In Search of the Perfect Running Shoe

Dr. Phil Maffetone

A recent New York Times article by Lesley Alderman—“For Running Shoes, It’s Fit First and Price Last”—got the attention of many triathletes and runners. It discussed minimalist running shoes, being barefoot, and the use of inexpensive options over high tech expensive footwear. Alderman sited two studies that basically showed what was most important in finding a good shoe: “fit first and price last.” A good recommendation. Fit—including the comfort of the shoe when you immediately put it on—should be almost perfect. But not while you’re standing there on a carpeted floor since it’s not how you’re putting the shoes to work. Walk or even run on a hard surface. If necessary, go outside of the store and use them. It makes finding the best shoe through the Internet more challenging, as many athletes settle for a not-so-good fit rather than send a pair back.

Here’s how I explain some issues of proper fit:
1. Never assume you’ll take the same size as your previous shoe, even if it’s the same type or model.

2. Always plan on spending adequate time when shopping for shoes. Don’t rush—if you’re short on time, postpone it and set time aside for this important event. You may not find the right shoe in the first store you visit. Most outlets carry only a few of the many shoes on the marketplace.

3. Always try on both shoes. First, try on the size you think would fit best then walk on a hard floor. Even if that size feels fine, try on a half-size larger. If that one feels the same, or even better, try on another half-size larger. Many people don’t realize that a larger shoe may actually feel and fit better.

4. Continue trying on larger half-sizes until you find the shoes that are obviously too large. You know especially by the heel—it will start coming off when you walk. Then go back to the previous half-size—more often that’s the pair that best matches your feet. There should be at least a half-inch between your longest toe and the front of the shoe for most shoes.

5. You may also need to try different widths to get the best fit, although many shoes don’t come in different widths. The ball of your foot should fit comfortably into the widest part of the shoe without causing the shoe to bulge.

6. Use comfort as the main criteria. Don’t let anyone say you have to break them in before they feel good. The best shoes for you are the ones that feel good right away. While many salespeople are aware of how to find the right shoe size, many are not.

7. If the difference between your two feet is less than a half-size, fit the larger foot. If you have a significant difference of more than a half-size between your two feet, it may be best to wear two different-size shoes. How you accomplish this is up to you.

(For bike shoes, much of this discussion still applies, especially the importance of comfort. While different pedal systems provide increased efficiency during pedaling, the shoe still must fit or foot stress will follow. Finding the shoe and system that best matches your need goes beyond the scope of this article, but comfort is still key.)

But searching for the perfect shoe is an ongoing endeavor, like the pursuit of perfect health. Through the years advertisers have given the sport a whole list of slang words and phrases that not only are misguided, but harmful because they make it seem like they know what kind of shoe you need. It’s like saying blue is for boys and pink is for girls. Even Alderman uses some of this industry jargon in her article: “Pronators, those whose arches roll inward, for instance, may need a shoe with motion control, which may be a bit more expensive than neutral shoes.” Motion control and neutral shoes are names the industry uses to help consumers buy quicker. By using scientific terms like pronation, their clever advertising almost seems real.

A 1997 British Journal of Sports Medicine paper by Steven Robbins, PhD, described the hazards of deceptive advertising of athletic footwear. Writing about our modern athletic shoes, Robbins stated, “Deceptive advertising of protective devices [in shoes] may represent a public health hazard and may have to be eliminated presumably through regulation.”

Almost all running shoe companies make some good products. Your job is find out which ones fit best because mass-produced shoes simply can’t take into consideration the wide range of feet. Instead, what I am suggest to try creating a better foot.

The Times article began by highlighting one runner’s favorite trainers: A $25 pair of Champion shoes she bought at Target. This was very interesting. Not because people are using these shoes for endurance sports, but because the article even mentioned this fact. It was around 1985 that I began searching for the best and cheapest shoes for running. Not only were my feet unhappy with the many new overhyped and oversupported running shoes that were heading for the unheard of $100 level, but I was seeing more injuries in my sports medicine practice as a result of this new breed of shoes. At that time, my favorite ones were the old Keds and a shoe from WalMart; both cost under $10. (Neither are available today being replaced by similar shoes.)

In those days, magazines were unwilling to print shoe stories except about the great features of all the new trainers and racers. That didn’t stop me from discussing the running-shoe paradox in my lectures at triathlon expos, where I cited a variety of medical studies on how shoes can cause foot, knee, hip and back problems. To demonstrate this, I would have an athlete run across the stage or up and down the aisle in his running shoes, pointing out the abnormal heavy heel strike that the cushioned shoe sole caused. Then I would ask the volunteer to take off the shoes and run barefoot. To the audience’s astonishment, the athlete’s stride transformed into a beautifully arched and light prance reminiscent of world-class runners.

The Times article referenced a recent study that said cheaper shoes caused less injuries. Finally articles on these types of studies, which have been out there for decades, are being published in the popular press. This is great news for triathletes, who not only buy millions of pairs each year, but often search for alternatives to poorly designed overpriced shoes.

The article also mentioned barefoot running. I’ve spent more of my life barefoot than shod (with shoes). That’s because it’s the best workout for the feet. When competing in high school and college, I would sometimes race barefoot—not just because Abebe Bikila of Ethiopia won the 1960 Olympic marathon running barefoot, but it was natural and felt right. When I ran my first marathon in New York City in 1980 in one of the simple, flat, low cost shoes, it coincided with a significant turning point for the shoe industry—they suddenly started making a very different shoe, not because of any scientific research, but rather marketing strategy. Running shoes became laden with all sorts of newfangled cushioning, thick waffle soles, shock-absorption, and rigid heel support. The advertising dollars were well spent as athletes pounced on this new “more is better” trend, buying shoes that, in reality, contributed to skyrocketing injuries.

Recently, triathletes have taken notice of the harm caused by built-up running shoes and are taking the matter in their own hands (I should say feet). Best-selling books like Christopher McDougal’s Born to Run have influenced this consumer trend toward barefoot running and minimalist, low-tech footwear. A few weeks ago, Christopher visited me to gather information on his new book, and to discuss his training. We took time to ponder the barefoot running scene. He runs barefoot, or sometimes with sandals, because his feet were nearly destroyed by running shoes. In November he’ll run the New York City Marathon barefoot.

I don’t suggest that everyone throw away their shoes and become barefoot runners. That too can be just as problematic as wearing the wrong kind of shoes. If you really want to do that, make the transition slowly. But there’s a more important benefit in being barefoot—it can help fix your feet.

Being barefoot can be an important—and therapeutic—component of triathlon training. Not running without shoes, but walking in bare feet. This can help muscles, tendons, ligaments and joints all can work better. Since the early 1980s I’ve recommend athletes regularly walk barefoot to help maintain better foot function, and recovery from injury. This “workout” can be done at home or work, or coupled with training such as walking barefoot for 15 minutes as an easy warm up before your swim session.

The Times article also highlighted the minimalist shoe trend. That word makes me cringe. It’s an industry term created to sell more shoes. They’re even called “barefoot shoes.” That’s an oxymoron. Any shoe can interfere with what your foot’s inner workings. This was first discovered in the 1950s when researchers found that muscle function was reduced when very simple shoes were worn.

Another problem with the so-called minimalist shoes is that many are the same oversupported, thick-soled trainers and racers that have been on the market for years, just with new colors and names.

Having treated triathletes since the sport began, it’s evident that shoes have created many hidden foot problems. Trainers and racers, along with footwear used for work, play and social events, have resulted in many deformed feet. Combined with a history of foot injuries, such as broken bones, bunions and lost toenails, and surgeries, it may be difficult to find a shoe with a great fit. Take a look at the feet of your fellow triathletes next time you’re at the beach, pool or a race and you’ll see what I mean.

While switching to a very flat shoe from an oversupported one, or rehabbing your feet by being barefoot, can be a bit of a shock for the body, those with chronic foot problems need to be especially careful to make this transition slowly.

The Vibrum Five Fingers shoe has become popular. Can you just slip your toes into this glove-like shoe and run off? Sure, if your toes are straight. That’s what I did when first trying them on—I was very impressed with the nearly barefoot feel. But when your toes are pointed all in different directions, sliding them comfortably into this “glove” of a shoe is easier said than done. If your toes want to go one way while the shoe is made for more “normal” feet, there’s a clash. It means rubbing skin on synthetic materials. That equals blisters. At least until your feet get rehabilitated—another example of your feet needing time to adapt.

Whether it’s the Five Fingers or a flat inexpensive shoe, if you have trouble with your feet even the best shoe won’t fit just right. It means you need to truly improve your feet first.

The more we understand about our feet, the better we can care for them and even fix them when their function goes astray. Our feet must last a lifetime. They’re subjected to more wear and tear than any other body part. Just walking a mile, you generate more than sixty tons—that’s over 120,000 pounds—of stress on each foot! Fortunately, our feet are actually made to handle such natural stress. It’s only when we interfere with nature that problems arise. Almost all foot problems can be prevented, and those that do arise can most often be treated conservatively through self-care by being barefoot.