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How Do Runner Injury Paradigms Influence Footwear Designs?

There are four primary schools of thought regarding the influence of footwear on running-related injuries: (1) Pronation Control, (2) Impact Force Modification, (3) Habitual Joint (Motion) Path, and (4) Comfort Filter.

Current evidence does not support the pronation control or impact force modification paradigms. Shoes can limit pronation, but that doesn't change injury risk. Pronation is needed during running and "excessive" pronation is not dangerous.

To attenuate peak impact force and loading rate, shoe-makers beef up the cushioning at the targeting landing area (midsole or heel depending on strike pattern). As with pronation, the adjustments don't influence injuries. The body adapts with gradual changes in running mechanics and efficiency and muscle mass and strength in the legs.

The habitual joint path and comfort filters lack data on whether injuries are reduced. They are more subjective assessments as well. I lean towards the latter in my assessment of footwear due to the power of subjective choice. If the shoe is comfortable and doesn't restrict movement, it is more likely to enhance performance (or not impair it) and make for a more enjoyable experience.


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