Friday, August 20, 2010

Rethinking the Shoe Selection Process

In the aftermath of the recent running shoe controversy (as I've documented here) I have been thinking a lot about runners and shoes. Like many others, I'm disturbed by the mounting evidence suggesting that the traditional method of matching shoe to runner based on foot type and arch height is not only wrong but probably injurious. Since the large majority of runners currently train and run in shoes that were prescribed to them at one point in time by a salesperson at a running store utilizing this conventional system of shoe selection, I wonder if there can be many who feel completely confident and safe in their shoes right now. Even if you've worn the same running shoes for many years (even decades perhaps) and suffered no ill effects, how do you know that there isn't another model/brand/type of shoe that would fit you better, enhance your running or prevent injury better than your current shoe? As consumers, faced with the plethora of misinformation, unproven theories, and annectodal evidence out in the various forms of popular media, how does one go about figuring all of this out?

Personally, I find the entire shoe selection process simply overwhelming and extremely problematic. To think I actually have a medical science background and enjoy reading and talking about shoes. So what about the newbie or the average runner who may not be as knowledgeable or share the same degree of running shoe fetish as I? Are they then doomed to the whim of the shoe salesperson at the running store and more than likely end up in a shoe that is not ideal or appropriate for them? This is so wrong on so many levels.

I think the average runner should be left out of this process entirely. I think the entire shoe selection process should be modified to involve specialists whose job it is to understand the dynamics of each specific shoe and figure out the foot and gait that it is designed to fit. Perhaps the task should involve two or three specialists similar to the way corrective lenses are prescribed for different visual abnormalities. There can be a primary doctor (likely a podiatrist) who would perform a general examination of the foot noting anatomical dimensions and structural defects that may warrant a particular type of shoe. Then there can be a second specialist who performs a gait analysis to determine your particular style of running and the functional nuances of your foot. Finally the information is passed to a salesperson who picks out the appropriate models of shoes for you to choose from. Yes, this entire process seems a bit cumbersome and potentially expensive but if a significant portion of the running community is already wearing the wrong shoes that will inevitably lead to injury, doesn't this mean that the science of shoes and feet is too complicated for the average person to understand and apply? After all, if it requires an ophthalmologist, an optometrist and an optician to help one nearsighted or farsighted individual find an appropriate set of glasses (or contacts), why should selecting appropriate running shoes for runners be any different?

11 comments:

marathonmaiden said...

i never really thought about shoe selection in this way. i've always just tried on shoes and then went with the cheapest. of course i've never had any bad effects from this which is probably why i keep doing it!

but i love the idea of having shoe specialists. especially multiple. feet and running should totally get the same treatment as things such as eyes like in your example. the impact of shoes on the body is definitely just as great as glasses on the body

NY Wolve said...

I saw the note in the NY Times blog and have been thinking about this also. I generally run in Stability Plus shoes. That means Gel Kayanos for me. But, on the other hand, I don;t like to run on the treadmill in those shoes. I prefer the lighter models, and my current favorite, which I just can't seem to give up even though they are at the end of their useful life, in Gel Nimbus 11s.

The Nimbus feel right and comfortable. But yet, I am reluctant to run on the streets in them. Maybe it is mental.

One thing I would stress, too, is toe box. For me an adequate toe box is critical. I recently bought sa pair of Brooks Glycerin to replace the Nimbus. The result after two treadmill runs: four purple toe nails and a blister. When I looked at it, the toebox is significantly smaller on the Brooks, and just didn't feel right. So, if anybody wants them.. size 12.5.

I recently was fitted for orthotics (that I don't use, btw.) The guy doing it was incredibly knowledgeable and explained how my foot was changing as I aged. My arch was collapsing, the nerves in the foot adjusting and my feet changing their motion dynamic from chang in shape and structure. It all made sense and supports your point that foot is a dynamic structure, changing as the body does.

Morgan said...

I've been really caught up in all this debate and have been reading everything I can. With my non-running days laid out before me I have been wearing my VFF's as much as possible and I'd like to invest in a minimalist shoe when I start running again. There's def something to be said that the runner's of the 70's long before Nike took the running world over, were able to run so well without all the extras.

Spike said...

First, I hope Nike sues Morgan for that slanderous comment.

Second, I also believe the shoe to runner dating process needs to be improved, I just hope a system is developed that doesn't end up costing the consumer even more money while producing the same 'fail' result we often get now.

Third, please try to use words with less than ten letters in them.

Brandon Wood said...

Ok, without going down the whole barefoot/natural is better thing, I think a lot of the problems come from not knowing where our "zero" is. Few of us (though, increasingly more) have taken the time to find out how our feet and our strides function without the intervention of a shoe. On top of that, how many of us are guilty of uttering the statement, "that shoe looks cool" or, "I like the big heel on that, it's so cushy".

You know where I stand on the shoe thing, but for anyone reading this that may not, I'll refer to a statement that I read recently here: http://tinyurl.com/2vlun5m

"The world is flat if you're a foot."

That said I think we should take a more simplistic approach to shoe selection. What shoe allows my foot to behave the way it wants to without restraint? I'll take that one.

Great post Lam!

FoCoRunner said...

Too much emphasis goes into rigidly preventing the foot from doing things we think it shouldn't do when we run. We try to fix problems that do not stem from the foot, by forcing the foot to conform to someone's ideal.

I think we have to ask the question (and some researchers are now, thankfully) of whether what our feet and lower legs are doing when we run is more related to a lack of appropriate functioning and support from the foot, loss of neuromuscular coordination and strength, higher up in the kinetic chain.

Recent research has indicated that we can change some aspects of our running form through simple learning in a relatively short period of time, and we may reduce the risk of some overuse injuries by fixing some of the problems in our gait from the top down. Meanwhile, other studies are showing that our attempts to prevent injuries by placing bolstering shoes on our feet may actually contribute to the very injuries and syndromes we have been told (with no supporting evidence) these shoes will prevent.

So, should the shoe selection process involves both a foot and gait analysis? Sure, but the evidence also suggests we should probably not attempt to correct all of our gait problems from the bottom up, with shoes that prevent our feet from serving their natural shock absorbing functions through pronation. Some of these gait problems should probably be corrected from the top-down instead through gait training, strength and flexibility exercises.

When you consider that we now spend so much more time sitting around than our ancestors, then we suddenly decide to start running after years or decades as couch potatoes... It is not surprising that many key muscles have atrophies, and that we have lost some of the neuromuscular coordination required to run well. Trying to correct this stuff with a shoe is now beginning to look like it may be ineffective for a large proportion of runners, and possibly misguided in general.

Interesting stuff coming out all the time. It seems like scientists are beginning to ask the right questions, though. Science should be about testing and questioning assumptions.

FoCoRunner said...
This comment has been removed by the author.
Greg Strosaker said...

I think there are a fair number of runners for whom a wide variety of shoes would work just fine, and too much emphasis is placed on matching shoes-to-foot (or gait). Therefore, I'm not sure that every runner needs such a specialist, but certainly your idea holds merit for those who either (a) want to gain every bit of extra edge possible, or (b) have had issues with injury or fit.
Right now, I'd settle for finding a model that fits me right with minimal damage to my toes. Every pair I've worn lately has damaged one side of my foot or the other. The other big frustration is the frequency and significance of design changes, so even when one settles on a shoe design, it changes which often forces you to go looking again.

Chris said...

Good luck with finding that expert. Because they would have to be GODLY in terms of their ability to pick up on the nuances of individual feet and running style and strengths and weaknesses of runners at "x" time in their development as runners.
Sure there probably some hard and fast rules for generalities: heavier people should probably wear shoes that are more supportive, heavy pronators should probably wear stability shoes and so on and so forth...
but the bottom line is that it truly is an experiment of one. You have to get out there and try as many shoes as possible to find out what will work best for you...
This coming from a man who is SOOOO in love with the Nike Free 5.0 that I don't even want to look at another brand of shoe. To each their own and I enjoy reading the posts and comments.

runner26 said...

i am in the market for new shoes (my current make/model has been discontinued). i'm absolutely clueless! i was actually going to try to talk to you about it. soonish.

Pete Larson said...

Lam,

I've been thinking about this post over the past few days, and I guess my big concern is how we could ever get specialists to agree on proper procedure for assigning footwear. There is so much disagreement out there right now, it seems that it would take a lot more time and research before we could create an army of specialists who could even begin to attempt to provide the best advice. I don't know that there is a better answer either, though. For now, I think the best we can do is admit, as another commenter did, that we are each an experiment of one, and that we should be better educated about the array of options available to us.

Personally, I tend to agree with Brandon - find the shoe that best allows you to preserve your natural mechanics without trying to overcorrect. Let's also get rid of marketing masked as science, and really figure out what works best. I have talked to a long-time shoe store owner who basically said that some of the most functionally well-designed shoes get shot down or modified by marketing and sales departments, which is a shame. When it comes to running shoes, fashion should not trump function, though there is no reason they can't be complementary.

Finally, and this is something I'm curious to hear your thoughts on, we need to pay more attention to kids shoes. We keep our babies out of shoes to allow the infant foot to grow freely, but in trying to find my 6yo son a decent pair of sneakers his only choices are mini versions of the thickly heeled and cushioned shoes that most adults wear. He, like most kids, runs on his midfoot and forefoot, and this kind of shoe is not appropriate for his biomechanics. All it does is constrict his foot and teach him early on to land on his heels. I've seen you mention that kids don't get adult running injuries - when does it start?

Pete

 
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