Pivot Pain–Get the Right Shoe for the Job
On a recent Saturday Solution session, I had the pleasure of meeting Tony. Tony has been training in the gym for just under two years. Between the classes and his personal training routine, he lost fifteen pounds and had a new-found enthusiasm for exercise. Unfortunately, Tony had developed pain in both feet. Pain was present “under the ball of the foot” and became stronger as the day progressed. Treatment with shoe orthotics and medications had not helped and the symptoms were getting stronger. He was frustrated and needed some answers.
During the evaluation, we were able to recreate the pain when Tony planted his foot and pivoted to change direction. Tony then removed his shoes, performed the same rotational-pivot movement, and the pain was minimal. Tony had been a distance runner so he wore a shoe designed for running when he trained in the gym. The brand he used had a thick sole and he liked them because they “controlled pronation”.
Running shoes are constructed to help manage the enormous cumulative shock forces of distance running. The current running shoe trend is toward a thicker, highly cushioned sole to help decrease impact. Distance running is a unidirectional activity–you travel forward. Running shoes are made to manage forces in only that single direction. Shoes made for multidirectional sports such as basketball and tennis do not look like running shoes. They have a thinner sole and wrap around the foot. This enables the athlete the ability to plant the foot and change directions. Running shoes are often designed to limit excessive pronation–rolling inward motion at the ankle and rearfoot. The well meaning, but unproven idea is that limiting pronation will decease overuse injuries. The ability of all of the lower extremity joints to travel through pronation and supination is a skill we need to train and not eliminate.
At Fenton Fitness, we design training routines that enhance motor skills in all directions. Tony had made the sudden switch from the single plane activity of running to a multi-directional training program. The motion control construction of Tony’s running shoes limited pronation at the rearfoot and ankle, but his brain was suddenly demanding a lot of pronation mobility to carry him through new multi-directional activities. The front of his foot became the center of pronation and this provided the tissue overload that was causing his pain. The solution for Tony was a switch to flatter, less restrictive, movement friendly footwear.
If your gym sessions consist of running on a treadmill and traveling through a series of strength machines, then running shoes will meet your needs. If, like my friend Tony, you are performing multi-directional movements that require a degree of athleticism, I suggest you use appropriate footwear. Two weeks after making the recommended shoe switch, Tony reported the pain in his feet had vanished.
Michael S. O’Hara, PT, OCS, CSCS