We have all experienced walking into a shoe store, or opening a shoe website, and being overwhelmed by the sheer number of varieties available to us. Options range from minimalist shoes with soles barely 1 mm thick to the new trend of fat soled shoes with foam multiple inches thick.
As a therapist and runner, I am frequently asked, “what is the best shoe?” They are usually disappoint when I tell them that there is no such thing!
For decades experts and slightly trained store clerks alike have used a simple test to decide what type of support people need in their shoes. Get the feet wet and stand on a piece of butcher paper, depending on how much of an arch showed, the person needed either more arch support or less arch support. In the last few years this has progressed to high tech looking pressure plates, but it is essentially the same test. Unfortunately, although this test is widely accepted as valid, it was invented by a bunch of guys sitting around guessing at how different foot shapes might need to be supported, but there was no experimentation to check if theories were correct. The theory was simply published as fact and accepted by the public at large. In recent years research has been done using military academies and basic training groups that has shown there is no correlation whatsoever between the use of the shoes this test prescribes and the lack of injury from running.
Along those same lines we have all heard the rule that running shoes should be changed out every 3 month or 300 miles due to break down of the supporting foam structure. Unfortunately, in recent years research has shown this to be a myth as well. It turns out that the foam structure of a running shoe shows no significant difference in breakdown between about 30 miles and 300 miles, so if the foam on your running shoe was the most important factor in when you get a new shoe most runners would be buying new shoes every week. Unfortunately, the theory that foam in your shoe sole absorbs shock and reduces forces going into your body has also been proven to false as the amount of force reduction by a layer of foam strapped to the bottom of your foot has been shown to be negligible, so buying new shoes that often for the purpose is just be a waste of money.
More research continues to come out showing the more supportive our shoes are, the more our brains attempt to rely on them and cause our muscles to shut down, leading to less effective movement and increasing occurrence of injury.
Now that I have destroyed all of your preconceptions about what a shoe can and cannot due for you the question comes back to, what is the best shoe to prevent injury and help with performance? My answer to that question is that you are asking too much from a simple shoe.
Consistently there are certain things that can predict likelihood of injury or pain with running and other activities and they are all associated with strength, flexibility, and control of movement. Low muscle mass in the feet, not being able to spread and move your toes under their own power, lack of ankle range of motion, low hip/rear end muscle mass, and lack of knee control during dynamic activities are all far more consistent predictors of injury and pain than the type of shoe you wear.
When our hips are weak one of the biggest things that we see is the tendency for the knees to point towards each other while we walk or do stairs, this also causes our ankles to drop in on the inside commonly known as pronation. This fault results in knee, ankle and foot pain.
When we have low muscle mass in our feet this is often easily detected by our ability to move and control our toes under their own power. This matters because when we don’t have strength in our feet our arches try to drop and we develop foot pain in our arch and heel. When we combine this with tight calf muscles and lack of ankle motion the effects are only made worse.
These simple faults make us more prone to injury and pain with simple activities like walking and using the stairs, but when we add in the extra forces going through our lower bodies by carrying around extra weight, or by running, jumping and performing higher level activities the effect is only amplified and shoes, no matter what kind of shoe you swear by, are simple unable to compensate for these faults.
Now that I have taken away the easy answer of getting new shoes to fix your issues at your knees and feet what do I recommend you do? Come to the clinic and talk with one of our well-trained staff who will be able to identify your specific weaknesses and movement faults. We will then be able to educate you on your specific needs and the exercises you can perform to correct the faults your have. Even if you don’t have any pain at this time, correcting these faults can still improve performance in your chosen recreational activities, and the next time you go to buy new shoes chose them based on what goes well with your outfit and what feels comfortable to wear.