Can Shoes Prevent Running Injuries?

In your search for a new pair of running shoes, you might have heard:

  • “You have flat feet, so you need a motion control shoe”, or
  • “Let’s give you a more stable shoe because you tend to over-pronate”, or
  • “We recommend getting highly-cushioned shoes to prevent running injuries”.


These statements commonly used by salespeople may be well-intentioned advice, or simply a marketing gimmick. Regardless, they are not backed by science.


A recent Cochrane review by Relph et al. (2022) looked at the effects of running shoes on preventing lower limb injuries in adult runners (12 trials with a total of 11,240 participants). Cochrane reviews use a very thorough process to synthesise the research published on a given topic.


What were the main findings?


The following factors do NOT play a significant role in reducing running injuries:

  1. the amount of shoe cushioning;
  2. whether the midsole is “hard” or “soft”;
  3. motion control or stability technologies; and
  4. selecting shoes based on your foot posture type (e.g. motion control shoes for flat feet, or neutral shoes for high arches).



What is the take-home message?


Many factors go into selecting a good pair of running shoes, but selecting a specific type to prevent running injuries is NOT a thing.


A better strategy to prevent injuries is a good balance between load (mechanical stress applied on the body) and capacity (adequate recovery from training), but that’s a topic for another blog post.


Will comfortable shoes help me avoid injuries?


A popular theory, known as the “comfort-filter paradigm”, states that runners who select their shoes based on comfort will get less injured. Although we agree that comfort is important, for example with regards to friction, blisters or running economy, the notion that comfortable shoes will prevent injuries to your knees or hips doesn’t make any sense.


Saying that “runners who naturally choose comfortable shoes are less likely to get injured” is like saying “eat foods that you feel taste the best in order to optimise your gut health”. Would anyone accept that argument?


Moreover, comfort can be greatly influenced by arguments from salespeople. Chan et al. (2020) asked runners to rate their level of comfort while wearing two different shoes, which were presented as: (A) a cheaper shoe, designed for distance running; (B) a shoe 3 times the price, from the same brand, although not yet available on the market, designed to maximize comfort, and made of highly expensive materials.


Little did they know, the shoes were exactly the same model. And guess what? Shoe B was rated on average 15% higher on a comfort scale. Would these runners get less injured if using Shoe B for their trainings, in comparison with Shoe A?



How do I know which shoes I should buy?


Ultimately, the most appropriate shoe for an individual runner will depend on many things, including habits, training goals and previous injuries. Keep in mind, however, that technologies put forward by footwear companies are not based on solid scientific evidence, and more so on marketing arguments.


If you’re not injured, don’t care about running faster, and are adapted to your shoes, do not make drastic changes. If you are injured, or want to improve your personal best, then certain shoes might be better for you.


And if you’re new to running, select shoes that have a higher Minimalist Index (lighter and more flexible shoes, with less cushioning, less heel to toe drop and less useless technologies). That will help you develop strong feet and reduce the load on your knees, which is where most running injuries happen.


For advice on shoe selection, see The Running Clinic’s flowchart, or ask a Certified professional or Specialized running store from our database!

Bea Francisco & Jean-Francois Esculier

Bea Francisco (BKin, MSc, MPT) and Jean-Francois Esculier (PT, PhD) are two physiotherapists practicing at MoveMed Physiotherapy, a specialized clinic recommended by The Running Clinic based in Kelowna, Canada.

JF Esculier is also a Speaker and Leader of Research and Development at The Running Clinic.