The Right Running Shoe: An Experiment of One
If there’s anything to take away from the constantly changing landscape of the running shoe is that there is no “one size fits all”. For every publication that advocates minimalist and forefoot striking, there is another that supports the other side. The anatomy of your shoe should generally align with your foot strike (although I am less concerned about foot strike for and more about stride length) and you should understand why you’re going with one option vs the other, but the most important thing to understand is that this is really an ever-changing experiment of 1 and your comfort is the most important factor.
The Minimalist/Forefoot Strike Argument
Advocates for this style of running base their stance on evolution. The idea being that we evolved to run barefoot, and until the development of the modern running shoe, that’s what we did. Take a heel striker out of their 10mm drop shoes and remove the cushioning and they’ll land on the ball of their foot and vice versa. They'll debate that a light and flexible shoe allows for normal joint kinematics of the foot and ankle during ground contact (normal pronation into resupination). It’s well documented that forefoot runners land on average about 50% lighter than heel strikers. Less cumulative load over thousands of steps over the course of a run is likely connected to reduced rate of injury.
The Counter Argument
Zero drop and increased loading to calf could increase risk of Achilles injury or other pathology of the foot like metatarsal bone stress injury.
Feet with excessive midfoot pronation have to be controlled with some support structure
Might be more difficult for older athletes who have spent many years in a supportive shoe and may have a harder time creating their own intrinsic arch support.
Takeaway
Good option for someone dealing with load-sensitive pathology like chronic knee, hip, or back pain or recurring bone stress injury up the chain.
Transition must be slow and progressive. Foot and calf strengthening are a required prerequisite and mileage must build very slowly to adapt to the change.
The Cushioned/Motion Control Argument
Advocates for the traditional shoe will cite the need for cushioning for "shock absorption" and the need to support an overly pronating foot with a motion control component. Supporters will also site some success in reducing pain associated with plantar fasciitis and Achilles tendinitis. This is because the rocker bottom creates less demand on the foot and calf for forward propulsion and the thick cushion usually feels pretty good on an irritated heel.
The Counter Argument
Evidence supporting higher impacts with more cushioned shoes continue to mount.
You can improve the strength of your foot intrinsics. Our feet evolved with muscles and systems to support themselves and don’t need the “crutch” of manufactured support.
Excessive stiffness and cushioning prevents the foot from moving and adapting to ground contact as it naturally should.
Takeaway
Option for an Achilles tendinopathy history that doesn’t tolerate a flatter drop, someone with a history of metatarsal bone stress injury or other pathology of the foot like neuroma or plantar plate.
Older athletes and those with very high pronation may have a hard time building enough strength to counteract years of midfoot collapse and require some motion control component.
My Clinical Experience
I see an endless amount of runners making errors with suddenly changing their foot strike and/or footwear because of some article they read or just on a whim.
Some common cases I see:
Switching suddenly to a high-cushioned rocker bottom shoe to help foot pain.
These new maximalist shoes are touted for helping plantar fasciitis. These people often come to me with resolution of their foot pain but new knee pain likely because they’re landing harder. The increased cushion system seems to make people feel like they can land harder which usually starts to take its toll up the chain.
Changing to forefoot strike in your current highly structured 10 mm drop shoes.
These shoes often have a lot more flaring of material around the toe box which can alter your mechanics and the way your foot hits the ground if you are trying to land on your forefoot. In this scenario, I tend to see excessive inversion angles at initial contact which can lead to asymmetrical loading and injury to the lower leg as your foot naturally seeks to land on the most lateral point of the shoe.
Going from a high drop, high cushion, supportive shoe to minimal overnight.
You need to build the capacity in your foot and calves to make this transition. Going from 10mmm to 0mm places increased strain on the Achilles that requires an accommodation process and places high demand on your calf. Your foot has also relied on it’s arch support "crutch" for a long time, likely leading to weakness. This can result in plantar fasciitis, bone stress injuries and various tendinopathies of the lower leg among many other running injuries.
My two cents:
My #1 belief is that the right shoe is truly an experiment of 1 that comes with some trial and error and ultimately you have to feel comfortable in whatever shoe you're in first and foremost
Use shoes like a club in your golf bag. Lighter/more minimal for shorter speed workouts and some support and cushion for longer runs when your feet and calves are likely to fatigue. There is a lot of support for reduced injury risk with running in varying types of shoes
I tend to generally lean away from the far extremes of this argument for something more neutral without excessive cushioning for most but not all.
I like to try and get people out of orthotics/significant support and use their feet as the first line of defense. If that doesn't work we look to support with the shoe or insert.
Most importantly: I think that where on your foot you land (heel vs forefoot) is over-hyped. I less are about where the foot strikes and care more about the stride length and flexion angle of the knee. IF you land with some bend and compliance in the leg, land wherever that foot lands and carry on.
If you're wondering what the right shoe is for you, one of the best places to start is with a thorough gait analysis. Understanding your injury history and how you move is ultimately more important than what the hottest trend is.
If you have any questions please reach out! And if you're ready to schedule your gait analysis you can do so here!
