ACTIVE CARE

Have you been a subject of foot discrimination?  Relegated to the “supportive” section of the shoe store?  Those who over-pronate or have “flat feet” have suffered from an injury prejudice that has stemmed from the belief that this foot type predisposes one to a variety of orthopedic problems.  It has been deemed such a structural defect that flat feet can disqualify one from military service.

Of course, pronation is a natural part of every running stride.  When the foot hits the ground it flattens and rolls inward or pronates as a means to partially absorb the force of the foot striking the ground.  In the past, scientists and medical professionals have been concerned with over or under-pronation during the running stride and have long believed that those groups are at higher risk of injury.

Taking the lead from this firmly held belief, the athletic shoe industry has been built on the premise that every shape of foot needs a specific shoe.  Generally these three types of shoe are the “cushioned” shoe for the high arched or under-pronated, “stability” for the neutral foot and the “motion-control” shoe for the more severely flat-footed or over-pronated.

But despite this conventional wisdom, and best efforts of the salesperson at the running shoe store, new science may liberate your shoe choices.

In a recent study published in the British Journal of Sports Medicine, novice runners with flat feet or high arched feet didn’t suffer from any greater rate of injury when they ran in a neutral shoe rather than a motion-control or cushioned shoe matched to their foot type.

In the study, researchers followed nearly a thousand novice runners with different foot types for a year.  Every participant in the study received the same neutral shoe, regardless of foot type, and a GPS monitor to track mileage.  The volunteers were able to run as much as they wanted and at whatever speed they wished.

The group of runners ended up covering over 200,000 miles over the one-year study period and suffered from 300 injuries. While nearly a third of the runners in the study suffered from an injury during the year, the study concluded that, “foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe.”  Contrary to widely held belief, the over or under pronators didn’t didn’t suffer from an increased rate of injury.  Notably, for those participants that amassed more than 600 miles of running, the neutral footed runners actually experienced more injuries than those with flat or highly arched feet.

This well designed out study supports earlier evidence reported in the same journal in which female runners were randomly assigned a neutral, cushioned or motion control shoe before commencing a 13-week half-marathon training program.  Surprisingly, those that wore the motion control shoe experienced the greatest number of injuries and runners of all foot types reported the greatest level of discomfort with the ultra-supportive shoe.

Additionally, a recent review study in the journal Gait and Posture concluded that flat feet were not associated with any increase in injury rate other than a mild association with flat feet and shin splints. In fact, several studies in the review suggested that flat feet might be protective against the development of lower-leg stress fractures.

Now while those with a history of leg or hip injury may need more support, those that don’t have any problems shouldn’t rush to buy a heavily supportive shoe based solely on foot type.  Comfort and fit are important factors and given the above research findings, should perhaps be given greater emphasis when choosing a running shoe.

Researchers now suggest that beginning runners put greater focus on those factors that seem to have a greater association with running injury, such as body mass, training volume and any history of previous injury.