Cath Lab Digest

Study Examines Shoelace Patterns On Running Shoes

By Brian McCurdy, Senior Editor

   Before hitting the track, runners must take various factors into account to streamline their performance. A recent study in the Journal of Sports Medicine explores how different shoelace patterns can affect the biomechanics of runners.

   According to the study, researchers evaluated 20 experienced runners and the influence of shoelace tightness and the number of laced eyelets upon foot pronation during contact, tibial acceleration and plantar pressure distribution.

   Researchers found that running shoes with the tightest and highest lacing conditions exhibited reduced loading rates and pronation velocities. The seven-eyelet lacing pattern facilitated the lowest peak pressures under the heel and lateral midfoot, according to the study authors. Researchers concluded that a firm foot-to-shoe coupling with higher lacing facilitates a more effective use of running shoes, and may reduce the risk of lower limb injury.

   David Levine, DPM, CPed, says the study’s conclusion is logical as the tighter the shoelaces are, the more support the runner has and the better the foot will stay in place.

    “Lacing can be subjective as can the fit of shoes but the bottom line is that the shoe needs to be tied tight. Now there is data to support that,” says Dr. Levine, who is in private practice in Frederick, Md.

   Doug Richie Jr., DPM, agrees that a tightly laced shoe seems to enhance performance. He attributes this to either the enhanced “coupling” of the foot to the shoe as the researchers suggest or an enhanced proprioceptive mechanism that gives the athlete a better “feel” for the sport surface.

   Richard Bouché, DPM, usually recommends that athletes use all seven laces, which ensures good coupling of the foot and shoe. When athletes combine this lacing with a textured insole and an appropriate shoe for their specific foot type, it can be helpful in preventing injuries, notes Dr. Bouché, a Fellow of the American Academy of Podiatric Sports Medicine.

When Tight Lacing Is Problematic

   Dr. Richie sees more frequent injuries from shoes laced too tightly than from loose laces. He says injuries arising from too tight laces commonly include tendinopathy in the extensor tendons and in the anterior tibial tendon. Since there is little intrinsic protective tissue over the dorsum, Dr. Richie notes that shoelaces can impinge and injure tendons that are actively working during the contact phase of gait.

    “These injuries, once they occur, are extremely difficult to resolve. I would much rather advocate a comfortable, medium tension lace adjustment rather than a tight lace for most athletes,” says Dr. Richie, an Adjunct Associate Professor in the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt College.

   Dr. Bouché notes that if the quarter of the shoe is too high, the ALL7 lacing pattern can cause irritation on the ankle bones (fibular more than tibial) “because it snugs up the topline of the shoe opening.”

   Dr. Levine says there are several variables (including foot structure and bony prominences) that one should consider. He says runners might skip a pair of eyelets if they have bony prominences. Dr. Levine also points out that it can be impractical in some situations to lace a shoe tightly due to spurs or a high instep as this could cause dorsal nerve compression.

   In his practice, Dr. Bouché offers different lacing patterns for various types of patients. In addition to the high instep that Dr. Levine points out, Dr. Bouché says runners with a wide foot, narrow foot, pronated foot or supinated foot may require different lacing techniques. For example, he will employ a forefoot lacing pattern for patients with recurrent great toe problems to lessen excessive pressure that will help to prevent subungual hematomas.

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