Do High Tech Running Shoes Work?

All you readers out there be ready for some shocking news from a study published in the latest issue of the British Journal Of Sports Medicine. I think all the shoe companies out there will not be too impressed with this paper with regards to their technical running shoes.

The researchers reviewed results since 1950 from controlled clinical trials and systematic reviews (the two highest levels in terms of quality with regards to research papers).

Their aim - to investigate if running shoes with highly cushioned heels or pronation controlled systems depending on the wearers foot type had any effect on running injury rates, risk of osteoarthritis, overall well being and of course running performance.

First let's review some background information. American Frank Shorter won the marathon Olympic gold medal on September 10, 1972. It is believed that his victory ushered the start of the American running boom where millions of Americans took up running leading to a huge surge in running shoes being sold. This of course led to an explosion of a vast shoe industry.

Since the 1980's, the heels of running shoes are heavily cushioned and/or have features to control subtalar joint (also known as talocalcaneal joint; where the talus meet the calcaneus) motion. Prescribing such shoes along with orthotics are considered the gold standard for injury prevention. Depending on your foot type, overpronators, mild pronators and supinators are prescribed motion control, stability and cushioned shoes respectively.

The use of cushioning in running shoes are based on the following assumptions (1) impact forces while running is a significant cause of injury. (2) running on hard surfaces causes high impact forces. (3) a cushioned shoe reduces impact forces. (4) cushioning itself to cause injury is minimal.

Evidenced based facts (1) weak evidence to show that running on hard surfaces increases impact forces or injury rates. (2) weak or poor evidence to show that cushioning reduces impact forces or injury rates. (3) diminished proprioception (joint position sense) is a significant side effect of heavily cushioned shoes. (4) reduced ability to monitor impact and foot position carries a significant risk of harm.

Assumptions based on the use of pronation control systems (or motion control shoes) (1) helps to normalize subtalar joint motion in the foot. (2) overpronation linked to overuse injuries. (3) limiting pronation will minimize this risk of overuse injuries. (4) montion control shoes are effective in reducing injuries via this approach.

The evidenced based facts (1) subtalar joint motion or foot types are not consistently associated with runners' injury rates. (2) both motion control and cushioning shoes are relatively ineffective and unreliable in changing subtalar joint motion. (3) both motion control and cushioning shoes causes both small and inconsistent changes in subtalar joint alignment.

In addition it is suggested by shoe companies that raising the heel of a running shoe can minimize Achilles tendon strain and thus reduce Achilles tendon injuries. However the researchers found mixed results with this. In fact since the introduction of shoes with cushioned heels and pronation controlled systems, there has been in increase in Achilles tendon injuries rather a reduction.

Evidence also shows that foot placement on ground with the heel elevated causes the foot to be in a position of poor proprioception (or joint position sense). Read increase in injury as a result. Current levels of heel height in running shoes also been noted to increase pronation.

The researchers found no proof that high-tech running shoes reduce running injury rates, risk of osteoarthritis and overall well being. What about improving running performance? None as well!

The researchers mentioned that sports medicine professionals and not advertising was to blame for this myth regarding high tech running shoes. Why you may wonder? Sports Medicine Australia (SMA), the New Zealand Society of Podiatrists (PNZ) and the International Federation of Sports Medicine (FIMS) all have been endorsing shoes by ASICS despite no credible evidence was the reason given by the researchers. Also mentioned, these footwear recommendations made by SMA, PNZ and FIMS are as part of sponsorship arrangements with ASICS.

Well, here you go, not quite what you expected I'm sure. In my next post, I will discuss what we at Physio and Sports Solutions have been doing with regards to running for the past two years. Yes, we have actually not done what others have been doing with regards to running and running shoe selection. Now we have the evidence to back us up as well. Stay tuned.

Please email me if you want this article.

Reference
CE Richards, PJ Magnin and R Callister. (2009). Is Your Prescription Of Distance Running Shoe Evidenced Based. British Journal Of Sports Medicine. 43(3) pg 159-162.