S.M.A.R.T. Shoe Choices

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Many people choose shoes based color, design and how they feel on their feet while walking or running in the store not by what their feet need and how their muscular tension in their leg, hip, low back and shoulder region respond to the shoes. This can often lead to the wrong choice which will cause repetitive stress and strain to your feet and the rest of your body making your chronic injuries worse or bringing on new injuriessuch as Plantar Fasciitis, Shin Splints, Achilles Tendonitis, IT BandSyndrome, Piriformis Syndrome, Low Back Pain and even Shoulder and NeckPain.

The best way to chose shoes is to have a “sports specialist” professional test out your feet as well as check your chronically tight and tender spots before and after trying on various shoes. This will precisely narrow down type of shoe that is right for your body (stability, mobility, overpronation support, over supination control, extra heel cushioning, etc.).  This is best done in a shoe clinic at a local shoe store or by bringing several pair of shoes to their clinic for a one-on-one fitting and consultation.

Here are some quick tips for those purchasing running shoes if you are eager to roll forward with buying a new pair before being involved in a shoe clinic or personal fitting.  Just be S.M.A.R.T. when choosing your running shoes:

• S is for size; make sure you have your shoe professionally fitted.

• M is for motion control; make sure your shoe provides the proper stability for the way your foot moves.

• A is for ancillary stuff like socks, non-prescription or prescription orthotics; invest in good ones as it can make a big difference in your comfort and ease of running.

• R is for rest or retire; make sure you have two pairs of running shoes so that one pair can "rest," thus providing longer wear.  Retire your shoes before wearing is seen on soles.

• T is for terrain; be mindful of where you're running so you can make sure you've got the right shoe for the surface.

Size:
For most mid to long-distance runners, you want to go a half to a full size larger than your normal shoe size. Why? Just ask any one in this category to shoe you their toe nails. To prevent your toe nails from jamming into the front of your shoes and blackening them, increase your shoes size. Please note this procedure can be tricky…if you increase your shoe size too much your foot will slide around inside the shoe. This is something you will have to play with, no one can magically fit your shoes to prevent “black toe” with every brand of shoes. Easiest guide to insure that there is enough room is to have at least one thumb width between your longest toe and the end of the shoe. Most shoe reps only check where the first or big to is. Check yourself; this is especially important for those like me who have a second toe that is longer than their first.

Motion Control:
This topic throws the majority of shoe sales reps, avid runners and pros that have been running for years. Doesn’t everyone pronate and need motion control? Yes, everyone pronates but not everybody “overpronates” and needs a motion control shoe. We have seen several patients who have been misdiagnosed as an “overpronator” and put into motion control shoes, which subsequently caused their IT Band Syndrome. The only way to be completely sure as to what shoe you need is to have a “sports specialist” physical check the mechanics of your foot, analyze the callous on your feet, check the wear patterns on your shoes as well as assess for tension in your plantar fascia, IT Band, shin, calf, hamstring, hip, low back, shoulder and neck muscles. This physical examination and be compared to a computerize gait analysis (contact motion analysis) for the most accurate prescription for “you”. If we were to put you in the right shoes for “your feet”, the majority of your body tight spots would loosen up instantaneously. What do you think would happen if we were to put you in wrong shoes? You got it, all of these spots would get worse! That is why proper shoes are critical for insuring the long-term success of our clinic results.

While we are talking about motion, your shoes should be free and flexible in the metatarsal area (junction of toes and foot – balls of feet) and not any where else. Give your shoes the test, put you hands on either end of your shoe and compress it. Does it move and bend easily? Is the movement in the fore-foot (metatarsal area) or mid-foot (arch area)? If it does not bend easily, you will be wasting too much energy and effort to push off and propel properly. This will lead to overstraining of your calf and the Achilles tendon (Hello Achilles Tendonitis – Ouch!).

The second test, grab your shoe just in front of and behind the arch (mid-foot area). Try to bend it. What happened? Did it bend or stay rigid? “How do I know if I am bending too hard?” Remember this area is supposed to withstand 3-5 times your body weight during running. If it bends with 15-20 pounds of force, it will bend and fold while running. If it bends in the mid-foot or arch area you will hammer your plantar fascia, shins and piriformis muscles by over-straining the muscles that control arch movement and shock absorption.

Ancillary Products:
There is no need for me to preach to you the “sock sermon.” You all know how beneficial the right socks are (especially in the Houston heat) and how detrimental the wrong socks can be to your running or cycling. Make sure you have a sock that is breathable, wicks moisture, and minimizes chaffing. While you are at it, if you have not done so already…make sure all of your athletic clothing does the same thing! This minimizes heat and moisture build up… Lord knows we need all of the cooling help we can get in this humid climate.

Orthotics… are these those big ugly shoes? Go ahead and take out the insert in your running shoe. Put it flat on the table and push on the arch area.  How much support and shock absorption does it possess? Unless you currently have a pair of orthotics, I think you will see my point clearly. Shoe companies try to design components of shock absorption and motion control in the sole of the shoe. They know they can not build this into the inserts of their shoes without having to triple their shoe options (different arch supports for different people) so they leave most of their inserts with minimal support. Most prescription orthotics have about a 50% success and satisfaction rate. It is a coin toss as to whether or not you will like the device and if you will notice a difference in your body and performance.  We have been able to drive that up to a 98% success and satisfaction rate with computer aided gait analysis. Remember those days when your legs had that springy, bouncy feel when running? That is what it feels like with proper orthotics.

How do you know if you need orthotics? How do you know if you a pair of non-prescription (general support) or prescription orthotics (highly specific support)? We base that on the same assessment and data we gather for deciding what type of motion controlled shoe you need (see above).

Rest or Retire:
“Rest what…my shoes? Hey, I am doing all of the work here, not my shoes! Why do my shoes need a rest?” When you pound on your shoes, they are feeling 3-5 times your body weight on impact with the ground. The repetitive impact squeezes critical gasses out of the polymer material in the absorptive portion of your shoe (technically called ethylene vinyl acetate and polyurethane; I call it the white and grey spongy stuff). It takes around 48 hours for these gasses to full reabsorb and bring the shock absorption up to full capacity. If you are going to be wearing your shoes during the day or running on back-to-back days it is wise to buy two pair of shoes.  One pair for kick around shoes and one pair for running or flip-flop your pairs on successive running days.

Retiring your shoes really means putting them to use for anything other than running. Half (50%) of the absorptive capacity of your shoes will be lost in the first 100 miles of running or 300 miles of walking (FYI – running puts 3-5x the load on shoes as compared to walking). This means you will be retiring your shoes well before signs of wear on the soles is seen. We recommend you replace your shoes by 250 miles and retire them from active duty to kick-around/yard shoes or donate them to your favorite charity. They still will have some good life in them, just not for distance running.

Terrain:
It really goes without saying, the right shoe for the right surface is important. The amount of shock absorption and traction needed is what you should consider. Here, in decreasing order of hardness, is a list of running surfaces: Concrete, Asphalt, Rubberized Track, Granite Gravel Track, Hard Pack Dirt Trail, Loose Pack Rocky Trail, Grass, and Sand. Stop and think about what your bare feet would be helped most by on each of these surfaces. You will need more shock absorption but less traction for concrete and less shock absorption and more traction for sand.

For more questions on shoes, setting up a shoe clinic at a specific store or if you would like to come in for a Computer Gait Analysis and Shoe Prescription Consultation please contact Kimberly Sefcovic to set it up.

Author: Dr. J. D. Hasenbank, CSCS, CCSP - Sports Injury Specialist, Strength & Conditioning Coach & USA Triathlon Coach.  Founder of Spine & Sports Therapy and F.A.S.T. (Functional, Athletic, Sports Therapy). At  Spine & Sports Therapy,  “We Know What it is Like to Put in Long Hard Hours, Shooting for Lofty Goals, Only to Get Knocked Out by an Injury.  We’ve Been There, Felt Your Pain & Have the Solution.  We Live & Breathe this Stuff Too!  Our Goal is to Get You Recovered and Back Out There F.A.S.T.!!!” His website can be found at www.spineandsportstherapy.com.

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