April 2021

Motion-Control Shoes Reduce Pronation-Related Pathologies

Runners frequently sustain injuries. Increased and poorly timed foot pronation during the running gait cycle and movements that contribute to foot pronation (eversion, abduction, and dorsiflexion) have frequently been cited as risk factors for exercise-related lower-leg pain, medial tibial stress syndrome, stress fractures of the tibia, Achilles tendinopathy, plantar fasciopathy, patellar tendinopathy, and anterior knee pain. Alterations in the movements at the foot-ankle complex resulting in abnormal repetitive load can cause injuries at the foot-ankle complex, and more proximally in the kinetic chain.

Motion-control footwear may be effective in reducing (1) the amount of foot pronation during running and (2) running-injury risk among regularly active recreational runners. However, these authors suggest that it is more accurate to investigate the effect of motion-control shoes on the development of injuries specifically related to foot pronation, given that this shoe technology focuses, at least theoretically, on limiting excessive pronation.

The objective of this study was to investigate the effect of motion-control shoes on the development of pronation-related running injuries, which were defined based on existing evidence and/or a theoretically plausible mechanism. The authors hypothesized that motion-control shoes with a medial foot support aimed at reducing excessive pronation would reduce the risk of pronation-related running injuries in recreational runners compared to shoes with no motion-control technology. The secondary aim was to assess whether wearing motion-control shoes influenced the development of other running-related injuries.

The design is a secondary analysis of a randomized controlled trial of the effect of shoes on running injuries.

METHODS: Three hundred seventy-two recreational runners were randomized to receive either standard neutral or motion-control shoes and were followed up for 6 months regarding running activity and injury. Running injuries that occurred during this period were registered and classified as pronation-related injuries (Achilles tendinopathy, plantar fasciopathy, exercise-related lower-leg pain, and anterior knee pain) or other running-related injuries. With the use of competing risk analysis, the relationship between pronation-related and other running-related injuries and shoe type was evaluated by estimating the cause-specific hazard, controlling for other possible confounders like age, sex, body mass index, previous injury, and sport participation pattern.

RESULTS: Twenty-five runners sustained pronation-related running injuries and 68 runners sustained other running-related injuries. Runners wearing the motion-control shoes had a lower risk of pronation-related running injuries compared with runners who wore standard neutral shoes (hazard ratio = 0.41; 95% confidence interval: 0.17, 0.98). There was no effect of shoe type (hazard ratio = 0.68; 95% confidence interval: 0.41, 1.10) on the risk of other running-related injuries.

CONCLUSION: Motion-control shoes may reduce the risk of pronation-related running injuries, but did not influence the risk of other running-related injuries.

IMPLICATIONS: Clinicians might consider prescribing motion-control shoes for runners who are prone to Achilles tendinopathy, plantar fasciopathy, exercise-related lower-leg pain, and anterior knee pain.

Source: Willems TM, Ley C, Goetghebeur E, Theisen D, Malisoux L. Motion-control shoes reduce the risk of pronation-related pathologies in recreational runners: a secondary analysis of a randomized controlled trial. J Orthop Sports Phys Ther. 2021;51(3):135-143. Used with Permission.

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