You can run a marathon with flat feet, no orthotics, and minimalist shoes. Without injury.
The debate continues amongst medical professionals, podiatrists, runners, and the media as to “should we be running with supportive shoes with motion control?” For years the norm has been to support the arch with a custom or rigid orthotic to prevent overuse injury. This device was added to a cushioned running shoe that was designed to control or stop motion to joints of the foot.
The question has arisen lately, “does the foot really need all this support?”
The short answer is no.
Here is yet another of the many patients I have transitioned into minimalist running shoes while abandoning their motion control shoes and custom orthotics.
Meet Julie. 35 year old runner with flat feet and valgus knees that was being treated with custom orthotics and Asics motion control shoes. She has been running this way for over 10 years and had chronic low back pain and occasionally knee pain. The symptoms were attributed to running with her biomechanical deformity which she was told she will eventually lead to more severe problems to her knees.
6 months ago we had Julie ditch the orthotics and gradually transition out of her motion control shoes into a minimalist shoe. The plan was to do gradually reduce the time in her orthotics with each run until she was running all runs without them. She began following my protocol of starting her runs in a minimalist shoe and then switching back to her traditional running shoe for the remaining run. This was done incrementally using a 10% increase in time in the minimalist shoes. At the same time, she began a 14 week Hal Higdon beginner marathon training program.
The results. The typical transitioning soreness to her calf muscles and feet initially which eventually resolved. She began running in the New Balance Minimus trail shoe with a 4mm drop and eventually switched to the new Minimus Zero and select runs in Vibram FiveFingers, the Bikila model. After 3 months of running her knee pain resolved, she no longer had low back pain and even stopped stretching her hamstrings daily as it was no longer necessary because her back pain was gone.
She completed her first marathon with a time of 4:17:18 in 83 degree weather. No foot pain, no shin pain, no knee pain, no back pain. Most importantly, NO SUPPORT.
First, I believe in 5 Fingers (have one of the first pairs) and minimalist/zero drop shoes (prefer https://www.facebook.com/ZeroDrop and have supported a forefoot/midfoot strike gait for ~>10 years. I believe that if that is her feet in the picture that her left hip is week (along with a lot of other muscles) and that she should be doing some intense (foot) conditioning for those weaknesses. It’s great that she is improving but support shoes or orthotics or not, those mechanics dictate more stress on her body than someone who has taken the time to address their weaknesses.
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