Shoe Choice and Injury Prevention

Shoe Choice and Injury Prevention

Shoe Choice and Injury Prevention

Shoe Choice and Injury Prevention

Runners Shoe Choice, Injury Prevention and Rehabilitation.

 

Picking your shoes for training and racing can be one of the most important gear choices you can make. It can make the difference between enjoying your running or just being constantly injured. As a Personal Trainer and Running Coach I’ve noticed a few trends with my clients injuries and their choice of shoes yet more significantly I have witnessed that shoe choice can alas help elevate chronic pain from runners and allowing them to training whilst making their injured muscle stronger and more flexible.  I am sponsored by inov-8, I am on the inov-8 International Trail Running Team inov-8 shoes really work for me and yet I have noticed that my clients, every day runners have gained the same benefits as I have and avoided injury from following the below guidelines.

 

How many Ks Should I put into my shoes?

 

The amount of ks to be put into a shoe will vary depending on the brand and model of the shoe. As we run our natural or not so natural Bio-mechanics will determine the strike point and wear pattern that the clients running action will build up on the sole of the shoe.

This problem always must be in the back of your mind when a client whom body is sound, strong and with a good range of motion, thus injury free for a period of time suddenly starts to experience pain. Their shoe choice should be taken into consideration. Their pain could just be due to they may just need a new pair of shoes. Their wear pattern may have made the sole of the shoe more compressed on a point of the sole thus sending extra pressure through the ankle, knee, calf, hip, back, the list can go on.

 

I like to limit my clients to 500km per shoe for Long Distance Slow and High Intensity Running Sessions. After that the shoe can be their 30 min easy session shoe, gardening, walking etc.

 

The Importance of Shoe Rotation can not be emphasised enough.

 

On the plus side Shoe Rotation is also a great way to improve the longevity of your shoe. If the shoe is not rotated frequently the foam will compress faster than a highly rotated shoe.

 

I recommend 2-4 pairs of shoes to be used in the week and 1 pair of shoes to be used on the weekend for your long runs.

 

The reason for this is that the foam in the sole of the shoe will compress when training. It will compress more on hard surfaces like road or concrete. So I recommend the following;

 

  • Shoe A Wear on Monday and Tuesday
  • Shoe B Wear on Wednesday, Thursday (Old pair of Shoes)
  • Shoe C New pair of Shoe to be worn for light sessions in the 2 weeks -1 month before the event. The shoe stiffness and structure will determine the amount of wear in time that is needed before the event.
  • Shoe D Wear on Saturday or your Long Run day. Newest Pair.

 

Trail Running and its benefit to injury prevention and rehabilitation;

 

I’ve watched so many of my clients whilst training for a marathon, building up the kilometers on the road be crippled with Runners Knee (ITB) , Calf , Stress Fracture injuries. It is usually after building up ks over 30km on the road. The muscles in the body has to work extremely hard to cushion the impact of receptive force of running on the road. The amount of force on the body is 3 X Greater than running on Grass or Dirt. When the muscle become fatigued the bio-mechanics can alter in the running action, loss of form and increasing the risk of injury on the joints.

 

If a Road Running Client becomes injured from receptivity over use injury from road running I would recommend that all training should be completed on a trail, grass and dirt where ever possible.

 

In my programs for my clients I recommend that all Long Runs, Speed and Intervals are to be completed on grass, dirt or trail.

Trail running also forces your body to move in different directions. As the trail changes direction, the runners must too. Dodging, weaving, jumping using ones core to maintain balance, perfect form whilst clearing longs, steps, roots etc. The ascents and descents are usually bigger on a trail forcing the runner to become fore efficient with every step, adopting a shorter stride and increasing their cadence. The outcome is that the runner becomes more balanced bio-mechanically, stronger,  lighter and faster on their feet.

 

Barefoot Running

I like to have my clients running for 10 minutes in a cool down which equates for about 3 laps around an oval every week with NO SHOES ON. This will improve the strength and flexibility in the feet and their entire leg. It will also help encourage a more lighter running technique thus preventing impact injuries. If the athlete is a novice, I will walk and run with the client 20 steps running, 20 steps walking before running, 50 then 100 steps at a time. Encourage the client to walk around in Barefoot whenever possible.

 

Here are some common Injuries and how we can suggest a shoe choice to help prevent rehabilitate this injury;

 

Metatarsal Stress Fractures

Overuse injury usually in runners building up kilometers and NOT CHANGING THEIR SHOES OFTEN ENOUGH.

Check out the below link for my Stress Fracture Rehab in 2010-2011in which I had stress fractures in BOTH of my 2, 3 and on my left foot 4 and 5th Metatarsals.

http://www.shonastephenson.com/2011/12/stress-fracture-re-hab-program.html

After cross training and heaps of Ice Foot Baths and ultrasound I managed to rehab my feet.

I recommend

 

  • HIGH ROTATION of shoes should be adopted for a YEAR after running again and forever more.
  • Take note of how the shoe sole compresses and avoid shoes that compress in the ball of the foot too early in their lifespan.
  • Running Action should be checked and a lift rather than push action should be adopted. The client should be encourage to run lighter on their feet with a high cadence rate aiming at 200 steps per 60 seconds. 
  • Getting your client to ride a bike and to check their cadence rate on the bike will help them develop this higher cadence technique of 100 Revolutions/Min
  • I’d also recommend AVOIDING the road when ever possible. They will find that they will not be able to run fast on the road for more than 10km however be able to run 100km on the trail.

 

Whilst the client is injured the Hoka One One, Cloud Tech shoes are a way to get them running a bit more safely on the road. Inov-8 F-Lite 215’s will help perfect their running action to prevent them from injuring themselves in the future. The sole on the F-Lite is a rubber compound that will not compress like Foam base Soles will.

For the Trail I really like the Inov-8 Trailroc 255’s they are lite weight and have a rock protection plate in the sole to prevent rock protrusion bruising on the ball of your feet. The rubber sole does not compress and the longevity of the sole upper and lower is really high easily plus 500ks.

 

Shoes to Look for

  • Inov-8 f-lite 215’s
  • Inov-8 f-Lite 195
  • Inov-8 Trailroc’s 255, 235, 
  • Hoka One One
  • Cloudtec.

 

Runners Knee-ITB Band

Runners knee is caused by a lack of Glute Medial Strength and/ Or  Flexibility. Or an imbalance in the structure of the muscles around the knee.

If after strength and stretching exercised are not helping I’d suggest switching to a pair of shoes with less heal to help encage the Glutes to switch on and become more active whilst running. Again the Inov-8 F-Lite 215, Inov-8 F-Lite 195, New Balance Minimus. I like my clients to walk around daily in these type of shoes too to again teach the body to switch on the glutes to help gain more strength.

I’d also encourage my clients to complete all “Long Runs” and “High Intensity” Training on dirt, trail or grass. The impact is much softer on the body and as mentioned above the entire body is used whilst trail running and greater strength throughout the glutes and hamstrings is achieved.

 

Knee Strength Exercises;

  • Single Leg Squats
  • Running Man
  • Sumo Squats
  • Supine Hip Extensions
  • Walking Lunges
  • Bonus these exercise will usually fix a back injury too!

 

Shoes to Look For- Minimal Heal Drop 6min from front to back

  • Inov-8 F-Lite 190
  • Inov-8 F-Lite 215
  • Inov-8 X-Talon 212
  • Inov-8 X-Talon 195
  • New Balance Minimus
  • Nike Free
  • Adidas Zeros

 

Achilles Tendonitis and Calf Injuries

I’ve lumped these into on category but can be very different in their lead up. Achilles Tendonitis is an overuse injury of client who are usually carrying too much weight on their body whilst running over hilly terrain. This is a perfect storm for trail runners who are running massive climbs with a pack on their backs or in new clients who have lack of strength and flexibility in their calves and might be carrying too much weight on their body. Or can be cause by poor warm up then a sudden fast sprint.

Recommendations to clients would be to try and reduce the weight on their body and improve strength and flexibility, extend warm up period and introduce ROM into their warm up.

Calf usually injuries pop up in runners who are running FAST on hard surfaces and are using their calf muscles to soften the impact of running on their joints.

Both of the above injuries can also be made WORSE by wearing shoes with not enough Flexibility in the sole.

 

  • Shoes that are HEAVY and with NOT ENOUGH FLEXIBILITY in the sole will bring on an injury in a flash. 
  • NEW NOT WORN IN SHOES can be a perfect recipe for disaster for an athlete! 
  • So wear in shoes properly if they are stiff better still PICK light weight flexible shoes to begin with and hopefully the above injury can be avoided.
  • I have also noticed that shoes that are TOO NARROW in fit for the ball of the athletes’ foot can also lead to calf and Achilles injuries.
  • Make sure your shoe is the correct fit and wide enough for your foot and remember that your foot can swell up an extra size, in hot condition 2 extra sizes so it is important that the shoe is wide enough for your foot.

 

Again not enough flexibility and width in the sole can prevent the foot muscles from working properly.  This is because the foot does not have enough room to switch the muscles in the feet on to start the reduction of impact in the body from the balls of the feet up through the ankle and into the calf, hamstring, glute and so on. I’d encourage the client to check their shoes and make sure their feet are able to switch on and fully function whilst running. Foot activation can really help prevent most injuries.

The below shoes will increase the strength and flexibility of the athlete. Dropping the heal drop ands wearing more flexible shoes and can lead to initial calf soreness however the outcome is that the athlete will have a strengthen and great Range of Motion in their calf, feet, hamstrings and glutes. So strength and flexibility exercises must be improved to switch on and strengthen the muscles in your feet.

A Slow build up into dropping the heal drop must also be completed to prevent re-injuring the calf. After the calf is functioning properly Plyometrics should be added into the weekly routine to strengthen the calf and prevent the injury from reoccurring.

A heal insert can be won in the injured legs’ shoe to help with the transition also.

 

Examples of Light Weight Flexible Shoes;

  • Inov-8 F-Lite 190
  • Inov-8 F-Lite 215
  • Inov-8 X-Talon 212
  • Inov-8 X-Talon 195
  • Inov-8 Trailroc 235
  • New Balance Minimus
  • Nike Free
  • Adidas Zeros-Can be a bit stiff so be careful.

 

Calf Strength Exercises;

  • Calf Raises Single Leg with KNEE STRAIGHT! EVERY DAY!
  • Single Leg Squat to Calf Raise.
  • Point and Flex just like a ballerina 
  • When strong enough hopping and jumping.

 

In 2013 I tore my Achilles tendon from wearing a new pair of shoes with not enough flexibility in the sole of the shoe compared to what my body was use to whilst doing speed work on the road. I added an insert to my most light weight and flexible shoes, avoided the road like the plague, made sure my shoes I was wearing were wide enough for my foot, completed all my high intensity training on a stationary bike and in 6 weeks was able to race the Mt Blanc Marathon in Chamonix France and win a 9th Place in the Inov-8 X-Talons 190.

 

Hamstring Injuries

This injury is found in runners who have been running for about a 2 years and they have had the ITB Band, Calf/Achilles now it is the hamstrings turn become sore and tight. Or in people, mainly men who just don’t stretch and live a sedentary lifestyle.

The reason for this is that it could be that their glutes again are not firing and their hamstrings are taking up too much of the slack. They could also be doing NOT ENOUGH VARIED RUNNING Training and avoiding speed work in endurance athletes, thus the shortening of the hamstrings and less range of motion throughout each stride. Avoid the bike if cross training and get those glutes working again.

I’d have a look at the shoes and if they are in a pair of shoes with more than a 6mil Drop I’d be encouraging them to hop into a minimal running shoe to help lengthen and improve the range of motion in the hamstring and calf muscle. Hopefully your client with some more stretching and strength in the hamstrings will find relief within a few weeks. The pair of shoes I found had the best impact in my personal experience is the Inov-8 f-Lite 195 for the Trail Inov-8 X-Talon 190 and Inov-8 Trailroc 235.

 

Hamstring Strength Exercises;

  • Supine Hip Extensions
  • Opp-Arm to leg Back Extensions
  • Sumo Squats
  • Walking Lunges
  • Running Man
  • Burpees
  • Squat Jumps
  • Rowing Machine
  • Kettle Bell Swings

 

Examples of Light Weight Flexible Shoes;

  • Inov-8 F-Lite 190
  • Inov-8 F-Lite 215
  • Inov-8 X-Talon 212
  • Inov-8 X-Talon 195
  • Inov-8 Trailroc 245
  • Inov-8 Trailroc 235
  • New Balance Minimus
  • Adidas Zeros

 

Hip Injuries

Hips are the stabiliser of the body whilst running. Again those glutes can really help sure up the bodies defence again a hip injury. Apart from strengthening and stretching check the wear pattern on the sole of your shoe and see if the outside of the shoe has been worn down more quickly compared to the middle and inside of the sole of the shoe. If yes a new pair of shoes must be bought.

Any shoe with less heal drop will engage the glutes and build an armour around your hips thus preventing further injuries.

Becoming lighter on your feet, increasing your cadence, and reducing the impact suffered through your hip joint will also give relief to an athletes symptoms. I’ve found that heal strikers are in more danger of suffering from hip injuries. Again a shorter, high cadence running action should be encouraged.

A tip to help prevent soft tissue hip flexor injuries, driving forward with your knee rather than lifting your knees can also help with this injury. But again check the shoes and make sure a high rotation of the athletes shoes is being met.

 

Exercises for Hip Injuries

  • Lunge with a Row Opp-Arm to Leg 
  • Walking Lunges
  • Sumo Squats
  • Supine Hip Extensions
  • Running Man
  • Kettle Bell Swings

 

Examples of Light Weight Flexible Shoes;

  • Inov-8 F-Lite 190
  • Inov-8 F-Lite 215
  • Inov-8 X-Talon 212
  • Inov-8 X-Talon 195
  • Inov-8 Trailroc 245
  • Inov-8 Trailroc 235
  • New Balance Minimus
  • Adidas Zeros
  • Inov-8 TRI-EXTREME 245

 

Shin Splints

Again the overuse of shoes really does injure the body. I can not stress this enough. Shin Splints and calf injuries can go hand in hand. I found that 5 of my clients wearing one particular brand/model of shoe suffered this injury. I asked them all to switch brands and models and the pain subsided and they were able to run normally again.

Shoes that don’t allow for the normal blood flow to move from the foot up the calf will increase the risk of shin splints also. Shoes with laces done up too tight will also restrict the blood flow to the muscles in the calf thus leading to lack of performance in the muscle, bring on damage to the origin point of the muscle on the Fibular/Tibular.

Shoes that the upper inner sole and foot plate wears out too fast, breaks and compresses can also bring on shin splints, as well as treadmill running. Again rotate the shoes, make sure the shoes do not have more than 500ks in them and choose a pair of shoes with a rubber compound that won’t compress too early in it’s like span.

Wearing Compression Socks can help elevate the pain, increase the blood flow to the calf muscles from the shoe and help with the rehab of the injury. Again switch to a pair of shoes that allows the calf muscle to work efficiently.

Some clients especially older females must be careful when STARTING to RUN for the first time after years of inactivity. I’ve found they are at high risk of a hard tissue injury like a shin splint or full blown stress fracture because they do not have the strength or bone density to prevent a hard tissue injury like a shin splint. So a slow build up on grass is what I’d recommend for this client.

 

In Novice Clients I had them switch to Asics.

 

In more experienced runners I had them switch to

Inov-8 F-Lite 190

Inov-8 F-Lite 215

Inov-8 X-Talon 212

Inov-8 TRI-EXTREME 245

Inov-8 Trailroc 245

Inov-8 Trailroc 235

New Balance Minimus

Adidas Zeros

 

Every Day Novice Runner Shoes that I have found give little or no injuries to my clients are the Asics range and Adidas Range. The Nike Frees are good however the foam compound in the sole does compress and become uneven quite quickly.

 

Tibialis Posterior Tendonitis

I’ve found that clients who are again wearing their shoes for too long will suffer from Tibialis Posterior Tendonitis. It can be a bit like shin splints. The wear medial pattern of the shoe will usually indicate this for you. The runner will have collapsed the medial or inside of the shoe. The sole of the shoe will be too spongey and would have collapsed thus leading to a strain on the Tibialis Posterior Tendon.

In 2013 I banned a Type and Model of Trail Shoes to all my clients that I found was repeatedly injuring my clients

I’d recommend a shoe change to a more ridged heal and with stability in the ankle to let the tendon rest and heal.

 

Shoes that can help with Tibialis Posterior Tendonitis

Inov-8 Roclite 268

Inov-8 Roclite 243

Inov-8 TRI-EXTREME 245

 

 

 

 

Flat Foot Runners

Usually runners who are flat footed wear an orthotic. I’ve found that the Brooks Range are the best for these runners to start in. However I’d encourage your client when ever possible to drop into a lower profile shoe to help prevent any of the above injuries.

Basically when buying the shoe they are limited to what their orthotic fits into. I would still encourage the essence of the above advise on allowing your Foot do its job of being a foot.

A flat foot runner is at a greater risk of Plantar fasciitis. Plantar fasciitis is caused from the arch of the foot collapsing through lack of foot strength and flexibility the fascia tendon becomes hard, painful, inflexible and can even pull on the heal and lead to fragments of bone to be pulled off the heal bone. Ouch.

Again the reduction of weight is highly recommended in runners carrying extra kilos thus putting more stress on the joints. For every BMI point a client is above their healthy weight range they can increase their risk of injury by 14%.

 

An orthotic may be recommended or the client MUST Increase the strength and flax ability in their feet. I like to get my clients to treat their feet like Ballerina’s and advise them;

 

  • “Point and Flex” exercises.
  • Calf Raises
  • Single Leg Squats
  • Hip Extensions
  • Hot epsom Salt Baths
  • Massage will really help to break up the scar tissue in the arch.
  • Rolling the arch of the foot on a Golf Ball every night will help with the healing process.
  • Foot Ice Baths After Every Training Session that Inflammation is felt.

 

With gained foot strength and flexibility along with increasing Calf, Hamstring and Glute strength and flexibility and with a little help from cross training on a bike until the injury has healed the client should be able to return to running and shoe choice should be taken slow and gradually.

 

  • inov-8 Roclite 268
  • Asics

 

Ankle Injuries

A runner can be suffering from a life time of this particular type of injury. Women who have played Netball, Men/Women Football, Gymnasts, Basketball Players all usually would have sprained the ligaments in their ankle at some stage. Trail running is also an ankle killer. I recommend that the ankle/s are tapped if the athlete has suffered from a sprained ankle in the past.

 

What can increase the risk of a sprained ankle?

 

  • Shoes with too much Pronation Support can also increase the risk of an ankle injury, as well as some of the above injuries.
  • Shoes with too narrow a sole, or impact point can flip the ankle over also.
  • Shoes with not firm enough ankle structure 
  • Shoes with a ridged and straight edge to the catch point on the outside of the shoe.

 

  • Look for shoes that fit the ball of your foot correctly.
  • Avoid shoes with pronation support.
  • Check that the shoe fits the ankle snuggly

 

The for road I especially recommend the inov-8 TRI-EXTREME 245’s they are wide at the balls of the foot, fit snugly around the ankle, lock in the ankle at the heal and have a nice ride whilst running. The inov-8 X-Talon and inov-8  Roclite Range are great also as the Sole of the shoe has a clean straight edge.

 

  • Inov-8 F-Lite 190
  • Inov-8 F-Lite 215
  • Inov-8 X-Talon 212
  • Inov-8 X-Talon 195
  • Inov-8 Trailroc 235

 

Key Points to Picking a Shoe

 

  • Flexibility
  • Weight
  • Width at balls of Feet
  • Length for Correct Size
  • Fit around the ankle and arch of foot
  • Minimal Details around the toes
  • Heal Fit

 

The Tread is determined by the surface and terrain.

 

Cushioning

 

I’ve found that in clients who have followed a training program with proper strength and flexibility exercises especially designed to improve the running form and reduce their risk of injury can run in a more minimal style of running shoe to increase their strength and flexibility in their feet thus improving their form and reducing their risk of injury.

 

Entry Level first shoe for my clients are the following;

 

  • inov-8 Roclite 268
  • inov-8 TrailRoc 255/245
  • inov-8 f-Lite 215’s
  • inov-8 TRI-EXTREME 245

 

http://www.barefootinc.com.au

http://www.inov-8.com/New/Global/Index.asp?L=26

For more information on Shoe Choice and Injury Prevention please send us an email.

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