Family Life Magazine March 1997

Foot Notes Column

This is likely to be an active Spring. I do not remember getting so many questions from patients about athletic shoes. This might be a good time to share with you my ten tips on athletic shoes.

1. Shoes wear out in the middle. Shoes have many parts. The insole is the sock-like lining inside the shoe and the outsole is the "tread" on the bottom of the shoe. The most important part is the midsole which you cannot see at all. The cushion and stability come mostly from the midsole. When the midsole wears out the shoe should be replaced even if it looks like new. As a generalization, an athletic shoe that is worn and used daily probably needs to be replaced as often as every 4 or 5 months. Running shoes need to be replaced every 400 miles.

2. Not all shoes are the same. Every manufacturer tries to make a variety of shoes for each sport. Some are made very sturdy for unstable feet. Others are made with extra cushion for rigid feet. Few shoe stores will stock every style of shoe from one manufacturer, let alone all styles for every manufacturer. Please select only those shoe stores that will discuss with you the types of shoes that you need and will order a pair for you if it is not one they usually keep in stock. Since this takes extra time, it might be best to cultivate a relationship with a favorite sales person at a single store, especially if you have an unusual foot. A good sales person will be able to describe a pronated and a supinated foot.

3. Flat feet need rigid shoes. In medical-speak flat feet are called pronated. In shoe speak they are called over-pronators. If you know that your feet are flat, weak-arched, collapsed or pronated, you need a rigid shoe for over-pronators. Nearly every manufacturer makes such shoes for each sport. You can determine if a shoe is rigid by reading sport specific magazines (Runner’s World, Women’s Health and Fitness, Tennis, etc.), the sales catalog of the manufacturer or the advice of an athletic shoe sales person.

4. Rigid feet need cushioned shoes. Rigid feet in medical speak are called high-arched, cavus or supinated. In shoe-speak they are called under-pronators. Rigid feet are prone to repetitive stress injuries and need the cushion of a shoe made just for them.

5. All shoes need a rigid heel counter. The heel counter of a shoe is the part that surrounds your heel. A strong heel counter will resist your efforts to squeeze it from side to side. A stable heel counter will assist the midsole in providing sufficient support. A soft heel counter will provide poor support and the shoe will have a shorter life span. Deck and canvas shoes have such weak heel counters that they should be used just for leisure activities.

6. Toe box depth. If you tend to get blood blisters under the toe nails, it may be due to a toe box that is too shallow. Every shoe differs in the amount of room it has for the toes. Your shoe fitter should know which shoes have more toe room.

7. Not every foot is equal. The right and left foot can differ from each other in length and width. If the difference is substantial, fit your shoes to the larger foot. Feet that are the same height and width may have a difference in circumference which makes a shoe feel tighter on one foot. Again, choose the larger shoe and make up the difference in the shoe with the smaller foot with padding or a thicker sock. Also, feet should always be measured while standing with full weight bearing.

8. Feet swell throughout the day. If your feet do not get longer, they can often swell a bit and make your shoes fit tighter. To eliminate this effect, choose your shoe size at the end of the day when your feet are at their largest.

9. Socks can change the tightness of shoes. When you try on shoes wear the same thickness of socks you expect to wear with the shoes. If you always wear padded socks for tennis, then you can be misled if you try on your new shoes wearing nylon hose.