Transcription:
OACM's Guide to Running

oacmd031

Amanda Wilde (Host): You love running. It's more than exercise. It's a challenge for your body. It's meditation. It's your time for you. That's why we've asked our experts to answer some of the most asked questions on getting the most out of running and how to do it safely.

Hello. I'm Amanda Wilde. And I've got a bone to fix with you. We're talking form and footwear with Dr. Mark Lipton, a podiatrist and foot and ankle surgeon, and Karyn Dulaney, a physical therapist and running specialist at Orthopedic Associates of Central Maryland. Welcome to you both.

Dr Marc Lipton: Well, thank you for having us.

Karyn Dulaney: Yeah. Thank you for having us here.

Amanda Wilde (Host): Well, I have a lot of questions about footwear. Now, starting with you, Karyn. What is the best brand of shoe to buy?

Karyn Dulaney: That's a good question. And there's not only necessarily a best brand. It's important to know what the brand that you're looking at sells. For example, there's some brands like Altra, which is known for not having a drop in their shoes, so it's kind of a more minimalist shoe versus there's a brand called Hoka and they're known for having a lot of cushion. So it's good to know what the brands are that you're looking at and what they're known for. Most brands will make a variety of shoes. So it's really about finding what fits and feels the best for your foot.

Oftentimes your physical therapist might have a recommendation of what type of shoe that they want you to look for within a brand, or a podiatrist or a physician might give you recommendations on things that they want you to look for based on your specific foot, your medical history and injuries you've had in the past.

Amanda Wilde (Host): Oh wow. So very, very individual.

Karyn Dulaney: Absolutely. Yeah, it's good to just go to a shoe store and try on a bunch. And again, talk with your healthcare providers to kind of get a baseline idea of what to look for when you go to the shoe store.

Amanda Wilde (Host): So Dr. Lipton, how often do I need new shoes? Like what signs will I see that it's time to replace them? Or do I do that by the clock?

Dr Marc Lipton: Well, you know, a lot of times for people who run regularly, I'm thinking more than maybe three to five days a week, we tell them usually somewhere up to the 300 to 400-mile mark that they have to change out their shoes. I always tell them, if they're not sure that their shoes are wearing out, go ahead and try on a new pair of the same shoe and see how it feels. If there's a big difference between the way they feel, then maybe it's time to switch their shoes. Also, if they're starting to get some twinges of discomfort or maybe some heel pain or arch pain that they hadn't noticed before, they might think, "Well, now this is a good time to start looking at new shoes" and seeing if they need to be replaced.

A lot of runners, especially the more experienced ones, like to wear the same type of running shoes. And a lot of times they'll have more than one pair, so they can go ahead and just go put on that other pair they have and see if it feels different for them. I recommend that runners go to their local running shoe store. I like the ones that are locally owned because they can go in there and they can try on their shoe and they can run on the treadmill and get a good idea if a new shoe is right for them at that point.

Amanda Wilde (Host): And you were talking about switching shoes, and that sort of led to my next question for Karyn. should I train in racing flats or cleats, or should I move between?

Karyn Dulaney: So generally speaking, your body and your foot need to take time to prepare and condition for whatever type of shoe that you're going to be wearing. So if you are someone who's playing soccer and you do some training every week in a regular sneaker, it's a good idea to go ahead and put on your cleats and practice a little bit in them before using them in a game. So usually, we recommend at least a week or two in advance just to make sure they have a proper fit, that you don't have any unexpected aches or pains.

A lot of times when you start wearing a different type of shoe, you might develop muscle aches in different areas just from using different muscles. So it's a good idea to adapt and adjust. Also, some shoes such as racing flats that don't really have a drop, so the drop is when we look at the raise between the heel and the toe, it requires a little bit more flexibility in the rear of your foot. So making sure you're doing appropriate calf stretches and making sure that your Achilles has a proper motion to be able to wear those shoes without having issues is really important. So that's why checking them out ahead of time, practicing them and getting your foot used to how that shoe will feel is beneficial.

Dr Marc Lipton: Runners sometimes need different shoes for different conditions. If they're outside running in the rain or running on trails, they may need a trail running shoe that would be waterproof and a little bit sturdier than a regular training shoe. And sometimes, if they're recovering from injuries, they may want a different type of shoe, such as a shoe with a higher heel drop, versus a zero drop running shoe if they're maybe recovering from like an achilles tendon type injury. So they may choose more than one shoe. And I think most experienced runners have different types of shoes for different types of training runs. Also, some runners like to run in barefoot style shoes for training purposes, they feel to strengthen the intrinsic muscles of their feet. And so, they may have a day where they want to run in that type of shoe.

So novice runners, I'm sure wear pretty much the same shoes day in and day out. But they should have some shoes to switch on and off with. So they're not wearing the same shoe every day. I think if they wear the same shoe every day, they tend to stretch out a little bit and the shoe itself doesn't have time to recover. So what I'm getting at is most runners should have more than one pair of shoes, depending on the condition. And also, if they're running day in and day out on the same shoes, they should be able to switch off from time to time.

Amanda Wilde (Host): And you mentioned some special conditions. What if I have flat feet or the opposite, a high-arched foot? Is there anything specific to look for in a shoe?

Dr Marc Lipton: Most of the running manufacturers are making shoes. When we talk about a flat foot, we're talking about someone who overpronates. So most of the running shoe manufacturers are making shoes for overpronators, and more what we call or label a stability shoe. The shoe reduces the amount of motion the foot goes through when they're running. And people with a flat foot need those stability shoes, but not always. Sometimes they wear what they call a neutral shoe. And if they have an orthotic or a device they like to wear in the shoe to give them a little extra support, something like that would work well for them.

And then, there are people with high-arched feet that may need the certain style of shoe. I usually try to recommend for a person with a high-arched foot a curved last running shoe. They're not easy to find. But if you look at the bottom of the shoe, it looks like a curve. And the stability shoes or the shoes made for people with more of a flat foot have what we call a straight last shoe. And if you look at the bottom of the shoe, the last or the shape of the shoe is more straight, and that fits that type a little bit. better

Amanda Wilde (Host): This is really helpful information on what type of shoe I should buy that's going to be most comfortable and the least stress for my feet, and also to switch off shoes. Like you said, your foot and shoes need time to recover. This one's for both of you. Karyn, I'll start with you. Do you have any tips for trying on new shoes?

Karyn Dulaney: Yeah, I think it's best to try them on later in the day. So from the time that we wake up and when we're standing and walking throughout the day, a lot of times our foot will kind of compress and widen and might be a little bit swollen. So if you go in the morning, you might get a little bit of a different fit than later in the day. When you run, particularly if you're someone who's running a lot of miles, your feet tend to swell. So it's good to have that worst case scenario of what your foot might look like at its widest point when you're trying on the shoes.

It's also a good idea if you take out the insole inside the shoe and just put it on the ground and stand on that. And if your foot is really spilling over that insole, it's probably the idea that the shoe is not wide enough for your foot. So I think a common error is that people buy shoes that are too narrow, that squeezes the toe box of the runner.

So it's also a good idea when you're going to try on your shoes to make sure that you have the same kind of socks that you plan to run in. So some people like to wear a thicker sock with a little bit more cushion, and that'll take up more space in a shoe than someone who's wearing a really thin sock. So definitely bring your socks with you and try on what you plan to run with in your shoes to make sure that it's a proper fit.

The other thing to look at is how does your foot fit in the shoe in terms of length. So oftentimes we're told to kind of look at our big toe and base the length of the shoe off of that. But some people, their second toe is actually longer than their big toe. So whatever your longest toe is, that's what you want to base the length of the shoe on. And you want to have it be a little bit like about a half inch to the end of the shoe for appropriate room in that shoe.

Amanda Wilde (Host): Yeah. And then, even sometimes I've noticed another toe, just the way the shoebox is shaped, a different toe can be hitting in the wrong place as well.

Karyn Dulaney: Yeah, absolutely. And there's some companies that are known for having a little bit of a wider shoe or selling the same shoes in different widths. So for example, New Balance tends to have a little bit of a wider shoe, and they usually carry more of an average fit and then a wider fit. Altra is another brand that is known for having a wider toebox to accommodate people's toes.

Dr Marc Lipton: The other thing is people tend to think that they need to buy the size of shoe that they measure. So if you measure, let's say, a size 10 in a normal shoe just like a street shoe or a dress shoe or something like that, when you go to a running shoe, don't be surprised if your fit is better as a 10.5 or even an 11. So generally, running shoes run half to a full size larger than your normal shoe size. So it is really important, like Karyb mentioned, to check the fit and make sure you have that room between the end of the longest toe. A lot of people tend to buy their shoes a little too small and they end up with injuries or, as a result of that, bleeding beneath the toenails and blisters and aches and pains, and they don't realize that they're actually wearing the wrong shoe size.

Also, if you have a wider foot, if you even go up a half size in the shoe, it brings the wider part of the shoe up to the wider part of the foot, and you may get a better fit. People are afraid to wear shoes that may not be their exact size, and really it's whatever size fits your foot is the correct size. Just measuring your foot is giving them an approximate size of your foot. And a good shoe store, a good running shoe store will know that, "Oh, you have a size 10. And in this brand, you need at least a half size larger, and in this brand you need at least a full size larger." So having a good resource, like a local running shoe store that knows the products and knows how they fit is really important.

Karyn Dulaney: Dr. Lipton, to your point, I think a lot of people are buying their shoes online as well, and sometimes that's just availability, like lack of shoes in the store. So, make sure if you're buying online, to order from someplace that has a good return policy so that you can order a size 7, a size 7.5, and a size 8, and really be able to try on all those shoes and figure out which one is the best one for your foot and then return the ones that don't work for you.

Dr Marc Lipton: Absolutely. I agree to that.

Amanda Wilde (Host): Well, great tips and important factors to be aware of when shoe shopping and also when using your running shoes. On that note, thank you both so much for all this great information on how to run safely.

Dr Marc Lipton: You're welcome.

Karyn Dulaney: You're welcome.

Amanda Wilde (Host): It was great having you. For more information, jet over to www.mdbonedocs.com. We have eight PT locations and four office locations for your convenience. And you can subscribe to this podcast for more insight into topics of interest. That's all for today. I'm Amanda Wilde, and that was a bone that's fixed.