Thursday, July 23, 2009

Do Running Shoe Types Reduce Injury? How about No. But what about No Sneakers?

Ok, in a sort of inverse correlation here as to one more reasons why running shoes suck, and that freeing your feet is a Good Idea - and that thin soled shoes like vibram five fingers may be much better for improving your resistance to injury, this relatively just in.

A new prospective study shows that when a running shoe store recommends a specific type of trainer for you, based on your foot type (you may stand on a type of light box or do a "wet test" for foot print, to be told based on your arch the kind of shoe you need), that is supposed to be more helpful to your stride etc etc, injury levels do not seem to be decreased.

Journal of Strength and Conditioning Research:
May 2009 - Volume 23 - Issue 3 - pp 685-697
doi: 10.1519/JSC.0b013e3181a0fc63
Original Research

Injury Reduction Effectiveness of Selecting Running Shoes Based on Plantar Shape

Knapik, Joseph J; Swedler, David I; Grier, Tyson L; Hauret, Keith G; Bullock, Steven H; Williams, Kelly W; Darakjy, Salima S; Lester, Mark E; Tobler, Steven K; Jones, Bruce H

Collapse Box

Abstract

Knapik, JJ, Swedler, DI, Grier, TL, Hauret, KG, Bullock, SH, Williams, KW, Darakjy, SS, Lester, ME, Tobler, SK, and Jones, BH. Injury reduction effectiveness of selecting running shoes based on plantar shape. J Strength Cond Res 23(3): 685-697, 2009-Popular running magazines and running shoe companies suggest that imprints of the bottom of the feet (plantar shape) can be used as an indication of the height of the medial longitudinal foot arch and that this can be used to select individually appropriate types of running shoes. This study examined whether or not this selection technique influenced injury risk during United States Army Basic Combat Training (BCT). After foot examinations, BCT recruits in an experimental group (E: n = 1,079 men and 451 women) selected motion control, stability, or cushioned shoes for plantar shapes judged to represent low, medium, or high foot arches, respectively. A control group (C: n = 1,068 men and 464 women) received a stability shoe regardless of plantar shape. Injuries during BCT were determined from outpatient medical records. Other previously known injury risk factors (e.g., age, fitness, and smoking) were obtained from a questionnaire and existing databases. Multivariate Cox regression controlling for other injury risk factors showed little difference in injury risk between the E and C groups among men (risk ratio (E/C) = 1.01; 95% confidence interval = 0.88-1.16; p = 0.87) or women (risk ratio (E/C) = 1.07; 95% confidence interval = 0.91-1.25; p = 0.44). In practical application, this prospective study demonstrated that selecting shoes based on plantar shape had little influence on injury risk in BCT. Thus, if the goal is injury prevention, this selection technique is not necessary in BCT.

The cool thing in the study is that it had a high no. of participants and a goodly fix of stats and it was able to look at stats for a standard set of tasks, Basic Combat Training (BCT).

What was found to influence injury? Suprise surprise: general fitness.
The present study found a number of risk factors that
confirmed previous work in BCT. Higher injury risk pro-
gressively increased with progressively lower aerobic fitness,
lower muscular endurance, older age, less physical activity,
and more cigarette smoking, similar to results in much of the
BCT literature (1,9,14,16,22,28,29,37,41,43).
So next time a buddy says they're getting a particular kind of "stabilization" shoe to help so they don't ankle roll or whatever, they may want to consider these results.

Indeed, what this study did not look at, intriguingly, is what would happen if INSTEAD of using sneakers of any kind, thin soled shoes like tiger Tai Chi's or similar were used. In other words, all other things being equal, would the promises of proprioceptive joy offered by the less is more approach to foot wear, where the twist test of a shoe means more joint mobilization in the foot, more proprioceptive signals shot out to the brain to judge where we are in space, could actually improve injury reduction? My *guess* would be, based on folks's reports of feeling better in less foot wear, that going the other way - out of cushy soles of any kind - just might.

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4 comments:

Franz Snideman said...

MC,

You are a TRUE scientist! You are one of few people who studies, reads and explains research.

Great post!

dr. m.c. said...

Franz, you are a true gentle man. Thank you for dropping by. Hope you'll consider doing a piece on your blog on how you discovered ropes and why you love 'em

mc

kamal singh said...

MC,

I have "collapsing arches" in both feet. The right has it more than the left which I believe has led to PFPS (a catch all term) in my right knee. My PT has figured that the "collapsing arch" is structural and not functional. He recommends that I wear some kind of arch support either off the shelf like the ones from Scholl's or custom orthotics. Do you think wearing less of support aka thin sole shoes would be better for me.

Thanks

dr. m.c. said...

kamal - where are you? get thee to a z-health person to look at your movement overall.

Without seeing you it wouldn't be right to say "do x"

generally speaking, does running barefoot in the grass bother you in any way?

and second, have you considered z-health drills at all, just for general well-beingness in all your movements?

and finally,

most of the photos of folks who have never had shoes on (hard to find) have pretty wide "flat" feet.

mc

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