What Shoe Do You Recommend, Doctor?

Selecting a shoe must be based on the characteristics of the shoe and how it provides you the structure that your foot needs.

We all want our lives to be as easy as possible. There are plenty of challenges in life and if we can find a few easy ‘call it in” situations in our lives that would be great. Like what to make for dinner? Or what should I wear today? Just somethings we want to be provided to us to make our lives simpler so we can focus on the bigger things in our day.

One example is a question that I get often in my office about what shoes I recommend. “What shoe do you recommend, doctor?” I wish it could be that simple. Just look at someone’s foot, go through the files in my brain and come up with brand, a model and a style that will fit each of my patients, and there you have it! Boy, that would be great! Unfortunately, it is not that simple. There are so many shoe companies with some many styles and models that it is almost impossible to get you that answer in a precise way. Especially when we all have our own style and comfort level when it comes to shoes or clothing. As a podiatrist, I want to provide my patients with both the need for style, but also the need for support, comfort and biomechanical control that will help with either treating their pain or preventing pain from reoccurring.

When it comes to shoes, I want to provide you a simple approach to selecting a shoe that is right for you. Selecting a shoe must be based on the characteristics of the shoe and how it provides you the structure that your foot needs. This makes it simpler to find a shoe that is good for you for the price that you are paying. Just because a shoe is over $200 does not mean that it is “good shoe”. However, better quality shoes do come with a price. So, being educated and critical of the characteristics of shoes will make you likely to get the right shoe for you for the right price.

Characteristic #1:  Where does the Shoe Bend

We all think that a lighter and flexible shoe is better. Not always.  Weight is important, but if you can bend a shoe in the middle of its sole, there is an issue with the stability of the shoe.  Our foot bends at the toes and at the ankle.  But have you ever tried to bend your foot in the middle?  Our foot is constructed to be stable and firm in the middle in order for us to push off when we walk.  A shoe that flexes in the middle will cause more stress on that area.  This can lead to progressive overuse injuries such as plantar fasciitis, neuromas or stress syndromes.  

Where does the shoe bend

Characteristic #2:  Heel counter needs to be firm

The back of the shoe is also very important. If the heel of the shoe is too soft, then there is a lack of support for the heel. The heel does dictate where the foot will land in your gait. If the heel hits too much to the outside, then all the pressure will fall along the outside of the foot. If the heel makes too much contact along the inside part, then you are likely pronating (flattening) too much and you will see more wear on the inside part of the sole of the shoe. So, it is important that the heel counter, which is the back part of the shoe, is firm to allow the heel to remain more straight rather than rotating inwards or outwards. If you can squeeze and collapse the back of the shoe easily with one of your hands, then the stability of the heel counter is not recommended.

Test Heel Counter Rigidity

Characteristic #3:  Rotational Stability (Torque) of the Shoe

If you were to take your hands and hold a shoe with your left hand on the back of the shoe (heel counter) and your right hand on the front of the shoe and tried to twist it like a rag, what do you think it should do? Most shoes now a days just flip all onto themselves showing how “flexible” and “light” they are. But, do you think that shoe will hold up over time? Especially after you paid about 25% of you paycheck for it? Shoes are supposed to be stable to allow you more control during your gait. Step after step, the sides of the shoes, what we call the columns of the shoe, should provide some rigidity in order to tolerate your body weight with each step. The shoe should not be a brick, one you cannot even bend or move, but it needs allow enough resistance when you try twisting it, it is challenging. Shoes, just like any other material, will loosen and wear down over time due to the consent use. So make sure you have a firm shoe along the columns in order to be durable for your busy, daily activities.

Shoe Torque Test

Now, does this mean I have to wear “ugly, orthopedic shoes” for the rest of my life? No. However, the take home point is you want to make sure you pick the right shoe with the right characteristics that will provide you the stability you need for the activity you are partaking. If you are going to spend all day at Disneyland and enjoy the most magical place on earth for 8-10 hours, then do you think your flip flops you have been wearing for the last six months are going to provide you enough support and reduce your foot fatigue after twenty thousand steps though the magic kingdom? Likely not. Podiatrists are here to guide you through decisions that will reduce your chances of injury and pain by providing recommendations on which shoes you should wear to Disneyland vs what shoes you can wear when you are hanging out with friends at the beach.

So the next time you hear about a brand that is soooo good from your golf buddy or your mom’s night out, the value in the shoe is about its “character” and not its “name”. It is not about the “brand” or about the “cost”. You are likely to make a good decision about a shoe if you exam the characteristics about the shoe versus looking for the name of a shoe.

About the Author

Dr. Jeffery Gregori, DPM

Jeffery Gregori, DPM is board certified in foot and ankle surgery with the American Board of Foot & Ankle Surgeons. He comes to Bay Area Foot Care with over 20 years of experience in foot and ankle care and has a special interest in sport related problems and injuries. His special interest and experience is with sports injuries relating to the Achilles tendon and chronic ankle injuries.