Wednesday, June 17, 2009

Running Shoes

I finally opened my May 2009 issue of Outside magazine and turned immediately to "Spectrum: different runners require different shoes. Our guide to your perfect fit". The single page highlights three shoes, one lightweight cushiony trainer for the neutral runner, one stability shoe, and one motion control shoe. Note that the lightweight trainer is 12 oz (341 grams). Note also that they state that, combined, 80-85% of runners need a shoe to deal with moderate to severe overpronation. I'm sure this statistic is accurate, but the immediate response should be, "wait what?" If 80% of overpronate, maybe overpronation is not so bad?

I'm picking on Outside but they're just parroting the dogma from nearly every running shoe company, shoe store fit specialist, podiatrist, sports medicine M.D., chiropractor, and textbook. The only contrarians seem to be the loud-mouthed minimalists on, the hippy barefoot runners, and everyone who has recently read Born to Run. But given the universal acceptance of the "personally fit running shoes are necessary to reduce injury" model, you'd think there would be more evidence for this than something like, say, the ability of psychics to predict the next bus bombing. Here is the abstract of a recent paper from the British Medical Journal.

Published Online First: 18 April 2008. doi:10.1136/bjsm.2008.046680
British Journal of Sports Medicine 2009;43:159-162
Copyright © 2009 BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine.


Is your prescription of distance running shoes evidence-based?

C E Richards1,2, P J Magin1 and R Callister2

1 Discipline of General Practice, School of Medicine and Public Health, University of Newcastle, Australia
2 School of Biomedical Sciences, University of Newcastle, Australia

Correspondence to:
Dr C Richards, Discipline of General Practice, Bowman Building, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan 2308, Australia;

Objectives: To determine whether the current practice of prescribing distance running shoes featuring elevated cushioned heels and pronation control systems tailored to the individual’s foot type is evidence-based.

Data sources: MEDLINE (1950–May 2007), CINAHL (1982–May 2007), EMBASE (1980–May 2007), PsychInfo (1806–May 2007), Cochrane Database of Systematic Reviews (2nd Quarter 2007), Cochrane Central Register of Controlled trials (2nd Quarter 2007), SPORTSDiscus (1985–May 2007) and AMED (1985–May 2007).

Review methods: English language articles were identified via keyword and medical subject headings (MeSH) searches of the above electronic databases. With these searches and the subsequent review process, controlled trials or systematic reviews were sought in which the study population included adult recreational or competitive distance runners, the exposure was distance running, the intervention evaluated was a running shoe with an elevated cushioned heel and pronation control systems individualised to the wearer’s foot type, and the outcome measures included either running injury rates, distance running performance, osteoarthritis risk, physical activity levels, or overall health and wellbeing. The quality of these studies and their findings were then evaluated.

Results: No original research that met the study criteria was identified either directly or via the findings of the six systematic reviews identified.

Conclusion: The prescription of this shoe type to distance runners is not evidence-based.

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