The Ongoing Running Shoe Controversy and What I Do

Over the past week there has been a flurry of provocative news regarding running form and shoe selection that has caused quite a stir on the running community. First was the talk, as covered by Amby Burfoot from Runner's World, during a conference call in which Dathan Ritzenhein announced his entry into the 2010 NYC Marathon that Ritzeinhein has been experimenting with a new running form. Under the tutelage of Coach Alberto Salazar, Ritzenhein has been using shoe inserts and custom orthotics to adjust his running stance to be more forefoot, in an effort to prevent injuries, which has plagued him for the past couple of years. This news was intriguing as this was really the first instance that an elite American distance runner has openly declared an intention to switch to the techniques of forefoot running. Then, came the report of a study conducted by the military (summarized here by Gretchen Reynolds, in the New York Times Well blog), that found no correlation at all between wearing proper shoes (based on foot/arch type) and injury prevention. According to the report, "Injury rates were high among all the runners, but they were highest among the soldiers who had received shoes designed specifically for their foot types. If anything, wearing the “right” shoes for their particular foot shape increased trainees’ chances of being hurt." This study was frightening as it provided the first evidence that our current method of selecting shoes based on foot type may be erroneous. Then later that same day, my fellow blogger and evolutionary biologist friend Peter Larson posted a great review (Thanks Peter) on a recent study in the British Journal of Sports Medicine that involved a randomized control trial assigning women runners training for a half marathon to categories of shoes based on their observed degree of pronation. The authors found that 100% of runners in the highly pronated group assigned to motion control shoe (as would be normally done by convention) got injured! Not only so, but pronated runners suffered more pain from wearing stability shoes (that were assigned to them based on their foot type) than from wearing neutral shoes. There were other gross inconsistencies in the fitting of the right shoe to the right foot type, forcing the authors to conclude that "...our current approach of prescribing in-shoe pronation control systems on the basis of foot type is overly simplistic and potentially injurious." And if that weren't shocking enough, as Peter as astutely points out, one of the co-authors of this paper is Gordon Valiant, a biomechanist who works for Nike Sports Research Laboratory, and is the same guy who helped Dathan Ritzenhein, under the direction of Alberto Salazar to change his footstrike from heel to forefoot!

So what are we, the recreational athletes, the everyday warriors, who have been wearing shoes for years prescribed by a salesperson based on our foot types into this categorization of shoes that has now been proven not only ineffective but potentially injurious, supposed to take away from all of this? Are we supposed to take off our shoes immediately and run barefoot? Do we have to try every model of shoe out there, regardless of our foot type and decide based on "feel"?

Many runners and friends have asked for my opinion on this subject and I hesitate to give one because I do not believe there is yet enough conclusive evidence to know what is the "right" thing to do. Most of the science is empirical, theoretical and/or anecdotal which isn't the same as facts. So in the absence of facts, any discussion about the advantages/disadvantages of a particular style of running or a particular shoe disintegrates into a philosophical debate which doesn't really interest me.

Having said all that though, I do have some guiding principles about running and shoes that has served me well that I can share. (I'm doing this only because many people have asked.) Again, this my personal philosophy based on my knowledge of medical science. Don't take it as a general recommendation or authoritative dogma.

1. It's always better to run in less shoe than more shoe. As one sports medicine colleague advised me - Running in more shoe than you need is like running with a cast on your feet.
2. I believe strongly that the foot a dynamic structure. What that means is that the hundreds of muscles that make up the feet is always constantly changing and adapting to the environment and forces applied to it. Your foot will change from month to month, year to year. What works perfectly this training cycle will not be appropriate for your next training cycle. By extension, there's no sense in hoarding shoes for longer than six months to a year.
3. Rotate your shoes. Being in different models stressing different bones and muscles of the feet is beneficial to overall health of the lower extremity. It will also highlight and pinpoint areas of weakness and pain that you might not be aware of just running in one set of shoes all the time.
4. Don't be afraid to experiment and try new techniques and new shoes no matter what your preferences and biases are. Just be careful and listen and hear what your feet are telling you. (As a rule, runners are not good listeners...especially to their own bodies. Trust me on this.)
5. I train in Saucony Rides, do tempo runs and long races in Saucony Kinvaras and race short distances and intervals in Saucony Fasttwitches. Just sayin...