Runner’s World UK – September 2019

HEAVY LATERAL

FOREFOOT STRIKE

1. This wear pattern shows you are landing
   hard on the outside of the forefoot and
   twisting through to the toe. Typically, there
   is a lot of aggressive wear on the outside of
   the forefoot of the shoe, under the fourth
   and fifth toes. 2. There is little wear on the
   heel, in comparison. Sometimes it’s pristine.


2. The toe area shows one of two patterns
   of wear – over the inside of the big toe (3a),
   or wear over the tip of the shoe (3b).

RISKS

Stress fractures in the fourth and fifth

metatarsal bones. The heel and midfoot have

force-absorbing joints that are not being utilised.

The peroneal tendons run down the outside of

the lower leg and under the ankle bone into the

foot. They are overworking to control impact and

risk getting strained.

You are at risk of ankle sprains.

Wear on the tip of the shoe (3b) shows that you

are at least controlling the foot and not rapidly

overpronating on impact. However, all the above

risks still apply because of the lateral strike.

Wear on the inside of the big toe (3a) shows you

are pronating through the mid- and forefoot. This

risks stress fractures in the second metatarsal.

PERFORMANCE ISSUES

You are probably overstriding, slowing you down.

You are probably rotating poorly through the

pelvis and trunk, again reducing your speed.

Rapid pronation and driving off the inside of

the big toe doesn’t allow you to use your calf or

glute muscles properly, and you lose power.

HEAVY HEEL

STRIKE AND

ROLL TO INSIDE

OF BIG TOE

1. Wear on the outside of the heel (1a) and
   occasionally on the inside (1b) as well.


2. Wear over the inner edge of the big toe,
   with the rubber almost rolled smooth.


3. Little wear around the tip of the shoe.

RISKS

This wear pattern can contribute to the

development of problems with your Achilles

tendon and plantar fascia, as well as shin and

knee pain, to name just a few issues.

Overpronation at impact needs to be slowed

and controlled by the foot stabilisers, particularly

the tibialis posterior. Weakness there leads to

overloading of the tendon and shin pain.

PERFORMANCE ISSUES

Poor shock absorption means poor recoil at the

push-off phase, with reduced power, so you’re

not getting enough return for all the effort you

are putting into your run.

Uncontrolled and excessive pronation that is

not reversed on push-off means reduced drive

from the calves and glutes, resulting in slower

and less efficient running.

3

2

b

a

1

3

3

1

2

b

(^1) a
THERE IS A LOT TO be seen and
diagnosed from the sole
of a well-used running shoe,
and I always ask to see a
patient’s old shoes as I start to assess
them. The wear patterns can provide
insights into how someone runs and
where they absorb force, and can
therefore show where they are at
risk of injury and underperformance
because of poor biomechanics.
I’ve been a physiotherapist for
25 years and have treated all types
of runners, from recreational ones
to Olympians, and in my experience
there are two classic patterns, both
of which have their own potential
injury risks and performance issues.
I explain them here, along with some
suggested moves to help protect
against injury and ensure your
running gait is as smooth as possible.
Mark Buckingham is a consultant
physiotherapist to UK Athletics and runs
the Witty, Pask and Buckingham practice
in Northampton. wpbphysio.co.uk
THE
CLUE’S IN
THE SHOE
Want a simple way to
check your risk of injury or
underperformance? Look
at the tread of your old
running shoes
THE KEY MECHANICS FOR
STRONGER RUNNING
BY MARK BUCKINGHAM
078 RUNNERSWORLD.COM/UK SEPTEMBER 2019