title: Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study.
abstract: OBJECTIVE
  To investigate if running distance to first running-related injury varies between foot postures in novice runners wearing neutral shoes.
  
  
  METHODS
  A 1-year epidemiological observational prospective cohort study.
  
  
  METHODS
  Denmark.
  
  
  METHODS
  A total of 927 novice runners equivalent to 1854 feet were included. At baseline, foot posture on each foot was evaluated using the foot-posture index and categorised into highly supinated (n=53), supinated (n=369), neutral (n=1292), pronated (n=122) or highly pronated (n=18). Participants then had to start running in a neutral running shoe and to use global positioning system watch to quantify the running distance in every training session.
  
  
  METHODS
  A running-related injury was defined as any musculoskeletal complaint of the lower extremity or back caused by running, which restricted the amount of running for at least 1 week.
  
  
  RESULTS
  During 1 year of follow-up, the 1854 feet included in the analyses ran a total of 326 803 km until injury or censoring. A total of 252 participants sustained a running-related injury. Of these, 63 were bilateral injuries. Compared with a neutral foot posture, no significant body mass index-adjusted cumulative risk differences (RD) were found after 250 km of running for highly supinated feet (RD=11.0% (-10% to 32.1%), p=0.30), supinated feet (RD=-1.4% (-8.4% to 5.5%), p=0.69), pronated feet (RD=-8.1% (-17.6% to 1.3%), p=0.09) and highly pronated feet (RD=9.8% (-19.3% to 38.8%), p=0.51). In addition, the incidence-rate difference/1000 km of running, revealed that pronators had a significantly lower number of injuries/1000 km of running of -0.37 (-0.03 to -0.70), p=0.03 than neutrals.
  
  
  CONCLUSIONS
  The results of the present study contradict the widespread belief that moderate foot pronation is associated with an increased risk of injury among novice runners taking up running in a neutral running shoe. More work is needed to ascertain if highly pronated feet face a higher risk of injury than neutral feet.
authors.affiliation: Section of Sport Science, Department of Public Health, Aarhus University, , Aarhus, Denmark.
authors.forename: Rasmus Oestergaard
authors.initials: RO
authors.lastname: Nielsen
authors.forename: Ida
authors.initials: I
authors.lastname: Buist
authors.forename: Erik Thorlund
authors.initials: ET
authors.lastname: Parner
authors.forename: Ellen Aagaard
authors.initials: EA
authors.lastname: Nohr
authors.forename: Henrik
authors.initials: H
authors.lastname: Sørensen
authors.forename: Martin
authors.initials: M
authors.lastname: Lind
authors.forename: Sten
authors.initials: S
authors.lastname: Rasmussen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019567:Back Injuries / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005528:Foot / Q000502:physiology*; D006801:Humans; D035002:Lower Extremity / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011403:Pronation / Q000502:physiology*; D011446:Prospective Studies; D012307:Risk Factors; D012420:Running / Q000293:injuries* / Q000502:physiology; D012775:Shoes; D055815:Young Adult
keywords: Gait analysis; Injury Prevention; Lower extremity injuries; Running; Running shoes