Running a marathon is one of the greatest accomplishments that an athlete can achieve.  Months of preparation, dedication to a structured training regimen and sore, tired muscles and feet all culminate in a much-anticipated sporting event that will never be forgotten.

As an orthopaedic surgeon and a triathlete, I look forward to spending some time with you in the weeks ahead discussing issues that are common among runners and important to the success of marathon training.  I hope to provide you with information and tips that will make your training safer and more effective.

As a fellowship-trained foot and ankle specialist, I see many running-related injuries in my practice – most are related to ramping up distance or speed too quickly or not following a training regimen with the tools and techniques to get the job done.

It might seem obvious, but wearing the appropriate athletic shoe for specific sports activities can improve comfort and performance, and most importantly, prevent injuries. Sports can place tremendous pressure on the feet, ankles, and legs. Running and jumping, for example, generate an impact force through the legs that is three-to-five times a person’s body weight.

The following, provided courtesy of the American Academy of Orthopaedic Surgeons, provides an overview of the some of the points to consider in selecting the shoes that will carry you through your marathon training.

Today’s athletic shoes are designed with specific activities in mind.

Tips for finding the right athletic shoe

  • Because your feet swell throughout the day, try on shoes at the end of the day or after a workout.
  • To ensure a proper fit, wear the same type of sock that you typically wear when you are participating in the sport for which you are buying the shoes.
  • Make sure the heel counter — the back of the shoe that holds the heel in place adequately grips your heel to ensure stability.
  • There should be at least a 1/2 inch space between your longest toe and the tip of your shoes.
  • The toe box — the front area of the shoe — should have ample room so that you can wiggle your toes. Your toes should never feel cramped in an athletic shoe.
  • When you try on shoes, walk around the store on different surfaces (carpet and tile, for example) to ensure that they are comfortable.
  • Always tighten the laces of the shoes that you are trying on so that your feet are secure in the shoe. There are many different types of lacing patterns that can be applied to the shoe to adapt for, or minimize, foot pain or structural anomalies.

Try on both the right and the left shoes to make sure that they fit. Also, inspect the shoes on a level surface to ensure that they are straight, even, and without defects.

Make sure that the shoes have not been sitting on the shelf for an extended period of time. While the materials of an athletic shoe are designed to accommodate a lot of stress, the cushioning may become less effective over time, even without use.

Types of Athletic Shoes

Running Shoes

Much of the recent research in athletic shoes has focused on the development and improvement of running shoes. Running shoes are grouped into three categories:

  • Cushioned or “neutral” shoes are designed for runners with high arched, rigid feet. Runners with this type of foot are classified as “supinator.” The midsole of a cushioned running shoe will generally have a single color of soft foam material, ethylene vinyl acetate (EVA), in the arch and heel. A moldable synthetic material, EVA has varying density properties to provide more or less cushion in the shoe.
  • Stability shoes provide light to moderate stability for individuals with an arch that may collapse while running. This type of runner, classified as a “pronator,” needs to maintain their arch while running. Stability shoes have two to three different shades of gray polyurethane material in the arch, and possibly the heel, each with a different density to provide more support for the pronated (flat) foot type. The polyurethane material will make the shoe feel heavier than a shoe made only with EVA.
  • Motion control shoes are designed for runners who are “severe pronators.” Motion control are the most stable running shoes, and are the shoe of choice for runners with flat feet, and those with a heavier body weight. A motion control shoe may have an extra stabilizer added to the inside edge of the heel counter to provide maximum control. The outer sole of the running shoe will be made of carbon rubber or blown rubber, which is made with injected air. A carbon rubber sole is made from a heavier material, is somewhat stiffer, and provides more durability to the shoe. Blown rubber soles are flexible and lighter in weight providing more cushion than stability.

The best way to determine if you are a supinator or pronator runner is to have a professional evaluate your foot. To determine your foot type on your own, view your footprint when you step out of the pool or shower. If you leave a wide, flat footprint you have a pronated foot. If the footprint is missing the inside of the foot, where your arch did not touch the ground, you have a supinated foot type.

While knowing what type of foot you have is a first step toward buying the correct shoe, the pronation/supination component may be magnified during running. A professional can perform a gait analysis to definitely determine how your foot functions while you are running.

A running shoe professional can analyze your gait to help determine the best type of shoe for you.

Running shoes need to be replaced on a regular basis. The EVA starts to show structural damage after 120 miles. At 500 miles, the shoe has lost 45% of its initial shock absorption capabilities. A general rule of thumb is to take 75,000 and divide it by your weight to determine the number of miles that you can run before you need a new shoe. For example, if you weigh 150 pounds, your shoes should be replaced every 500 miles.

I hope this information will help as you purchase footwear for the upcoming race. Remember to examine your existing shoes and use the formula above to determine if it might be time for a new pair.

Best of luck as you begin your training!

Gregory Caronis, M.D. is a partner of Greenleaf Orthopaedic Associates, a community orthopaedic practice serving Lake County for over 50 years.  Dr. Caronis practices general orthopaedics and is a specialist in injuries to the foot and ankle and fracture care. 


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