By Chris Wilson - https://www.reactphysiotherapy.co.uk/

As previously discussed, many factors influence injury. A common question we get asked in the clinic is about someone's footwear. There is a tremendous amount of discussion, advice and advertising when it comes to footwear. There is also a wide variety of footwear available, with some bold claims regarding injury and foot control. There is a lot of science and research going into the development and design of footwear. This is not only for performance but also about injury, and the market is very competitive!... But with all this science and research, the one thing that hasn't happened is that we haven't seen a drop in running injuries, and we are actually seeing increases in running injury! This, as previously discussed, emphasizes that running injury is down to a variety of factors and not running shoes! What role can running shoes have on the damage? The type of shoe - Shoe geometry is an excellent place to start. If we think of the two extremes of footwear from a maximal shoe and a minimalist shoe. The potential influence that these may have on an individual is that a maximal shoe (due to its stack height) could promote rearfoot running.

In contrast, a minimalist shoe could promote forefoot running. This is not an issue if you are used to wearing these shoes. Still, suppose you decided to make a sudden change from one to another. In that case, you will likely experience load in tissues that are not usually accustomed to it, and therefore injury may occur. If consideration is being given to changing footwear like this, then it is recommended that gradual exposure to the new shoes be taken over several weeks - months to allow adaptation. But we can look at this another way and potentially use a particular shoe for an individual who may need to reduce stress on specific tissues as part of injury rehabilitation!

Shoe properties are discussed a lot with injuries and a major discussion is around the role of footwear in limiting pronation. Pronation is a movement vital for running; it allows the foot to absorb load during the initial contact and stance phase. Footwear would be built upon the medial aspect of the shoe to limit pronation. Some people (not as many as people are led to believe) may benefit from having this in place if the aim is to slow down the rate / reduce the range of pronation, but anti- pronation shoes do not prevent the pronation from occurring. If they did this, it is likely it would cause irritation and pain to the individual as the movement of pronation is vital!.... Here's something that may surprise you, in some people, the application of anti pronation devices can, in fact, increase pronation!

Other shoe properties may affect injuries, such as stiffness, toe box size or midsole rocker. Stiffness can be utilized with pain in the forefoot area, such as toe joint pain or irritation. The forefoot's stiffness can reduce the amount of significant toe extension at toe-off and reduce load through this area. A similar effect can also be seen with trainers that have a rocker sole. Toe box size can decrease pressure in the forefoot for conditions such as neuromas.

Footwear can have a role in the injury. It is doubtful that footwear causes damage! Many other factors influence injury, but footwear could reduce stress through specific tissues during injury recovery! There is a vast amount of confusing and poor information out there about footwear. When it comes to footwear, the evidence about causing injury is significantly lacking. There is not one particular make or model that will reduce damage! Footwear and how it behaves (applies load to the foot/body) will act differently on the individual.

The primary influence on injury that footwear has is when someone makes a significant change between footwear, such as a big difference in geometry of the footwear, which may add load to structures that are not usually accustomed to. When we get asked about how someone should select their trainers, the comfort filter is probably the main advice we have regarding the proper footwear for most individuals. It is a good idea to try on a variety of footwear and decide what feels comfortable, and it is likely they are the best shoe for you!

Ensure the basics are done well before looking at the more complicated elements!