Rotating Your Running Shoes Decreases Injury Risk | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

Rotating Your Running Shoes Decreases Injury Risk

Like anyone had to give me another excuse to buy a new pair of kicks. Embarrassingly, I must admit that the photo at left is what I've accumulated IN CHINA with regards to sneakers. Apparently if I wanted to go on a trip with a suitcase full of just shoes I would still have to be picky. And this doesn't even touch on what is in my storage unit in Los Angeles!

Lately, I've been doing a lot of research on shoes and gait patterns during my own recovery from a foot and ankle injury that has had me sidelined for months. With two marathons on my race calendar this year, I need to make sure that my rehabilitation is effective and efficient.

Most of my research and experimentation has focused on running cadence and foot strike pattern. While I won't get into the exact reasoning behind all of my choices (although I promise I will write about this in the future -- it's been quite an interesting and enlightening journey), a lot of what I believe is based on the importance of sensory input at the foot and its effect up the kinetic chain. When I first got hurt I saw multiple medical practitioners, including MDs, Podiatrists, and Physical Therapists. They were quick to put me in super supportive shoes, orthotics, shoot me up with Cortisone, and even suggest surgery as an option. Many told me to find a new sport and that running wasn't a good choice.

After getting progressively worse (despite being a good patient,), I started to think maybe all of this support was actually resulting in global weakness. Although this is a concept I tell my patients about all the time, telling myself was a different beast - but my atrophied right calf don't lie. I had to take the blindfold off my foot and get it back! All of it; the small muscles, the stabilizers, the proprioceptors, the sensory units, the bigger muscles - everything. This led to a lot of time barefoot (see my Feb barefoot post) doing toe yoga and dry needling myself. After 3 months of waking up my foot from its hibernation along with consistent strength training, I was finally ready to get back on a running progression. But which shoes to lace up? My newer support shoes or my older minimalist shoes?

There is a fair amount of research coming out that actually ties high support shoes to increased forces - the exact opposite of what a lot of people pay the big bucks for. A new article, available this month ahead of print in the Journal of Applied Biomechanics, found that forces up the leg were significantly higher when running in maximalist shoes versus minimalist shoes. This supports another study by Ruder et al presented at last year's ACSM Annual Meeting that had similar findings. Fluctuations in forces have been attributed to changes in strike pattern due to cushioning, as well as blunting of sensory receptors. With my first hand ties to the importance of sensory receptors in the foot, my instinct was to toss out my super supportive Pegasus and Zoom Structures in lieu of my Lunar Tempos and Frees. But I just wasn't sure I was 100% committed to the idea of minimalist shoes and forefoot running.

The more I read and the more I experimented out on the track, I realized the reason I couldn't commit to one strike pattern is because there isn't one best strike pattern for everyone. 
Perhaps its the ability to adapt to varied force distributions and striking patterns that makes you most resilient to injury. In a study published in 2015 in the Scandinavian Journal of Medicine & Science in Sport, authors Malisoux et al found that runners who rotated between different pairs of running shoes were 39% less likely to get injured versus those who ran in predominantly the same pair of shoes over 22 weeks. It's possible that rotating between different shoes, and thus different strike patterns, minimizes the repetitive strain at each specific tissue structure and allows for more effective recovery and overall decrease in injury risk.

To circle back to my suitcase full of sneakers... Now that I'm ramping up training for my upcoming race in May, I'm strategically varying my shoes (although runners in the study rotated between an average of only 3.6 shoes...) - as well as cadence, pace, and terrain. I believe that adaptability is the key to injury reduction and, ultimately, performance. More to come!

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Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

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