The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.
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Choosing the Correct Running Shoe Based On Foot Type or Why Not Just Go Barefoot?
Most people believe that running barefoot is dangerous. Certainly, depending upon the surface, they would be correct. However, there is some suggestion that running barefoot may reduce injuries.
By Tod Sweeney, MD
Sports and Family Medicine of Colorado
Who doesn’t remember their first experience running on the beach, barefoot and carefree? - The freedom of the open air and that connection with Terra Firma. Well, running barefoot is not a new phenomenon and has existed for most of human evolutionary history. In fact, the modern running shoe was not invented until the 1970’s. Most people believe that running barefoot is dangerous and hurts. Certainly, depending upon the surface, they would be correct. However, there is some suggestion by researchers that running barefoot might reduce injuries. Daniel Lieberman, PhD, professor of human evolutionary biology at Harvard University and colleagues recently published an article in the January 28th issue of the journal of Nature that suggests that runners who run without shoes usually land on the fore-foot before bringing down the heel versus those in shoes who typically land on the rear-foot, facilitated by the cushioned and elevated heel of the typical running shoe.
Biomechanical analysis in these studies have shown that running barefoot causes less collision force to the feet than running in cushioned shoes. More research in this area is needed to truly determine if injury patterns can be affected by running barefoot.
For those running enthusiasts interested in going barefoot, they should certainly ease into this process. A slow transition is critical to build strength in the foot and lower leg muscles. One might consider starting by walking barefoot around the house, doing foot and lower leg strengthening exercises and then starting with low mileage on a flat surface. Shoe running on grass is another way to strengthen the lower leg muscles as a bridge to barefoot running.
Runners who want some level of protection from ground elements might consider the footwear sold at Vibram Five Fingers. They also have a short video on their website on barefoot running by Dr. Lieberman. Another possible bridge to barefoot running might include the Nike Free shoes, which provide less support.
Choosing the Correct Running Shoe
For those who cannot overcome the fear of running barefoot or simply have no interest, shoes would be in order. So how does one choose the shoe that is right for them? Everyone has different needs, so there is no single best answer. Many factors, such as biomechanics, weight, running surface and the shape of your feet will play a role in choosing the correct running shoe. A running analysis performed by a professional and/or a wet footprint test can often lead you in the proper direction regarding shoe ware. These tests can determine your foot type.
The normal foot has a normal arch and the normal foot lands on the outside of the heel and rolls inward. These runner’s often benefit from a stability shoe with some control features.
The flat foot has a low arch and often indicates an overpronated (rolls inward) foot – or one that strikes on the outside of the heel and rolls inward excessively. Motion control shoes or high stability shoes can help reduce the degree of pronation and hopefully prevent overuse types of injuries. Highly cushioned or curved shoes which lack stability should be avoided.
The high-arched foot is generally supinated (turned outward) or underpronated. Lack of shock absorption is often a problem with high-arched feet and thus cushioned shoes with plenty of flexibility should be considered. Consider staying away from motion control or stability shoes, which reduce foot mobility.
Most major running shoe manufacturers produce shoes ranging from total support to total cushion and people really need to try them on. I recommend people go to a specialty running shoe store and get videotaped to see exactly how their foot responds to the running load placed on the feet. Shoe companies come out with new or redesigned models at such a pace that it is often difficult to keep up with them.
Dr. Sweeney is a Sports and Family Medicine Physician practicing in Arvada, Colorado.
Tod Sweeney, MD
Sports and Family Medicine of Colorado
6390 Gardenia Street, STE #140
Arvada, CO 80004
Foot strike patterns and collision forces in habitually barefoot versus shod runners. Lieberman DE – Nature - 28-JAN-2010; 463(7280): 531-5
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