Does Cushioning In Running Shoes Prevent Injuries?

A study published last year shows that soft cushioning in shoes that had been marketed to runners as extra shock-absorbing to prevent injuries, makes no difference in injury prevention.

Researchers took 250 regular runners and conducted a blind trial with identical looking shoes with varying levels of cushioning. They found that body weight and overall fitness made a difference in injury rates, but shoe-softness did not. 

"The results do not support the common argument from the running shoe industry that runners with higher body mass should be recommended shoes with great shock-absorption characteristics," said lead author Daniel Theisen of the Sports Medicine Research Laboratory of the Department of Public Health in Luxembourg.

Previous research had suggested that cushioning can reduce certain mechanical stresses on the body, and Theisen, who has a PhD. in sports science and is a runner himself, decided to test that theory. 

However, past tests of extra cushioning in real world situations, such as with the US Air Force recruits in basic training, did not show any benefit. Theisen's team set up the first randomized, double blind controlled trial to see if shoe-softness affected running injuries in leisure runners. 

Participants were recruited through newspaper articles and Internet sites and randomly split the 247 participants into two groups. The men and women were between the ages of 30 and 50, had body mass indexes that were normal or slightly overweight, and ran an average of 10 miles per week.

Shoes were provided by "a renowned sports equipment manufacturer" and were customized versions of a model sold in stores. The shoes were stripped of decorations and appeared identical, except that half of the shoes had a soft midsole. The difference in shock absorbing qualities was found to be 15%. Theisen said that no larger difference could be produced as it participants would have noticed the differences. 

The runners were instructed to train at least once a week and to wear their shoes just for running. The shoes were worn for five months and all training data and injuries were reported on an Internet platform. An injury was defined as pain from running that caused the runner to stop for at least one day. 

Of the 69 runners who had injuries, 32 had hard soled shoes, and 37 had soft soled shoes. The majority of the injuries were chronic overload injuries of tendons, joints, and muscles. 

"We evaluated the severity of the injury by looking at how many days people were not able to do their normal running training and or whether they stopped running altogether, " Theisen told Reuters Health.

The differences between shoe models may have been too small to detect a noticeable difference, but Theisen thinks the study results "make good sense because our ancestors were great runners but they never wore running shoes."

Dr. Mark P. Kelly, an exercise physiologist with the American Council on Exercise and a veteran runner himself, believes that cushioning "takes away from the tactile sensation that tends to protect a runner. In other words, if something hurts our feet when we are jogging, we will naturally change things up so it doesn't hurt. If anything, a harder midsole offers more protection, because it may induce more stability on the plantar surface of the foot and thus spread the impact out more evenly."

Kelly is currently working on studying the effects of minimalist shoes on running injuries and running gait, and added, "The more we learn about running the more we are learning that more cushion and support is not only better but may actually be worse."

Reference: Baltimore Sun. 

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Connecticut Foot Care Centers

Podiatrist in Middletown, CT and Rocky Hill 

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