Sound Advice

SOUND ADVICE

30 years ago when I began life as a podiatrist, there were many shoes! Now, the choice is almost

endless with a countless myriad of running footwear available. So, the question shouldn’t be “what is

the best shoe for me”, but rather “who is the best to advise me before I make my purchase?”

Making life even more difficult these days is that footwear advice seems to come from everywhere.

The inexperienced runner may be duped by marketing hype, the injured runner may listen to his

running buddies and make desperate decisions and the shoe shops will have their own

recommendations, sometimes based on video gait analysis or pressure sensor data. There are even

online questionnaires purporting to be able to find your correct shoe! Often the advice is conflicting,

resulting in even greater confusion.

With a lack of any real evidence that a given shoe is better(aka more likely to reduce injury or help

performance) than any other, it often comes down to a judgement call as to what is the most

appropriate category of shoe, for specific runners. Who is best to make this judgement?

It is still a common shoe fitting philosophy that certain foot-types are matched up with certain

categories of shoes. Rightly or wrongly, if you pronate you need a support shoe, if you pronate a lot,

you need a control shoe etc. Footwear manufacturers design their shoes around this paradigm. In

recent times, the genres or categories of shoes have increased, now including control, support,

cushioned, neutral, minimal/maximal etc. And the technical components of running shoes have

increased within each category with every brand spruiking their own features designed to do

whatever it is the brand says it will do!!!

Sadly, I rarely see clients who will book an appointment just to get advice on what is the right shoe

for them. By the time I see them, they’re in pain…they’re injured! And so I try my best (and I think

that it is expected of me) to correlate their particular injury with their foot mechanics and then,

along with other advice and treatment, if they’re not already wearing it, recommend a category of

shoe which might help prevent a re-occurrence of the injury when they return to running. My first

question is, are the shoe’s they were wearing a problem in the first place? Having a sound

knowledge of foot function, common injuries, the range of footwear available, current treatment

modalities, the latest research in to podiatry and footwear, and of course more than 30 years as a

runner, helps me in my decision making.

Many factors are involved in the development of an injury. Examples are a rapid increase in load,

muscle or biomechanical imbalance, overuse/repetition, poor core control along with inappropriate

or worn out footwear. Runners all have different requirements and ambitions and other factors

such as weight, sex, base of support(distance between the feet), cadence, stride length, speed, heel

or forefoot striker, medial or lateral striker etc, can all be critical. A runner’s recent shoe history can

also give some important clues. Video analysis and pressure plates are great tools, but there are

many other variables that need to be considered before suggesting a shoe. And recommending a

specific model is always fraught with danger. I will always recommend two or 3 shoes within a

category and leave it to the client and retailer to discuss fit, feel, comfort and most importantly,

colours!

Only after lengthy history taking, assessment and discussion with an experienced podiatrist can an

educated and informed judgement be made on what is the most appropriate category of shoe for

any given athlete. A judgement is all that it can be, and podiatrists are well placed to make the call!

A thought to end on:

Many times I’ve run behind runners whose feet function differently to each other. Perhaps one

pronates and the other supinates,or maybe one is more intoed than the other. If wearing the right

type of shoe for your foot-type is so important, why are they wearing the same shoe on each foot?

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