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Lifestyle | Physical Therapy

A Runner’s Guide to Choosing the Right Footwear

Published September 6, 2021
By Health Loft

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The importance of choosing the right running shoes

Make sure you eat a healthy breakfast because it’s almost time to go running. But first, we need to pick the correct pair of running shoes. It is important to consider both the fit and function of a shoe rather than simply the look. The proper shoe can be the difference between enjoying your run or suffering an injury. Not only is the number of shoe choices overwhelming, it is a choice that we as runners have to make frequently. To avoid injury and preserve the ability for training shoes to function as they were designed, it is suggested that training shoes should be replaced every 300-500 miles. It has been shown that as many as 79% of all runners suffer at least one injury every year, which is why it is important to get a good foundation to reduce your chance of injury. Following these guidelines will help you put your best foot forward with each and every stride.

How to Pick the Correct Shoe size

Let’s start with the basics: you need to have the correct size shoe. In a recent narrative review, it was found that up to 72% of the participants were wearing shoes that were not appropriately fit. The fit of a shoe relates to the shoe accommodating the specific characteristics of an individual’s foot. To pick the correct size shoe, you need to first measure your foot accurately. This is commonly completed at the shoe store; however, as more people shop online, home measurements are becoming necessary.

Measuring Your Foot Length

To measure your foot, stand on a piece of paper while someone traces the outline of your foot. It is important to measure your foot while standing, as the foot will spread when loaded. Make sure to take your measurements at the end of the day, because it is normal for your feet to swell up to 1.5 shoe sizes bigger by the end of the day compared to when you first wake up. Once your foot is traced, measure the length of your foot, starting at the back of your heel and ending at the tip of your big toe. The proper length of a shoe should be this length plus 1⁄2 inch. This addition of 1⁄2 inch between the end of the shoe and your longest toe allows the required movement of your foot as you move into the pre-swing phase of the gait cycle. If you are one of the many people who have one foot that is larger than the other, it is best to buy a shoe that is slightly too large versus too small.5 Likewise, a larger shoe allows room for heel supports, arch supports, or other orthotics which may be needed to properly support your foot and facilitate proper running mechanics. If you already have shoe inserts you typically run with, bring these with you when you try on shoes. However, if your feet differ by 1 full size or more, it is recommended you buy 2 different size shoes. Some brands and websites offer this option without extra cost.

Measuring Your Foot Width

The next step is to measure the width through the ball of foot from side to side. This important and often overlooked step facilitates the widest part of the shoe to be aligned with the first MTP joint. The correct width shoe can prevent injuries. A shoe that is too narrow can lead to deformities of the foot such as bunions, hammer toes, as well as pain in the metatarsals from compression. On the other hand, if your shoe is too wide, this tends to lead to blisters and calluses. In an effort to counter width differences, womens shoes typically are sold in width sizes AA (narrow), B (standard), and D (wide), and men’s width sizes include B (narrow), D (standard), 2E (wide), and 4E (extra wide). This information is typically listed on the shoe box as well as on the tongue of the shoe. Proper shoe fit is especially important for women, as multiple studies have concluded women suffer foot pain at a higher rate than their male counterparts. In one study, it was found that 88% of women studied in America were wearing shoes that were too narrow for their feet, with the authors concluding that a “greater emphasis should be placed on both footwear fitting education… particularly in relation to foot width.” Once you have your measurements, simply look at a standard conversion chart to decide the appropriate size shoe.

Determining Your Foot Type

Next, you want to look at your foot type. The most common difference in people’s feet, aside from size, is the arch type. You can have a high arch (pes cavus), an average arch, or a flat foot (pes planus). To determine this, use the Wet Test. For this test, take a piece of colored paper or a brown paper bag and stand on it with a wet foot. Someone with an average arch will see about half of the arch outlined on the paper. If you see almost your entire footprint, you have a flat foot. In contrast, observing the heel and ball of your foot with line along the outside of the imprint represents a high arch foot. Another way to determine this is to look at an old pair of shoes. Overpronators (low arch feet) wear out the inner side and under pronators (high arch feet) wear out the outer side of the shoe. It is important to know this information so you can select the correct type of insole for your shoe to facilitate the functional demands of running.1

Shoe Sole Options

When selecting a running shoe, shock absorption is key, as repetitive weight bearing motions have been shown to lead to stress fractures. In fact, in a review of 320 athletes with stress fractures, runners displayed the highest prevalence of this serious injury. Specific designs allow you to modify how weight is transferred when you land on your feet, to reduce the risk of injury. Additionally, competitive runners need to be conscious of this, as they have been shown to have increased incidence of knee and hip osteoarthritis vs recreational runners. Proper running shoes mitigate the high force impact of the heel strike while running via shock absorption through the midsole. Midsoles are generally composed of ethylene vinyl acetate (EVA), polyurethane (PU), or combination of the two. Midsoles made of EVA are made up of thousands of foam bubbles, allowing shock absorption as air is pushed out of the bubbles. This material makes shoes lightweight and flexible; however, they wear out more quickly. In contrast, midsoles made of PU are heavier with increased rigidity, facilitating increased durability. Many shoes try to marry the two to make a sole created out of Placing the PU on the outside of the midsole for durability and EVA in the core facilitates light weight shock absorption runners require. This information can often be found on the tongue of the shoe or in the name, such as Asics EVAte 2. To maximize the benefit of the rebound capabilities of EVA, consider alternating between two pairs of shoes if you run every day. This will allow more time for the shoe to rebound from the repetitive compression of running daily. Research supports the use of shoe rotation to decrease the chance of heel/arch pain.

Different Types of Shoes

The proper shoe offers control and stability for the foot, which provides a mechanical advantage when running. The 3 main types of training shoes are stability shoes, motion control shoes, and cushioned shoes. Stability shoes are appropriate for most runners with average feet. Stability shoes deploy dual density midsoles with supportive medial posts to mildly limit how far the foot twists inward, and to support the foot. This type of shoe is best used with a runner with a normally arched foot or a lightweight runner whose foot tends to bend inwards a little more than it should. If you have a flat foot, mildly pronate(bend inwards), and are a heavier runner, or significantly overpronate, a motion control shoe is designed for you. A motion control shoe limits rearfoot and midfoot pronation by deploying firmer support medially and through the arch. It is common for frequent runners with flat feet to injure the deltoid ligament in the ankle, which increases the likelihood of stress fractures. In contrast, someone with a high arch wants a shoe with flexibility and a soft midsole that encourages the essential function of pronation. During pronation the arch collapses, allowing shock absorption. This is supported by a cushioned shoe. This cushioning is essential, as runners with a high arch have an increased incidence of 5th metatarsal stress fractures.

Specialty Shoes

One common mistake runners make during shoe selection is to purchase a cross training shoe; however, these shoes are not designed for high mileage running. While discussing shoe choice, it is worth mentioning that some runners are exploring the possible benefits of minimalist shoes. However, transitioning to minimalist shoes is associated with increased stress fractures and warrant further study prior to blanket recommendation.
Racing shoes are best tolerated by people without significant motion control problems, as racing shoes are built with lightweight flexible materials with minimal support. However, for most runners, this decrease in foot control is overshadowed by the benefit of having a lightweight flexible shoe, as adding weight to shoes increases oxygen consumption. Interestingly, soft soled flexible shoes have been shown to decrease oxygen consumption versus shoes with a firm cushioning system despite being the same weight. This will give you that edge that racing sometimes comes down to.

Now that you’ve picked the best shoe for you, don’t be afraid to run a few extra miles in them. How many extra miles should you run? Well, that’s a conversation for another article.

However, keep in mind that finding just the right shoe for you is just the beginning. Regular physical therapy for runners can help with general upkeep and maintenance of muscles and joints. Though the right shoe can significantly prevent damage to your ankles and even reduce impact on your leg muscles, it’s always a good idea to periodically check in with a physical therapist for runners, thereby saving you from avoidable injuries and discomfort.

For personalized treatments and check-ups from physical therapists for runners, consult with one of our physical therapists in Chicago, IL (virtually via our telehealth platform or in person) by calling us at (312) 374-5399 or by scheduling an appointment online. Remember to also check out our Facebook, Instagram, and Twitter pages for more fun facts and articles on nutrition, physical therapy, and exercise!

 

REFERENCES

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