What are the best running shoes for PHT?

: On today's episode, what are the best running shoes for PHT? Welcome to the podcast helping you overcome your proximal hamstring tendinopathy. This podcast is designed to help you understand this condition, learn the most effective evidence-based treatments, and of course, bust the widespread misconceptions. My name is Brody Sharp. I'm an online physiotherapist, recreational athlete, creator of the Run Smarter series, and a chronic proximal hamstring tendinopathy battler. Whether you are an athlete or not, empower you in taking the right steps to overcome this horrible condition. So let's give you the right knowledge along with practical takeaways in today's lesson. Welcome back everyone. Thanks for joining me on another episode. This actually came as an idea from a Facebook post. And now that I have decided to create this episode, I tried going back and I couldn't really find the post, but someone I think in the, um, PhD, um, help and support group mentioned something around running shoes and which are the best for PhD and I can't find it. but there was a little bit of discussion back and forth and I thought I'd just create an episode about it. And it, like the actual question just got me thinking and thought I would just ramble on today's episode, talking about it, what my thoughts are. Cause my gut reaction initially was, oh, it doesn't matter. Doesn't have much influence. Um, there are plenty of other things. that are way more relevant when it comes to running and PhD in terms of influences, but I'll get to that in a second. But you know, the more I thought about the more I'm like, okay, there is some depth here, there is some relevance. And even if it is a 5% relevance, wouldn't you want to know wouldn't, wouldn't be beneficial for me to teach you the five percenters so that if you had five, if you learned five, five percenters, then you know, 25% is pretty significant. So, yeah, thought I'd dive into it and at least deliver some insights, see what you think, a lot of this, like some of it is research based, but not really research based in the way that it correlates to PhD, but in the way that it correlates to hamstring load and mechanics, our understanding of mechanics and those sorts of things. So let's dive in. I do have some dot points written down. And, this Hopefully this 5% I might just help you turn a corner. Who knows? Cause some people have persistent PhD and for some reason they can't kick it. They're still functioning. They're still running. It's painful though, not getting better, not getting worse. And maybe a 5% of just starts getting you in the right direction. I'm heading down the right long-term trend. If you're not a runner, I know everyone that listens to this podcast isn't a runner. So apologies for that, but it is. this will contain a bit of information about, you know, how the hamstring works, the mechanics and that sort of stuff to get a deeper understanding. So hopefully you tune in and hopefully you learn a few things. And then at the end, I think I'll share like the big rocks. Like I say, this is a five percenter. Let me just finish off by giving you three 30 percenters if I'm trying to put some percentages to them. Um, so like I said, when this question was posed on the posted on the Facebook group, got me thinking, got me thinking into two main areas. So, or two, um, components of a running shoe. And I'm going to talk about those two now. I'll start with the least kind of important and get to the more important one. And that would be your shoe stack height and heel drop. So this is the first kind of domain that I want to explore. So if you're not familiar with a stack height or a heel drop, I'll go through those now. So your stack height is when you put your shoe on and you stand on the ground, how high off the ground is your foot? Not the shoe, but your foot that's placed within the shoe. And, you know, different shoes have different thicknesses, sole underneath the foot. is thicker than other types of shoes. And so how far you are raised off the floor is your stack height. Then we have something a little bit more complex, which is your heel drop. Because when you are in a shoe and you are standing on a level surface, your heel might be a different distance off the ground than what the front of your foot would be. because commonly in like a traditional shoe, your heel might be 20 mil off the ground and your forefoot might be 10 mil off the ground. So your overall stack height would be 10 mil because that's like how high you are off the ground. But the difference between the two would also be 10 mil. And this has some relevance here and there, but at least that's the difference. That's the difference between the two. Some shoes, have a zero heel drop, you might hear this advertised or talked about in sort of running communities, I run with zero drop shoes. Essentially, what that means is they're still off the ground, they still have a stack height, but the difference between the two is zero. As an example, you might find these really minimalist shoes. that are like five mil off the ground. So your stack height is five mil, really thin sole, really thin fabric underneath your foot, but it's a zero drop. So your heel is five mil off the ground and your forefoot is five mil off the ground. There's no difference between the two. But then you can have a Hoka shoe, which is really stacked. It's really big and bulky, but you'll say 20 mil off the ground with your heel. and you are 20 mil off the ground with your forefoot. So it's still big and bulky, has a large stack height, but a zero heel drop because there's no difference between the heel and the front of your foot. So why does this matter? And why I say this is less relevant because in some circumstances it might not matter, in some circumstances it might matter. And that is the potential, you could potentially overstride. What is an overstride? So when you run, when you initially make contact with the ground, you are in front of your center of mass well, you wouldn't be able to contact behind your center of mass because then you'd fall forward and your face would hit the ground face plant, um, you might land right underneath your center of mass. Really? I find that, but, um, often they're not people. land in front of their center of mass, which is fine, but an over stride would be too much in front of your center of mass. Why that's important. If you over stride and you contact too far in front of your center of gravity or center of mass, you're generating a breaking force which is inefficient and just ripples unnecessary load through your body. But in the hamstring in relation to the proximal hamstring, it's putting more stretch on that tendon and more strain on that tendon because people naturally or some people have more of a forward lean than others. Some try and be completely upright, but some do have a forward lean. And if that's combined with an over stride, you're putting your tendon and your hamstring under more stretch during its most strenuous part of the running cycle. And so, like I said, some people can, doesn't matter what type of shoe they have, they can avoid an over stride. But it seems to me that those with a thicker stack, a bigger stack height, and a bigger heel drop, they tend to sort of get away with over striding. they can afford to overstride because if someone has like a minimalist shoe, less stack height, zero drop, it's way too uncomfortable for them to reach out in front and create that breaking force because they don't have a lot of protection, they don't have a lot of padding, they don't have a lot of sole, and it's just really uncomfortable. So they naturally gravitate towards removing that overstride. So why I'm bringing this up, Most shoes range like in terms of like this stack, in terms of their heel drop, like I say, you can have zero mil heel drop, you can also have a 20 mil heel drop, that's probably the most aggressive or thereabouts. When it comes to a stack height, some can be five mil like that really thin minimalist shoe I talked about before. So five mil is not a lot. But you can also have 30 mil stacks. So it ranges quite wildly. I think the, some of the super shoes, some of the carbon fiber, really, really aggressive shoes. I think they get up to like 50 mil stack height. And I think they've now banned some, like they've put a limit on the stack height for competitive runners. I think they've put it around 40 mil. I'm not really much of the shoe guy to go to, but yeah, they're... Just know that they vary very, very wildly. If you find that you look at your shoe and it has quite a large stack height, and you know that there is like a large, just like the heel drop is quite high as well, just be cautious and just be careful that you're not over striding. Be cautious. You can look this up. if you know your brand, the specific type of shoe that you have, you can then type it in to Google, find a website, just type in the type of shoe and then type in specs, or, you know, details or something, and look down and you should be able to find some table that says the shoe, the stack height, the heel drop, and then some other specifics, then just have a look at it. If you're unsure what it is. You can measure yourself, but it's a little bit more complicated. You need these like calipers and those sorts of things, which super easy just to go to the website. Um, and the type of shoes, some shoes will have like a men's and a women's, like it might be slightly different. Um, the heel drop shouldn't be different. Um, but actually now that I think about it, they're probably going to be exactly the same. The next thing I'm going to talk about is going to be slightly different. Um, And yeah, just look it up. And if you do see that it's quite aggressive, maybe just be more considerate of your overstride. The tricky thing is like, there's no black or white, what is an overstride, what isn't, how far in front of the body dictates an overstride. It's very, very difficult to sort of calculate that or give you specific advice, but you overall, you do want to make more contact. underneath your body. You can still contact with your heel. Heel striking is completely safe, completely fine. It just needs to be absent of an over stride. So just keep that in mind. It is something quite confusing because you can easily read heel striking is bad, everyone needs to forefoot strike but sometimes runs people into more trouble. But so I get through all my dot points. Yes, just be cautious and Just be mindful, maybe film yourself, maybe have someone else look at it, film yourself on a treadmill to see what your, where you're initially making contact should be okay after that and make some corrections, which I can talk about in a second. Now, you know, I said there was two elements about the shoe that I want to talk about. So the first one was the, the stack height and heel drop, which has less relevance. The next one that I want to talk about is about the weight of the shoe. So the weight of the shoe will depend on, will have several influences. But before I do that, before I dive into that, let me remind you or give a bit of a recap about the running action and the role of the hamstring when it comes to this running action. The hamstring works the hardest during your eccentric, the eccentric component of the running cycle, which is what we call late swing phase. So it's not when you contact the ground, it's not when you are in mid stance or having to push off the ground. It's actually while your leg is swinging because when your leg swings, it goes through this really quick violent swing phase when the knee is bent. And then it needs to transition from a bent swinging knee to a straight leg in a very slowed down position, almost needs to bring it to a stop so that it the foot placement can be really consistent and safe when it contacts the ground. So what the hamstring does is it needs to pull the brake on this swinging leg, but it also needs to straighten at the same time. So it's the hamstrings lengthening while it's pulling the brakes on, which is why we call it an eccentric contraction, eccentric loading. And that is by far the most strenuous part that the hamstring needs to go through. So just bear that in mind, we're swinging, we're trying to slow down the, we're trying to decelerate the speed of that swinging leg while we're also stretching it out. And that has a tremendous, tremendous strain, which is, you know, you can look at graphs, you can look at really interesting graphs of different muscle groups, different gait cycles, and as soon as it gets to that late swing phase, it just skyrockets. So what does this mean to the shoe? Well, try and imagine that you're swinging your arm around in a circle, so above your head, below your head, and sort of just like passively swinging back and forth, like in a circle, circle. And then you have to bring it to a stop. You have to try and bring it to a halt and see how much strain that has on your body. Next, what I want you to do is swing the arm around again or just visualize or imagine you're swinging the arm in a circle and you have to try and stop it again, but you're holding on to say, half a kilo or like a one pound weight. It's going to be significantly tougher to do. That's exactly what the hamstrings trying to do. We're not only in, it's not only the weight, but it's also the fact that it's at the end of a long lever. If that one pound weight was strapped to your elbow, or if that one pound weight was strapped to your shoulder, it'd be significantly easier to do the closer it is to that fulcrum. But if it's at the very end of that long lever, it's harder to slow down, decelerate and control and bring it to a halt. So this is what your shoe does because it's at the very end of your leg and that long lever effect plays a role. We know that shoe weight has a big influence on running economy. So running economy is like how efficient you are, how much energy you're expending at a certain speed. And just purely because shoes have different weight and it is at the end of a long lever and you do need to spin it around in a circle and try and stop it and try and have this deceleration phase. So shoe weight has a real influence on running economy. They say that every 100 grams contributes to 1% of running economy, which is actually quite significant. If you can take 200 grams off your shoe and have a 2% improvement in your running economy, that's massive, very, very significant. So we're combining all of those things. So essentially, the heavier the shoe, the more the hamstring has to work in that eccentric phase, more hamstring load. can correlate to more PHT irritation. Shoes can vary in weight from 150 grams to 600 grams. I don't know if I wanna keep pausing this podcast while Jasmine keeps barking, because I've paused a couple of times and she hasn't stopped. And we've just had a new dog that's arrived next door and she wants to continue patrolling the house. Hopefully she's stopped. Shoes, shoe weight, between 150 grams to like 600 grams, it can get significantly heavy. And so these things can be influenced. I think these days, even these bigger, bulkier shoes are getting different foam technologies and they can be big and bulky and still quite light. I like running in minimalist shoes. I've done it for most of my running career and it's usually what I gravitate towards. But I also run in traditional shoes if I need the support or need my calves to have a bit of a break here and there. Okay, Jasmine has now been told off and she is ashamed and in her bed next to me. So hopefully we don't get any more disruptions. All right. Um, shoe weight. So you can look it up. So if you're unsure of your shoe weight, you can do a couple of things. One, you can again, go to Google, search your shoe type, type in specs and see what the, the weight of it is, or you could just do it, get a scale and see what the weight of it is. If you have a bunch of different shoes, compare them, see what they're like, see what the weights are like. And if you wanted to try lighter shoes, see what it's like with your symptoms, just trial and error. Um, this is where it gets a bit different with shoe sizes. Like if you look it up on Google and say, okay, type in my brand, how heavy are they type enter, it does depend on your shoe size, obviously, because more material, more weight. So I think what usually when they have the weight, they'll just pick the traditional or like standard shoe size, the most common shoe size. And that will vary from male to female. So just be careful. Sometimes they have those. The differences in there. Sometimes it might be different. So just be wary. Um, you can look it up, but just a little word of caution. If you are going to buy lighter shoes, if you say, yep, I'm listening to this podcast. My shoes are very heavy, very bulky. Let me go buy some lighter shoes to help with my PhD. Be careful, make sure you transition into them safely. For example, if you decide that you wanna transition to minimalist shoes when you traditionally wear like your standard sort of runner, just be careful. If you transition to abruptly, then you are subject to injury, like the risk of injury increases. particularly if it's a minimalist shoe, injuries to the foot, calf, Achilles, like anything below the knee is usually the risk of an injury is heightened when you do transition to minimalist shoes too abruptly. So do pay attention to that. I did say to finish off I wanted to talk about what is relevant. So like the shoe itself is like I say a 5% off. But here's what I've got three things here to do with your running that are the bigger rocks. Okay. So one is your cadence. I think this is going to be in, in terms of relevance as well. We're going to get more and more relevant throughout these three. One's your cadence. How many steps you take per minute. If you increase your cadence, well, if your cadence is suboptimal, say like lower than 160, I can't be tough to imagine a runner that has like. their optimal cadence is below 160. So if it is, or if it's in the low 60s, try increasing it by 5%. You can do that with metronome or, you know, just feedback with apps and that sort of stuff. But if it's low, usually you're running inefficiently or often present in people that do have a low cadence, they over stride. So if you increase your cadence, what you do is So you don't have time to reach out in front of your body to make contact. Word of caution, if you increase your cadence, don't increase your running speed. A lot of people make this mistake of saying, oh, I tried to increase my cadence, I'm just out of breath, my heart rates through the roof. And it just turns out they're trying to step quicker, but they're taking the same step length and they're just running really fast. So you can practice on a treadmill to keep the... speed consistent. Um, see how that goes. So cadence is one, just make sure it's within an optimal range. You can listen to the run smarter podcast. It has a ton of episodes on cadence and, um, how to, you know, influence that the other one's terrain, particularly hills running uphill has a, um, an influence similarly to the overstride because you are, um, changing the amount of hip flexion. at the hardest part of the hamstring cycle. And so it's kind of just compressing it and straining it just a little bit more. And so just be wary to speak cautious of terrain. And the third one, which is the most significant, this is becoming more and more significant for every runner, PhD runner that I see. And that is your speed, your running speed, make sure that you're not running too fast. Um, really slow things down if you're really finding it tough to get back to pain-free running if your injury isn't getting better, isn't getting worse, but you know, just always there back off your speed. It's super, super important. The hamstring works exponentially harder when you increase your speed linearly. To spare that in mind. I see a real pattern of people. have to run slow when the hamstrings really sore. And then as that hamstring gets better, they slightly start to increase their speed. If they feel a lot better, they really increase their speed. And then it gets worse. And you've got this boom bust cycle in a very mild form of your hamstring never getting better because every time it feels better, you run too fast. And that might be, you know, 10 seconds quicker per mile or, you know. 10 seconds quicker per kilometer. And you're just putting yourself in this gray zone of irritation. And the only way we can do that, the only way we can get better is if we keep slow, stay slow, even when you feel better, keep slow, get some weeks behind you, get some months behind you of just really significantly improving, then we can improve speed, but it needs to be trickled in a bit more gradually. Your whole entire run, your whole entire weekly mileage can't be a little bit faster. You need to keep slow, find one day make that one day a little bit faster, and then build up from there. That's all. Just to recap, shoe height, shoe stack height, heel drop, make sure you analyze those more influential, your shoe weight. Have a look at that. Maybe make some adjustments. But the big rocks in this particular topic will not really do with shoes but do with running your cadence, your terrain and your speed. Good luck with your rehab this week and we'll catch you in the next episode. Thanks once again for listening and taking control of your rehab. If you are a runner and love learning through the podcast format, then go ahead and check out the Run Smarter podcast, hosted by me. I'll include the link along with all the other links mentioned today in the show notes. So open up your device, click on the show description, and all the links will be there waiting for you. Congratulations on paving your way forward towards an empowering, pain-free future, and remember... Knowledge is power.