Our last blog in this 'Running' series is left in my capable hands. It's a case of aiming to demystify running shoes for you all.
Shoes these days are as clear as mud to the general public, and unfortunately many clinicians never analyse the effect of the running shoe on the ankle, hip, knee and back.
Working in a profession that involves footwear I see it/ hear it everyday and when I ask this question to patients. "Why are you wearing those running shoes?"
The generic answer is;
“To give me support”
“control rolling in of my foot”
Shoes are an extremely powerful product that can cause damage from the moment you put them on, the structural changes they cause through the foot can be mind blowing.
First of all, supportive shoes cause the foot strike to occur further away from the centre of gravity, this causes a series of ground reaction forces as a result!
The foot starts to lock up, and then it’s a progressive wear and tear process moving further up the chain. Leading to locking of foot and ankle, leading to knee instability, poor hip control, onset of trendelanburg sign (sway hips), and further compensation of the thoracic/ arm swing.
Neutral vs. Supportive Shoes
Neutral shoes – Allows us to move our foot in a natural way.
Neutral shoes have no added support and they allow the foot to do what it needs to do through the gait cycle - Pronation to Supination. This allows the natural force transition through the foot over a greater amount of time, leading to force dispersion and the ability for the knee and hip to have enough time to operate and control their home joints.
Stability shoes – Have support in the inside of the shoe to prevent pronation.
Stability shoes do not allow for ideal forefoot pronation with running. This causes foot lock, and therefore does not allow the foot to move during the impact phase, causing a reaction force quickly up the chain, where the knee and hip often doesn't have time to operate and control their respective areas.
This leads to decrease in power and performance not only in the short term but long term. In addition to causing lower leg, knee, hip and back issues over time.
You can read below for issues that are commonly caused by this affect on the foot and ankle due to supportive shoes and the gait cycle.
So things to look out for with Stability Shoes
1. Wearing down of the outside of shoe
2. Early onset of Locking of the foot
3. Increase lateral (outside) tissue stress
4. Outside calf pain
5. Outside knee pain
6. ITB syndrome
7. Lower back pain
8. Upper thoracic tightening
9. Gait compensation
10. Musculoskeletal stress through out the body
What do I prefer as a Sports Podiatrist?
Firm neutral shoes and why.
I have noticed a massive difference when I personally made the transition from supportive shoes.
I personally lost 80-90% of the secondary symptoms I was facing regularly with running and since being a practitioner for the last six years its nice to see a strong result of patients transitioning across to firm neutrals.
They know the positive outcomes!
Here's a recent review from a client to prove I'm not spinning you a web.
"Pep is a fantastic podiatrist with an extensive knowledge of biomechanics. Before being treated by Pep, I was experiencing pain in my knees and feet, and as a result I struggled to run for more than 100 metres. Pep quickly diagnosed my problems and developed an exercise program to strengthen key muscles that had not been activating due to my reliance on anti-pronation shoes for several years. I was amazed at my rapid progress after seeing Pep for only a few short weeks.
I am now pain free (without requiring supportive shoes or orthotics) and am regularly doing 5 km runs. I have also been able to significantly progress other aspects of my strength training. I really appreciated that Pep thoroughly explained everything along the way so that I can continue to be pain free in the future. I would highly recommend Pep and the Evolutio team!"
Pep is the Sports Podiatrist at Evolutio and is one of the most sought after Podiatrists in Melbourne after working with the New Zealand All Blacks. He currently operates out of our South Yarra clinic on Mondays, Wednesdays and Saturday mornings and Kew tuesday/friday.