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THE BEST SHOE FOR YOU IS NOT WHAT YOU THINK IT IS !

February 24, 2018

 

An interest with discovering the most appropriate form of footwear for people started when I read an article in 2010 (link below) with the major statement showing a direct link between the price of shoes and the injury rate in these shoes. THEY BOTH GO UP TOGETHER. I thought to myself 'how can this be? This does not make any sense. What about all those millions of dollars that are spent on research and designing these shoes?' I was probably as baffled as you are right now because of this statement. As a note; at this time I was wearing a pair of chunky, full support shoes, had quite severe knee pain, always felt like I was propped up on my toes, and had quite low flexibility, reduced range of motion and was overactive all in my posterior muscular chain (calves, hamstrings, gluteus maximum, lower back, thoracic spine, neck extensors). 

 

According to a market report published by Transparency Market Research, "Athletic Footwear Market - Global Industry Size, Market Share, Trends, Analysis and Forecast, 2012 - 2018," the global athletic footwear market was worth USD 74.7 billion in 2011 and is expected to reach USD 84.4 billion in 2018, growing at a CAGR of 1.8% from 2011 to 2018 (1). 

 

These statistics show exactly how much money is invested into what goes on our feet.  With trends in footwear changing every couple of years including aspects such as extra padding around the foot, increased longitudinal arch support to support running technique and joint loading especially during long distances, additional heel support to reduce loading and make you feel like you are running on a cloud. The list goes on with leading brands such as Nike, Brooks, Asics, Adidas, and of course now Reebok coming up the ranks turning over hundreds of millions every year as they follow changes in fashion trends (colour and knit type), science research based influences such as the biomechanical impact and specificity to body type and running style and so on. 

 

So what is the best shoe for you? If there was a simple answer, everybody would be wearing this 'perfect' shoe and would be the perfect specimen (not really). Unfortunately there are too many angles to come from to figure out which one is perfect. However, I love a good dose of research and felt the need to break down a few common shoe types and the possible advantages and disadvantages to the human body during exercise. 

 

The 'Full Support' Shoe:

This type of shoe provides everything. One of the leading brands who supply these shoes (I am not going to name them) provide you with many different options in the one style of shoe; Low, medium and high arch support, options for track / field, off-road or trail, use for competition or recreation, and whether your pronation is mild, moderate or severe. 

So what this style of shoe essentially does for you is exactly what your muscles should be doing. Only in some far gone cases would I see these as the best options for an individual. 

Let's try and draw a word picture to make this a little easier to understand.  

These 'full support shoes' are an overprotective mother, who never lets their child go out and experience life and develop as an individual. They have already decided that life is too hard and therefore want to provide support in every way, shape and form for their child (the mum is the shoe and the child is the foot, remember). BUT, One day the child needs to be strong, independent and self=reliant (the foot in a different pair of shoes, or on an uneven surface) but of course the child cannot function effectively because of this over-protective mechanism that has provided support for so many years. Ok, you get the point...I hope. 

 

So is this good or bad?

You may be able to tell that I am not the biggest fan of just finding the quickest 'fix' (not usually fixing anything) for an issue; over the counter medication, full support shoes etc. I would try and take a little longer and prevent the issue from occurring again. Which is why I am not the biggest fan of the 'full support shoe' in the majority of cases. Let me explain why I think these shoes are NOT the best option;

  • When running, these shoes make it almost impossible to NOT land on the heel in the shoe. Biomechanically, this has been shown to be less advantageous in comparison to running landing toward the mid-foot or toe running. This is due to the impact that is created by landing on the heel with a relatively straight leg; this transfers additional stress through the ankle, knee and hip joint which can have additional negative effects on pelvic control. The flow on effect can of course cause pain and discomfort in the lower back and influence the spine up to the neck and shoulders. 

  • By providing so much heel support; majority of these types of shoes actually prop you into a forward leaning position. When standing without shoes on, resting back on the heels provides the entire musculoskeletal system with its optimal position with regards to muscle balance and joint loading. By providing the additional heel support, this can have the tendency to change the centre of mass and gravity in the person wearing the shoes. This switches on continuous muscle activation through the posterior chain of the body (calves, hamstrings, gluteus maximum and lower back, neck extensors) due to the body's necessity to constantly re-align itself to its 'neutral' position. Depending on the time spent in these shoes and the activity undertaken; overactivation and time under load of these muscles can cause excessive fatigue and even postural related pain or discomfort from the heels up the neck. 

  • By providing almost full structural support for the foot, you do not allow your foot and ankle to strengthen itself around what your are doing. The foot and ankle will not adapt to the forces and work you are putting through the joint and surrounding musculature which has a large possibility of providing you with pain and discomfort in the future. Muscles are made to get stronger and develop.

These shoes are best for:

  • The person who goes for the relatively quick fix. 

  • The person that has been prescribed this type of shoe by a caring (and educated) health professional if completely necessary and a last resort. 

  • The person who usually has a fairly long injury list and is seen as 'unfixable' or 'too hard.'

 

The 'Medium-minimal Support Shoe'

You are probably thinking of shoes such as Nike Free Runs when I mention the term 'minimal support shoe,' and you would therefore be correct. The major premise from Nike's point of view is to mimic barefoot running. As much as these shoes are alot closer to barefoot than say the 'full support shoe' they definitely do not mimic barefoot running. Barefoot running is in a completely different league which has the additional benefits stated below;

  • Has been shown to reduce injuries to calf and achilles tendon due to ability to stretch and lengthen naturally during strides.

  • Runners will learn to land on the forefoot rather than the heel which is shown through research to be the most effective stride pattern. Landing on the heel for each stride is biomechanically less effective and less efficient than landing on the forefoot, not only for short distances but also long distances. 

  • It can improve stability and proprioception in the ankle, foot and lower leg by activating the smaller muscles in these regions. This can reduce the chance of acute and chronic long term injuries for people who enjoy exercise and movement and use these shoes for those activities. 

So is this good or bad?

Although the 'minimal support shoe' is not barefoot running, it is a relatively close fit. These shoes do provide some support and can soften the impact that running can provide whilst also allowing for proper stride and loading technique. They also reduce the propped forward effect of the 'full support shoe' and allow for a more neutral position of the musculoskeletal system (which obviously gets my vote). The reduced 'over-protective mothering' aspects also allow for the foot and ankle to gain some stability, subtle strengthening and increased proprioception which is definitely a good thing. This is what I see as a good mid range shoe between the 'full support shoe' and the 'no support shoe' (which will be broken down below) as it provides a decent amount of support and padding but also allows for the body to strengthen itself in a subtle way. Remember, this is not me telling you to go out and buy a pair of these RIGHT NOW; I am just attempting to feed your (hopefully) inquisitive nature and also think outside the box that general marketing tends to provide the public with. 

 

This shoe is best for:

  • The short or middle distance runner. 

  • The person who is starting to take control of their ankle and foot stability. Transitioning between your old full support shoe and this style is the best way to go. Don't go jumping from full support shoes to almost no support as this will in most cases cause you some pain. Take the time to let your body strengthen itself with the appropriate rehab exercises and exercise modalities. 

  • The cross-trainer. The person that throws around some heavy stuff, includes some running and cycling in the mix and likes to do a few different modes of exercise. 

 

The 'No Support shoe'

The most well known shoe in this field would be the Vibram Five Fingers. For those of you that do not know what these are, they look like those toe socks you used to wear as a kid (or adult) but in shoe form. Follow this link for an image; http://www.vibramfivefingers.com/barefoot-sports/barefoot_running.htm. The basis of the Vibram Five Fingers is to mimic bare foot running as closely as possible. Taken from the website, Vibrams "allow you to land on your forefoot, directly below your centre of gravity. Resulting in optimum balance, increased stability, less impact and greater propulsion. Running in  Five Fingers delivers increased sensory feedback that improves agility and equilibrium and allows for immediate form correction. In addition, it stimulates and strengthens muscles in the feet and lower legs." Of course there is a sole on the shoe that protects you from the elements and harsh surfaces you will be running on but the major premise is that of minimalism. 

 

So is this good or bad?

Well it really depends on what angle you come from. As the title states, there are so many opinions and professionals who will suggest so many different things and research that will contradict the next article about the same topic. So please remember that this is the view that I personally hold after reading many journal articles, seeing many patients with issues possible related to (and fixed by altering) their footwear, testing theories on myself (what I suggest YOU do) and attempting to understand the logic and science behind different viewpoints. The 'no support shoe' is the type of shoe that should be utlised from a young age. Throwing a middle aged man/woman who has always worn 'the full support shoe' into a pair of these will only cause problems. It all depends on your history. I do not believe it is ever too late to attempt to fix your body which is why I do what I do for a living; but sometimes progression can be slow, but remember, progression is progression.

 

This shoe is best for:

  • The person who has previously, or is willing to take the time and put in the effort to become a self-maintaining and balanced unit. This means including rehabilitation, understanding muscular balance and proprioceptive control, mobility work and massage into their regime if necessary. Good things take time remember. 

 

In summary:

We were born without shoes on, and we were born with muscles that are the most incredible, adaptive things around. They can get stronger and bigger when we need to lift heavy things and feed them correctly, they support every movement we do (twisting, running bending, etc), they can even lengthen and relax if we treat them properly. So my suggestion is this; utilise them. PROPERLY. 

Allow children to play barefoot for as long as possible from the moment they are born to about 16-17 which is when growing tends to slow down; these are the most important years for growth and development. Allow them to run, jump, fall, balance and most importantly adapt to what is beneath them. Who knows, your child may need some additional support or strengthening in their lower limbs, hips, ankles and feet but I research shows this does not mean cramming their feet into the most supportive shoes you can find. These years will influence the type of footwear they will be wearing for the rest of their lives; and let's hope they do not require too much external support. 

Like everything in life; prevention is key. Or at least getting onto it as early as possible. However it is never too late to start trying to get yourself sorted. If you do not know how, then talk to someone who does. GOOD LUCK. 

 

Oh, and finally, I now train in a combination of bare feet, Strike Movement Shoes (from Vancouver, Canada) and Dunlop Volleys; my knees have not felt this good in a long time, I can run alot further than I could before without those little niggles and aches. I feel comfortable lifting heavy stuff off the ground knowing my body is in more of a neutral position. In saying that, it has taken me quite a while to get to transition from those big bulky shoes I used to wear and the pain I used to experience. The process was gradual but definitely worth it. 

 

Dylan Kvas-Rothwell

Exercise Physiologist

Director - Coogee Beach Fitness Club

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