With all the marketing hype around, you might be forgiven for thinking that footwear is the key to preventing running injuries. Especially now, with most runners at least aware of the “barefoot” craze, it’s becoming harder to know what is the right shoe. The “old” advice around finding the right shoe for a particular foot-type is slowly being tested, and the trend is towards a more lightweight, minimalistic running shoe.

This phenomenon is primarily due to Chris McDougall’s book, that I’m sure everyone has read or at least knows the context, and to a study published in the British Journal of Sports Medicine. There will likely many more studies popping up in the next couple of years to corroborate these findings, as this is a big shift in thinking around footwear and running.

The study, by Ryan et al., showed that matching the “correct” shoe to a foot type had no effect on injury rates in a group of 81 female runners. In fact, those that received the “correct” shoe were slightly more likely to get injured. I think it’s important not to take this conclusion too far, as this was a relatively small study and had some major limitations. It does, however, give some credence to the view that we need to reassess the way we professionals in sports medicine approach running footwear.

While a bit un-scientific, selecting a shoe based on comfort is probably our best bet at present. For example, a study on 206 military personnel, who were allowed to select a foot insert based on their feelings of comfort, showed a significant reduction in injury rates, even though the inserts often had no association with their “foot type” or what would normally have been considered the appropriate insert for their foot. If you have a specific injury, or history of injury, affecting your foot then a consultation with a good physiotherapist or sports podiatrist is probably appropriate.

Anyway, regardless of all this hype and innuendo, a far more important issue than footwear is how you manipulate your training variables. Some studies have suggested that up to 80% of overuse running injuries are attributable to training errors. How you build your training up—including mileage, terrain, speed, and frequency—is the most important single consideration in avoiding a running injury. Regardless of what shoes you wear, how you run, how tight your hamstrings are or how poor your core control, the body needs to adapt to new loads. If you haven’t run much before, or you’re ramping up in preparation for an event, how you choose to do this will be the major factor in determining success or injury.

The 3 keys to avoiding injuries:
1) Plan your event preparation, including the training variables of mileage, terrain, speed, frequency and, of course, the rate of increase in these variables. Discuss your plan with a sports medicine professional as well as a coach.

2) If you’re unsure on the footwear issue, discuss it with a professional. At present, research evidence suggests that you select a shoe that is comfortable for you, rather than one that has been “prescribed”. The way I address this is to give you a few options and suggest you go for a run around the store and select the one that feels the most comfortable.

3) Have a good biomechanical assessment – it’s a small investment in the overall scheme of things and will allow you to deal with pre-existing issues and risks, and help to prevent further problems.
…and it really is preventing an injury that is the key. Once an overuse running injury has occurred, it’s much harder to fix the problem and get you back on track.

What should be covered at the 3-month check up? This is probably the most critical point in preparing for an event. Identifying problems at this stage gives us the time and opportunity to fix the issue before it takes you out of training or results in a serious injury.

The key elements are:
• Discuss previous history of injury and any current niggles
• Assess weaknesses and areas of potential overuse injury
• Discuss your training plan and current fitness level
• Discuss your footwear
• Assess running mechanics using video analysis
• Establish a plan to avoid any potential injuries

At SSOP our expert physiotherapists can do a running analysis and provide advice & assessment for the very best outcome. Call us on 9252 5770 for more information, or visit our website www.sydneyphysiosolutions.com.au

Good Luck with the training.

Dr Brad McIntosh