Is your prescription of distance running shoes evidence based?

NewsBot · Apr 22, 2008

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Is your prescription of distance running shoes evidence based?
Richards CE, Magin PJ, Callister R.
Br J Sports Med. 2008 Apr 18 [Epub ahead of print]

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 MeSH searches of the above electronic databases. Via these searches and the subsequent review process, controlled trials or systematic reviews were sought where 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 wearers foot type and the outcomes measured 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 was identified either directly or via the findings of the six systematic reviews identified which met the study criteria.

CONCLUSION: The prescription of this shoe type to distance runners is not evidence based.
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Admin2 · Apr 23, 2008

Related:
Other running shoes threads

NewsBot · Mar 11, 2009

Here is a news report from today on this story:
Sports shoe claims still untested: scientists

Scientists say there is no evidence to support the widespread belief that running shoes with sophisticated cushioning or heel supports prevent injury.

Researcher Craig Richards from the University of Newcastle says his team searched almost 60 years of articles relating to running, shoes and injury prevention, and found no published tests on whether hi-tech shoes have a real world benefit.

"We searched all the articles we could identify in the major databases since 1950," Dr Richards told ABC Radio's PM program.

"None of them have actually been control trials and most of them are just reiterating expert opinion or referring to studies which have been performed in a laboratory which don't actually have any real world meaning.

"The bottom line is that these shoes have been experimental for the last 20 years and [are] still experimental."

Dr Richards admits some will argue with his findings.

"To health professionals, to runners to shoe retailers and to the sort of shoes that manufacturers have been producing this is absolutely heretical," he said.

"This is why it is such an interesting finding and one which really needs to be pursued by some careful scientific research now, to establish whether these shoes are good for you, whether they do nothing for you or whether they are actually harmful for you."

President of the Australasian Podiatry Council Brenden Brown says that does not mean consumers should necessarily jump off the treadmill and throw away their shoes.

"I think that it's quite easy to say to say that there are no studies out there suggesting that these shoes in fact work, but there are many products that we use in medicine, health and everyday life [and] there aren't studies to back up their use," he said.

Ben Ly, who manages a fitness centre in inner Sydney, says high quality performance footwear does make a difference to training.

"If you look at the Olympics that were in you know, the 70s and the 60s when they were running in pure flat based shoes on tartan [sic], a lot of people were probably getting more stress fractures than ever before," he said.

"There was no orthotics, there was no inbuilt arch.

"Flat feet is a growing problem. A lot of people are getting pronation in the ankle which relates to knee pain which relates to knee injury, which relates to the hip to the back. It all relates to everything, it all starts at your feet."

Liz Brett, a sports and recreation manager and former Australian Olympic volleyballer, also recommends people spend money on shoes to reduce the risk of injury.

"I do chat to people who come to the UTS fitness centre occasionally and particularly those who aren't wearing proper running shoes who are on the treadmill, I'll often go up and ask them if they've considered purchasing a pair of running shoes," she said.

"You can hear it, you can hear the slapping when you're on the treadmills and you think, it's just an injury waiting to happen."

But she admits she hopes she has not fallen victim to a marketing con job.

"Bloody hope not. I've spent too much money over the years on [shoes] to be conned," she said.

"While there may not be enough information out there or enough research on this particular topic, I do think it's fair to say that there really are good shoes that improve not necessarily improve performance but certainly reduce the risk of injury."
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Link to story

Atlas · Mar 11, 2009

Was telling your 9 year old not to smoke in the 1950s evidence based? Thank goodness parents back then had the wisdom of common-sense and the threat of a cane.:boxing:

Contrary to what I have been told on numerous occasions, I am yet to find a running shoe with "good arch support".

The laziest thing we do is recommend brands. The reality is that shoes are multi-component...and you really have to match the component that matters.

The other thing is that there are footwear sellers that pride themselves on fit. Well until you get a patient with a different foot size (left versus right) coming out with different shoe size (left versus right), no seller should pride themselves on fitting expertise. I realise that there are huge negatives (odd size...cost...stock discrepancy), but if a retailer can't fit the shoe to the foot (not feet), there is no such thing as expert fitting.

Ron
Physiotherapist (Masters) & Podiatrist.

Paulo Silva · Mar 15, 2009

http://www.barefootongrass.com/index_files/MeettheBarefootonGrassboys.htm

Craig Payne · Mar 15, 2009

Paulo Silva said: ↑

http://www.barefootongrass.com/index_files/MeettheBarefootonGrassboys.htm
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THATS INTERESTING. I wonder if the authors of the paper disclosed their financial interest in a barefoot running product to the editors of the journal! They have a vested interest in their being no evidence for running shoe prescription. That does not mean anything is wrong in their publication ... BUT, it should still have been disclosed for potential bias reasons.

Craig Payne · Mar 15, 2009

Just on this topic of evidence for running shoe prescription, there was the post in the Clinical Trials Update thread on this 'clinical' trial:
Footwear and Injury Prevention Study

The purpose of this study is to assess whether shoes that are more controlling for movement of the foot and ankle, compared to shoes that are less controlling, will reduce the overall number and severity of injuries experienced during a 13-week running programme. Our hypothesis is that runners who wear more controlling footwear during the 13-week programme will experience less injury events.
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Atlas · Mar 15, 2009

For the views of a Sydney (Pod) Surgeon & Hugh Jackman's trainer...

http://video.msn.com/?mkt=en-au&brand=ninemsn&tab=m164

(Take note of Australia's quality commercial journalism.:pigs: Probably in the same league as Murdoch's Fox News in the US)

Last October during the Melbourne half marathon, an 80 year old in KT-26's flew past me...with 1 mile to go. The KT-26's were heavier and daggier than my 45 gram Nikes, but he got to the line first.

Apologies for the sample of 1.

Ron
Physiotherapist (Masters) & Podiatrist

Craig Payne · Mar 15, 2009

Craig Payne said: ↑

THATS INTERESTING. I wonder if the authors of the paper disclosed their financial interest in a barefoot running product to the editors of the journal! They have a vested interest in their being no evidence for running shoe prescription. That does not mean anything is wrong in their publication ... BUT, it should still have been disclosed for potential bias reasons.
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Just got the full paper and the author does disclose this interest. However, a close read of the "tone" and use of words in the paper does reflect the author biasis.

BEN-HUR · Mar 15, 2009

This issue has arisen on another forum...

['BEN-HUR' 'Mar 12 2009, 11:32 AM']
Dr Craig Richards has been on this issue for quite a while. He also has a blog & a website:
Blog: http://barefootrunningshoe.blogspot.com/
Website: http://www.barefootongrass.com/index.htm
Dr Richards is also a member (or has been) of CoolRunning. As cited by K_run - the person who started this thread ( http://www.coolrunning.com.au/forums/index...amp;hl=evidence ) & posting under the profile of BOG (which is actually the acronym of Barefoot On Grass) is Dr Richards.

As seen in the above links Dr Richards does have a vested interest in this area & is developing his own variety of shoe (to mimic bare foot running which are named BOGs). He does tend to have a condescending attitude towards the major shoe companies (see blog) & maybe they deserve it to some degree.

I tend to agree with Dr Richards to some extent as described in the following post: http://www.coolrunning.com.au/forums/index...st&p=300633 ... but I do believe that some of the running shoe structures do help the biomechanically challenged continue to partake in running whilst reducing (offsetting) their chance of meeting their injury threshold to some point.
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Running injuries is multifactorial i.e. training errors,'poor' biomechanics, 'poor' muscle conditioning for the activity etc.; running shoes is just one of these factors & probably a minimal factor in relation to the group.

However I do believe in all (for 'efficient' & 'inefficient' runners) cases, the height of the heel should be reduced in the majority of running shoes - from the 'neutral' to the 'control' categories.

Craig Payne · Mar 15, 2009

BEN-HUR said: ↑

This issue has arisen on another forum....
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I wonder how they will respond when we get the results of this trial:

Craig Payne said: ↑

Just on this topic of evidence for running shoe prescription, there was the post in the Clinical Trials Update thread on this 'clinical' trial:
Footwear and Injury Prevention Study
Click to expand...

I don't mind people being biased, as long as they are up front with what "colour lens" that they are looking at the world through, so we can interpret what they say and do with that context in mind.

NewsBot · Mar 31, 2009

Press Release:
Podiatry New Zealand Steps into Sports Shoe Debate

Podiatry New Zealand, the peak body for podiatrists in New Zealand today warned
that consumers would be foolish to believe a recent University of Newcastle
study suggesting sports shoes provided no protection against injury.

President of Podiatry New Zealand, Mr Bruce Baxter said the recent report
(published on 11 March 2009) unfairly discounted the important role sports
shoes played in supporting feet.

“It’s important we keep in mind that no one has questioned the legitimacy of
the University of Newcastle’s report or the validity of the research on which
it is based,” said Mr Baxter.

Mr Baxter asked readers of the report to note the second hand nature of the
research.

“I have information that would suggest the foundation on which this study was
based came from, not a ‘pool of sports science research’ as suggested, but just
‘one’, singular British study in which the University was involved,” said Mr
Baxter.

Mr Baxter said that although there may be no strict evidence (of a sports
medicine nature) showing sports shoes prevent injury; there was nothing, no
hard evidence, to suggest they didn’t play a part in protecting feet.

“I think it’s unwise to suggest that sports shoes play absolutely no part in
protecting the foot from injury,” Mr Baxter commented.

“I know if I was running a half marathon, I’d prefer to be wearing a pair of
well designed sports shoes than to run in bare feet,” said Mr Baxter.

Mr Jason Mansfield, General Manager of Britain Wynyard who is the designer and
distributor of the ASICS brand, said there was evidence that refuted the claims
made by the University’s study.

“Britain Wynyard use Biomechanists to ensure our sports shoes pay the highest
level of attention to not only comfort, but safety, so I believe the report is
a little misinformed,” said Mr Mansfield.

Biomechanics is the application of mechanics and physics to a biological
system, such as the human body. Typically, biomechanical engineers have a
technical background in engineering (both mechanical & biomedical) with
additional experience and education in biological science.
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