What you need to know about physiotherapy and podiatry.
Physio&SoleClinic Podiatry December 22 2014
Wearing ill-fitting or incorrect footwear while running is the main cause of lower limb injuries, such as heel pain, ankle sprains, muscle fatigue and stress injuries.
What is important in a pair of running shoes is not how they look, but how well they fit you.
Running shoes must be carefully chosen to suit your running style in order to prevent injury while running.
Each shoe company has its own philosophy and technology in shoe design.
Consumers should be discerning of these technological and marketing fads when choosing shoes, said
Mr Tay Kai Ming, a podiatrist at the Changi General Hospital.
The key considerations include stability, cushioning, durability and especially comfort, he added.
Runners should take into account mileage, pace and performance requirements when choosing their footwear.
For example, a marathon runner will need shoes with increased durability, whereas a non-competitive runner covering far shorter distances may require shoes with only general cushioning.
The choice of shoes will depend on the frequency of use for assorted training and for competition.
The terrain is also a factor. There are a variety of shoes catering to running on different terrains, such as road, track or trail.
Wearing footwear that matches the terrain improves grip and stability. Wearing ill-fitting or ill-suited shoes creates risk of injuries from slipping or tripping.
Also, do not forget about body weight, said Mr Tay, which should be taken into account. Heavier runners will require more durable shoes, and may find unsuitable footwear wearing out quickly. A person keen to start running should be careful when choosing running shoes.
Amateur runners should consult a sports medicine doctor or a podiatrist if they are experiencing existing lower limb injuries or have difficulties finding appropriate shoes.
How to choose the correct pair of shoes
Podiatrists conduct visual gait analyses of patients by observing how they walk and assess foot joints and muscle strength before recommending shoes and prescription insoles, if required.
Mr Tay Kai Ming, a podiatrist at the Changi General Hospital, demonstrates the qualities of a good pair of running shoes for the average runner.
Go through these steps each time when buying shoes as sizing in footwear varies slightly between manufacturers.
Types of running shoes
They are generally categorised into the following groups:
Motion control or stability shoes
Each of these shoes is commonly wide-fitting, has a heavy durable outsole, a firm heel counter for added motion control, and increased support in the instep.
A firm heel counter is a sturdy back of the shoe that cups the heel to restrain excessive motion when it lands on the ground.
Motion control or stability shoes have specially dense material in the midsole, such as ethylene vinyl acetate (EVA) or polyurethane, to enhance stability and cushioning.
These are mouldable rubber materials conventionally incorporated into sports shoes for shock absorption and cushioning.
Footwear companies often recommend motion control or stability shoes for runners with excessive pronation of their feet, that is, people whose feet roll inwards so they have a tendency to place their weight on the inside of the feet.
People who pronate their feet may experience inward rotation of the knees and forward tilting of the pelvis.
Foot pronation ranges from mild to moderate to severe. Pronation is an example of lower limb malalignment.
With an increased degree of malalignment, one is more likely to experience pain in the feet, knees, hips, back, shoulders and neck.
However, there is no conclusive evidence that motion control and stability shoes can correct malalignment, warned Mr Tay.
One would need functional orthoses (shoe inserts) to effectively control excessive foot motions.
These should ideally be prescribed by a podiatrist.
Nevertheless, this type of shoes still has its place for long distance runners and heavy runners because of its durability.
Each of such shoes commonly has a single layer EVA midsole with increased cushioning materials, such as gel, air pockets and silicon, on the high-pressure areas of the foot, such as the heel and forefoot.
These shoes are suitable for runners with malalignment issues which result in poor shock-absorption during running.
These are race day shoes designed to increase performance during competition because they are lightweight and responsive during running.
Each shoe has a thin midsole design, which compromises on its overall cushioning and stability.
Runners must be careful when using these shoes as they are prone to causing muscle damage (micro tears) during running.
A good alternative to racers are racer trainers, which have cushioning adequate for marathon events and offer moderate stability.
Racer trainers are often used for short, specific training, such as interval training.
These are specifically designed for trekking and trail running.
Each shoe is mostly constructed with a rugged outer sole so as to prevent slippage and to enable a stable foot strike on outdoor terrain.
Barefoot running or minimalist shoes
Barefoot running is an “in” thing in running circles.
This concept became popular after some researchers were inspired by native tribes, such as the Tarahumaras in Mexico, who were able to run barefoot on gruelling terrains without sustaining injuries, said Ms Hu Wenyan, a podiatrist at Changi General Hospital.
This running style emphasises a midfoot or forefoot landing, also known as “toe-running”, in which runners land on their mid or forefoot instead of their heel on each running step.
It is claimed to improve running efficiency and allow for natural bone and muscular development.
From this concept, footwear companies have designed shoes with features that emulate barefoot running.
Each shoe is very lightweight with minimal material construction, and a thin midsole which allows flexibility.
Though there are some anecdotal reports of better performance by seasoned athletes with the use of such shoes, there is no conclusive evidence that barefoot running is the ideal way of running or that such shoes are beneficial.
Therefore, runners should be cautious when considering a change of running style or selecting minimalist footwear.
Barefoot running may not be suitable for everyone as research has shown that 80 per cent of the running population are natural heel strikers, instead of midfoot or forefoot strikers.
Sudden changes in running style may also cause impact and injuries.
It is advisable to speak to a sports medicine doctor or a podiatrist for lower limb biomechanics assessment before attempting any drastic changes in running style.
These are shoes with outsoles that are convex at the midfoot area, thus causing a rocking movement which will cause instability.
Creating such instability is believed to allow increased muscle activation and overall toning of leg muscles.
Rocker-bottom shoes may be helpful for certain foot conditions in which forward motion and propulsion are impeded.
However, runners should be cautious as such instability may not be beneficial for everyone, such as those who are prone to ankle sprains, said Ms Hu.
Footwear outlets also carry walking shoes and cross-trainers.
But these shoes are designed with differential features and should not be used for running activities.
Cross-trainers are recommended for gym workouts, weightlifting and a variety of sports such as badminton and tennis.
These activities involve multi-directional and randomised movements.
Cross-trainers are designed to provide a wide base of support with flex points and traction specific for such activities.
They generally come with non-marking outsoles so they do not leave streaks or marks on court surfaces. Such outsoles use slightly denser rubber that does not wear out or distort under stress, and provides better grip.
But one must be cautious when wearing cross-trainers for intensive sporting activities as different sports have varying sport-specific motions and cross-trainers may not provide adequate support.
Walking is a one-directional activity.
Hence, walking shoes are designed with flexibility and traction for forward motion. Each shoe has a wider base, a firm heel counter and increased forefoot cushioning.
These shoes are appropriate for brisk walking or casual walking.
They are suitable for all who do morning or evening walks or have a brisk walking regimen, especially the middle-aged and elderly.
This article was published in The Straits Times on 31 Jan 2013.
Photo by JESHOOTS.com from Pexels.