Today’s Patient Money column takes a look at the many upgrades shoe makers are adding to athletic shoes.
Shoe manufacturers keep adding bells and whistles to shoes in the form of cushioning gel pods, microprocessors and so-called thrust enhancers, but these upgrades don’t seem to make runners safer. A review of current studies on running shoes published in 2009 found that there were no evidence-based studies that show running shoes actually help prevent injury. Indeed, injury rates have not gone down.
Fancy running shoes may even lead to injury, experts say. Some studies show that when runners don expensive running shoes that promise superior cushioning, they incur more injuries than runners using cheaper shoes.
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For Running Shoes, It’s Fit First and Price Last
By LESLEY ALDERMAN
Published: October 22, 2010
SHARON TANENBAUM has been a serious runner for six years. The Brooklyn resident, 30, has completed three marathons and several shorter races. Each week she logs about 20 miles.
Her favorite trainers? A $25 pair of Champion shoes she bought at Target.
“I like running in simple shoes,” she said. “The more you pay, the more unnecessary stuff you get.”
She is right. Money often buys higher-quality goods, but not when it comes to running shoes.
Over the last three decades, running has exploded as a leisure sport. In 2009, 476,000 runners completed a marathon. In 1976, the number was just 25,000. Sales of running shoes reached a record $2.36 billion in 2009, 60 percent more than a decade earlier.
But some of those dollars may not have been well spent. In 2007, Scottish researchers tested running shoes at three price levels, ranging from $80 to $150, and found that low- and midcost shoes within the same brand cushioned runners’ feet just as well as high-cost ones — sometimes even better.
“The perception is that if you pay more, you will get better shoes,” said Rami J. Abboud, director of the Institute of Motion Analysis and Research at the University of Dundee in Scotland. “Our research did not show that.” Professor Abboud and his colleagues have just completed a similar study, as yet unpublished, with nearly identical results.
Shoe manufacturers keep adding improvements to shoes in the form of cushioning gel pods, microprocessors and so-called thrust enhancers, but these upgrades don’t seem to make runners safer. A review of current studies on running shoes published in 2009 found that there were no evidence-based studies that showed running shoes actually helped prevent injury. Indeed, injury rates have not gone down.
Fancy running shoes may even lead to injury, experts say. Some studies show that when runners don expensive running shoes that promise superior cushioning, they incur more injuries than runners using cheaper shoes.
The authors of one such study concluded that there was a “tendency in humans to be less cautious when using new devices of unknown benefit because of overly positive attitudes associated with new technology and novel devices.”
If you want to run well and run safely, consider fit first and price last. “You want a shoe that helps you maintain a balanced position,” said Mark Montgomery, manager of the JackRabbit Sports store in Union Square in New York. “A more expensive shoe is not always the solution.” With the ING New York City Marathon approaching on Nov. 7, here are some guidelines for buying the best shoe for you.
A SHOE THAT FITS If you are new to running, or have not been fitted in a few years, go first to a reputable store that specializes in running shoes. A well-trained salesperson should analyze your gait and inquire about your running habits before recommending a shoe.
At JackRabbit Sports, a salesperson typically videotapes customers running on a treadmill to figure out what type of stride they have. Pronators, those whose arches roll inward, for instance, may need a shoe with motion control, which may be a bit more expensive than neutral shoes.
That first fitting is important, because it will give you a sense of what type of shoe is best for you. Once you know, you can head down-market for the bargains.
“When I first started running, I went to a specialty store,” said Ms. Tanenbaum. “Now I can shop anywhere, even Target, because I know what works for me.”
It is wise, though, to get refitted every few years. Over time, your arches tend to fall and your feet become longer. The model or type that worked well for you in your 40s may not be the best one for you in your 50s.
SIZE IT UP What is a good fit? Buy a running shoe that is a half size or so larger than your regular shoe. There should be a thumb’s width between the tip of your big toe and the top of the shoe.
Don’t get too hung up on the official size. Sizes vary from brand to brand and model to model. Ms. Tanenbaum buys shoes that are two sizes larger than her regular shoes.
“Most shoes are mass-produced these days, with no real attention to detail or quality,” said Professor Abboud. “If you take two pairs of shoes from the same brand, you will not be guaranteed the same size shoes. It may vary by up to one size in length.”
Make sure the shoes are not too tight across the arch and that your heel is snug. They should feel comfortable right away. “The shoes should feel like they belong on your feet,” said Gordon Bakoulis, 49, a running coach in New York City who has competed in four United States Olympic Marathon Trials.
If you are planning to run a long race, spend at least two weeks breaking in your new shoes before start day.
LESS IS MORE The cheapest solution? Forgo shoes altogether and join the legions of runners who have embraced the barefoot trend.
It is not just a fad. A few studies have suggested that running barefootmight be better for your body over the, ahem, long run than running in shoes. A 2009 study found that compared to going barefoot, running shoes put more pressure on the hip, knee and ankle joints and concluded that running shoes could put athletes at greater risk for osteoarthritis of the knee. Earlier studies found that running shoes could increase the risk for plantar fasciitis and ankle sprains.
But podiatrists urge caution before running without shoes. “I tell my clients it’s great thing to try,” said Dr. Karen Langone, a sports fitness podiatrist in Southampton, N.Y. “But it’s not for everyone, and it should be gradually incorporated into your running program.”
Some people require the mechanical support that a running shoe offers. “I saw quite a few patients this summer who had developed shin splints from running barefoot,” she said.
Minimalist shoes are a good hedge for runners who favor simplicity, but who do not want to fully embrace the barefoot trend. If you want to approximate the experience, look into the Nike Free (about $85) or the Saucony Kinvara (about $90). To get even closer to the ground, try Vibram’s Five Fingers shoe ($75 to $125), which has very little support and is more akin to a water shoe than a running sneaker.
“The less you think about a shoe, the better,” said Ms. Bakoulis, the marathoner.