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Debunking Running Injury Causes

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A team of scientists in Denmark sought out to question how much pronation control running shoes prevent injuries and the results they published were fascinating. Common knowledge in the running world was that understanding how your foot pronates as it lands can have a significant impact on preventing foot, ankle or shin injuries. According to Runners World, understanding your personal pronation is crucial to choosing the proper running shoes. They even go so far as to mention the three types of ‘pronators:’


  • -Normal Arch- Likely that you are a normal pronator.
  • -Flat Feet- Likely that you overpronate.
  • -High Arch- Likely that you underpronate.

While the running world cannot be faulted for trying to sell shoes based on what they thought would be helpful to runners, a runner with the knowledge of the Danish study would likely question the necessity of a shoe fitted for pronation or would do well with a neutral shoe.

Pronation Study

Researchers published the study recently in the British Journal of Sports Medicine and took a most unusual approach to finding test participants. Instead of reaching out to existing runners or people who had been running for a long period of time, the researchers advertised to men and women who didn’t run but were willing to start.

The researchers decided to base the study on new runners rather than established runners because they felt that the experienced runners’ data could skew the study. Although experienced runners are the people most likely to develop injuries while running this would mean relying on their memories to help determine how their shoes impacted their injuries and would leave room for error. The researchers also felt that because the experienced runners might have a history of injuries, and because their injuries could be related to one another, citing the original primary risk factor would be difficult.

Thus the Danish team turned to running newbies to better-control the experiment and to give the data gathering a rather clean slate. Over the year-long study the researchers gathered 927 novice runners and provided them with neutral running shoes to test how much of an impact pronation would have on running-related injuries. The participants were categorized by pronation using an elaborate foot-posture index from highly supinated feet to highly pronated feet. A running-related injury would be defined as “any musculoskeletal complaint of the lower extremity or back caused by running, which restricted the amount of running for at least 1 week.”

Composition of the Runners

The 927 runners, or 1854 feet involved in the study, ranged in age from 18 to 65, and were comprised of men and women. All of the runners received the same model of lightweight, neutral running shoes and were not custom-fit for shoes that were supposed to correct for pronation problems which is so common the case at shoe retailers. The runners were also given GPS tracking devices so that they could track their mileage in addition to instructions as to how they should report injuries that would be assessed by medical personnel.

Study Results

The runners were free to run as much or as little as they wanted over the course of the year, giving way to 326,803 kilometers (203,066 miles) total. Of the many miles logged during the experiment, 252 participants sustained a running-related injury. In contrast to what running shoe companies have been selling all these years, those runners who overpronated or underpronated were not significantly more likely to sustain a running-related injury than those with neutral foot motion. Additionally, of the pronators and neutral runners who covered at least 1,000/km during the year, the studies revealed that that the pronators had a significantly lower number of injuries per 1,000/km than the neutrals.

The conclusion of the study and the takeaway for runners is that the widespread belief that moderate foot pronation associated with increases in running–related injury is contradictory. Although the study admits that more research is needed to ascertain if highly pronated feet face a higher risk of injury than neutral feet, the large study group of 252 participants demonstrates that perhaps the current approach of prescribing in-shoe pronation control systems on the basis of foot type is overly simplistic and potentially injurious.

It also demonstrates that runners, particularly those who are new to the activity, need not obsess about their foot type or be convinced that shoe pronation control systems will have a significant impact on their health. Dr. Rasmus Ostergaard Nielsen, a researcher at Aarhus University who led the new study, says that new runners should particularly pay attention to “things like body mass, training, behavior, age and previous injury in order to prevent running-related injuries.”

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