Expensive vs Cheap Running Shoes

Do you get value for money when you buy an expensive pair of running shoes?

An investigation of the Institute of Motion Analysis and Research, Ninewells Hospital, Dundee (Clinghan RT, Arnold GP, Drew TS, Cochrane L, Abboud RJ, Br J Sports Med. Published Online First: 11 October 2007. doi:10.1136/bjsm.2007.038844) aimed to determine if more expensive running shoes provide better cushioning of plantar pressure and are more comfortable than low-cost alternatives from the same brand.

Design: Three pairs of running shoes were purchased from three different manufacturers at three different price ranges: low (£40-45), medium (£60-65) and high (£70-75). Plantar pressure was recorded with the Pedar® in-shoe pressure measurement system. Comfort was assessed with a 100 mm visual analogue scale. A follow-on study was conducted to ascertain if shoe cushioning and comfort were comparable to walking while running on a treadmill.

Participants: Forty-three female and twelve male subjects participated in the main and follow-on studies respectively.

Main Outcome Measure: Evaluation of plantar pressure and comfort.

Results: Plantar pressure measurements were recorded from under the heel, across the forefoot and under the great toe. Differences in plantar pressure were recorded between models and between brands in relation to cost. Shoe performance was comparable between walking and running trials on a treadmill. No significant difference was observed between shoes and test occasions in terms of comfort.

Conclusions: Low and medium cost running shoes in each of the three brands tested provided the same (if not better) cushioning of plantar pressure as high-cost running shoes. Cushioning was comparable when walking and running on a treadmill. Comfort is a subjective sensation based on individual preferences and was not related to either the distribution of plantar pressure or cost.

Mike O’Neill, podiatric surgeon and spokesman for the Society of Chiropodists and Podiatrists said “it is not the cost of the trainers that is important but the suitability of the trainers. Cross trainers should not be worn for running and running trainers should not be worn for playing squash or tennis. It is important to purchase trainers from a sports outlet that specifically has the knowledge as to which trainer is best for the individual in relation to their foot type and sport undertaken. Trainers purchased from multiple high street retailers often do not possess the same qualities that are desirable to prevent injuries when sports are being undertaken on a regular competitive level.”

The report says that advertising of advanced safety features for more expensive running shoes is often deceptive. Mike O’Neill said, “the research and development that goes into deciding the type of trainers is undertaken to a very high level.”

Trainers are also produced in two types:

High arch type foot – these trainers require specific shock absorbers,

Low arch type foot – these require the foot to be stabilised within the trainer and these trainers have additional stability qualities.


Mike O’Neill says, “Also the weight of the individual is important when choosing the type of trainer as some trainers are designed to absorb greater shock and control more motion which would be exerted by someone of more weight.”

Trevor D Prior, Consultant Podiatric Surgeon and spokesman for the Society of Chiropodists and Podiatrists said, ” At first, it may seem strange that surgeons would be interested in the outcome of studies on running shoes. However, given that we often recommend this as the first type of shoe worn following foot surgery, the relevance becomes more obvious. In many instances of forefoot surgery (i.e. bunion surgery), patients are able to return to trainers as soon as two weeks post surgery although it can take as long as 6-8 weeks. Of course, there are many types of running shoe and having the appropriate shoe of correct size is important; with the vast array of such shoes now available, the choice can be difficult.

The online publication of this article has, understandably, raised a lot of interest in the media as it questions the benefit of expensive running shoes. However, as with much research, the devil is in the detail which does not always serve the best interest of headlines.

As indicated in the abstract, the main aim of this well constructed paper was to compare the plantar pressure between shoes, with the researchers also dividing the foot into discreet regions to allow further analysis.

No significant difference was found between each type of shoe and each brand. Whilst differences did exist between different areas of each shoe/brand, this was not a consistent picture in that the site of the differences varied between shoes; perhaps not surprising as the different brands may have different aims when determining where to position the cushioning. The authors do report that, whilst there was no statistical difference between the shoes, there was a trend to the low cost shoe demonstrating more cushioning. To the delight of the media, this non statistical finding has been termed ‘if not better’. Whilst the authors postulate that this subtle difference may be more significant over time with repetitive impact loading, the reverse may also be true. More research is required, a point acknowledged in the paper.

It is perhaps not surprising that the authors decided to analyse the pressure values alone, rather than any level of functional control as the former variable is more discreet and easier to quantify for research purposes. In the introduction/review of the literature, they report:

1. That better cushioning materials in more expensive shoes attenuate impact force to a greater extent than less expensive alternatives,

2. That it has been suggested that the protective devices advertised are deceptive and runners subconsciously subject themselves to greater impact forces, increasing the risk of injuries,

3. That this is supported by a 123% greater injury frequency observed in runners training with expensive running shoes compared to less expensive models/brands.

Given that the authors go on to postulate that the subtle improvement in cushioning may be more significant over time, it is not clear from the paper whether this would be a good or bad feature.

Of course, other factors should also be considered when determining the benefit of any shoe and these include:

– The density (termed durometer) of the material will have a profound effect. A low durometer may provide greater cushioning but may not be sufficient for a heavier runner. Similarly, the durability of the low durometer material may be much less, requiring renewal of the shoe more rapidly.

– There is no data relating to the weight of the subjects or the durometer of the material between the varying shoes. It is quite possible that this varies arbitrarily between models and brands.

– The positioning of the cushioning may be important in injury protection and, based on this paper, this seems to be more brand than expense related.

– Many running shoes have features designed to help control foot function depending upon the individual foot type. These features may not relate directly to cushioning, indeed the opposite may be true if the aim is to resist excessive motion. Many stability/motion control shoes have a higher durometer material on the inside of the shoe which is claimed to resist pronation. Thus, the nature of the individuals foot function is an important factor. In this study, there had been no history of lower limb pathology and no gait abnormality although the criteria for the latter were not detailed.

Whilst we all aim to practice evidenced based medicine, the evidence base is not always available and one has to rely on experience and patient feedback. It is true that there are those that can run in less than the perceived optimum shoe without injury, much as there are those that can smoke all their life with no obvious ill health. However, for the cast majority, the correct shoe for their body weight, foot type/function and activity levels is important; a fact only too well appreciated by those regularly treating running injuries.

As previously mentioned, this is a well constructed study and the authors acknowledge the need to study a greater number of shoes. They have presented the data well although some of the terminology they have used has been seized upon by the media. What they have highlighted is that the price of the shoe alone is not necessarily the important factor. In my experience, when considering shoes for function:

– Shoes under £60 generally have less support/durability.

– Shoes between £60 and £100 are generally more supportive/durable and worth the additional investment 3. Shoes significantly greater than £100 rarely have the additional technology to justify the increased price tag.

So what should someone look for in a running shoe?

1. Fit is crucial as all too often, shoes are purchased too short. There should be a 1cm gap between the end of the longest toe and the shoe. This will then require the lace to be used to hold the foot in position.

2. Generally, the better quality shoes have a removable insole. This can be helpful for patients having had foot surgery as this can be removed to allow more room for swelling in the earlier stages of recovery.

3. The shoe should be of adequate width (or volume) – generally around two fingers width between the lace holes is ideal. Too close is too narrow and vice versa.

4. The shoe should be stable in the arch area (i.e. not bend) but flex (bend) at the front to co-incide with the ball of the foot.

5. Several shoes have some extra support on the inside to provide more stability (hence the term a stability shoe) which can be of particular benefit if there is a lower arch/flatter foot. A podiatrist or specialist running shoe shop will be able to advise the best type of shoe.

6. Some shock absorption beneath the heel and the ball of the foot helps with protection.

7. It is worth investing in a good running shoe even if you are having foot surgery but not going to run when you have recovered. A good fitting supportive shoe which is designed for marathon distances will be extremely good for walking/shopping etc. and help to minimise the recurrence or development of further problems. The same is true for anyone with foot or lower leg pain.

Whilst these are generally accepted principles, what is clear is that much more research is required to evaluate the effect of the various factors involved in the construction of running shoes and this should include more than just cushioning. In the future, the emphasis will be on the running shoe companies to produce the evidence they have available to support the claims made for individual features/footwear.


source:  Society of Chiropodists and Podiatrists

What is Podiatry?

Who are Podiatrists/Chiropodists?

Podiatrist/chiropodists are members of the Allied Health Professions. These professions are registered with the Health Professions Council (HPC). The terms podiatrist and chiropodist are protected titles and as such should only be used by people registered with the HPC. It is a criminal offence for any one to use these titles unless they are registered with the HPC. You can check if your podiatrist is registered by clicking on this link: http://www.hpc-uk.org/check/

What is podiatry?

Podiatry is the clinical discipline concerned with the diagnosis and comprehensive management of foot and lower limb pathologies. This involves the management of a wide variety of disorders, injuries and local manifestations of systemic conditions. This podiatric management may be curative, preventative or require long-term palliation or health education.

Children and Sports

As children take up a particular sport and become more active at school, foot and lower limb problems associated with unaccustomed exercise can occur. Growth, possible weight gain and increased exercise contrive to cause a wide range of painful foot and lower limb conditions. These complaints should always be taken seriously and a diagnosis made as soon as possible. Failure to recognise and treat these overuse symptons can lead to long-term problems for the child and an inability to reach their true sporting potential.

Most problems can be readily managed by your podiatrist utilising a variety of methods. But the treatment may also require periods of rest and a change to everyday footwear and activity footwear. Often the problem can be solved with footwear advice alone. Always remember to wear the correct footwear for that particular sport.

Barefoot activities, e.g. karate and judo are good exercise for the foot but also cause problems due to the foot having a relatively lower heel from what is it is used to. This puts strain on the arch of the foot and the back of the lower leg. Careful training and preparation are essential.

If a child indulges in any form of activity, injuries can occur and there will be aches and pains from time to time. Children are no different to adults in this respect but they tend to repair more quickly. Also, they tend not to rest when injured and need to be monitored carefully. Very young children may regard the problem as the norm and not complain. All aches and pains in children should be taken seriously and investigated professionally, particularly during periods of active growth.

Follow the 1cm rule – when shopping for the perfect sports shoes ensure you can wiggle your toes a little and leave 1cm of room from the top of your longest toe at the end of your shoe. Try on both shoes and walk around the shop to make sure they don’t pinch or rub.

Warm up and stretch – before starting any form of exercise, stretch and warm up your entire body and then stretch and warm down at the end of every session.

Always wear socks to reduce the risk of fungal infection and blisters. The best running socks are ones that are made from synthetic materials which are designed to wick sweat away from the skin, (such as CoolMax™) as they don’t absorb moisture like 100% cotton socks, and keep the feet drier.

Choose the correct shoes for the sport. If running is the choice for 2010, buy a running shoe which has adequate cushioning in the midsole and a flared heel for stability. However, if it’s a racquet sport such as squash or tennis, buy shoes designed for racquet sports that give better stability when moving and stopping suddenly around the court – a running shoe wouldn’t be suitable due to lack of lateral support.

How to avoid blisters – Blisters are painful, fluid filled lesions caused by friction from ill-fitting shoes, excessive moisture, or wrinkled socks against the skin. To prevent them, keep your feet dry, always wear socks as a cushion between your feet and your shoes and always wear properly fitting shoes. If a blister does occur, never pop it.

Choosing the Best Shoes

Footwear should be given the same consideration as any other piece of sporting equipment.

Sports shoes should protect as much as possible, be durable, and should be right for the sport and surface. If running, the shoe should have adequate cushioning in the midsole and a flared heel for stability.

What to Look for in choosing the best shoes

Feet come in all sizes, yet although shoes differ in type and style, how many of us wear the best shoes for our feet?

The 26 bones in each foot do not fully set until we are around 18 years old, and the shoes we wear as children are vital to our future foot health. However, we can still do enormous damage to our adult feet by wearing the wrong shoes.

As a general tip badly fitting shoes can be very damaging to feet. In fact, many adults’ foot problems occur, or can be made worse, because they wear poorly fitting shoes. To help prevent damage to your feet, try to apply the following rules when you buy shoes.

Heel – this should have a broad base, and should be no greater than 4cm (11/2”)

Heel Counter – this reinforces the heel cup and stabilises the foot upon ground contact

Sole – should provide cushioning and protection for comfortable walking, and enough grip to prevent slipping

Upper – ideally made from natural materials such as leather or breathable fabrics to keep feet comfortable.

Linings – breathable materials such as leather or fabric keep the foot fresh; they need to be smooth and seam-free.

Fastenings – laces or straps with buckles or touch fastenings help to hold the foot securely within the shoe.

Toe Box – sufficient depth to prevent rubbing and allow toes to wiggle within the shoe.

Insole – preferably removable to allow easy insertion of padding or orthoses.

Running Health Risk


  • 27 per cent of people are running or jogging, more than going to the gym (23 per cent)
  • 70 per cent admit to not wearing shoes specific to their sport
  • 30 per cent of people experience leg pain, but more than a quarter of these do not seek professional advice
  • Increased stress to cartilage and joints is linked to arthritis.
  • Cases of arthritis of the foot are on the rise

New research reveals that we have become a nation of pavement pounders but are not taking adequate steps to protect ourselves from injury or long term damage, according to The College of Podiatry, the academic authority for podiatry in the UK.

Research released earlier this year shows that 27 per cent of people are running or jogging once a week or more, that’s more than going to the gym (23 per cent). Those aged 35-44 are on the biggest fitness drive, with 35 per cent running once a week or more. After walking, running was revealed to be the most popular form of exercise. Fitness is clearly on the agenda with 35 per cent of people say they are currently, or are planning to be, more active in 2012.

However, when it comes to buying sports shoes, 70 per cent of people do not buy sports shoes specific to the sport that they take part in, with people prioritising price (52 per cent) and the appearance of the shoe (32 per cent). Running requires a show which has adequate cushioning in the midsole and a flared heel for stability.

Running, particularly on hard pavements, can cause stress to the cartilage in the joints which over time, can potentially lead to osteoarthritis – wearing adequate footwear is a way to help reduce stress to the feet and joints. Research shows that arthritis is on the rise, with 60 per cent of cases in the feet[1]. The research reveals that 30 per cent of the population cite that they experience lower leg pain occasionally and nearly one in ten (9 per cent) cope with it frequently. However, 27 per cent of those who have experienced leg pain have not sought any medical advice and have carried on as usual.

Foot experts are warning that many people are putting themselves at increased risk of injury and of long term problems such as arthritis, by not preparing for sports correctly and wearing inadequate sports shoes which do not provide the right mechanical assistance for the foot. Experts cite overuse, training errors, inadequate footwear, poor muscle strength, poor core stability, flexibility and poor balance as factors contributing to exercise injuries.

Dr Nat Padhiar, a Consultant Podiatrist who is a Lead Clinician and Team Leader for Podiatry at the London 2012 Olympic & Paralympic Games said: “Running and jogging are a great, low cost way to keep fit. In order to get the most out of your exercise routine and to prevent injury or long term problems, it is vital to prepare properly. Ensure you wear appropriate footwear that is specific to that sport, warm up and cool down effectively, and make sure you gradually build up your exercise routine. We see a lot of injuries as a result of people suddenly and dramatically increasing the length or intensity of their exercise. It is better to gradually increase it and build up your fitness, flexibility and muscle strength over time. If you do experience ongoing foot or leg pain then seek professional advice – do not run through pain.”

Top tips for safe running and exercising:

Choose the correct shoes for the sport. If running is the choice for 2012, buy a running shoe which has adequate cushioning in the midsole and a flared heel for stability. However, if it’s a racquet sport such as squash or tennis, buy shoes designed for racquet sports that give better stability when moving and stopping suddenly around the court -a running shoe wouldn’t be suitable due to lack of lateral support.

Follow the 1cm rule – when shopping for the perfect sports shoes ensure you can wiggle your toes a little – leave 1cm of room from the top of your longest toe to the end of your shoe. Try on both shoes and walk around the shop to make sure they don’t pinch or rub.

Always wear socks to reduce the risk of fungal infection and blisters. The best running socks are ones that are made from synthetic materials which are designed to wick sweat away from the skin, (such as CoolMaxÒ) as they don’t absorb moisture like 100% cotton socks, and keep the feet drier.

Warm up and stretch – before starting any form of exercise, stretch and warm up your entire body and then stretch and cool down at the end of every session.

Prepare your body– incorporate strength and flexibility exercises into your regime to ensure that your body is in the best possible condition for exercise and sport

Seek expert advice if necessary – if you have ongoing foot pain that doesn’t go away, have it examined by a professional.

Killer Heels

The ‘G’ Factor: Glamour, Glide, Guide and Give

Ask any woman…high heels are an essential part of the wardrobe – they make your legs look longer, bottom smaller and can convert you from a drab ‘shopper’ to a diva ‘spectacular’ and no podiatrist would dare to tell you otherwise!

However, ‘high’ heels can become ‘killer’ heels causing problems ranging from blisters, corns and calluses to serious foot, knee and back pain. But as it’s a party essential, rather than wagging the finger in caution, we are offering words of wisdom to help you and your feet.

Lucky for all divas, The Society of Chiropodists and Podiatrists have discovered the ‘G’ Factor of High Heels, offering four easy tips to help women enjoy wearing high heels without damaging their feet:

Glamour – Let high heels give you that extra ‘sparkle’ and save wearing them only for glamorous, special occasions. Try limit wearing them to around three to eight hours, and the height of heels, even for the most ‘A-list’ of events, shouldn’t be so high you have trouble walking! For everyday wear, heel height shouldn’t be more than 4–5 cms.

Glide – Don’t look like you’re rushing to catch a bus…. slow down, take smaller steps and shorten your stride when wearing high heels. Put the heel down first and glide! Not only will this minimise damage to your feet, but will give you that sexy high-heel wiggle! In fact, Lady Di wore low heels as her long legs and slender frame didn’t allow her to wear high-heels and glide elegantly.

Guide – Let the experts guide you into buying the right size shoe. According to leading podiatrists, 90 % of patients wear shoes that are too small. Sizes vary according to the brand and style, so, be sure to have shoes correctly fitted and check that there is up to ½ inch of space in the shoe beyond the longest toe and that the shoes are not too narrow. Also, nip any foot related problems in the bud to avoid them getting worse and before they impact on your lifestyle – use the guidance of experts such as your local podiatrist for advice.

Give – Give your feet some extra special attention during, and after wearing high heels. Exercise the calf, heel and foot muscles by stretching them out to increase circulation and help them relax – you can even do it whilst standing at the bar waiting for a drink! Give your feet a moisturising massage when you get home (after bathing!) to again help your foot muscles relax and put back some of the essential moisture you lose wearing backless, or open-toe heels.

“Forget the X factor, look out here comes the G factor! says TV fashion expert and stylist to the stars, John Scott.

“All women love their heels, they look better, they walk better and most importantly they feel better…. so why do we abuse our feet so much? After all, we have facials and manicures and massages to look after the rest of our body so now lets all do the G’s to look after our feet. Glamour…glide…guide and give will be the new mantra for the new year…so come on ladies put the spring back into your step and follow these simple but oh so effective tips.”

Women’s love affair with high heels means they are never going to go out of fashion. However, following The Society of Chiropodists and Podiatrists’ four simple ‘G’ Factor tips means all women can experience and enjoy high heels!

But, if you are one of eight out of 10 adults who just can’t seem to ‘kick’ foot or joint pain, contact us for advice.

A Tale of Two Chiropodists!

2012 is an auspicious year, as it witnesses not only the centenary of organised chiropody in the UK but also the bicentenary of the birth of one of our most illustrious literary figures, Charles Dickens.

It may seem a stretch to find a way of linking these two disparate events but anyone who has read David Copperfield may remember the character of Miss Mowcher, who was chiropodist/hairdresser to David’s friend, Steerforth. Controversially, Dickens was accused of basing this character on his family chiropodist and neighbour Jane Seymour Hill.

Miss Mowcher

Dickens introduces Miss Mowcher in Chapter 22; he describes her as ‘a pursy dwarf, of about 40 or 45, with a very large head and face…throat she had none; waist she had none, worth mentioning…’ Copperfield’s reaction to this unusual person was to say ‘altogether I was lost in amazement and sat staring at her, quite oblivious, I am afraid to the laws of politeness.’ Miss Mowcher then proceeded to produce from her bag ‘a number of small bottles, sponges, combs, brushes, bits of flannel, little pairs of curling-irons and other instruments which she tumbled in a heap upon the chair’. She then says ‘look here…scraps of the Russian Prince’s nails…I keep his nails in order for him. Twice a week! Fingers and toes.’ She then goes on to explain ‘they are the best introduction. If Miss Mowcher cuts the Prince’s nails, she must be all right. I give ‘em away to young ladies. They put ‘em in their albums. I believe. Ha! Ha!’ Miss Mowcher then proceeds to trim Steerforth’s hair and whiskers but afterwards Copperfield declines her offer of similar treatment. After she leaves, Steerforth and Copperfield laugh for some time but Copperfield then says, ‘when we had our laugh quite out, which was after some time, he told me that Miss Mowcher had quite an extensive connexion, and made herself useful to a variety of people in a variety of ways.’