Emphasizing Proper Shoes And Orthoses In Runners

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Author(s): 
Lisa M. Schoene, DPM, ATC, FACFAS

Keeping Minimalist Shoes In Perspective

I love shoes and the shoe industry has fascinated me for many years. When I was a podiatry student, I would visit the biomechanical guys at the Foot Locker test wear center in Illinois, make friends with the biomechanics experts at Brooks footwear in Michigan and visit all the rest of the shoe booths at conferences. I believed in the shoes they were selling as they were working well for my patients and me.

   Yet we still have to remember that the shoe industry is a billion-dollar business. At any shoe booth at a conference or show, the exhibitors will have the expensive rocker shoe right next to the expensive “barefoot” shoe. This suggests to me that shoe manufacturers do not really have one strong opinion either way.

   So what do we do with the newfound fad of barefoot running that surrounds us today when it comes to taking care of runners’ shoe needs?

Ensuring A Sound Biomechanical Solution And Patient Education

In regard to the philosophy of there being a shoe for every foot, it all goes back to taking a really good history and performing thorough physical and biomechanical exams so we can get to the bottom of the problem. We know that if someone has specific forefoot or rearfoot needs, a single shoe cannot change that and that is why custom orthotics are a necessity in many of the patients we treat.

   We all know we can slow down or halt the progression of some forefoot deformities, namely hammertoes, hallux valgus or hallux limitus, with a thoroughly prepared functional orthotic device, not from a wedge or a slit in the sole of a shoe. Depending on the level of fitness, strength, flexibility and biomechanical foot needs, we can assess if the runner needs a lighter shoe with or without an orthosis. We know this takes biomechanical knowledge and a good examination.

   We can also educate our runners on proper form and make sure that the body is just forward of the plumb line and that the foot lands in a more “midfoot” strike position. Doing this will limit overstriding and increased stresses at heel strike. If we keep the cadence to 85 to 90 beats per minute, we can ensure the runner has eliminated overstriding.

In Conclusion

There are groups in the media and on the Internet telling us how to run and what our feet and body should look like. However, in the end, it all boils down to good form, well aligned biomechanics, good strength, flexibility and not doing a foolish 26-mile run if you have not properly prepared for it.

   Dr. Schoene is a triple board-certified sports medicine podiatrist and a certified athletic trainer. She is a Fellow of the American Academy of Podiatric Sports Medicine and the American College of Foot and Ankle Surgeons.

   Dr. Richie is an Adjunct Associate Professor in the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt University. He is a Past President of the American Academy of Podiatric Sports Medicine. Dr. Richie is in private practice in Seal Beach, Ca.

References

1. Divert C, Mornieux G, Baur H, et al. Mechanical comparison of barefoot and shod running. Int J Sports Med. 2005; 26(7):593-8.
2. Lieberman D, Venkadesan M, Werbel W, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010; 463(7280):531-4.

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Sasusays: March 27, 2012 at 12:59 am

Nice to read a reasonable article on shoes and orthotics!

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