the Netherlands.

“This is a controversial finding as it has been assumed for many years that it is injurious to run in shoes without the necessary support if you over/underpronate,” he says. Rasmus Nielsen emphasizes that the study has not looked at what happens when you run in a pair of non-neutral shoes, and what runners should consider with respect to pronation and choice of shoe once they have already suffered a running injury.

Orthotics Are Not The Answer

Other support systems besides the foot itself will aggrevate this problem for many. When you remove the primary support system of the foot and use supportive devices instead, everything relating the lower body joints becomes weak. This includes the ankle, knee, hip and even lower back.

It affects everything. What essentially occurs when you use supportive devices such as cushioned footwear and orthotics is that you interfere with the normal neural processing that is meant to occur between the point of impact and propulsion. This dramatically and detrimentally affects the natural development of the joints and their strength. If we compare the joint and muscle strength of feet and ankles of those in developed societies to those in underdeveloped societies such as in Africa, there is a substantial difference in the development of these joints and muscles.

One of the problems with using performance footwear is that once they’re out of the support, they don’t necessarily use their foot correctly to initiate a lot of the basic movements, including walking for that matter. So they run into an issue where they don’t really use the foot and they’re more from-the-knee-up dominant versus athletes such as distance runners or recreational runners.

They have a tendency to just use the foot passively in the sense that it’s there just to make contact and you just are going through the motions with your legs. The foot actually has an integral part to a toe-off which most people won’t use. And sometimes shoe wear and potentially orthotics can actually hamper that dysfunction.

The whole scenario whether it be a weight belt, orthotics, or potentially certain types of footwear, is that our body is meant to respond to a stimulus, a change if you will, and that change or stimulus has a threshold for stimulating the body. Once you’ve reached that threshold, which in each person is a slightly different, the body decides to shut off because it knows that something else is doing the work and many times that’s where people run into problems. That dependence now becomes or supersedes a lot of what they’re doing in their training or daily lives. It becomes a crutch that does not address the root causes of dysfunction in gait, muscle strength ratios and other biomechanical deficits. The well-intentioned use of orthotics may actually backfire for a large percentage of the population.

Focus on other risk factors

Three-quarters of runners who wear shoes land squarely on their heels -- about 1,000 times for every mile run. But even well-cushioned sports shoes attempt to address pronation or help distribute weight across the foot cannot fully absorb the shock of these blows: 30 to 75 per cent of regular runners each year suffer repetitive stress injuries so it's time to focus on other risk factors besides pronation.

The researchers are now predicting that in future we will stop regarding foot pronation as a major risk factor in connection with running injuries among healthy novice runners.

Instead, they suggest that beginners should consider other factors such as overweight, training volume and old injuries to avoid running injuries.

“However, we still need to research the extent to which feet with extreme pronation are subject to a greater risk of running injury than feet with normal pronation,” says Rasmus Nielsen.

Three key results

In the British Journal of Sports Medicine, the researchers point to three key results:

  • The study contradicts the current assumption that over/underpronation in the foot leads to an increased risk of running injury if you run in a neutral pair of running shoes.
  • The study shows that the risk of injury was the same for runners after the first 250 km, irrespective of their pronation type.
  • The study shows that the number of injuries per 1,000 km of running was significantly lower among runners who over/underpronate than among those with neutral foot pronation.

Tammy McKenzie
is a certified personal trainer and fitness specialist with a speciality in women's fitness.

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