Are trainers the cause of your injury?

In short, it’s unlikely. I would put trainers lower down the list of things to focus on if you’re suffering from lower limb injuries, like plantar fasciitis (now termed fasciopathy), Achilles tendinopathy, calf strains, shin splints (including medial tibial stress syndrome, stress fracture or compartment syndrome).

However, if you have recently changed your trainers and haven’t noted the profile or technical specifications of your old ones, meaning your new trainers could be very different, this may contribute to the development of new injuries.

On occasion, there are things to look out for in trainers that may help to reduce the stress on the area causing your pain. I would consider this in line with other factors and with professional help. It is VERY RARE for trainers to be the sole cause of your issue and you’ll waste money chopping and changing in your desire for a resolution.

What to look for in new trainers

When I’m talking about trainer profile I’m talking about the characteristics (technical specification) of the trainer. These are a few that I look out for:

Heel drop

• Support

• Cushioning

• Toe box

• Special features

Heel Drop

This is the difference between the height of the sole at the heel compared to the height at the toes. Trainers can range from zero, so no difference front to back, to 15mm. 1.5cm is quite significant and therefore you should treat each millimetre of change with respect! From both knowledge and experience, you will notice a change of 3mm in how much greater work your calf is required to do, and therefore a sudden change may make you more susceptible to calf injury. A higher heel drop will also put a greater load onto your forefoot, perhaps exacerbating injuries around the plantar fascia.

 Support

This primarily refers to the arch. There is a long-held belief that pronation is bad, and the term over-pronation is thrown around a lot. Pronation is a necessary & natural part of the gate cycle. However, excessive, repeated or a lack of strength to control pronation can cause an issue with conditions like plantar fasciopathy, ankle synovitis, and tibialis posterior tendinopathy. Increasing your strength to control pronation is more desirable than buying a pair of trainers to stop it. However, for some, it is a quicker fix, or perhaps where there has been an injury causing difficulties with arch control greater support may be necessary and this style of trainer can be beneficial.

 Cushioning

The cushioning of a trainer is generally described as ‘responsive’, ‘balanced’ or ‘cushioned’ depending upon the brand you are purchasing. Whether you opt for a more cushioned shoe is entirely personal preference. Brands either sell their type of cushioning based on its ability to absorb impact forces or they go further and suggest the trainer gives a ‘spring back’ force to assist propulsion. The jury is out for me on this, and I would say the impact is negligible for most amateur runners. Just make sure they are comfortable for you.

 Toe Box

I have recently fallen in love with the wider toe box and I think the trainer market appears to be moving in this direction, with Hoka bringing out wide models of their shoes. The wide toe box often comes with features that you will commonly see in a minimalist shoe, like zero heel drop & a very flexible sole, enter the Altra. Allowing the metatarsals in your feet to spread can help the foot contribute to the whole gait cycle, namely the big toe in propulsion. Most modern shoes do not have a wide toe box and the appearance can take some getting used to. I certainly found them to feel like clown shoes to begin with!

Special Features

Some trainers now come with a rocker system. Designed to reduce the time spent in the transition from midfoot to toe-off in the gait cycle and reduce stress on the Achilles tendon. Research suggests this does reduce Achilles tendon load, however, there is evidence that it causes an increase stress on other muscles and also the knee joint. Perhaps a consideration if you feel knee pain when running to avoid this special feature.

This information should not replace going to a shop and trying the shoes on. Comfort is your greatest measure of success. And above all, don’t expect to grab a new pair of trainers and just crack on with your current training plan. Take some time, some shorter runs, to get accustomed to the change.

An assessment of the pain in your foot, ankle, knee or hip can pinpoint to cause and provide you with a treatment and rehabilitation plan, that might involve investigating new trainers! But a holistic approach to your pain resolution is paramount.

Contact Me to discuss further.

References

Sobhani S, Zwerver J, van den Heuvel E, Postema K, Dekker R, Hijmans JM. Rocker shoes reduce Achilles tendon load in running and walking in patients with chronic Achilles tendinopathy. J Sci Med Sport. 2015 Mar;18(2):133-8. doi: 10.1016/j.jsams.2014.02.008. Epub 2014 Feb 14. PMID: 24636129. https://pubmed.ncbi.nlm.nih.gov/24636129

Sobhani S, van den Heuvel ER, Dekker R, Postema K, Kluitenberg B, Bredeweg SW, Hijmans JM. Biomechanics of running with rocker shoes. J Sci Med Sport. 2017 Jan;20(1):38-44. doi: 10.1016/j.jsams.2016.04.008. Epub 2016 May 3. PMID: 27167559. https://pubmed.ncbi.nlm.nih.gov/27167559/