Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding

Abstract

Background/aimThis randomised controlled trial investigated if the usage of running shoes with a motion control system modifies injury risk in regular leisure-time runners compared to standard shoes, and if this influence depends on foot morphology.MethodsRecreational runners (n=372) were given either the motion control or the standard version of a regular running shoe model and were followed up for 6 months regarding running activity and injury. Foot morphology was analysed using the Foot Posture Index method. Cox regression analyses were used to compare injury risk between the two groups, based on HRs and their 95% CIs, controlling for potential confounders. Stratified analyses were conducted to evaluate the effect of motion control system in runners with supinated, neutral and pronated feet.ResultsThe overall injury risk was lower among the participants who had received motion control shoes (HR=0.55; 95% CI 0.36 to 0.85) compared to those receiving standard shoes. This positive effect was only observed in the stratum of runners with pronated feet (n=94; HR=0.34; 95% CI 0.13 to 0.84); there was no difference in runners with neutral (n=218; HR=0.78; 95% CI 0.44 to 1.37) or supinated feet (n=60; HR=0.59; 95% CI 0.20 to 1.73). Runners with pronated feet using standard shoes had a higher injury risk compared to those with neutral feet (HR=1.80; 95% CI 1.01 to 3.22).ConclusionsThe overall injury risk was lower in participants who had received motion control shoes. Based on secondary analysis, those with pronated feet may benefit most from this shoe type.

Logical fallacies in the running shoe debate: let the evidence guide prescription

“…Yet, traditional shoe prescription has not prevented RRIs—consider five quality randomised controlled trials (RCT) and observational cohort studies 1–5. In contrast, a recent investigation6 found that motion control shoes protected against injury in experienced runners who had pronated feet. There are likely important methodological reasons for the discrepancies between these studies, such as differing definitions of RRI and various experience levels among runners.…”

The Preferred Movement Path Paradigm

“…Running shoes 50 with specific design features, such as, increased cushioning, stability and/or control have 51 been constructed to help alleviate the development of running injuries previously linked to 52 risk factors such as high impact forces or excessive pronation (13). Despite the 53 implementation of various features, the incidence of running injuries has not substantially 54 changed (13) and there is often limited or contrasting evidence that running shoes can 55 alleviate a sustained or self-reported injury (10,19,24). This inconclusive evidence does not 56 help to understand the role that running shoes may have on influencing a runner's movement 57 patterns.…”

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“…A Cochrane review 16 found orthotics could play a key role in avoiding stress fractures.Malisouxet al 17 showed that motion control shoes where the midsole hardness is 15% higher than the lateral part reduced running related injuries. In their study 32.4% of participants in the standard shoe group recorded injuries whilst only 17.6% of the participants in the motion control shoe group recorded injuries.…”