Should I run barefoot? Do I need a minimalist shoe? Do I need more stability? My doctor told me I need motion control. These are all statements I hear daily from patients in my practice and customers in my running store. In order to answer these and other questions I will need to explain what minimalist running shoes are compared to traditional running shoes as well as provide an understanding of what constitutes stability or motion control in traditional running shoes. There are three basic "traditional' running shoe categories. Cushion/neutral, stability and motion control.
All of these categories provide more cushion in the heel than under your toes. This has the effect of lifting your heel and leaning you forward similar to a women's heel on a dress shoe. The most common ratio is approximately 22mm in the heel to 11mm in the toe. Other effects include shortening of your calf muscle when you are not running (by raising your heel), providing cushioning to help dissipate shock on landing (whether you are a heel striker or forefoot runner) and dampening of the nerves in your foot. This dampening can result in comfort but also affects your foot sensors and can change how your foot interacts with the ground. This effect can be positive in some runners but negative in others. For example; in one runner the shoe may help them absorb shock and reduce stress on their knee (the same way a knee brace might work). In another runner the shoe may cause them to land with a straightened knee and actually increase the shock into the knee thus causing knee pain.
This is essentially the crux of the argument for those advocating barefoot or minimalist running. It is thought that the shoe may interfere with a runner's natural tendency to flex their ankle, knee and hip joints upon landing thereby naturally dissipating impact forces. By wearing no shoes or "less" shoe these advocates of minimalist running hope to reduce injuries. This theory assumes that running injuries are related to impact and not excessive strain or torque or other physiologic forces. Traditional running shoes have also tried to address impact as well as strain and torque. Cushion/neutral running shoes are designed to accommodate a runner who under-pronates and has a high, rigid arch. It is not that these shoes do not provide stability, they do, but they have a higher ratio of cushioning to stability.
Stability shoes are designed to function with a runner who pronates normally (yes pronation is normal) and has an "average' arch with "average" flexibility. These shoes have denser cushioning which is supposed to increase support and resist excessive pronation. Motion control shoes are intended for runners that over-pronate and have flatter more flexible feet. It is thought that they are excessively flexible and therefore require more control. The additional control is provided for by denser foam which increases support and prevents pronation. These shoes are all designed under the premise that pronation is an abnormal movement, can be quantified as too little or too much and if the runner is matched correctly to a shoe type running injuries will be reduced.
Dr. Runco is a U.S. Navy and Gulf War Veteran. Graduating as a Doctor of Chiropractic he began private practice in San Diego in 2000. He has been a professor of Anatomy, Physiology, and Biomechanics at various colleges and continues to teach continuing education in the fields of rehabilitation, custom orthotics and athletic taping. He is also a member of the American College of Sports Medicine, National Strength and Conditioning Association and is a Certified Strength and Conditioning Specialist. He is also an orthopedic doctor that specializes in treating foot injuries and problems.