Many, if not most running clients ask for my opinion about their running shoes or for my recommendations on running shoes at some point during our time together. Very rarely do any of them ask me for advice or recommendations about their footwear for when they are not running?
Here lies the disconnect, because the attention we pay to our feet and shoes should probably be more focussed on the shoes we spend the most time in rather than solely on the shoe we wear for what amounts to a relatively small percentage of our day. Indeed, many clients are surprised to hear that I don't really stress too much about their running shoes and care substantially more about the shoes they walked in with or what they wear to work.
But I care most about the functionality of the feet and legs - do they have the requisite strength, stability, and alignment to function optimally. If not, what is the process we need to adopt to restore function?
Sure, a shoe with the right stability or cushioning can help us move and run without pain, however, the issues we feel when running are 100% of the time issues when not running, it is just with the higher impact forces we feel them here first. I have never analysed a client's running technique and found a problem/inefficiency which I cannot see somewhere or throughout the rest of our Functional Movement Assessment.
Why? Because the shoes we wear and have worn all our lives have seriously affected our feet' structure and function.
In this blog, I am going to do a rundown of the problems with modern footwear and the effects that can spread right up into the lower back and beyond.
It is important at this stage to say that I am not totally against shoes and traditional running shoes. I do think they could be better however and I do think we wear stiff, highly cushioned, and supportive footwear way too much when we should be spending time barefoot.
The Shape of a Foot
This is the most obvious and, for me, the most important and frankly ludicrous realization about most modern footwear. They are not the shape of a human foot. The widest part of a human foot is the toes, however, most shoes taper to some sort of point which drastically alters the position of the toes. This inward orientation, particularly of the big toe, results in a reduced ability to create a stable base of support where the big toe is constantly in use to stay balanced when weight-bearing and shifting the angle of the big toe can cause hallux valgus (bunions) and associated pains and stiffnesses. With reduced stability at the front of the foot, we lose a lot of control of pronation and supination and as we know, that's what a lot of shoes claim to do...the same shoes that taper at the toes.
Why? due to fashion and cost-cutting (yes really). For 100s of years, fashion has dictated that smaller feet are prettier and a wide foot is ugly, and making shoes in a more symmetrical shape is said to be cheaper.
The foot-shaped shoe is my biggest non-negotiable when I talk shoe recommendations.
2. Zero Drop Sole
There's nothing wrong with a bit of a heel on a shoe, however, the longer we wear these shoes the more the foot and ankle adapt to this position and problems ensue. Consistently having the heel higher than the forefoot causes big problems.
The Achilles tendon, calf, and other posterior structures shorten as they are not routinely required to be longer.
Increased weight bearing on the forefoot and toes (imagine standing on a downslope all day) can cause pain at the metatarsal heads.
Alter joint angles at the ankle, knee, hip, and lower back to compensate for standing on a slope. This creates a quad-dominant and stressed anterior knee, an anteriorly tilted pelvis, and increases lumbar lordosis.
Whilst the body can easily cope for extended periods in these positions, over time the effects start to cause pain and discomfort. The most extreme effects of course we see with high heeled shoes, however often we can see up to a 1.5cm elevated heel in running shoes and 2 cm heel in men's dress shoes which seem to cause significant problems too in terms of alignment and gait patterns.
The heel drop (term used for height difference from toe to heel) in running shoes can reduce stress on the Achilles, but again, if this is the standard position of the heel in every shoe then the Achilles and calf become shortened and any beneficial effects are lost.
The main concern I have with people constantly wearing heels is that they become unaware that their weight has shifted forward towards their toes. I a lot of time every day with clients helping them try to regain some glute and hamstring feeling/dominance so they can move more efficiently/pain freepain-free/faster. The biggest single issue hampering the progress is that the weight (even barefoot) shifts so quickly and unconsciously onto the toes at the slightest hint of movement. This anterior weight-bearing dominance/habit is a major issue for knee pain, back pain, shin, and foot pain.
3. Cushioning
Some cushioning in running shoes I can get behind. Some. Cushioning to take the sting out of the landing is for obvious reasons quite nice and good to have. Especially if one is doing long distances or racking up the km´s each week. The impact of landing when running can be up to 5 x your body weight (with poor technique) and even the gliding pros usually sit around 2/3 times with every step. So it would be a little blinkered to suggest that all cushioning is bad.
However, what we see since the advent of Nike Air and Reebok Pumps in the late 80s is an obsession with cushioning and comfort which in a lot of cases has gone far and beyond what we require for running. Combined with the increased heel height that we routinely see (and studies show) is that the more cushioning we have, the more we use, so one tends to land harder the more cushioning they are used to.
The cushioning drastically dampen the impact, sensations, and reactions at the foot but the force of impact remains high and has to be absorbed further up the leg in the knee, hip, and lower back.
Like I said, however, a bit of cushioning is ok as long as the running technique is good cushioning can heavily mask the damaging movements and forces of poor running technique and even encourage worse technique by encouraging a heavy heel strike.
4. Stiffness
The stiffness of the shoes comprises any structure which stops your foot from moving naturally. Your foot has 26 bones and 33 joints, all of which have evolved to move. So encasing them in shoes that do not allow for free movement in all natural directions will over time cause issues. Joints that cannot move, get stiff and muscles that would ordinarily move and support these joints get weaker as a result. Here is where the old school doctors and therapists would tell you that you need more support in your shoes rather than try to help you fix the problem itself. A major part of the problem is that the foot has nothing to do so it gets weak, so a big part of the solution must be changing footwear and spending time barefoot.
Stiffness is not just arch support and leather work shoes, however. The thicker a sole is (also cushioning in running shoes), the less mobile the foot will be allowed to be. In children and toddlers shoes this is a major major problem as the soles remain insanely thick but the shoe is much smaller resulting in basically a cast for a developing foot. The result is an epidemic of weak, flat-footed, injury-prone kids. Did you know that it takes up until about 8 years old for the arch in the foot to form?
5. Toe Spring
Toe Spring is that little lift on the front of your shoe which effectively keeps your toes off the ground in standing and is a by-product of stiff soles and high cushioning. With higher stiffness and thickness, the ability to extend the toes is drastically reduced. When walking barefoot, this extension is a natural part of the gait cycle where we roll over the ball of the foot onto the big toe to get the most elongated, efficient walking and running pattern. To counteract this loss, a toe spring was developed so that the shoe works as a "rocker" to help get over the big toe.
Whilst this is lovely of shoe designers to fix a problem they created, the elevated toes and the elevated heels create an unnaturally high weight-bearing pressure on the Metatarsal Heads (base of the toes) which is a major cause of degeneration and common conditions such as Mortons Neuroma. Combined with a pointed toe box it is a disaster for forefoot health.
In Summary, less shoe is better for all-day wear and when buying your next shoes, try to think about hitting these targets for each new pair
Wide - Flat - Thin - Flexible
Important!!
This advice is general shoe advice and should be taken in the context of the shoes one wears most often. Looking after your body and feet is most important and most effective when is done regularly. Simply changing your running shoes will likely change very little and can often cause more problems than you had before.
One can be a strong believer in barefoot health and spend all day barefoot and still wear cushioning well-fitting running shoes - We must not be blinkered in thinking that we must be barefoot or minimalist 100% all of the time. Look after your feet and learn how to restore your feet after years of misuse or just after an afternoon of skiing, running, football or rugby.
Foot restoration kits are available from our online shop and come with instructional videos on how to help restore your foot function.
Check out our friends at The Foot Collective for more information and online workshops.