No Reason To Worry About Pronation

For many years, shoe companies, magazines and assorted running experts advised pronating runners to seek out motion-control shoes. The idea seemed simple: The inward-tilting motion of the legs after ground contact (i.e., pronation) caused injuries, and various motion-control shoes could limit that motion, and therefore the injuries.

How things have changed in the last four or five years. Several widely-read papers poked holes in: 1, the idea that pronation causes injuries; 2, the idea that pronated feet performed more healthily in motion-control shoes.

A new study from a Danish team with a strong background in running-injury research adds to the death throes of pronation and motion-control shoes. They call their new injury project the DANORUN study.

The study has several strong points. It followed 927 beginning runners for 12 months after they started running, and it used trained physiotherapists to decide their foot type – highly supinated, supinated, neutral, pronated or highly pronated. All the runners were given GPS watches that uploaded their workouts to a website, and all injuries were double checked by medical professionals. (Some of them weren’t running injuries.) All runners wore the same neutral shoe.

The researchers measured their results in a number of different ways, for example “relative risk of injury in first 500 kilometres” and “injury incidence per year.” For the first, they found “no significant risk differences between highly supinated, supinated, pronated and highly pronated feet compared with the neutral feet.”

For the second, they found the following injury percentages over one year: highly supinated feet (24.5%), supinated feet (17.9%), neutral feet (17.4%), pronated feet (13.1%) and highly pronated feet (33.3%). Few of the beginning runners actually had highly-pronated feet, and the study team acknowledged this as a weakness in the study.

The authors concluded: “The results of the present study negate the importance of foot posture, especially moderate foot pronation, as a strong indicator of injury among novice runners.” At the same time, they added: “It is important to stress, however, that motion control shoes may be a feasible choice for injured pronators.”

The Danish researchers believe that training errors are likely the major cause of running injuries, and that the best way to prevent injuries is through intelligent training choices. “Clinicians should focus on guidance in training distance, duration and intensity,” they write, “rather than guidance in shoe selection on the basis of foot posture.”

Most running biomechanics experts now believe that pronation falls under the “born to run” hypothesis. That is, it’s a normal and healthy way for the body to move when we run.

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