San Francisco Podiatry Video


Thursday, September 18, 2008

Pick the Perfect Running Shoes

Running Shoes...Your Injury Prevention Gear

Proper running shoes prevent injury. I am a foot and ankle surgeon. I am also an Ironman triathlete. I wear the very best running shoes. The very best for me, that is. Which of course implies that there is also a very best running shoe, just for you, as well. The shoes that are best for me are specific to my activity level, running style and foot type. For you to find the shoes that will help you to run most efficiently, and also help to prevent injury, you will need to know your running style and foot type as well.

At this point, I will let you in on a secret.  You don't need to see a foot doctor, or even read the rest of this article, if you might be in a hurry (because you are afraid you will miss one last run today). If you go to one of the few local specialty running shoe stores in your town, you will get free advice about which shoes are best for you. I can say, they know what they are talking about. Now, if you want to learn anyway, read on.

When considering new running shoes, take past experience with shoes into account, but don't bank on it.  The shoes you love now, may look similar and even have the same name next season, yet the fit and characteristics may be completely different.  If you have logged a lot of miles with a given model, you may want to buy more than one pair now. The reason is that manufacturers will frequently make unannounced design changes. These changes can vary from width, to cushioning, to major structural midsole alterations. I used to run in a shoe I loved, and then they suddenly changed the last (the form on which the shoe is constructed) and made the toe box smaller.  The result was a shoe with the exact same name, that I couldn't wear anymore.

If you have a pair of shoes that always causes blisters, heel pain, or shin splints, obviously, you should try something else. Having said that, if you have any pain from your shoes when you run now, you should drop those shoes in one of the "Keeping Chattanoogans On Their Feet" shoe donation bins around town. We have the locations listed on the Community Partners section of our If you do donate your old running shoes, I will personally see to it that they stop slowing you down, and go to help one of the 4,000 homeless people in Chattanooga. Treat yourself to a new pair!

Most runners have a rough idea about their foot type and this will determine what category of shoes will provide the right combination of cushion and support for your feet while you run.  The three main types are "Motion Control," "Stability Cushioning," and "Cushioning." Motion Control shoes are best for “over-pronators” who’s feet roll inward when they walk and run. Often associated with flat feet, theses athletes have arches that flatten out completely when running. These folks need the added support of Motion Control running shoes to prevent injury. Stability Cushioning shoes are best for “Neutral Runners or Natural Pronators” with a medium arch. These feet disperse shock effectively when they walk and run. They need a shoe that maintains this natural pronation, protecting against over-pronation and preventing injury. Cushioning shoes are best for “Under-pronators or Supinators” who’s feet don’t roll inward when they run. These feet are often associated with high arches and are prone to shin splints and pain in the big toe joint. This foot type is often rigid and does not effectively absorb shock. They need flexible shoes with maximum cushioning against impact when running.   

The wrong shoes can, and will, lead to injury. If you see an expert (found in a good running shoe store that maintains an excellent reputation among your local running community) you will get the right shoes. Then you just have to make sure you replace them before they are worn out and can no longer provide the shock absorption and/or support your body needs. Even if you use custom orthotics to correct some of the biomechanical limitations your foot type creates, worn out shoes will still lead to injury.

One of the most common questions I get from patients is "how many miles can I run before replacing my running shoes?" I typically recommend safely replacing running shoes every 200-300 miles.  Your mileage may vary. For example, I am 6'2" tall and weight nearly 200 pounds. I over-stride on downhills, which is high impact. I also usually either run on asphalt hills or concrete flats. Both are poison to running shoes. Now, if you weigh less, don't over-stride, and avoid hills and concrete, you may be able to go 500 miles. Go more than that and you are flirting with disaster. 

If you don't count miles or calories, there are several ways to evaluate the structural integrity and wear on your running shoes. If you are a heel striker (you land on your heels first when you run) look at the back of your shoe. If you see wrinkles in the material on the back outside half of the sole, you have worn out the midsole material.  The shoes can no longer provide sufficient shock absorption and should be replaced. If you are a forefoot striker (you land and run on your toes), look at the front outside edge of the sole at the ball of the foot. If you see wrinkles in the material here, you have worn out the midsole material and you need a new pair. If you look at the back of the shoe and the sole is compressed and tilting inward, you might need more pronation control. Start with the running shoe store fro a new pair of shoes. If that doesn't work, see a podiatrist. Always bring you old shoes to be evaluated at your visit. The wear patterns provide a great deal of information about you running style and possible injuries.

Once you get your bright, shiny new pair of running shoes, you have to break them in to avoid blisters and tendonitis. Do not show up for a Saturday morning long run and expect to show off your new shoes. I usually take my new ones on my long runs, but only wear them for the first 3 miles or so, then I switch back into my old shoes. Make sure you log at least 30 miles of short "break-in runs" before you go long. Your new shoes will still be bright and shiny for that long group run. That is, if the group can keep up with your new, more efficient stride long enough to notice!

Dr. Christopher Segler, DPM is a runner, triathlete and podiatrist in San Francisco. He has a podiatry practice that caters to busy young professionals and athletes in the Bay Area. To accomodate them, he makes house calls so they don't have to miss work (or a workout) when they start to have foot pain. You can reach him by calling 415-308-0833.

Ankle & Foot Center


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