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Fitness girl running on treadmill. Woman with muscular legs in gym

I received a large and diverse response to my last post on the potential benefits of running barefoot. I will not bore you with the gory details, but suffice to say barefoot running stirs up more emotion than the last Presidential election.

Most runners, at some point, sustain injury. One of the most common is knee injury/pain, followed by achilles tendon/calf problems, metatarsal problems, toenail problems, hip/groin pain, plantar fasciitis and heel pain, ankle pain/sprains, shin splints, nerve injuries, quadriceps, hamstrings and back problems.

Could Improperly Fitted Running Shoes Be the Problem?

A survey of 1200 runners by the American Orthopedic Foot & Ankle Society found that almost two-thirds of runners sustained injury that they believed shoe related. In analyzing the survey, the American Orthopedic Foot & Ankle Society implied that it was necessary to have the shoe broken in and stressed the importance of “proper fit” and “comfort.”

Achieving “proper fit” as a runner can be laborious process, and perhaps NOT achievable.

The Running Advisor has a detailed process on How to Choose a Running Shoe, which is good and worth a read. One problem is, there is no consensus on what exactly the definition of proper or perfect shoe fit is. Numerous “experts” have guidelines, but no definition exists. Worse, even if a definition existed, meeting it would rarely be possible.

A 1982 survey by the Prescription Footwear Association found that all people have “mismatched” feet. Keep in mind this is looking at the foot in three-dimensions. Even if both feet have approximately the same shoe size, their structure (arch height, ball width etcetera) will differ. It would be extremely rare for someone to have two feet with same size, shape, proportions, and biomechanics.

Further, feet change shape. Four factors must be considered when sizing shoes to feet. These factors are dependent on activity and external factors.

The Four Shoe-Fitting Factors No One Tells You

At rest, the foot has a STATIC shape, when standing the foot’s 26 bones shift position creating a WEIGHT-BEARING SHAPE, under walking or running the foot will change shape again (FUNCTIONAL SHAPE), and lastly, the foot will change shape in response to temperature and humidity (THERMAL SHAPE).

Not to complicate the matter but the newest literature shows that our diet and our body’s hormonal fluctuation can affect foot shape and the way we walk. Machado has shown that plantar pressure distribution under the feet of young women varies with the woman’s menstrual cycle.

Further, throughout the day, as we walk, our feet swell. William Rossi in his book Professional Shoe Fitting claims that this swelling is approximately 5%, and he says during exercise, such as jogging, our feet can expand as much as 8% or a one and a half shoe size difference. Let’s repeat that: during jogging your foot could expand one and a half shoe sizes. Therefore, a runner who bought their running shoes in the morning, before much activity, and then went for a run on a hot day potentially could find their foot squeezed into a shoe one and a half sizes too small!

Proper Running Shoe Fit is a Myth – It’s Never Happened!

How can running shoes perfectly (properly?) fit non-expanded feet in the morning (or at the start of a marathon) and expanded feet at the end of the day (or 12 miles into a marathon), combined with the fact that each of our feet (left and right) are different? They can’t. Like the Loch Ness Monster, proper shoe fit does not exist. Sure, some salesman may tell you your shoe fits, but ask him about Static fit, Dynamic fit, and how the shoe will fit your foot after you run five miles in the heat.

On the Runner’s World forum, Barefoot TJ wrote: “Doc, I have Morton’s Neuroma (2 in each foot).  The pain became so unbearable that I could no longer run in those over controlling, so-called, high-tech running shoes; I was in crippling pain by 1 – 3 miles feeling like I had fractured my toes.  Running barefoot allows me to run farther, much farther before that horrible pain comes on, and I’ve been doing this for a while now.”

Morton’s neuroma causes cramping, tingling (a feeling of pins and needles), burning, or shooting pain in the toes or ball of your foot. A neuroma is a painful growth on a nerve that forms when the nerve becomes irritated.

In TJ’s case, once you understand correct shoe fit—or more importantly, lack of correct fit, one can understand how TJ’s shoes were, while running, becoming too snug and compressing the forefoot (and the nerve) and aggravating her Morton’s neuroma. Now, she could buy larger shoes, but that could lead to the foot moving too much and cause other problems, such as blisters.

All runners are compromising on shoe fit. For some, this may be fine. For others, it may be contributing to injury.

The American Orthopedic Foot & Ankle Society recommends proper fit as a recommended solution. Could the 2/3 of runners surveyed who are injuring themselves and blaming their shoes all not be wearing properly fit shoes? Or are other forces work?

Coming Soon:  Could Running Shoes Themselves Be the Cause of Runners’ Injuries? 

Resources on Shoe Fit and Sizing:

Zappos Running Shoe Fit Guide

Runner’s World Right Shoe Fit Guide

Asics Shoe Fit Chart

Cool Running Shoe Guide for Dummies

Dick’s Running Shoe Fit Guide

Sierra Trading Post Shoe Fit Guide

Wiki How to Choose Running Shoes

Running Shoes – Finding the Right Fit

Image Credit – Fitness girl running on treadmill. Woman with muscular legs in gym Photos by Pond5

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