All injuries - Sports Injury

Best running shoes for calf pain: look for these…

by Pete Colagiuri - Sports Physiotherapist

Finding the best running shoes can be a challenge. Trying to find the best running shoes for calf pain adds another dimension!

Running shoes can have a big impact on the pressure in the calf muscle when you run. So it makes sense that the right running shoes should be able to help take the pressure off the injured area.

To get the best shoe for your calf, you ideally need to know what’s causing your calf pain.

We’re releasing an app in the 2nd half of 2021 that can provide you with an accurate diagnosis for your calf pain.

Until then, have a read of this great article that can help you find the cause of your calf soreness.

Choosing the best running shoe for calf pain

When we choose the best running shoes for calf pain, there are number of key features that control how much load the calf muscle is under:

Heel-toe offset
Level of support
Stack height
Grip/outsole

Feature #1 – Heel-toe offset

The first is heel toe offset, also known as heel to toe drop. This describes the height of the heel relative to the height of the toe.

It tells you how much the foot is angled downwards when you’re standing. This downwards angle reduces the amount of stretch on the calf. So a high heel toe offset, typically around 10mm or greater, will reduce the amount of stretch of the calf.

If your calf symptoms are linked to shorter calf muscles, a higher heel toe offset is helpful.

A high heel toe offset is also useful for very painful, irritated conditions as it provides some pain relief. It allows you to run faster with less pressure on the calf compared to low drop shoes.

Feature #2 – Level of support

The level of support is rated from neutral (no direct support), then minimum/moderate/maximum support levels and finally, motion control.

Neutral shoes make the calf work harder by increasing the amount of muscle work required to stabilise the ankle.

The min/mod/max support options provide more structure and support (obviously) which reduces the stability work required. But it can inadvertently make it harder for the calf to propel you forwards.

Motion control options are rarely required and make normal biomechanics almost impossible.

The best advice for support levels is to go with the lowest level required to maintain a consistent running technique for the duration of your runs. If you start well but lose form in the last few miles, you might benefit from an upgraded support level.

Feature #3 – Stack height

Stack height refers to the overall height off the ground – basically it’s the amount of foam under your foot.

Higher stack heights, as seen with Hoka running shoes and other brands, reduce the calf muscle work with landing. As you impact, the cushioning help with shock absorption. That means your calf muscles won’t be as active, which should reduce calf muscle fatigue.

Feature #4 – Outsole or grip

Last on our list is the outsole or grip on the shoe. And this one might surprise you!

Better grip – either from new shoes or more aggressive grip patterns – actually increases the load on the calf.

As you push off, the improved grip ensures that you don’t slip. So all that force generated in the calf is matched by a firm attachment to the ground, maximising calf muscle loading.

Compare that to an old shoe, smooth grip patterns or road shoes worn on trail, and the opposite occurs. The calf force is allows to slip a little as it pushes off, reducing the forces pushing back against it. that will reduce your performance slightly but it’ll also reduce your calf pain in each running session.

11 best running shoes for wide feet

by Pete Colagiuri - Sports Physiotherapist

Trying to find the best running shoes for wide feet is a long held frustration for anyone gifted with a broad forefoot!

Wide feet, defined as having an increased width (across the ball of the foot) relative to its length, require a shoe with slightly different proportions.

Who has wide feet?

Feet will naturally widen over time, and this happens faster with excessive body weight or poor ankle/leg stability.

Looking at cultural differences, wide feet are more common amongst Asian cultures (source).

Who needs wide fitting running shoes?

Some surveys found that up to 50% of people need a wider fitting shoe. So they should be pretty common, right?

Oh so wrong unfortunately…

Side note: we look in detail at the best running shoes for wide feet below. We’ve created a dedicated post for women’s wide fitting running shoes, link TBA.

Where do you find running shoes for wide feet?

Looking at the 800+ men’s shoes available on runningwarehouse.com, less than 15% of running shoes are for wide feet. If you need a trail-specific running shoe, less than 10% have options for wide feet.

In considering the best running shoes for wide feet, there is no “best” shoe because everyone’s needs are different.

It would be like trying to recommend a “best” car – some people need a station wagon for the kids, others need a sports car for the look while some prefer an off-road vehicle for, well, off-road.

What to look for in a wide fitting running shoe?

The two key features of a shoe that are needed to narrow your selection are the heel to toe offset (aka heel to toe drop) and the amount of support it provides.

Road shoe without support

If you prefer a lower offset shoe (anything under 6mm) and you don’t needs support, the HOKA ONE ONE range now includes a selection of wide fitting shoes. Runners love HOKA because of their generous cushioning and smooth ride.

In a mid offset shoe (around 6-8mm) without support, your best options are in the Saucony or New Balance range. Saucony’s wide fitting running shoes are a little bit heavier than the New Balance options but accommodate a higher volume foot (nice way of saying a “fatter foot”).

For your high offset wide fitting running shoes without support, you’ll be looking at Brooks, Mizuno or Asics shoes (although there are some options in the New Balance range as well).

Road shoe with support

If you need support in a wide fitting road running shoe, the best options are:

Hoka One One Arahi (low-mid offset)
Saucony Guide (mid offset)
Asics GT-2000 (high offset)
Brooks Adrenaline GTS (high offset)
Mizuno Wave Inspire (high offset)
New Balance 860 (high offset)

Trail running shoes

If you’re looking for trail running shoes for wide feet, the options are even more limited.

Trail running shoe with support

First point, THERE ARE NO SUPPORT OPTIONS FOR TRAIL SHOES!!!

Your only options are to go for a supportive road shoe or to add a supportive orthotic to a well structured neutral shoe.

Trail running shoe without support

For a trail shoe that fits a wide foot and doesn’t have support, the favourite options are:

Altra Lone Peak (zero offset – ie. dead flat)
Hoka One One Speedgoat (low offset)
Saucony Peregrine (low offset)
Brooks Cascadia (mid-high offset)
Salomon Speedcross (high offset)

3 common causes of inner ankle pain while running

by Pete Colagiuri - Sports Physiotherapist

We asked our Physiotherapy team about the most common causes of inner ankle pain while running. This was their three most common causes and, more importantly, their most effective treatment for inner ankle pain.

Inner ankle pain while running is typically due to some form of overload. That may be muscles being overloaded beyond their capacity or it might be joints that are sustaining higher loads due to a lack of muscle bracing.

Once the overload begins, it generally causes the area to become sensitive which makes further episodes of inner ankle pain more likely.

What are the most common causes of inner ankle pain? And what are the best fixes for each injury?

Cause 1: Tibialis Posterior Tendinopathy

The Tibialis Posterior muscle, also known as Posterior Tibialis, is a muscle that runs down the inside edge of the shin, around the inside of the ankle and connects on to the arch of the foot.

As you can imagine, its main job is to control the position of the arch as you run. As you impact the ground during foot strike, the Tibialis Posterior must slowly lower the arch and control the rate of pronation.

If the muscle isn’t performing its task, either due to weakness or another deficit, it will rapidly stretch the tendon which wraps around the inside of the ankle.

This leads to an injury called Tibialis Posterior Tendinopathy, which causes inner ankle pain and some swelling around the inside ankle bone (medial malleolus) with a rope-like appearance.

Best treatment for Tibialis Posterior Tendinopathy

For a Tibialis Posterior Tendinopathy, the best treatment is to reduce the loading on the muscle while increasing its capacity.

You can reduce the loading on the muscle by using orthotics, supportive shoes or foot taping called Low Dye taping.

In order to increase the capacity of the muscle and tendon, you can perform eccentric (slow lowering) exercises.

The simplest example of this type of exercise is leaning against a wall on the same side as the leg (this puts the leg on an angle) and then raise and lower the arch.

Cause 2: ankle joint synovitis

Another common cause of inner ankle pain is due to overstretch of the joint capsule around the inside of the ankle.

This joint capsule has a very sensitive lining, known as synovium, which is prone to inflammatory reactions if it is overstretched or compressed.

The most common mechanism behind ankle joint synovitis for inner ankle pain is an overstretch mechanism. Essentially the inner part of the ankle stretches on impact due to poor muscular or physical stability at the ankle.

This diagnosis can be associated with some ankle swelling, although it tends to be localised around the ankle joint in a donut-looking pattern.

Best treatment for ankle joint synovitis

The best treatment for ankle joint synovitis is to attack it in three ways simultaneously.

Anti-inflammatory options, including anti-inflammatory medication and ice packs, can reduce the inflammatory response after each run.

Increased physical stability around the ankle, using orthotics, supportive shoes or even just new shoes, reduces pressure on the synovium.

Then you can add stability exercises to improve the ankle’s ability to brace itself on impact. These exercises should focus on bracing the ankle on solid ground while the body is pulled away from the centre of mass using a resistance band or a one sided weight.

Exercises using a Bosu ball or similarly unstable surface are almost useless as they train the ankle to continually follow an unstable surface rather than bracing on solid ground as we do in running.

Cause 3: subtalar joint pain

The last of our top 3 causes of inner ankle pain is due to subtalar joint overload.

This is an overload injury but that isn’t to say that you’re putting too much force through the foot.

It’s just that the subtalar joint, which is responsible for tilting the foot, is not able to move through the range of motion required of it when you’re running.

With each foot strike, the subtalar joint is forced beyond its tolerable range of motion due to a lack of stability or a lack of range or both.

As the subtalar joint becomes more painful, it becomes harder to stabilize the ankle in light of the inner ankle pain.

Best treatment for subtalar joint pain

The best treatment approach for subtalar joint pain is twofold.

You can improve the range of motion by doing lateral movement exercises or by receiving hands-on joint mobilization from a therapist.

The other treatment is to improve your ability to stabilise the ankle, which can be done through drills such as plyometric lunges, walking lunges or small hops (if they are pain free).

Other causes of inner ankle pain

Plantarfasciitis

Calcaneal bone stress

Tibial bone stress

Talar Dome lesion

Peripheral nerve irritation

Should I run with calf pain? 3 simple steps…

by Pete Colagiuri - Sports Physiotherapist

“Should I run with calf pain?” – this is one of the more common questions we get from runners in our physiotherapy clinic.

The question isn’t as straightforward as it seems.

On one hand, feeling your calves working hard and occasionally tightening up isn’t a bad thing.

On the other hand, any muscle tightness could be the start of an injury.

So here’s our simple three step checklist to determine if sore calves are a warning sign or just part of the running experience.

The screening process

Step one: is the calf pain just on one side, is it sharp?

If the calf pain is only on one leg, it tends to indicates an asymmetrical loading pattern. This may not be an injury in itself but the asymmetrical loading pattern is a major cause of many running injuries.

Step two: did the calf pain happened after an easy session or has it happened on a few occasions now?

If you got calf pain after a single high intensity session involving sprints or hills, it’s less of a concern. This is because we are expecting the calf muscles to work extra hard.

If you get calf pain after an easy run, that starts to ring alarm bells. We’re not expecting the calf muscles too overload during those sessions so muscle soreness seems out of character.

If you keep getting calf pain after running sessions on a few occasions, this may indicate that your calves are struggling to keep up with your training or that there’s an injury brewing. Either way, it’s an early warning sign that you need to back off before injury strikes.

Step three: is the calf pain persisting beyond after 24 hours?

Most muscle soreness after overload can be pretty nasty the day after training. But it begins to loosen up after 24 hours and completely resolved after 3 days.

If the calf pain isn’t easing after 24 hours, there may be another cause behind the trouble. This can include things like bone stress conditions.

So can I run with calf pain?

In answer to your question “should I run with calf pain?“, it’s a NO if you can you answered YES to any of the above questions.

If your calf pain is one-sided, sharp, recurrent or persistent, this could be an indication of an underlying calf injury.

Until our sports injury app is released, we can’t tell you exactly what that injury might be.

But in the meantime, see if any of these symptoms match what you’re feeling.

Possible causes of calf pain

Calf muscle injury

Calf muscle injury often begins with a localised painful tightness in one part of the calf. It is usually sore to push on that location.

Tibial bone stress

Tibial bone stress can cause a deep diffuse calf pain. It still feels sore during heel raises, which can often lead to a misdiagnosis as a muscle injury. The big clue here is after each run, the pain will persist for up to 3 days.

Vascular conditions

Vascular conditions can includes occlusions of blood vessels behind the knee reduction in flow capacity of the blood vessels deep in the calf. The defining feature of most vascular conditions is that they significantly restrict your running but the pain resolves within a few minutes after you stop.

Shin splints

Shin splints is an umbrella term that covers a number of possible conditions. We’ve gone into detail on which conditions are involved and what they feel like in our article on shin splints.

Compartment syndrome

Compartment syndrome is caused by an increase in pressure in the calf, which then squashes nerves and blood vessels. Much like vascular conditions, the calf pain results within a few minutes after you stop running.

Referred pain

Referred pain can come from nerve irritations at the lower back or conditions like Sciatica. Most episodes of referred pain can be correctly diagnosed because the pain continues down into the foot or extends up into the hamstring.

Ruptured Baker’s Cyst

A Baker’s Cyst is it pocket of fluid that collects at the back of the knee. If this pocket of fluid ruptures, it causes symptoms very similar to a muscle tear. There’s a rapid onset of pain and significant tightness.