These Shoes Might Be Putting You at Greater Risk for Running Injuries, Study Finds

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Here’s some potentially helpful news for both long-time runners and those thinking about picking up the habit in the new year. Scientists have recently found evidence that the heel thickness of your shoes can affect your risk of injury.

Researchers at the University of Florida conducted the study, which aimed to better understand the risk factors that lead to running injuries. They found that people wearing thicker-heeled shoes were more likely to have recently experienced a running injury. The findings suggest thicker shoes make it harder for people to gauge how their feet are hitting the ground while running, the researchers say—an inaccuracy that may then contribute to injury.

Some studies have indicated that both the thickness of our shoes and how our feet land on the ground (also known as our foot strike pattern) could be risk factors for running injuries. But researchers at the UF Health Sports Performance Center wanted to get a better sense of how these two things might interact with each other to make running riskier. So they went back and looked at data collected from over 700 runners who visited their clinic over the years to improve their performance or their chances of injury prevention.

After accounting for factors like age, weight, or level of competitiveness, the researchers noticed several consistent trends. People who wore thicker-heeled shoes were more likely to have endured a running-related injury in the last six months, and they were less able to correctly predict their foot strike pattern (runners were asked about their usual pattern of running, then had their running objectively measured by the clinic).

While running, people will strike the ground with either the rear, front, or middle of their foot. The researchers found that non-rear runners who accurately knew their pattern were the least likely to report getting recently hurt, whereas those who didn’t know their running pattern at all were the most likely to get hurt. Meanwhile, rear-foot runners were the most likely to guess their pattern wrong, especially if they wore thicker-heeled shoes. The team’s findings were published last month in the journal Frontiers in Sports and Active Living.

The results only show an association between heel thickness and running injury, and it’s not clear whether heel thickness directly increases injury risk, the researchers say. As with other aspects of running, it’s likely to be complicated. Some research has indicated that fore-foot running is healthier or helps prevent injury than rear-foot running, for instance, while other research hasn’t.

It might be the case that the best methods to prevent running injury will depend heavily on the individual runner. So while thicker shoes may not directly increase injury risk, they could make it harder for people to know what style of running will work best for them over the long term, the researchers say.

“The shoe lies between the foot and the ground, and features like a large heel-to-toe drop make it more challenging for runners to identify how they’re striking the ground. That clouds how we retrain people or determine if someone is at risk for future injury,” said lead researcher Heather Vincent, director of the Health Sports Performance Center at UF, in a statement. “The runners who correctly detected mid- or fore-foot striking had very different shoes: lower heel-to-toe drop; lighter; wider toe box.”

That said, trying to switch to a different style of shoes or running too quickly can itself raise injury risk, according to the UF researchers. The pattern was true in this current study, since people who recently switched shoes were more likely to report a recent injury. So any big change in your running should be done gradually, Vincent notes.

“I had to teach myself to get out of the big, high-heeled shoes down to something with more moderate cushioning and to work on foot strengthening,” she said. “It may take up to six months for it to feel natural. It’s a process.”

Vincent and her team next plan to run controlled studies testing out whether changing shoe type can help improve people’s accuracy of their running style and reduce injury risk. And from there, they might be able to unearth the best ways to keep injuries down for every kind of runner.

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