Running: A Source of Exercise Or Pain?

Running can be a great exercise, however it can also cause a lot of extra stress on our feet, knees and even hips and backs. There are a plethora of opinions and factors involved in running. The best surface. Proper shoes. Orthotics. Barefoot running. Before we get to that, a little background is necessary.

There are predominantly two types of foot strike while running -- heel strike or forefoot. Heel strike is the most common, the majority of people land on their heel and then roll onto the ball of their foot. This can cause a very high impact with all of your body weight landing on just your heel. Traditional running shoes encourage this because of what's called the heel drop. Often this heel drop is 10 mm or greater, the higher the number, the higher the heel on the shoes compared to the forefoot. These shoes can cause running to be more comfortable because they help to distribute your weight and provide cushioning.

Forefoot strike is when you land on the ball of your foot. This generally means less stress on your legs and heels. Only about 1/5 to 1/4 of people land this way. Barefoot or minimalist running shoes take advantage of this type of running. The heel drop is lower, less than 8 mm all the way down to 0 mm. This means that you are better able to land on the ball of your foot instead of the heel. Most people, however, find it very difficult to run this way. If you strike with your heel, it is hard to change your muscle memory.

Barefoot running generally goes along with this. There are long distance runners in Mexico and Africa who have been running all their lives without shoes and studies generally show or postulate a lower incidence of injury with a more natural foot strike. This is fine for those people, their foot type is adapted to this type of running -- their toes are splayed for purchase and stability and their soles are toughened. But consider that you have been wearing and running in shoes for 20 years, or 30 or longer. Imagine how hard this can be to try to adapt. In fact, this often leads to more injuries when people try this.

So how does all of this impact you on your next run? Put simply, it is important to distribute force throughout the foot and minimize the stress on other joints. Shin splints, for example, are often a result of overpronation, usually in flat footed people. Overpronation can also cause extra stress on the knee. And heel striking can cause a lot of extra impact and require extra cushioning. This doesn't mean that you need to try out barefoot running or retrain yourself. What it does mean is that you need to find appropriate shoes to run in and that you may also benefit from orthotics in addition. A high arch type may need the shock absorption that orthotics can provide whereas a flat footed person may need more motion control. This is something that your podiatrist can discuss with you and come up with the best solution so that you can run and exercise injury and pain free.