Gait Analysis and Shoe Fit: Do They Prevent Injury?

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A common question asked by our athletes is: "What type of shoe should I wear to avoid injuries?"

In recent years, shoe manufacturing companies have gone to great lengths to produce highly-engineered, sport-specific shoes in order to improve performance and prevent sports-related injuries. The resulting shoe types vary in design from neutral to full-stability and include specifications for over-pronators, heel-strikers, forefoot runners, supinators, high arches, flat feet and so on.

In turn, many running stores have started analyzing running styles and foot-strike patterns so they can more accurately fit the athlete with a shoe that matches their gait pattern. As a result, many injured athletes have gone to great lengths, spending time and money trying to find a shoe type that will help them avoid injuries.

On the surface, if you are a so-called over-pronator, it makes sense to think that you should be wearing a shoe type referred to as a "stability" shoe. The idea being that the shoe will limit the amount of pronation and therefore reduce the resulting injuries commonly caused by this condition. This has been the advice that many professionals, including ourselves, have been giving athletes and patients when faced with the question.

Surprisingly, the most recent studies say otherwise!

Two studies recently published in The American Journal of Sports Medicine and the British Journal of Sports Medicine found absolutely no correlation between shoe types and injury reduction/avoidance. The study published in the American Journal of Sport Medicine (ajs.sagepub.com; Injury Reduction Effectiveness of Assigning Running Shoes Based on Plantar Shape in Marine Corps Basic Training) involved thousands of military recruits who were divided into various groups. Some were fitted with the "proper shoe type", while others were given shoes at random without any assessment of foot strike or gait pattern. At the end of the study period the reported results indicated that there was no relation between fit and injury prevention.

In the British Journal of Sports Medicine (bjsm.bmj.com; The Effect of Three Different Levels of Footwear Stability on Pain Outcomes in Women Runners) a similar study was done involving 80 female runners who completed a 13-week running trial. Interestingly, in this study the majority of those who reported missing days due to injuries or pain were those who were fitted to their shoes.

The final recommendations based upon these studies were that shoe fitting has no bearing on injury prevention as it relates to running. It seems to boil down to the basic rule that any athlete should follow: If it hurts, it's not right for you.