The Influence of Different Running Shoe Technologies on the Musculoskeletal Load in Running and Injury Outcomes in Recreational Runners

Abstract

This biomechanical study of 38 male and female recreational runners demonstrates the relationship between the four most frequently used footwear technologies and the biomechanical load on the lower extremities during running. Running with the four midsole technologies ((1) neutral, cushioning running shoes (N_LS), (2) supportive, motion control running shoes (S_LS), (3) maximalist, carbon-fibre plate running shoes (M_LS), and (4) running shoes with a U-shaped midsole construction and highly cushioning foam (U_LS)) indicates a strong impact of the midsole technology on the kinetics of the lower extremities. Midsole construction and material of the four running shoe categories systematically influence joint moments at the foot, ankle joint, and knee joint, thereby modulating the mechanical load on the biological structures of the lower extremities with each running step. The data demonstrate no significant differences in running kinetics between N_LS and S_LS, while M_LS increases and U_LS decreases ankle joint and knee joint load during the stance phase. A 12-month standardized and randomized intervention trial surveyed 1697 recreational runners who used one of the four dedicated running shoe categories in more than 75% of their runs. The results demonstrate a strong relation between the development of running-associated injuries in general, and knee and Achilles tendon problems in particular, and the footwear categories. While neutral and supportive running shoes show no significant differences in the development of running-related injuries, M_LS increases and U_LS decreases this risk, especially the occurrence of knee pain. Other risk factors, such as age, gender, BMI, running distance, average speed, surface as well as foot morphology and leg axis, only had a minor effect on the development of running-related injuries in the 12-month survey. Running shoe midsole technologies offer a sophisticated causal explanation for overload injuries of biological structures in the lower extremity during running and the resulting running-related injuries.