‘Minimalistic’ running shoes may help marathoners run ‘free’ of injury

Are you among the 45,000 runners in the final stretch of training for the Bank of America Chicago Marathon October 13? Have you been wearing the right shoe?

Many runners choose to train and run in “minimalistic” style running shoes, says Jessica Knight, D.P.M., AACFAS, Podiatrist/Podiatric Surgeon with Northwest Community Healthcare (NCH) Medical Group.

“Free, or minimalistic running is the use of limited-control running shoes, which provide protection for the foot while running, yet mimic the effects of barefoot running,” explains Dr. Knight. “This type of shoe is intended to help the foot function in its optimal anatomic position, thereby decreasing stress placed on other areas of the body, such as the ankles, knees, hips and back, during running.”

Dr. Knight says many patients she treats who run in minimalistic shoes say they have less chronic pain. However, she emphasizes, minimalistic shoes can create excessive forces across the foot, creating the potential for stress injuries, including stress fractures of the foot. Dr. Knight says the key to properly running in minimalistic shoes is to follow these tips:

1. Purchase the shoes at a reputable running shoe store. Going through a thorough fitting process for the shoes is important in lowering risk of potential injury and ensuring a specific model of shoe is correct for your foot type. If the store offers a training class on how to use minimalistic shoes, take it and learn as much as possible.
2. Change to a forefoot striker style (a running style in which you run off the balls of your feet). Many runners strike the heel first, which is not recommended for running in minimalistic shoes. To learn the different running style, attend a class or work with a coach who can train you to modify your running pattern.
3. Break in the shoes. The break-in process can take weeks, but Dr. Knight says this is critical. She advises first walking, before running, in the shoes. Walk in the shoes during your normal, daily activities. The break-in process allows your feet to adapt to the shoes and the forces they create across the feet. Eventually, you can make the transition to using the shoes during workout classes and training runs.

These recommendations are intended to help runners achieve the full benefits of minimalistic shoe gear, while decreasing their risk for a foot injury.

Now that you have the right shoes, here are some running tips:

Benjamin Hasan, M.D., an NCH Medical Group board-certified physician in both family medicine and sports medicine, is a regular Chicago Marathon volunteer at the 12.5-mile mark where he assesses injuries during the race. He has run seven marathons, and he has seen runners make a lot of common mistakes when preparing for the marathon.

At the 12.5-mile mark, he says, “we have over 100 runners dropping out at that spot every year.” Those who drop out may be injured, undertrained, dehydrated or ill.

“If you feel pain or you’re not feeling right, you should drop out,” he suggests. It’s OK, he adds, because you can always run another race.

Dr. Hasan says a common mistake runners make when training is running too many miles, which increases their risk of injury. Anything over 35 miles per week increases risk. Avoiding stress fractures is another big issue with runners.

“In sports medicine, we talk about two types of broken bones,” Dr. Hasan says. “We can have traumatic fracture by falling or we could have a stress fracture, which occurs over time from gradual, multiple pieces of trauma like running. So if we’re training for the marathon and we end up with pain in a bone in the lower extremities, that may actually be a stress fracture.”

Dr. Hasan says you should not run with a broken bone, and a stress fracture is a broken bone. He recommends stop training and let it heal.

Symptoms of a stress fracture include pain with running, getting worse and worse over time. It differs, he says, from a muscle strain or sprain, which gets better over time.

“A muscle strain occurs when the stress of the activity is greater than the strength of the muscle,” he says. “A tendon or ligament sprain occurs when the stress is greater than the strength of the tendon or ligament.”

Differentiating between the two requires a physical exam by a physician trained in sports medicine.

Dr. Knight practices at 2101 S. Arlington Heights Road, Suite 108 in Arlington Heights. To schedule an appointment, call 847-725-8401.

Dr. Hasan practices at 1941 Rohlwing Road in Rolling Meadows. Call 847-618-0850 to schedule an appointment.