Physiotherapy 97 (2011) 250–255 Effect of motion control running shoes compared with neutral shoes on tibial rotation during running Alice Rose a,∗ , Ivan Birch b , Raija Kuisma a a Division of Physiotherapy, School of Health Professions, University of Brighton, UK b Faculty of Health and Human Sciences at Thames Valley University, UK Abstract Objective To determine whether a motion control running shoe reduces tibial rotation in the transverse plane during treadmill running. Design An experimental study measuring tibial rotation in volunteer participants using a repeated measures design. Setting Human Movement Laboratory, School of Health Professions, University of Brighton. Participants Twenty-four healthy participants were tested. The group comprised males and females with size 6, 7, 9 and 11 feet. The age range for participants was 19 to 31 years. Main outcome measures The total range of proximal tibial rotation was measured using the Codamotion 3-D Movement Analysis System. Results A one-tailed paired t-test indicated a statistically significant decrease in the total range of proximal tibial rotation when a motion control shoe was worn (mean difference 1.38 ◦ , 95% confidence interval 0.03 to 2.73, P = 0.04). Conclusions There is a difference in tibial rotation in the transverse plane between a motion control running shoe and a neutral running shoe. The results from this study have implications for the use of supportive running shoes as a form of injury prevention. © 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved. Keywords: Tibial rotation; Running; Motion control shoe Introduction In today’s society, one of the greatest challenges faced by the Department of Health is the growing epidemic of obesity. The cost of overweight and obese individuals to the National Health Service is estimated to be £4.2 billion [1]. This has led to considerable media attention on the wider health risks of our sedentary lifestyles, and has resulted in an increase in the number of people participating in recreational running [2]. In order to understand the effect of running shoes on gait, a basic knowledge of lower limb mechanics is essential. Within the first 20% of the stance phase, the subtalar joint pronates to allow solid contact of the foot with the ground [3]. As forward progression continues through the middle of the stance phase, maximum pronation and ankle dorsiflexion occur. Pronation is a normal part of the running cycle because it allows for shock absorption and accommodation on uneven terrain [3]. However, in some individuals, excessive pronation ∗ Corresponding author. E-mail address: alice2rose@googlemail.com (A. Rose). may occur for various biomechanical reasons [4]. Excessive pronators present with a broad range of pathologies, such as stress fractures, achilles tendonitis and iliotibial band (ITB) tendonitis [4]. Yates and White studied naval recruits and found that those with a pronated foot type were almost twice as likely to develop medial tibial stress syndrome compared with those with a normal or supinated foot posture [5].A risk estimate revealed that recruits with a more pronated foot type had a higher relative risk (1.70) than injury-free recruits. In an attempt to minimise the risk of injury, athletes have started to seek specific equipment, particularly running shoes [5]. Neutral cushion shoes are generally best for runners with an excessive supinatory gait to provide additional shock absorption, whereas motion control shoes are better for the moderate to severe overpronator. Motion control shoes include a reinforced heel counter and a denser midsole to help control any excessive pronation [5]. Clarke et al. [6] found that shoes with a positive heel flare and a hard midsole allowed significantly less maximum pronation and total rear- foot movement compared with shoes with a softer midsole. 0031-9406/$ – see front matter © 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.physio.2010.08.013