I was recently approached by Kristian Manietta and Peter Lever – owners and hosts of trispecific.com and the Fat Black Podcast. They had seen my video online regarding Prescribing Running Shoes and read other posts on my blog and thought it would be worthwhile to interview me on running injuries, biomechanics and prescribing running shoes. I was (and still am) flattered. The Fat Black Podcast is a popular podcast with 20,000 downloads per episode.
The podcast can be found here (click on the pic):
Speaking to 20,000 people can be a bit unnerving. Speaking to 20,000 people when you have a pre-rehearsed speech will be hard enough however, speaking to 20,000 people when you’re getting asked questions and you can’t anticipate questions would be even more difficult.
That being said, I did make a couple mistakes:
1) At the 15:00 minute mark, the Brian Noehren study showed increased hip adduction did correlate with more patellofemoral pain I know the study inside and out and I don’t know why said “less”.
2) I got into many details and got sidetracked by my own ramblings quite often. I guess the issue is really about focusing on training errors as well as looking at the whole individual and not just biomechanics, shoes, stress levels, hormones, antibiotics, diet or other things that can be taken singularly and not as part of a larger picture
3) If the question comes down to whether or not giving a motion control shoe to someone who you deem is overpronating, or they have flat feet will affect injury rates, we need to just look at a few studies. The answer according to a few studies on that is “no”. Knapik et al. (2014) reviewed 3 studies of about 6,000 military recruits assigned shoes based on their foot type, like whether they has high arched or low arched feet, while they had a control group were assigned stability shoes regardless of their foot type. They found there were no differences in injuries between the two groups. Ryan did another similar study in 2011 and looked at women training for a half marathon and found the same thing, which was assigning a shoe based on the shape of your foot has no affect of injury. So then this year, Laurent Malisoux released a study where they found that motion control shoes did, in fact reduce injury in those with flat feet. The unfortunate part about that study is that 18% dropped out of the study in the group given neutral shoes and 31% dropped out in the MC group. We aren’t told WHY they dropped out. Why did 31% of the people who were given motion control shoes drop out when only 18% who were given neutral shoes drop out. Really? Almost double the amount of people drop out when they’re given MC shoes and we aren’t told why, and when they drop out, they aren’t included in the statistics at the end of the study, so they concluded that motion control shoes reduced injury. That seems strange to me when 31% of those people mysteriously dropped out of the study.
In the end, I still firmly believe that our bodies are amazing and are capable of adapting to the various loads we place on them. Most injuries in running are overuse injuries (unless you fall, roll your ankle or get hit by a bus). That basically means that the load is exceeding the capacity of the body to withstand that load. There are two ways to deal with that: 1) reduce the load and 2) increase the capacity of the body to take that load
- Reduce the Load: this is in the form of offloading for a while to let the body adapt and/or reducing the load in terms of altering your training pace, spreading the load out more during the week, altering some biomechanics or maybe altering the shoes
- Increase the capacity of the body to take that load: This would include GRADUALLY increasing training and giving the body time to make the necessary adaptations by increasing bone density, ligament strength, tendon stiffness, muscle strength etc. In addition I believe heavy resistance training is beneficial for tissue strength and hormonal factors.