Body Alignment: From the Ground Up

The posture debate. This, like the insoles themselves, is also seeing a renaissance in recent years, with Functional Movement Screens being used in sports, exercise professionals implementing weird and wonderful corrective exercises, and now, the show companies, particularly the sport shoe companies, are getting in on the act.

So, basically, many companies make the claim that each individual has a different foot structure, mainly the structure of the arch in their foot. They can have high arches, low arches, or 'collapsed’ arches, where the feet are quite flat in structure. They then claim that this foot structure causes the foot to roll inwards, a movement known as inversion (not pronation, as it's commonly called), or roll outwards, known as eversion (not supination). This movement is then claimed to either directly cause ankle pain and injuries by placing stress on the ankle joint or foot or indirectly cause pain and injuries through the body compensating for the ankle inversion or eversion by moving the knee or hip joint to accommodate the ankle.

So, firstly, addressing the idea that the ankle, hip and knee joint move in response to, or along with, the ankle; It does. Of course if does. Otherwise we would run the risk of tearing tendons and ligaments at every imperfect step. The knees and hips act like springs and shocks absorption, buckling under pressure during trips, slips and falls or simple missteps, lessening the pressure on the foot alone. So, yes the movement of the hips and knees is substantially related to, or dependent on, the movement of the ankle. However, the real question that should be asked is, if our foot inverts or everts, does this increase our chance of injury or pain?

The answer seems to be no. In fact two studies assessing the injury prevalence of those wearing specialized, specific insoles found no significant impact in injury rate. While there was a significant difference in one of the studies in 'high pronators’ (people who have extreme pronation in their feet) seem to only make up about 1% of the population, so it's highly unlikely that the majority of the people wearing the insoles need them for injury prevention.

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But what about the pressure on Achilles tendon? The one the salesman told me about?

Well, turns out the Achilles tendon is pretty tough and can take a bit of pressure. Plus, even if you do get new insoles, there's no guarantee that it's going to align the force that travels up through your heel in a straight line. This is due to the fact that your body seems to have a ‘preferred movement pattern’ that it will do its best to stick to no matter what footwear you use. So putting insoles in your shoes can have a pretty random and sporadic effect on how the forces in your foot travel and your movement. Whether this is good or bad, is still unknown.

There may be something beneficial to wearing these specialist insoles or shoes beyond the placebo effect (the name given to an effect that is caused purely from the belief that something should work). There may also be a way to get the claimed benefits of the specialized shoes or the insoles without having to actually spend more money to get them.

Staying In Your Comfort Zone: How Your Shoe Choice May Affect Performance

There have been studies showing that more comfortable shoes not only help reduce injury but also allow you to utilize more of your muscles in both the ankle’s surrounding musculature, like the calves, and the knee musculature, like the hamstrings and quadriceps. So, the magic behind this resurgence in orthotics may be in the added comfort, through the extra cushioning many of these shoes and insoles offer, of wearing the shoes. Studies have also shown a correlation between shoe comfort and injury and pain reduction. Added shoe comfort can also reduce oxygen consumption during running, allowing you to increase your speed without running out of steam.

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So, you may be able to increase your performance in training and competition by simply picking the most comfortable shoe for you. Also, there may be some merit in choosing shoes that don't disturb your preferred movement path. But, unfortunately, to get an accurate estimate of that, you would need around four to six cameras taking frame by frame images of your foot while walking and running and you would have to design a shoe from scratch and even then there's no guarantee it would work.

Conclusions And Recommendations

Don't spend too much time worrying about how your ankle is moving, and how this is affecting your knees, hips and overall posture, and instead just go for the most comfortable shoe for you. If you do pick up an injury, from running or other activities, there's a long list of potential reasons for it before you should consider the shoes you're wearing. However, if your shoes are causing little niggles or discomfort or pain, you should probably consider switching footwear.