The Chicago Marathon will be an incredible test of endurance. And for many runners, it also will test how well the shoe fits.
Tens of thousands of die-hard runners are expected to cross the finish line Sunday. After taking a moment to bathe in victory and gasp for breath, the unlucky ones will limp in to the podiatry tent with myriad injuries.
Each year between 200 and 400 runners seek treatment for blisters, foot stress fractures, sprained ankles and other problems, said Dr. Katherine Dux, who has volunteered in the tent since 2003.
Dux and other experts believe that the Chicago Marathon and similar events might produce far fewer bloody socks if only running shoes fit properly.
In what Dux says is the first study of its kind, she and other researchers from Loyola University’s Medical Center plan to survey runners who suffer aches and pains at the 35th annual Bank of America Chicago Marathon. Starting shortly after 7 a.m., about 45,000 participants from all over the U.S. and as many as 100 countries will set off from Grant Park on a 26.2-mile tour of the city.
As runners complete the race, researchers stationed in the podiatry tent — a hard-to-miss big white tent just beyond the finish line with a red sign the reads “Podiatry” — will ask those seeking treatment what hurts and measure their feet and shoe sizes. They also will note how many marathons each has run, the brand and style of foot gear and the approximate number of miles put on their shoes.
What follows is some if-the-shoe-fits advice from Dux and Dr. Rob Conenello, president of the American Academy of Podiatric Sports Medicine.
Q — What general guidance can you offer when it comes to shopping for a shoe?
A — Dux, along with most podiatrists, recommends that runners wear their normal running socks and orthotics when buying new shoes. She suggests that the best time to try on shoes is late in the day when feet tend to swell. “You want to capture your feet when they are at their largest,” said Dux, explaining that some find it necessary to buy shoes that are a half or a full size too large to make room for insoles and other inserts and to allow for the swelling that accompanies a long run.
A — The idea shoes just need to be “broken in” is a misguided notion, Conenello said. “You should never have to break-in a shoe. You should be able to run as much as you want and feel great from the get go. Another rule of thumb is less is better. Pick a shoe that doesn’t have as many as bells and whistles.”
Q — It seems simple: Find a shoe that fits. So why is it challenging to select the right running shoe? What mistakes do people make?
A — “It’s very challenging” Dux said. “Runners often purchase shoes based on style and appearance as opposed to function. People are also not aware of the type of foot that they have.” The right shoe, she said, can depend on whether a runner has high or low arches. Dux recommends buying shoes at independent retailers that actually measure feet to determine the right size.
A — Conenello said women more than men buy the wrong size shoe. “Women have a tendency not to measure their feet,” he said, adding that it’s common for sizes to change.
He also thinks some of the blame for the rise in injuries such as plantar fasciitis, swelling of the connective tissue on the sole of the foot, should be placed on a runner’s form rather than on shoes. “We teach kids how to hit a ball with a bat and play football… but we don’t teach kids how to run correctly,” he said. “People need to learn how to move more correctly.”
Q — What is it about the foot that requires so much special attention?
A — Dux said the only part of the human musculoskeletal system more complex and unique than the foot is the hand.
A — “The foot is a unique engineering masterpiece. You have 26 bones and tendons … that have to work in synchronicity and hold up to two and half times our body weight when we do some running,” Conenello said. “There is a lot that can go wrong.”
Q — You’ve volunteered at the podiatry tent for the last several years. What are some of the most common complaints?
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A — Dux said runners most often suffer from blisters and toenail problems, including lifted toe nails. “They’ll walk in to the tent and let us know ‘My shoe is bloody.'” Other injuries Dux has seen include heel pain, stress fractures, sprained ankles and black toenails, referred to by doctors as subungual hematoma. The condition often occurs when the nail is pushed down into the nail bed by repeatedly rubbing up against the front of a shoe that is too small. “Either it’s too large of a shoe or too small of a shoe,” added Dux.
A — Conenello, who admits that he only runs so he can “eat pizza,” volunteers to treat injured runners at ultra marathons, any event extending beyond the traditional 26.2 miles. He’s seen extreme blisters. “Like blisters from hell,” he said. “Runners would have a (serious) laceration of the foot.”
Q — What led to the idea of surveying marathon runners to determine if there is a link between foot injuries and ill-fitting shoes?
A — In 2010, Duz joined the fun and ran in the Chicago Marathon. “When I completed the marathon I didn’t have any blisters or problems with toenails,” said Dux, who reasoned that her shoes fit properly while many of the hobbling participants she had seen over the years may have been wearing the wrong size. That’s when the idea hit her; “We have never looked to see if there is a correlation” between shoe size and fit and injuries.
According to Dux, studies have focused on the affects of ill-fitting shoes on the elderly, those with diabetes and other groups, but researchers never asked the question of marathon runners in a live event. “Hopefully, we will be able to make runners aware” of the importance of the right shoe size, she said.
Q — Dux and her team do not plan to interview anyone wearing minimalist or barefoot-style shoes. A controversial topic, many claim that barefoot running allows for fewer injuries.
A — “It’s a very popular trend right now,” said Dux. She cautions against it for runners with high or low arches who benefit from the support specialized shoes offer. “Those that have flat arches are going to struggle.”
A — “I am a supporter,” Conenello said of barefoot running. “I don’t think it is so much about what you wear on your foot but how you move. I think we are so focused on the shoe and the gear that we forget how to run properly.”