Two weeks ago, I traveled from Little Rock to Austin, Texas to expand my knowledge on
evaluating and treating runners of all skill levels. This course covered a wide array of topics but in this blog post I will break down some quick tips on running shoes and common gait
impairments.
Shoe Types
With more advanced running shoes coming out on the market every year, runners are having a challenging time deciding on which running shoe to buy. The hot running topic being discussed today are between the “super” shoe and minimalist shoe.
1. Super shoes
• For those who are not familiar with these shoes, they contain a carbon fiber
plate embedded within the sole or cushion. Carbon fiber is a unique, light weight
material that can benefit runners by helping absorb some of the ground reaction
forces. This can help reduce some of the stress and strain on runner’s leg
muscles and bones. These shoes are designed for races and speed training,
which is one reason why these should not be worn as an everyday shoe such as
for school or work. Theses shoes are intended to help propel you forward onto
your toes to create better power and performance. One downside of these is the
cost, since some of these shoes go for close to $250+ a pair.
2. Minimalist shoes
• I am not well-informed on these shoes, but I think the intent of minimalist shoes
is to reduce excess cushion and provide a more natural barefoot experience to
the runner. Realistically, transitioning to this type of shoe takes time and should
be a gradual process. Unfortunately, overzealous runners are making the switch
too soon, which will likely increase their risk for injury since their body has not
had sufficient time to adapt to these ground reaction forces. Barefoot or
minimalist running has positively been shown throughout the literature to
improve intrinsic foot strength and stability, but I don’t believe they should
replace traditional more supportive running shoes. In our course, we discussed
the importance of rotating different running shoes throughout the week
depending on the type of workout and distance. I think it would be beneficial to
go to a school and practice barefoot running on either turf or grass, to gradually
improve foot strength, tissue resilience and stability. The costs for these shoes
vary depending on brand but consumers can expect to pay close to $100-180 a
pair.
When it comes to picking out running shoes, consult someone you trust that works in a running store. Fleet Feet is a prime example of a store that provides a wide array of shoes and will assess your foot pressure and arch support to help you find the right shoe. Try a pair on in the store first and make sure it feels comfortable and light, since you will be wearing these for awhile.
Gait Patterns/Mechanics
For this section, I will provide some tips on what to look for regarding kinematics and
how these can impact runners.
1. Hip/Pelvis Alignment
• A common movement fault in runners is a hip/pelvic drop typically seen on one
side when viewed from either the back or front. There are a few reasons this
may occur, with one being weakness in the gluteus medius muscle. This muscle
acts to maintain a level pelvis during stance phase, and when weakness is
evident, you will notice the pelvis drop below horizontal such as in the image
below. Another reason could be due to a leg length discrepancy which will cause
the runner to lean to one side in order to compensate.
2. Ankle Pronation/Collapsed Medial Arch
• The ankle joint is able to move into pronation and supination thanks to the congruency of its bony surfaces. One movement fault I observe in some runners is the ankle pronating excessively during heel strike into stance phase. We all have some degree of pronation at the ankle joint, but when this motion becomes excessive and rapid, risk of injury begins to rise. This is where shoe selection or orthotics can be useful to improve stability at the medial arch and ankle control.
3. Knee Valgus
• This term describes the alignment of the knee in relation to the pelvic and ankle.
Valgus refers to when the knee changes position to rotate inward towards the
opposite knee. In runners, this can lead to increased stress on internal knee
structures from an opposing lateral force. It is important to note, knee valgus is
not inherently bad. We may all have some degree of knee valgus while we run,
squat or jump, which can be normal. Some runners on the other hand exhibit
this in extremes, but if you don’t have the required strength and stability to
withstand these forces, then it can impair performance and lead to injury. This
picture below depicts an example of knee valgus.
Key Takeaways:
- Rotate different running shoes throughout training and race season.
- Select a running shoe that feels comfortable but also is compatible with your
foot arch and pressure.
- Lower limb kinematics while running can affect performance and even lead
to potential risk of injury, but there are some slight variances that are not
inherently detrimental depending on your strength and experience level.
- As medical professionals, our intent is not to directly change someone’s
running technique, but instead provide useful cues or exercise interventions
that will improve overall performance and reduce likelihood of injury.
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