Motion control shoes reduce the risk of pronation-related pathologies in recreational runners: a secondary analysis of a randomized controlled trial

by Sarah Voelkel Feierstein PT, DPT, OCS, CMPT


Runners frequently encounter injuries to their lower extremities. An increased amount and poor timing of foot pronation have been cited as risk factors for running-induced lower leg pain, medial tibial stress syndrome, stress fractures of the tibia, Achilles tendinopathy, planter fasciitis, patellar tendinopathy, and anterior knee pain. Motion control footwear may be effective in reducing the amount of foot pronation and reducing injury risk in runners. The authors in the study investigated the effect of motion control shoes on the development of pronation-related running injuries in a prospective study.


372 recreational runners ages 18-65 years old who ran at least one session/week for at least six months were included in the study.  Their baseline foot posture index was assessed and participants were randomized to receive either the “standard shoe” or the “motion control shoe.” Participants then kept track of training data on an internet platform where they reported type of activity, context, duration, subjective BORG scale, distance covered, running surface and shoes worn. They also reported any injury sustained which included those to the lower limbs or lower back and impeded running for at least one day. The injury description included anatomical location and participants were evaluated at the end of the session.

The injuries were classified as an overuse injury associated with over-pronation including Achilles tendinopathy, exercise related lower extremity pain, plantar fasciitis, or anterior knee pain. The Injuries which are not associated with overpronation include ankle sprains, hamstring strains, and iliotibial band syndrome, to name a few.


Data from 372 runners (mean age:40 years, 40% female) who completed the trial were analyzed. Twenty-five runners sustained pronation-related running injuries (PRRIs). Sixty-eight runners sustained other running-related injuries (ORRIs). The effect of type of shoe on injury showed that the probability for sustaining a PRRI with the motion control shoe is lower compared to the standard shoe. Shoe type was a significant predictor of PRRI but not ORRI and a previous injury significantly increased the risk for both a PRRI and an ORRI.


The results show that running in motion control shoes reduced the incidence of sustaining a PRRI, confirming the authors’ hypothesis. There was a 2.5x lower risk of developing a PRRI in motion control versus standard shoes. However, there was not a significant difference in motion control shoes on sustaining an ORRI. The authors encourage clinicians to recommend shoes to specifically target PRRIs as those shoes benefited the recreational runners in this trial.


Wearing motion control shoes reduced the risk of pronation-related running injuries in middle-aged recreational runners, but not other running-related injuries.


Willems, Tine., Ley, Christopher., Goetghebeur, Els., Theisen, D., Malisoux, L. Motion control shoes reduce the risk of pronation-related pathologies in recreational runners: a secondary analysis of a randomized controlled trial. Journal of Orthopedic and Sports Physical Therapy. Epub 11 Dec 2020. doi:10.2519/jospt.2021.9710