Foot Health for Running
Selecting and Fitting Footwear
Selecting the right running shoes is perhaps the most complicated aspect of foot health for runners. The landscape of running footwear is constantly changing, and many shoe companies change their shoe lines and styles frequently. The American Academy of Podiatric Sports Medicine (AAPSM) categorizes running shoes into five types: maximum stability/motion control, stability, neutral/cushioned, minimalist, and barefoot.
In the last several decades, shoe recommendations have been based primarily on a person’s gait type. A maximum stability/motion control running shoe is recommended for over pronators; a neutral/cushioned shoe is recommended for supinators (who tend to have high arches and relatively inflexible feet); and a stability shoe is recommended for individuals with slight pronation or who demonstrate no significant inclination to pronation or supination. Minimalist shoes and “barefoot” running shoes are lightweight, with minimal cushioning. The AAPSM is a reliable source of information about shoe types and choices. Although the information is somewhat dated, this article has good general information for shoe selection.
In a recent study published in the British Journal of Sports Medicine, researchers reviewed the relationship between running injuries and shoe design, and found no conclusive evidence that shoes designed for specific gait types (pronation, supination or neutral) helped prevent injuries; therefore, they questioned the practice of choosing running shoes based on gait and foot type. The same study recommended two new paradigms for selection of running shoes: “comfort filter” and the “preferred movement path.” The authors suggest that runners intuitively choose shoes based on how comfortable they are, and on how well they accommodate the runners’ specific gait types (i.e., their “preferred movement path”). For the runner choosing shoes, this translates to: select what feels comfortable and natural on your feet, and change the type of running shoe you purchase if it does not provide these characteristics.
A specialty running store can often help with shoe selection. But if you’re a seasoned runner, the style and type of running shoe you started with may not be appropriate forever. Multiple factors determine gait and thus the type of shoes that are most appropriate, and these factors can change over time. These include your weight, muscle strength, average length and frequency of stride, your balance, the range of motion of your joints (particularly the hips, knees, ankles and feet), the speed at which you run, running form and running regimen (the distance and frequency of your runs). Thus, running shoe selection and fitting is an ongoing process. The AAPSM also provides some good general tips on running shoe selection, and this site provides extensive reviews of individual brands and styles.
It is also important to note that, according to the AAPSM, running shoes should be replaced after about 300 to 500 miles of wear, because the midsole usually loses its protective effectiveness at this point (the rest of the shoe may look fine, even though the midsole is completely worn). This means if you run an average of 25 miles a week, you should change out your running shoes at least every four or five months. There is also evidence to show that rotating several pairs of shoes concurrently can help reduce injury.
The type and fit of the socks you wear while running also affect your risk of foot pain and other foot conditions. IPFH suggests that runners wear padded socks with the appropriate running shoes and any inserts or orthotics prescribed or recommended by a doctor or foot health professional, all properly selected and fitted as part of an integrated approach. Peer-reviewed, published studies have shown that wearing clinically-tested padded socks can help protect against injuries to the skin/soft tissue of the foot. Clinically-tested padded socks designed specifically for running have also been shown to reduce blisters and control moisture. The AAPSM provides good information on choosing socks for running.