Shoe Analysis - Fitting a Shoe

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Top Contributors - Wanda van Niekerk, Kim Jackson, Jess Bell and Tarina van der Stockt  

Introduction

Running for health has lead to a growing running shoe market worldwide. Over the the past 50 years running shoes designs have changed significantly. The purchase of a running shoe can be overwhelming for a runner with the market full of shoes of different weights, designs, features and materials and prices. Often the consumer is dependent on the advice of a salesperson to select the correct shoe. The challenge for clinicians treating runners is to stay informed of the continuous changes and updates in footwear as well as the forever changing scientific landscape of shoe benefits and risks to help runners make informed decisions.

Shoe Analysis – Fitting a Shoe PP page

Finding the right fit

Consider the following:

The runner’s anatomy

The shape of the foot

Pre-existing or previous conditions – certain shoes may assist in supporting certain structures and prevent the irritation of other conditions

Shoes must fit correctly

To prevent blisters

To maintain good circulation

To prevent tightness especially as feet swell

To prevent pins and needles (paraesthesia)

To ensure shoes are comfortable to wear

It is important to know what type of surface the runner is predominantly running on: road, trail, or track? Does the runner need one versatile shoe for both road and trail? Is your runner wanting to have different pairs of shoes for road running and trail running? Also, consider the affordability of this.

Fit the Shoe Correctly

These are guidelines, but they need to be adapted for each individual runner.

Ideally fit a shoe at the end of the day.

Put the shoe on, then test while standing to see that there is a finger space in the front to allow room for the toes.

Walk in the shoe and determine comfort.

Ensure that the heel doesn’t slide up.

Check the lacing - lace the shoe as normal to get an accurate feel of the shoe.

Proper fitting of the shoe may prevent blisters.

The running shoe must not be too tight – allow for feet to swell. This is especially important for ultra runners who spend a long period in their shoes.

Some trail runners, in particular, prefer a more snug fit, especially for technical terrain. This comes down to what has worked for the runner and their personal preference.

If the shoe is too tight it could possibly cause circulation problems or even pins and needles (paraesthesia).

The way the shoe is laced may also have an impact on the above, even if a correct size shoe is worn.

These guidelines will help you fit the shoe well, understand the shoe and be able to have the knowledge to guide runners into which shoe may be the best for them.

Basic Anatomy of a running shoe – provide link to page and course

Finding the right fit

One size does not fit all

Important for physiotherapists working with runners to be knowledgeable about running shoes

Need to be accurate and thorough in the fitting of a running shoe and to provide runners with sound advice about their shoes

Can advise on shoes based on

Foot size of the runner

The way the runner runs

What distance do they run/ mileage?

Runner’s mechanics of running

History of previous injuries or current injuries

The goal is to be able to guide runners to a type of shoe that suits their abilities and needs

Vast amount of running shoes on the market and the technology keeps changing

Important to recap:

Understanding your runner – important to have a full understanding of which shoe to suggest

Physiotherapists needs to know

Runners aims

Current running and planned running aspirations

Are physio able to provide one shoe that fits together with the whole picture or is this a process and as the runner grows and develops in their running their shoe selection will change? Think about runner currently only doing short distances but who wants to run longer distances or on trail and do more technical runs

Subjective and objective assessment of the runner is NB

Have a good understanding of training, musculoskeletal screening (??)

Things(?) that will impact shoe selection

Type of running

Distance

Terrain

Runner’s aims

Type of running – road vs trail, track running

Multiterrain shoe vs road running shoe vs trail shoe

Distance will also impact shoe selection

Their aims

Assessment of a runner’s shoes

Ask runner to bring old and worn running shoes to physio session

Look at all the different parts of the shoe – Basic Anatomy of a Running Shoe

Always better to analyse a runner’s older shoes than brand new ones

Blog: https://www.runstore.co.za/its-not-always-a-shoe-fault/

Few common issues found in running shoes that is not always the product’s fault:

Toe lift

Running shoe upper with a hole in the area of the big toe

Contributing factors:

Windlass mechanism of the foot – tightness of plantar fascia (and possibly Achilles and calf muscles) causes big toe to lift and thus making contact with the upper of the shoe

https://drive.google.com/file/d/1p-d6E9PGhoiIxQ0nkkArFGGZQWcu__-U/view

Shape of shoe

Volume of upper around toe box

Flexibility of the shoe

Combination of shoe materials

Ankle and foot mobilisation, myofascial release of plantar fascia and surrounding areas could reduce toe lift incidences

Blog: https://www.runstore.co.za/its-not-always-a-shoe-fault/

Heel Collar Scuffing

Contributing factors:

Shoelaces not tied correctly

Refer to lacing techniques

Narrow base of running gait due to weakness or lack of range of motion in hips and glutes – this means that the opposite foot may strike the upper collar causing excessive wearing

Shoelaces not tied properly adds to this as the collar will be more open and exposed

Runners with low flat arches or wider feet may also experience this scuffing around the heel collar

Heel drag

On the outside of the heel of the sole of the shoe excessive wear will be visible. This is often caused by the gluteal muscles not firing properly or leg length discrepancies, pelvic tilt or scoliosis. In the image on the right – this runner was battling with a hamstring injury and see the visible differences between left and right.

Splitting sides

Contributing factors:

Shoe too wide

Shoe too narrow

Incorrect shoe type eg. Neutral runner running in a stability shoe

Lack of cleaning or incorrect cleaning of shoes – especially trail shoes (dirt between mesh layers can act as sandpaper and damage the upper of the shoe)

Internal heel wear

Contributing factors

Shoelaces not tied correctly

Runner with a Haglund’s deformity

Shape of the conforming heel cup to the shape of the heel – if this does not match excessive wear is possible

Toe bumper coming loose

Incorrect shoe care (washing machine, tumble dryer)

Stress or trauma to area – trail running in tricky terrain

Washing and maintaining shoes

Never wash shoes in washing machine

Never artificially dry shoes

Do not leave shoes in car in the heat – this softens the foam and influences the life span of the shoe

Do not leave shoes in the sun to dry

Be careful with common cleaning solvents

For the complete blog read here: https://www.runstore.co.za/its-not-always-a-shoe-fault/

Assessing a runner’s shoe

Mileage on the shoe

The type of shoe

Consider the cushioning and heel to toe drop of the shoe

Apps available that can provide this information

Assess the wear on the shoe

Always compare left to right

Try and be methodical i.e start from the front, laces, different angles, side view and back view

Look at wear on shoe on uppers but also underneath!

Older more worn running shoes will provide more information

Resources

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