How to choose running shoes: what the evidence actually says

Do running shoes prevent injuries?

The most thorough summary is a 2022 Cochrane review led by researchers in the North West. It pooled 12 trials involving 11,240 people and compared different types of running shoe. Most comparisons showed little or no difference in injuries, or an effect too uncertain to call, and the certainty of most of the evidence was low or very low (Relph et al., 2022).

The one finding the reviewers were moderately confident about was that choosing shoes based on foot posture probably makes little or no difference. Those trials were in military recruits, so they may not apply perfectly to recreational runners.

How to choose running shoes: comfort first

For years, shoes were designed around two ideas: reduce impact forces and control pronation (how much the foot rolls in). A 2015 review by Nigg and colleagues found the evidence that either of these caused running injuries was inconclusive. They proposed a different approach called the comfort filter: runners tend to choose the shoe that feels most comfortable, and that shoe lets them keep running in their own natural way of moving, which the authors suggested may lower injury risk (Nigg et al., 2015). This is a proposal rather than a proven rule, but it fits with the trial evidence above.

In practice we suggest:

• Try several pairs and move in them. Comfort when you jog matters more than how a shoe feels standing still.
• Check the fit. No rubbing or pressure points, and room for your toes.
• Buy for the running you do. Road, trail or treadmill, and the distances you run.
• Do not judge by price or label. There is no good evidence that one brand or price point prevents injuries better than another.
• Consider two pairs. In a study of 264 recreational runners followed for 22 weeks, those who used more than one pair of running shoes in rotation had a lower risk of injury (Malisoux et al., 2015). This was an observational study, so other differences between runners may explain some of it.

Cushioned running shoes: are Hoka trainers good?

Hoka is a well known example of a brand making highly cushioned running shoes, sometimes called maximalist shoes. Whether Hoka is a good brand for you comes down to the same test as any other shoe: does it feel comfortable and fit well when you run?

The research on cushioning is mixed. In a trial of 848 recreational runners given shoes that differed only in cushioning, those in the harder shoes had a higher risk of injury over six months. When the runners were split by body weight, the difference was seen only in lighter runners, not in heavier ones (Malisoux et al., 2020). On the other hand, the Cochrane review found little or no difference between soft and hard midsoles when trials were pooled (Relph et al., 2022).

A small lab study of 12 men compared a highly cushioned shoe (a Hoka model) with a conventional running shoe. At a faster running speed, the cushioned shoe produced a higher impact force and loading rate, which the authors put down to runners landing with a stiffer leg (Kulmala et al., 2018). That study measured forces in a lab, not injuries, so it does not show that highly cushioned shoes cause harm. It does show that more cushioning does not automatically mean less impact.

So cushioned running shoes are a reasonable choice if you find them comfortable, and so are firmer ones.

Do I need stability shoes?

Probably not just because a shop has said you pronate. In a Danish study of 927 new runners who all started in neutral shoes, those with moderately pronated feet did not have a higher injury risk over a year than those with neutral feet. The authors said more research is needed for very pronated feet (Nielsen et al., 2014).

One trial did find a benefit. Among 372 recreational runners given either a standard or a motion control version of the same shoe, 17.6% of the motion control group were injured over six months, compared with 32.4% in the standard group, and the difference was clearest in runners with pronated feet. The authors described the foot type finding as preliminary, and the study was co-funded by a sporting goods retailer that also employed some of the authors (Malisoux et al., 2016). When the Cochrane reviewers pooled the evidence, the effect of motion control and stability shoes was uncertain (Relph et al., 2022).

If a stability shoe feels more comfortable to you, it is a perfectly good choice. There is just no strong reason to pick one based on a footprint or a quick look at pronation alone.

The best running shoes for injury

No shoe treats a running injury on its own, and how much and how quickly you build up your running usually matters more. Our guide to common running injuries covers this. A few footwear points are worth knowing, though.

Change gradually

Switching to a very different shoe changes how your feet and legs are loaded. In one study, 10 of 19 experienced runners who moved gradually into minimalist shoes over 10 weeks showed increased bone marrow oedema in at least one foot bone on MRI, significantly more than a group who stayed in their usual shoes. The authors advised changing very slowly and gradually to avoid stress injury in the foot (Ridge et al., 2013).

Heel pain

For plantar fasciitis, NHS advice is to wear shoes with cushioned heels and good arch support, to try soft insoles or heel pads, and to avoid flip flops, backless slippers and walking barefoot on hard surfaces (NHS 111 Wales, n.d.). If heel pain is not settling, see our page on plantar fasciitis treatment.

Shin pain and recurring injuries

If you have shin pain, new shoes are rarely the whole answer. If the same injury keeps coming back, a running gait analysis with a physio can look at how you run alongside your training and injury history, rather than only at your feet.

Frequently asked questions

Are Hoka trainers good for running?

Hoka trainers are a well known example of highly cushioned running shoes, and they are a good choice if they feel comfortable and fit you well. Research has not shown that any brand prevents injuries better than another. One small lab study found a highly cushioned shoe increased impact forces at faster speeds, but it measured forces, not injuries, so it does not show the shoes cause harm.

Is Hoka a good brand for running shoes?

There is no good evidence that one running shoe brand reduces injuries more than another. Hoka is known for highly cushioned shoes, and research on cushioning is mixed: one large trial found softer shoes linked to fewer injuries in lighter runners, while a Cochrane review found little or no difference between soft and hard midsoles overall. Choose the pair that feels most comfortable when you run.

Do I need stability shoes if I overpronate?

Not necessarily. A study of 927 new runners in neutral shoes found moderately pronated feet were not at higher injury risk over a year. One trial found motion control shoes helped runners with pronated feet, but the authors called this preliminary, and a Cochrane review rated the effect of stability and motion control shoes as uncertain. If a stability shoe feels more comfortable, it is a fine choice.

What are the best running shoes for injury?

No shoe treats a running injury on its own, and how quickly you build up your running usually matters more. Choose a comfortable, well fitting pair and change to very different shoes gradually. For plantar fasciitis, NHS advice is to wear shoes with cushioned heels and good arch support. If an injury keeps coming back, get it assessed by a physio.

Are cushioned running shoes better for your joints?

Not clearly. In a trial of 848 runners, harder shoes were linked to more injuries, but only in lighter runners. When a Cochrane review pooled trials, soft and hard midsoles made little or no difference to injury rates. A small lab study even found a highly cushioned shoe increased impact forces at faster speeds. Cushioned shoes are a reasonable choice if you find them comfortable.