by Barry Gordon, PT, DPT
How much arch support do I need? Do I need cushioning? Is a minimalist shoe right for me? What else should I look for in a shoe? These are common questions that many individuals are plagued with when faced with the task of purchasing a new walking or running shoe. Choosing the right shoe to fit your needs and match your running style as well as your body’s natural structure is no easy task. There are numerous things to consider and hopefully we can shed some light on how to make the right decision for you.
First, we’ll review some brief background information on the history of the running shoe. Going back to the early 1970’s when running became vastly popular amongst the masses as a convenient and effective form of exercise the medical community observed a sharp rise in the incidence of running related injuries. To address this spike in injury rate, three prominent sports podiatrists at the time determined that the injuries people were sustaining were either the result of an excess amount of motion and instability in the ankle and foot (over pronation) or they were the result of a lack of motion or rigidity in the ankle and foot (lack of pronation) which did not allow the ankle and foot to absorb force properly when striking the ground. As a result of these insights three categories of shoes were developed: motion control, stability, and cushioning. To this day we continue to use these categories to determine the proper shoe for different foot types.
The three different foot types, which correspond to these shoe categories are as follows: flat foot, neutral arch foot, and high arched foot. The flat foot is thought to pair best with the motion control shoe, which provides for maximum arch support and none to minimal cushioning in order to guide and control motion in the ankle and foot. The neutral arch foot is thought to work best with stability shoes, which provide minimal to moderate arch support and minimal to moderate cushioning to support normal mechanics in the ankle and foot. The high arched foot is thought to match best with cushioning shoes, which as its name implies provides higher levels of cushioning to make up for a loss of shock absorption that results from a rigid foot type. The way to determine your foot type is to look at your self in the mirror. Shift your weight to one leg at a time and observe what happens at the inner arch of your foot. If the inner arch of your foot flattens and touches the ground it is likely you have a flat foot type. If the inner arch of your foot is not in contact with the ground and there is an even amount of contact of the outer and inner half of the foot with the ground then you likely have a neutral arch foot. Finally, if the inner arch of your foot is not in contact with the ground and only the outermost surface of the foot is in contact with the ground then it is likely that you have a high arch foot type. If uncertain about your foot type it is best to consult with your local physical therapist or visit with your local shoe supplier to assist you.
It is also important to consider the anatomy of the shoe and determine if there are any particular considerations you need to make depending on your foot shape and medical history. Starting in the front the toe box is the part of the shoe that covers your toes. The toe box should be wide and long enough to allow some wiggle room for your toes. A toe box that is too short and narrow can cause hammertoes, bunions, metatarsal pain, neuroma, or other painful conditions in the forefoot and toes. If you have a previous history of pain at the ball of the foot it is important to look for a toe box that does not squeeze or constrict your forefoot or toes. The vamp is the top and mid section of the shoe where the laces typically are located. The vamp should provide enough support so that your foot does not slip back and forth, which will ensure your ankle has enough stability and provide protection against ankle sprains. The sole is the bottom of the shoe. There are numerous different types of soles available, which provide blends of flexibility, shock absorption, and/or support. Recently, minimalist shoes have gained popularity in the running world as well as a lot of attention in the sports medicine community. These shoes provide for increased flexibility in the sole with minimal to no stability.
The minimalist shoe is thought to promote a more natural foot striking pattern when running in which the forefoot hits the ground first, opposed to a heel strike pattern. A forefoot striking pattern has been found to improve shock absorption through the ankle and foot, which decreases strain and potential for injury to the joints in the lower extremity and back. There are a few considerations to make however if deciding to try a minimalist shoe. First, while shoe companies are now blending different aspects of minimalist, cushioning, and arch support in their shoes, a purely minimalist shoe does not provide support for your foot arch and requires a certain amount of strength in your lower leg to adequately support your ankle and foot. Therefore, if you have a flat foot type and/or have a history of foot or lower leg pain then a minimalist shoe may not provide you with enough support for your ankle and foot. You may be more successful with a shoe with more arch support. Second, if switching from a shoe with arch support and cushion to a minimalist shoe make sure that you do not immediately run at the same mileage as you did with your supportive shoe. Since a minimalist shoe does not provide a high level of passive stability it is essential that you slowly accustom your body to the minimalist shoe starting with lower mileage and progressing back up to your previous mileage at a comfortable and steady rate.
When choosing your new pair of shoes it is important to remember that everyone is an individual and each individual has particular preferences in their shoe selection. While some degree of trial and error is naturally a part of the process, this article is meant to provide you with a framework to narrow down your search and set you up for success. Particular shoe brands that I have found success with through my patients’ and my own experience include Brooks, New Balance and Asics. In addition to fitting yourself with the proper footwear it is also very important to ensure you have a well-rounded strengthening and flexibility program to address weakness and muscular imbalances that may predispose you to injury. Your local physical therapist can help to build an individualized program to address your needs. Happy trails!
This article was written by Barry Gordon, who graduated with a Master’s Degree in Physical Therapy from California State University, Fresno and with a Doctoral Degree in Physical Therapy from University of California, San Francisco. His hobbies include spending time with his family, soccer, tennis, general athletic activities, and writing music. He became a physical therapist to study movement, work with people, and help his community live healthy and happier lives.