Physical Therapists Using Clinical Analysis To Discuss The Art And Science Behind Running and The Stuff We Put On Our Feet

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Welcome to our second Doctors of Running Q&A! We rounded up some of our favorite user submitted questions from our Instagram to tackle in today's edition. Make sure to follow us on Instagram to catch future opportunities to send questions in, or email us your questions to!

Doctors of Running Q&A, Volume 2

1. How/why do different shoes work better for some and not others? (jco004)

Senior Contributor Andrea Myers: There are so many factors that go into why a particular shoe works well for one person and not for another. These factors fall into two general categories: fit and ride. Factors related to the fit of the shoe include overall length, width at the forefoot, midfoot, and heel; upper volume and material; shape and cushioning of the heel counter; and lace type and pattern. Factors that affect the ride of the shoe include the amount and type of cushioning, stack height, presence of rockers or toe spring, carbon or composite plates, or stability features; and heel-forefoot drop. As a personal example, I love the ride of the Hoka Rincon, but the sidewalls in the medial forefoot give me horrible blisters no matter what socks I wear or how I lace the shoes. One thing that has helped me figure out what shoes I am likely to like or not like is to break down the fit and ride factors that matter most to me. For example, I know that I like shoes with a later toe spring (like the Topo Cyclone or Specter) as compared to an early toe spring (like the Asics MetaRacer or Magic Speed). I also know that any Hoka with sidewalls in the forefoot will not work for me, and that I generally prefer a shoe with a stiffer midsole. Looking at the characteristics of shoes that work for you (and those that do not) may help you to more easily identify other shoes that may work for you in the future.

Senior Contributor Nathan Brown: I think a question like this has to start with thinking about what we mean by the phrase “work better.” Working better from a performance standpoint versus an injury standpoint may lead us to thinking about the answer in different ways. The other reality is that there is not a definitive answer as to “why”. When thinking from an injury standpoint, it seems most plausible to me that a shoe lines up best with a runner’s specific strengths, weaknesses, and training habits. For example, someone who has very weak calf muscles may not do as well in a zero drop shoe as someone who is strong in their calves and uses motor patterns that advantage those muscles anyway. Or conversely, someone with weak hips or limited mobility in the hips may not do as well with a heavily rockered shoe. From a performance standpoint, I think that some of the comments above are applicable here, but there are also other factors. Some that haven’t been fully explored are things like body weight and shoe interactions on performance or varying vibration frequencies (between runners) of tendons/muscles and how that matches various foam compounds. Vibration can be a factor in leading to fatigue and breakdown of muscles, and if someone’s tendon vibration matches well with a certain foam, it may help with long term performance over training and distance. However, right now there is no way to measure this. On top of all this, having a shoe that fits your foot well will be important, as something that is too loose or tight can be an issue. So some shoes built on a wider last may work well for some and not others.

2. What’s the best two day strength training split to add in addition to running and cycling? (jordandmiller21)

Senior Contributor Andrea Myers: I would recommend doing strength training on interval/workout days (whether they are cycling or running). This usually results in 3-4 days between strength training sessions, depending on your individual training schedule. Strength training done on other days can result in muscle fatigue/soreness that might interfere with your harder workouts. You should have an easy day the day after your interval workout, which will also help ensure you recover from strength work prior to your next interval day.

Contributor Ryan Flugaur: Adding strength training into a running program is important but oftentimes can be challenging for a couple reasons. First, adding a strength program takes time. Adding 2-3 strength sessions into your workout each week can add an extra 2 hours of training a week which can be challenging for some people. Second, the muscle soreness and fatigue that occurs following a strength session can make it difficult to continue with a hard workout the next day. This is why you typically want an easy day following a strength training session. I typically add strength training to my normal base training days, planning to leave a few days between my strength workout and my long and interval run days. This gives my legs time to recover from lifting and the muscle time to repair. If you are new to strength training, start slow with low weight. Beginning with bands and body weight will likely be enough. The delayed onset muscle soreness (DOMS) that occurs from strength training can make it challenging to continue with your running and cycling program if you begin too heavy. If your legs are accustomed to lifting weights, the muscle soreness will not affect you as much and you can begin with heavier weights. Sometimes something short such as a 15 minute glute workout is easy to add in following an interval day like Andrea mentioned. I will sometimes add a quick banded glute session in place of my strides to get a low stress workout at the end of a run. 

3. What are your favorite running shorts? (steel02001)

Chief Editor Matt Klein: The Saucony Core Outpace 2.5” Split Short is my absolute favorite. They are short, split shorts with a high split that provides excellent flexibility for easy and fast runs. There is a large rear pocket for keys and gels (this is incredibly important to me). The inner liner is extremely comfortable and I have used these for up to 30 mile runs without chaffing. These have been my go to short be it for hard workouts, long runs or easy runs.  

Content Manager Bach Pham: I’ve absolutely been loving the Beach Break 5’ shorts from Rabbit this summer. They have been super durable, highly comfortable and feature a ton of really great pockets that are both useful utility-wise and also slim enough that they don’t get in the way during the run. The shorts feel surprisingly minimal despite the four different pockets available. They also do a great job of staying relatively odor free for me and can handle a few runs before washing since they quick-dry so well. 

Senior Contributor Andrea Myers: Rabbit Leggy 4” shorts have been my favorite for the past several months, but now the Leggy 2.5” are my new favorite for the summer. The material is very lightweight, doesn’t get baggy when sweaty, doesn’t chafe, and have large hip pockets and a rear zipper pocket, making them perfect long run or marathon shorts.  

Senior Contributor Nathan Brown: I’ve been using the Brooks Sherpa 5” for about 5 years and for me it’s hard to beat. The price point is good, it has adequate storage, and they’re just very comfortable for me. It’s a pair I always keep around regardless of what we are testing on the team.

4. What are your thoughts on using super shoes for training? (demarbn)

Chief Editor Matt Klein:  It depends on the type of training you are using them for. For speed workouts, tempo runs and racing, I think they are excellent tools that not only facilitate more efficient running, but potentially faster racing times and recovery. If you are planning to use them for a marathon, it is important that you use them during at least one long run to get used to them.      

When it comes to using them for daily runs, that’s where I start to go the other direction. These shoes were designed and developed for faster running. Using them for easy days means you are using a tool outside its intended purpose, which may carry some risks. These shoes are extremely aggressive, stiff and bouncy. We do not know what happens to the body when you expose it to that all the time. Anecdotally, I have seen a large number of Achilles tendon and hamstring injuries in those who use these shoes full time in training. The softer foams, excessive stiffness and rockers do change where forces are being applied and created.     

Will some people get away with this, enjoy their running and stay injury free! Of course! There are always exceptions. For the majority of the population, we do not encourage this and suggest using a daily training shoe for your easy training. Have a few pairs of different shoes to switch between not only will give your legs a chance to recover, it allows for a different stimulus to your legs rather than the same one repeatedly (which may lead to overuse injuries). There is evidence this can decrease your injury risk. Staying in the same shoe all the time, especially one that aggressive, is not what we suggest.  

Senior Contributor Nathan Brown: Barring any specific condition that makes a stiff, rockered sole the only option for daily training, I do not think super shoes have a place in regular training and daily mileage. There are a lot of changes on the body that occur with shoe of this nature, and I think to maximize the benefit of a super shoe on race day (and during workouts, which is another place I tend to say they are good for use) I believe the rest of your mileage should be done in shoes that allow your body to move as naturally as possible while still being comfortable and enjoyable to run in.

5. Can you run with peroneal tendinitis? (logan_671)

Chief Editor Matt Klein: For those wondering, peroneal tendinitis is an irritation of the tendons of the muscles on the outer side of the lower leg (behind your lateral ankle bone). You can certainly run with any tendinitis but it depends on the severity of your symptoms. If you cannot even walk normally, then you probably shouldn’t be running. However, if it only shows up while running and is tolerable, then you may be able to continue running. Often times tendon issues will feel irritable during the warm up and start to feel better after you get into the run. We highly encourage anyone with or without a tendon issue to properly warm up. Heel walks, toe walks, calf raises and toe raises, lateral walks, etc can all be great pre-run exercises. Isometrics for these muscles (ie hold your foot out against resistance) is also a great warm up (just don’t do too many prior to running).   Footwear suggestions will depend on which of the tendons are irritated. There are two that plantarflex (like the calves) and one that dorsiflexes. The tendons that are more commonly irritated are the plantarflexor group. I usually suggest then you use a higher drop shoe with an appropriately placed rockered that isn’t too rigid or too unstable. When this starts to heal, you can transition into lower drop or stiffer shoes (like racing shoes).  

Senior Contributor Nathan Brown: As Matt mentioned, running while having a tendinopathy is acceptable, but it all centers around load management and truly listening to your body. One model that has been studied to help know if you should progress with running or stop running is called the Pain Monitoring Model. This was developed for Achilles tendinopathy, but certainly can apply here. The model states that you can run or participate in an activity if:

1. The pain is ≤5/10 on a pain scale during, after, and the morning after an activity,
2. The pain returns to baseline by the next morning, and
3. Pain does not worsen week to week.

This is a great model, but it requires you to be honest with yourself and pull back if you need to. Keeping a daily log can be helpful. Additionally, if you continue running but aren’t working on the other things that led to the development of the tendinopathy, you won’t find yourself improving.

6. Do you have any advice/comments about the depth/height of the shoe upper? They’re often shallow. (ptoledo911)

Chief Editor Matt Klein: Yes and I highly encourage you to think outside the box on how you use your laces. Some shoes are just way too low in terms of height, but many others can be modified by changing your lacing technique. The one I most commonly suggest to improve the volume and height of the upper is the Lydiard Lacing Method. This involves relacing the shoe so that the laces do not cross, and can reduce pressure on the top of the foot. You can also do this specific parts of the shoe (ie in the forefoot/midfoot) instead of the full length.

Senior Contributor David Salas: One thing to look for with uppers is their accommodation to your foot. Most people would like a shoe that gently holds their foot snug but not tight per se.  Some uppers may come off as shallow because they are looking to try and get a good hold over the top of the foot, as the laces and tongue ultimately secure the foot and upper to the platform.

7. How to arrange work/daily homework/training and sleep well for recovery in one week? (sanloman)

Chief Editor Matt Klein: That is a great question. As someone who generally runs at least once day, works full time, is also a full time PhD candidate and runs this website, staying on a schedule and getting my run done in the morning has been of the utmost importance for consistency. I highly suggest you run early in the morning as it gets training done before the rest of the day. That way no matter what happens, at least you got your run in. In regards to work and homework, I will often use a shorter run as a break to help my brain recover. Homework and studying is important, but your brain is no different than your body. It also needs recovery and brief rest periods (just like a workout). So planned short breaks can be helpful to get extra mileage in. Getting enough sleep comes down to scheduling and dedication. I encourage you to stick to a schedule of getting to bed by a certain time. There is a great deal of research on the importance of sleep hygiene in regards to a regular sleep schedule. The better you sleep, the better your brain and body will recovery for optimal training, work and studying.

Contributor Megan Flynn: This answer is going to depend on what your schedule is and what life demands you have, but I’m a big proponent of routines. I prefer to get the bulk of training done first thing in the morning. Mainly because it leaves less room for curve balls that could affect your training - you never know what can be thrown your way during the day and totally throw off your training plans. If you do it first thing in the morning, then you know you’ve had a quality day (in terms of training at least) no matter what the rest of the day brings. Another thing that has really worked for me is actually writing somewhat of an agenda for the day. Allot specific times during the day for work, family time, relaxing, etc to maintain some structure for your day. The best thing to do for recovery/sleep is to get into a consistent routine/pattern leading up to bed and make sure you are at least giving yourself the opportunity to get 8 hours of sleep each night. Set an alarm on your phone to remind you to start your routine and get to bed at a normal time!

8. How do you know it's time to change shoes? - nya.shara

Chief Editor Matt Klein: That is a great question. Previously, most companies recommended changing out your shoes after 300-500 miles of use. We now know that number varies quite a bit, especially with many shoes not being as durable now due to lighter materials. From a biomechanical standpoint, once you start to see significant uneven wear in the outsole, that is a good time. This is because that extreme wear will exacerbate whatever abnormal movement patterns you have and may increase your injury risk.

9. Are there benefits to using a variety of shoes for training? Or am I just rationalizing owning too many pairs? (david_g_watt)

Senior Contributor Andrea Myers: There may be benefits to using a variety of shoes for training. A study by Dr. Laurent Malisoux and colleagues in 2015 examined whether runners who use different running shoes have a lower risk of running related injury. They found that using more than one pair of running shoes was a protective factor with regards to running related injury. Specifically, they found that runners who used more than one pair of shoes had a 39% lower risk of injury as compared to runners who only used 1 pair of shoes. This may be due to the influence running shoes have on a person’s impact forces and running kinematics. Runners tend to adapt their mechanics to the characteristics of a shoe - for example, midsole hardness, heel-toe drop, and age of the running shoe may influence impact forces and kinematics.

Rationalize away - having a shoe rotation may reduce your risk of injury, and on a lighter note, having more than one pair can certainly make running more fun! 

Reference: Malisoux L, Ramesh J, Mann R, Seil R, Urhausen A, Theisen D. Can parallel use of different running shoes decrease running-related injury risk?. Scand J Med Sci Sports. 2015;25(1):110-115. doi:10.1111/sms.12154

10. What is the best way to motivate your athlete that gives into negative self-talk during workouts? (thejordanlang)

Contributor Megan Flynn: That is a tough one! I think almost every athlete has faced negative self-talk at one point or another and being able to overcome it takes time and mental practice. During workouts is a great place to start working on reducing the negative self-talk because when it gets tough during a race, negative self-talk could make or break your performance. The fact that they are out there doing workouts tells me they have something intrinsically motivating them. One idea is to have them recognize and acknowledge that intrinsic motivator or their purpose for being out there training everyday. Have them write it down to make it more tangible; have them remind themselves of this motivator during the tough points of workouts. I’ve also found that having go-to mantras for tough points in workouts and races have been very helpful. That way when the going gets tough you already have the positive self-talk in your pocket and ready to use. The mantras don’t have to be said out loud or anything; I actually sometimes write them on my wrists as a reminder. Every athlete is different and there are many, many strategies to change their mindset!

11. For marathon training time goal, how would you balance mileage/intensity? (<3:15) (timcoleman0810)

Contributor Megan Flynn: When training for a marathon, it’s important to consider the training you have done leading up to the marathon. How much of a base have you built? Are you going into training straight off of a break from running? Have you run a marathon before? Have you already been doing any intensity-type workouts? There are a lot of important factors to consider. When designing a marathon plan I try to focus on the percentage of miles per week done at or below marathon pace. This percentage will fluctuate during training depending on the point of the training cycle and should be ~15-20% of your weekly mileage (again, depending on what level of training you are at!) In terms of mileage volume, no greater than a 10% jump is usually a good rule of thumb as long as you are allowing proper recovery time. Make every 2-3 weeks a “down week” with lower mileage and shorter workouts. Ultimately, the important days are your workout days and the days between should be focused on optimizing recovery to get you to the next workout feeling as fresh as possible!

12. What are the best stretches I can do after a long run 20k plus? (dannygospage)

Senior Contributor David Salas: Taking a little time to hit the major muscles groups for blood flow and down regulation will be good. Gentle calf stretching, hamstring, hip flexor, and quads will usually work pretty well.

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Thanks for reading!

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