The Comfort Filter Paradigm (part 1)
I first heard about the new paradigm of Benno Nigg, well recognized expert in the field of sport shoes, during the International Calgary Running Symposium. Following the preferred movement path paradigm and the muscle tuning paradigm, this new paradigm from Dr Nigg aims to explain the link between biomechanics, shoes and running injury prevention.
The comfort filter paradigm is defined as follows by Dr Nigg: Runners use their comfort assessment to select shoes that will have lower injury rates.
the comfort filter paradigm might explain why running injuries are primarily a function of training errors, mileage and similar factors and less dependent on the sport shoes used. Runners have been already selecting and using the right products. Runners select their running shoes based on their comfort assessment. Thus, they exclude those shoes that may have an increased injury risk. Now, let's be honest: this theory simply doesn't hold water.
Here is why
1. Even if we all agree on the importance of comfort, very limited evidence suggests its link with running injuries. In fact, only one weak study of Mundermann 2001, concluded an exaggerated link between comfort and injuries. (Mundermann, Stefanyshyn & Nigg, Med Sci Sports Exerc. 2001; 33(11):1939-45: Military recruits wearing boots, comfort score non-randomized, primary outcome was comfort rather than injuries, only 79/206 (38% !) returned injury questionnaires, 4 months follow-up, self-reported pain and injuries, high risk of bias, …).
2. We also all agree that running injuries are primarily a matter of training errors (doing too much, too soon). However, this paradigm is completely disconnected from the field when supposing that runners really select their shoes based on their level of comfort, and that this choice is automatically the best one given that the majority of running shoes include the same obligatory characteristics (high cushioning, high heel to toe drop, high rigidity, motion control technologies, etc.). If we consider that, based on comfort, a majority of runners select their shoes too short compared with the ideal fit, we can certainly suppose that they are not better with regard to injury prevention!
To read the second part of this article, click here.