Welcome to our newest blogger, physio Rob McCabe from McCabe Physiotherapy in Newbridge.
Rob will contribute and write about injury prevention, runners and all things physio! Below is his first post, a relevant topic on the best running shoes to wear… Hope you enjoy.

Born To Run by Christopher McDougall (2009) ignited a long awaited world wide debate on the multi million dollar industry that is the running shoe. Since then the debate has continued and the market has adapted accordingly. The worlds’ leading shoe manufacturers shifted their beliefs about supportive cushioning and ‘air’ filled gel heels to accommodate the modern, more knowledgeable athlete in search of a minimalist shoe. Well not entirely. They still mass produce the controlled runner and in fact more recently the trend has inversely shifted towards a new breed of running shoe with maximum support. So is it any wonder one of the most commonly over heard conversations you’re likely to hear amongst a group of runners (apart from their 10km PB or what energy gels they use) is about which running shoe they use.

As a runner myself I have a personal interest in this particular topic. I’ve tried out quite a few different brands and types claiming this and that; barefoot, minimalist, mid foot striking, high control. And my thoughts? First of all let me state this: I’m sceptical in general. If there’s someone or some company making a claim about a product I’d like to see some evidence in support of whatever that claim may be. More specifically I’d like to see evidence where the research carried out hasn’t been funded by the brand themselves (ahem leading brand sports drinks love this, especially the one that claims to make you go 33% longer). In other words good quality studies. Nothing springs more to mind here than a brand of Barefoot running shoes who claimed their shoe would result in injury free running. Numerous stress fractures and millions of dollars paid out in compensation later they realised just how crazy a claim they had originally made. It was based on no evidence and while their intentions may have been correct (more on this later) how any legal team of a big brand company gave them the go ahead for such a statement is mind boggling.
So when they stated ‘injury free running’ in their claim what they really meant to say was: ‘By wearing this minimalist shoe your stride length, stride rate, how you strike the ground, and the resultant ground reaction forces transmitted up through your body on impact should alter’. But that’s not a very catchy slogan is it. As well as that, wearing a minimalist shoe and not changing any of these factors will directly result in injury…..bad injury. The idea is that with less cushioning around the sole of the shoe you are forced to land more softly and ideally on the mid foot where two rows of tarsal bones are in place designed to be able to adapt to terrain. And if introduced gradually with guidance and feedback over short distances initially it is sound advice. Without this approach does the risk outweigh the potential benefit? Yep. Landing on your heel in a barefoot or minimalist shoe once will send shuddering vibrations all the way up to your jaw. Land on your heel in a barefoot or minimalist shoe over the course of a marathon? All the best with that.

I’ll cut to the chase here. So with all the research (non biased) carried out what is the conclusion? Drum roll please……..Whatever is comfortable. Yes the body of research to date concludes that as long as the shoe feels comfortable, i.e. not causing pain, you’re on the right track. That doesn’t mean a pair of casual converse flat shoes. They’re just not going to be comfortable to run in. But for those of you that have been told you’ve got flat feet and over pronate and should wear this or that type of shoe maybe think twice before forking out for the latest version high end running shoe. Saying that if that same high end running shoe is indeed comfortable and not causing you any problems who am I to argue with the evidence? Who cares if you over pronate? Everyone does. In fact we have to pronate a little for a normal gait. And there’s plenty of people out there over pronating with no pain at all. Once there’s no pain or decline in performance forget about arch support, foot strike, orthotics. However if there is pain this needs to be addressed. It may be to do with the shoe or it may be something entirely different. That’s where a comprehensive musculoskeletal assessment comes in.
So my advice is this: By all means try a minimalist shoe if you’re willing to put the time in to getting it right. And by time I’m talking a year if you’ve got your heart set on the idea. Trying to do the same mileage immediately after switching from a standard to minimalist or barefoot shoe is a stress fracture waiting to happen, and the wait won’t be that long. While you’ll have the aerobic capacity and endurance to do the same mileage the bony structures around the lower limb will not be used to the extra forces being transmitted through them. I would advocate using them as a training tool to use while focussing on technique. You’ll get great feedback from how you contact the ground by how you’re body reacts. But here’s an even more sensible approach: why not just try implementing the key components of bare foot running into your normal, comfortable runners. That is a soft landing, a mid foot strike (not heel, not toe), an increased cadence (i.e. more steps per minute), and try a slight reduction in stride length to supplement the mid foot strike. By landing in this way and spending less time in contact with the ground the forces transmitted through the body will be less while maintaining the comfort and protection of a standard running shoe. There may be other strengthening issues around the core, hip and knee that need addressing but trying to change your running style may be the first place to start. In fact the first place to start for anyone that hasn’t already read it might be ‘Born to Run’ by Christopher McDougall.

For more information on any of the issues addressed throughout this article please contact Rob via email at mccabephysiotherapy@gmail.com, Twitter @mccabephysio, Facebook at McCabe Physiotherapy or visit http://www.mccabephysiotherapy.com
Rob McCabe MISCP
Chartered Physiotherapist
MSc (pre reg) Physiotherapy, BSc Sport Science and Health, MSc Sports Physiotherapy, PG Dip Orthopaedic Medicine