Motion-Control Shoes Reduce the Risk of Pronation-Related Pathologies in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial

J Orthop Sports Phys Ther. 2021 Mar;51(3):135-143. doi: 10.2519/jospt.2021.9710. Epub 2020 Dec 11.


Objective: To investigate whether motion-control shoes reduce the risk of pronation-related injuries in recreational runners.

Design: Secondary analysis of a randomized controlled trial of the effect of shoes on running injuries.

Methods: Three hundred seventy-two recreational runners were randomized to receive either standard neutral or motion-control shoes and were followed up for 6 months regarding running activity and injury. Running injuries that occurred during this period were registered and classified as pronation-related injuries (Achilles tendinopathy, plantar fasciopathy, exercise-related lower-leg pain, and anterior knee pain) or other running-related injuries. With the use of competing risk analysis, the relationship between pronation-related and other running-related injuries and shoe type was evaluated by estimating the cause-specific hazard, controlling for other possible confounders like age, sex, body mass index, previous injury, and sport participation pattern.

Results: Twenty-five runners sustained pronation-related running injuries and 68 runners sustained other running-related injuries. Runners wearing the motion-control shoes had a lower risk of pronation-related running injuries compared with runners who wore standard neutral shoes (hazard ratio = 0.41; 95% confidence interval: 0.17, 0.98). There was no effect of shoe type (hazard ratio = 0.68; 95% confidence interval: 0.41, 1.10) on the risk of other running-related injuries.

Conclusion: Motion-control shoes may reduce the risk of pronation-related running injuries, but did not influence the risk of other running-related injuries. J Orthop Sports Phys Ther 2021;51(3):135-143. Epub 11 Dec 2020. doi:10.2519/jospt.2021.9710.

Keywords: competing risk; footwear; prevention; running injury.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Athletic Injuries / prevention & control*
  • Biomechanical Phenomena
  • Equipment Design*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pronation*
  • Running / injuries*
  • Shoes*
  • Young Adult