Do Runners Get What They Pay For With Expensive Shoes?

By Brian McCurdy, Senior Editor

When choosing a pair of running shoes, consumers have a wide range of choices with a number of models available in different price ranges. Does buying a more expensive running shoe necessarily translate into getting a better quality shoe? A recent study suggests there may not be that much difference in cushioning between inexpensive and more expensive shoes.

The study, which was recently published in the British Journal of Sports Medicine, compared a total of nine pairs of men’s running shoes from three different manufacturers. Researchers compared low-priced shoes (£40-45), medium-priced shoes (£60-65) and high-priced shoes (£70-75) with all prices in pounds as per United Kingdom (U.K.) currency. Forty-three men participated in the study and wore size 8 or 10 shoes (U.K. sizes).

Researchers used the Pedar® in-shoe system (Novel Electronics) to measure plantar pressure from under the heel, across the forefoot and under the great toe. The study also assessed comfort with a visual analogue scale, according to the study. Researchers also recorded differences in plantar pressure among shoe models and among shoe brands or costs.

The study authors concluded that low and medium cost shoes in all three brands demonstrated the same or better cushioning than more expensive shoes. The performance of shoes was comparable in both walking and running trials on a treadmill, according to the study. Study authors noted that comfort is a subjective phenomenon and there was no difference in comfort among the shoes tested.

However, Nicholas Romansky, DPM, cites defects with the study. He contends researchers should have examined how shoes performed one to two months later and should have considered more parameters in the study. Doug Richie, Jr., DPM, adds that he is “not surprised” that researchers noted no significant difference between cheaper and more expensive shoes when comparing brand new pairs.

“The essential difference I have observed is the rapid deterioration of cushioning, which is seen in cheaper shoes in just several days of use,” says Dr. Richie, a Past President of the American Academy of Podiatric Sports Medicine (AAPSM).

How Important Is Cushioning?

In general, Richard Bouché, DPM, looks at three areas for running shoes: injury prevention (pronation/supination control and cushioning), performance (shoe weight, efficiency and energy dissipation) and comfort (fit, climate, cushioning). He notes cushioning may play a role in all three to some degree. However, Dr. Richie notes there is not enough evidence in the literature that confirms whether cushioning has an impact in injury prevention for runners.

“There is no consensus in the scientific community that cushioning plays a major role in the prevention of injury to the lower extremity,” says Dr. Richie, an Adjunct Associate Clinical Professor in the Department of Applied Biomechanics at the California School of Podiatric Medicine. “While intuitively, we would assume that cushioning is important, studies have failed to verify that this will prevent injury.”

Although Dr. Bouché thinks cushioning does play a role in athletic shoes, he concedes that having more cushioning is not necessarily better. He says numerous durometers are available and though machine testing may conclude that softer may be better, physiologic testing with patients indicates that paradoxically, the softer the midsole, the more impact there is on the lower extremity.

Drs. Bouché and Romansky say there are multiple factors to consider when it comes to recommending running shoes. Although runners can get good shoes that are inexpensive, Dr. Romansky maintains that one should consider the patient’s height, weight, running surface and whether the patient is a forefoot or a heel-toe runner when it comes to making shoe recommendations.

“There probably is an ideal amount of cushioning for individual athletes based on shoe type, surface, activity, weight, foot type, lower extremity mechanics, injury history, etc. We look at all of these factors when determining the best type of shoe for an individual athlete,” says Dr. Bouché, a Staff Podiatrist at The Sports Medicine Clinic in Seattle and a Past President of AAPSM.

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