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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The Monday Shakeout: Do Heavier Runners Need Different Shoes Compared to Lighter Runners?
By Matthew Klein

This week Matt attempts to answer one of the more frequent inquiries we receive. Those who write us often ask if they need a different or specialized type of shoe because they may be taller, have a larger body mass, etc. With a decent amount of evidence, he answers this question with some answers that may not be expected....

When runners reach out to us, one of the most common metrics they provide us is their body mass. A frequent question is whether they need special shoes if they are heavier, larger, and/or taller. While conventional wisdom may suggest that heavier runners need a more cushioned shoe, the actual evidence paints a different picture. My hope today is to present the current best practice guidelines and answer the question, "Do Heavier Runners Need Different Types of Shoes?"

A Misconception

The common assumption is that heavier runners need more cushion. This is assumes that with more weight comes greater impact. However, this has frequently been found not to be true. Runners with obesity have actually been found to "dampen impact forces and control loading rates" far better than runners with no obesity (Vincent et al., 2020). Ground reaction forces were higher in the runners without obesity, while peak hip moments were higher in the runners with obesity group in this study. This may suggest that larger runners do a better job controlling forces but do so through the hip joints. This may be further emphasized by the fact that body mass is NOT a risk factor for the development of knee joint or patellofemoral pain syndromes (Willy et al., 2019). This has been found repeatedly, so larger runners should rest easy knowing that their knees are no more at risk than smaller runners (and knee pathology is NOT associated with running).

Actual Areas of Injury Risks?

While impact forces may not necessarily be higher in larger runners, they do have some different responses to shoes compared to smaller runners. There is evidence that larger/heavier runners may be more at risk for injury running in minimalist shoes compared to lighter runners (Fuller et al., 2017). However, other evidence has suggested that the only group that actually has a decrease in injury risk with the use of more cushioned or maximal shoes are lighter runners (Malisoux et al., 2020). This would suggest that while minimalist shoes may need to be something larger runners approach with caution/ease into, maximalist or highly cushioned shoes are no more protective against injury than traditional, standard cushioned shoes (Malisoux & Theisen, 2020).

A Wider Consideration

What larger runners MAY have to consider is shoe volume and fit. While foot length and cushioning needs may not be different, foot volume may be different. This can be challenging as many shoes recently have come out with incredibly low volumes and may be compressive/uncomfortable for runners with larger foot mass. This is NOT the same as width, which is sometimes an easier fix by going up to a D (from a B in women's) or a 2E (from a D in men's) or more. We do our best in our reviews to address volume, so checking out of fit section may be more helpful for a larger runner than the comments on cushioning.

What We Know

As with most runners, the shoes that are most comfortable and fit the needs of the individual will work best. For larger runners, weight is less of a factor unless they are interested specifically in minimal shoes. For those with that interest, doing extra strength/mobility work and cautiously easing into their use is suggested. Outside of that, the type of shoe and amount of cushioning should match the preferences of the individual rather than stereotyping them based on their body mass. As mentioned, body mass has NOT been found to be a major risk factor for many injuries. Running injuries are far more complex than that, as demonstrated by the evidence cited above. Rather than only looking at body mass, additional factors, like training experience/history, goals, use, terrain, fit/volume and more are far more important variables to consider. So unless you are interested in minimalist shoes (just approach carefully), if you are a larger runner, you should run in whatever you want to try and whatever feels best to you.

Learn More in This Conversation


Fuller, J. T., Thewlis, D., Buckley, J. D., Brown, N. A., Hamill, J., & Tsiros, M. D. (2017). Body mass and weekly training distance influence the pain and injuries experienced by runners using minimalist shoes: a randomized controlled trial. The American Journal of Sports Medicine45(5), 1162-1170.

Malisoux, L., Delattre, N., Urhausen, A., & Theisen, D. (2020). Shoe cushioning influences the running injury risk according to body mass: a randomized controlled trial involving 848 recreational runners. The American Journal of Sports Medicine48(2), 473-480.

Malisoux, L., & Theisen, D. (2020). Can the “appropriate” footwear prevent injury in leisure-time running? Evidence versus beliefs. Journal of Athletic Training55(12), 1215-1223.

Vincent, H. K., Kilgore III, J. E., Chen, C., Bruner, M., Horodyski, M., & Vincent, K. R. (2020). Impact of body mass index on biomechanics of recreational runners. PM&R12(11), 1106-1112.

Willy, R. W., Hoglund, L. T., Barton, C. J., Bolgla, L. A., Scalzitti, D. A., Logerstedt, D. S., ... & Torburn, L. (2019). Patellofemoral pain: clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of orthopaedic physical therapy of the American physical therapy association. Journal of Orthopaedic & Sports Physical Therapy49(9), CPG1-CPG95.


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Skratch Recovery, Coffee Flavor: Mental and physical boost post run. Coffee flavor is excellent and goes great straight into a fresh brewed cup
goodr Sunglases: Run in style with goodr's super fun sunglasses.
Feetures Socks: Massively grippy socks that will make you feel more one with the shoe
Amphipod Hydraform Handheld Water Bottle: Perfect for long runs when you need hydration in the summer
Trigger Point Foam Roller: Help get those knots out post-run and feel better for tomorrow
Theragun Massager: This small version is great on the go for working tired legs
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Shoe Rotations for Different Runners

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