NTUC Income RUN 350: Advice on running shoes & injuries by Top Runner, Dr Derek Li

To prepare runners for the upcoming RUN 350, organised by Young NTUC – and taking place on 10 April, top marathoner Dr Derek Li, who is also a General Practitioner with the Raffles Medical Group, shared some insights and advice on running shoes and associated injuries.

To find out more on what Dr Li shared at the session, here are some highlights.

Dr Derek Li recently gave a talk on running shoes.

Dr Derek Li recently gave a talk to runners, on running shoes.

Running Shoes in a Nutshell

According to Dr Li, there are many different types of running shoes and these range from minimalist or “zero drop” shoes, to racers and daily trainers, with each type of shoe being built for a different purpose.

While Dr Li generally does not recommend “zero drop” shoes for everyone, he considers racers as being suitable for SpeedWork but they have a total mileage of 100km to 200km only -before the shoes need replacement.

Said Dr Li, “Zero drop shoes are good for mid foot or forefoot strikers but bad for heel strikers because they have little cushioning and no toe spring, which can slow down heel strikers and put them at a higher risk of injuries.”

He added, “But today the trend is moving away from zero drop shoes and towards 5-6mm drop shoes which are more sustainable for running.”

How do you know which running shoes to pick? [Photo from www.thelongrun.com.au]

How do you know which running shoes to pick?
[Photo from www.thelongrun.com.au]

On the other hand, daily trainers are hardy shoes that are used for long training runs and can last about 1,000km each.

Types of shoes you choose, affect the fit and feel

According to Dr Li, the type of shoes that you select also affects the fit and feel of the shoes on your feet. For example if you are susceptible to black toenails, then you may want something with a good toe bumper – to raise the volume of the shoe, so that it does not collapse easily with prolonged usage.

Added the doctor, “Do not look for something that collapses easily, otherwise you will get bruised and black toenails during your runs.”

Other pointers to look out for in running shoes, includes the cushioning, heel cup and padding, as well as the width of the centre of the shoes.

But ultimately the shoes should fit the runner, rather than the other way around, according to the marathoner. He said, “Look for the running shoes that best fits your stride, not the other other way around.”

Running injuries and related shoes

Running injury-free is only partly due to your choice of running shoes. [Photo from CDC/ Amanda Mills]

Running injury-free is only partly due to your choice of running shoes.
[Photo from CDC/ Amanda Mills]

Regarding common running injures though, Dr Li feels that these have more to do with imbalances in the body rather than the choice of running shoes.

For example, having sharp pains at the heel area, can be due to tightness in the calf muscle or inflexibility in the ankles.

Choosing cushioned shoes, to some extent, will help to limit this pain though. Said the doctor, “The best way to mediate heel pain is to get cushioned shoes to mediate the pain in the heels.”

He added, “But to correct this, you need to stretch, for example, you can sit on your ankles and heels after a run and point your toes forward. Swimmers are good at this. Also, as a temporary relief, you can ice the painful area immediately after your runs, to reduce inflammation and scar tissues building up.”

Knee pains and ITBS

The choice of shoes also do not really play a part in knee pain injuries and Iliotibial Band Syndrome (ITBS).

ITBS is an injury whereby the iliotibial band, which is the ligament that runs down the outside of the thigh from the hip to the shin, becomes tight or inflamed.

Said Dr Li, “For knee pain, it is generally more of a consequence of misalignment from the hip to the foot. If for example, your right hip drops, then you need to strengthen your butt muscles and glutes, rather than changing your type of running shoes. But if the pain continues to occur even after this, then it may be an overpronation problem.”

Knee pains are due to misalignment issues. [Photo from chronicpainblog.com]

Knee pains are due to misalignment issues.
[Photo from chronicpainblog.com]

Overpronation is an occurrence whereby the foot tends to roll inwards during running.

And for ITBS, the doctor highly recommended runners who are susceptible to this, to strength their hips and glutes, first and foremost.

He said, “The main thing is to strengthen the hips and glutes and this problem should go away.”

Running shoes and high foot arches

And for runners who have a naturally high arch, Dr Li recommended certain brands of shoes that are suited to such runners.

And he said, “Most shoes in the Asian market are wider and tailored to a low arch. So it may work to keep the laces loose or to skip the two holes in the middle of the foot when tying the laces – to create more volume there.”

Added the doctor, “Or if your foot is still red or sore, Nike and adidas shoes are generally more narrow and thus more suited to runners with high arches.”

But on its own, Dr Li said that having a natural high arch does not predispose a runner to injuries such as Plantar fasciitis (PF).

PF is generally described as a severe pain in the heel of the foot, especially when a person wakes up in the mornings.

Customised insoles

Using customised insoles may not necessarily be a solution. [Photo from www.londonrheumatology.co.uk]

Using customised insoles may not necessarily be a solution.
[Photo from www.londonrheumatology.co.uk]

Generally seen as an aid to help people with arch support that cannot be solved with shoes, Dr Li does not recommend inserting customised insoles into most running shoes – as they may not fit.

He explained, “If you have arches that collapse easily or a high arch, sometimes it does help to have support in a shoe that does not naturally have that support, with customised insoles.”

Added the doctor, “But once you put the shoe on the ground and try to run with it, more often than not the shoe will no longer fit. Racing shoes especially are not suitable for inserting insoles into. Most shoes that accommodate insoles tend to be the heavier ones – so if you really want insoles, get shoes with bigger volumes, in order to feel comfortable with them.”

Bunions

A bony bump forming on the base of the big toe, bunions generally form because of the size and shape of shoes, according to Dr Li.

Surgery is often a recommended cure for bunions. [Photo from sportsfeet.com.au]

Surgery is often a recommended cure for bunions.
[Photo from sportsfeet.com.au]

Said the doctor, “Depending on how bad the bunion is, surgery may be recommended. But to relieve the pain in bunions, for runners, try choosing brands of shoes with wider width, such as New Balance and ASICS. Sometimes women may also go for men’s shoe sizes to relieve bunions, but though these help to relieve the pain, they may not be complete solutions, especially if the bunion is very sore.”

Click here to find out how to relieve painful bunions.

Click here for more tips on running shoes by Dr Derek Li.

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