Running Shoes History Anatomy, & Tips on Purchasing Your Ideal Running Shoe

HISTORY, ANATOMY, & TIPS ON PURCHASING YOUR IDEAL RUNNING SHOE

By Dr. Michael M. Cohen, DPM, FACFAS

A 3 PART SERIES

ANATOMY OF A RUNNING SHOE (PART 2) How important are running shoes and what role do they play in preventing or even causing injury?

Before answering this question, one must ponder this important point. Running requires conditioning and conditioning requires a consistent and deliberate training schedule. Running shoes are but an adjunct to avoiding injury. Who can forget the great Ethiopian marathoner Abebe Bakila who in 1960 won a gold medal in the Rome Olympics in 2:12 barefooted? To Africans, running barefoot is not a particularly unusual sight. Ethiopians and Kenyans are known to train barefoot and had been doing so since they were children because running is the sole source of transportation to and from school.

The Tarahumara Indians in Copper Canyon New Mexico hunt deer for several days covering 100-200 miles of rocky mule track. These exceptional athletes would hunt deer by literally running them to exhaustion. The incredible feat is accomplished while wearing homemade sandals constructed from the treads of discarded truck tires.

What is it that keeps the Indians and Africans from becoming injured in light of the fact that they are not wearing high-tech running shoes? The answer lies essentially in one word, conditioning. Running shoes are but half the battle against injury prevention, the other half requires a proper training schedule. While it’s true that our concrete jungles do not mimic the natural impact absorbing properties of soil and sand found in other regions, we nevertheless require the conditioning necessary by training smartly and safely. Novices quickly discover that the shoe is not a substitute for good training. That being said, the purpose of a running shoe is twofold. It is necessary to absorb impact and stabilize- or control unnecessary and abnormal motion of the foot in the shoe. Chronic overuse injuries generally occur because of excessive impact, excessive motion, or both. We describe the motion in the foot in terms of pronation (an excessive pronator has flat feet) and supination (an excessive supinator generally has high arched or cavus feet). Running shoes are designed to accommodate specific foot types, training distances, and body weight. They may also be used in certain circumstances to avoid or treat specific injuries. One needs to know how to match these features with their particular needs. Because of the many variables described it is clear that there will be no single perfect shoe for everybody.

To find an appropriate running shoe it’s essential that runners become familiar with a shoe’s anatomy. Below are a few of the major components:

ANATOMY OF A RUNNING SHOE

▸Toe box: This is the front of the shoe where the forefoot and toes lie. It can take many shapes: pointed (narrow), rounded (wide), low or high. The size of the toe box allows the shoes to accommodate for the width of the foot as well as hammertoe and bunion deformities. ▸ Midsole: This is the rubbery white or grey stuff in the sole of the shoe and is made of EVA or polyurethane. It functions to control movement and absorb shock and may harbor additional shock-absorbing inserts such as air or gel. A disadvantage to air and gel lives in the loss of stability with additional cushioning is adversely proportional to the stability of the shoe. ▸ Counter: The heel counter is the portion that wraps around the back of the heel and helps to control its motion, it provides stability. The stiffer the counter the better the stability. A stable heel counter is good for flexible feet (usually the flexible flat foot type). ▸ Last design: This refers to the shape of the shoe. It may come in straight (good for flat feet), semi-curved (the average foot), or curved (good for high arched feet and midfoot strikers). (HINT: Trace your foot and matched it to the shoe design.) ▸ Lateral: Outer edge of the shoe. ▸ Medial: Inner edge of the shoe (along the arch and great toe). ▸ Insole: Removable footplate and shoe which often comes with attachable arch cookies. ▸ Motion control: These are designs used to control overpronating feet (rolling in of the foot), and is generally necessary for feet that are flat and flexible. I do not recommend this type of shoe for runners or walkers who are plagued with knee arthritis because of their inherent

lack of shock absorption. ▸ Outsole: The material on the bottom of the shoe which contacts the ground and is made of carbon rubber. The outsole grips the ground and is a descendent of the Nike waffle pattern designed by

Oregon coach Bill Bowerman over half a century ago. ▸ Upper: This is the cloth or lesser portion of the shoe connected to the rubber portion or the midsole. ▸ Rocker: this refers to the shape of the bottom of the shoe while viewing the shoe from the side. There may be a curve under the ball of the foot referred to as a forefoot rocker or in the center of the arch referred to as a midfoot rocker.

Rockers are excellent for offloading the ball of the foot and are appropriate for those with a history of metatarsal stress fractures, inflexibility, or arthritis in the ball of the foot and the Achilles tendon.

Rockers are also very effective in treating plantar fasciitis. ▸ Last type: If you pull the insole out of the shoe, you can observe how the last was constructed. Slip lasted shoes are sewn like a moccasin from the heel to the toes along the center of the shoe, this is the most flexible design. A board lasted shoe maintains a firm fiberboard throughout and is the most rigid design.

This provides the most stiffness and best stability. Combination lasting is a combination of the two and provides advantages of both designs. Most shoes now bear this type of last.

Look for Part 3: Tips on Choosing the Ideal Running Shoe in the July issue of OUR CITY.

▸Michael M. Cohen, DPM, is a Board-Certified Foot and Ankle Surgeon and Diplomate of the

American Board of Foot and Ankle Surgery. He is a Fellow of the American Board of Foot and

Ankle Surgeons and Board Certified and Diplomat of the American Board of Podiatric Medicine. He practices with the Foot, Ankle and

Leg Specialists of South Florida specializing in lower leg injuries and reconstructive surgery of the foot and ankle. The South Florida Institute of Sports Medicine in Weston is located at 1600 Town Center Blvd., Suite C, (954) 3895900 and in Pembroke Pines at 17842 NW 2nd

Street, (954) 430-9901. The practice website is www.SOUTHFLORIDASPORTSMEDICINE.org.

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