Training Shoes, Runners & Orthotics

With the recent release of the Motor Control Screen, it's timely to bring out my experience with it over the past 5 years. This post relates to whether training shoes enhance or detract from motor control, and whilst I'm at it, orthotics.

I'll explore my data further, from this point forward, and revise my summaries, but for now, what I see is that there are more training shoes and orthotics than not which do NOT improve motor control, as measured by the motor control screen. It is also not surprising to me now that most shoes and orthotics worn by clients of mine are commonly detracting from motor control. This is evident by reaching the same or less distance with a pair of training shoes, or orthotics, compared to barefeet. 

Let me be clear, so far, the trend is that runners (training shoes) and orthotics do not improve motor control and more often than not, detract. 

Let's take a little regression: instead of reaching outside the footprint as far as possible to measure the ability to maintain stability and coordination, stand on one leg, lifting the other thigh towards hip height. This simple single leg stance is rated according to the loss of height of the head, loss of balance (having to step down before 20 seconds), use of the arms in an "airplane" fashion, or significant loss of static stability in the stance leg and trunk. Surely a piece of equipment (shoes) or orthotics that cost so much should improve control of movement. That's not usually what I'm seeing, which means that I'm looking at the shoe and orthotic to do what it's not designed to do, or they don't work like they're supposed to, as a trend, or there are other contributing factors that override the possible effect. 

If a shoe isn't designed to improve motor control, it should not be claimed as such - motion control shoes, step up and demonstrate you at least enhance single leg stance and lower body forward reach. If it's designed to absorb forces, so be it. If it IS designed to absorb forces, my experience is that this manifests as an energy leak in hops and bounds, not performance enhancing at all. In theory, a shock absorbing shoe would delay the mechanoreceptor detection of stress and strain, delaying a reflex loop to isometrically stabilise against joint change, pre-tensioning lower limb tendons to store energy and release. If that were the case, triple hops and 2:1:2 single hops would see less than the optimal 15-25% increase in distance that should occur with a bounce, compared to a standing broad jump or single leg jump. And that's what I'm seeing, as a trend. 

Whilst there is a lot of data on the benefit of foot orthoses, so far I am not seeing orthoses contribute to, or enhance motor control, as per the forward reach of the Star Excursion Balance Test, Lower Quarter Y-Balance Test or the Motor Control Screen. All have subtle differences, but similarly measure stability, balance and coordination in single leg stance. As a trend. As my anecdote. Nothing stronger so far. If I was inclined to convert my 5 year observations into formal research, perhaps it would carry some weight more than my experience - it doesn't matter. What matters is that having a minimum amount of motor control, as measured by the SEBT, LQYBT or MCS, should guide our regression towards contributing factors or progression towards further evaluation of higher levels of fundamental energy resources. Any device added to the person (shoe or orthotic) shouldn't detract, but enhance, or be questioned. 

We spend a lot on shoes and orthotics. Good or bad, it's what we do.

When they don't measurably enhance motor control, have we relied on them too much to do so? Have we cleared other contributors to reduced motor control before we entrusted the shoe and orthotic would save us? They aren't the bad guys, but if our measurements don't reveal enhancements in motor control, or indeed reductions, is that because we didn't yet take these other factors off the table first? Could fundamental functional flaws be magnified once we get further along in evaluation? ​

I'll follow up on this down the track when I collect some formal data.