Shoe Analysis - Fitting a Shoe

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

Introduction[edit | edit source]

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.[1]

Finding the Right Fit[edit | edit source]

Physiotherapists working with runners need to be knowledgeable about running shoes and need to be accurate and thorough in the fitting of running shoes. Furthermore, it is important to provide runners with sound advice about their running shoes.[2] For a quick review, read this page: Basic Anatomy of a Running Shoe

Physiotherapists can advise on shoes based on[2]:

  • The foot size of the runner
  • What distance do they run/ mileage?
  • Running mechanics
  • 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.[2] To be able to do that, it is important to:


It is important to determine if[2]:

  • The runner needs one pair of shoes that can be versatile
    • e.g. running on road and trail
  • Different shoes are necessary
  • The shoe selection may change over time as the runner's aims and goals change, for example:
    • beginner runner wanting to do longer distances
    • road runner wanting to do more trail running
    • trail runner wanting to run on more challenging and technical trails

Understanding your runner and their goals are important to advise on shoe selection. The subjective and objective assessment of the runner is important and valuable as this determines factors that will impact shoe selection. These factors can include[2]:

  • Type of running (road; trail; track)
  • Running distance/mileage
  • Running terrain
  • Runner’s aims
  • Preferences for multi-terrain shoe vs road running shoe vs trail shoe vs track shoe

Assessment of a Runner’s Shoes[edit | edit source]

  • Ask runner to bring old and worn running shoes to physiotherapy consultation/session
  • Assess at all the different parts of the shoe - Basic Anatomy of a Running Shoe
  • It is always better to analyse a runner’s older shoes than brand new ones

Common Issues in Running Shoes That Are Not Always the Product's Fault[edit | edit source]

Grant Bryant from the Run Store published this blog: It's Not Always a Shoe Fault and highlights some common issues found in running shoes that are not always the product’s fault. These issues to be aware of include[3]:

  • Toe lift
    • Running shoe upper with holes in the area of the big toe
    • Contributing factors:
      • Windlass mechanism of the foot[4] – tightness of the plantar fascia (and possibly Achilles tendon and calf muscles) causes the big toe to lift and thus making contact with the upper of the shoe.
      • Shape of shoe
      • Volume of upper around toe box
      • Flexibility of the shoe
      • Combination of shoe materials
    • Ankle and foot mobilisation, myofascial release of the plantar fascia and surrounding areas could reduce toe lift incidences.
  • Heel Collar Scuffing
    • Contributing factors:
      • Shoelaces not tied correctly
      • Review lacing techniques here: 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, for example 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
  • Contributing factors:
    • Incorrect shoe care (washing machine, tumble dryer)
    • Stress or trauma to area – trail running in tricky terrain

Washing and Maintaining Shoes[edit | edit source]

  • 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[3]
  • Do not leave shoes in the sun to dry
  • Be careful with common cleaning solvents

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

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Sub Heading 3[edit | edit source]

Resources[edit | edit source]

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References[edit | edit source]

  1. Vincent HK, Vincent KR. Considerations in the Selection of a Running Shoe. In Clinical Care of the Runner 2020 Jan 1 (pp. 95-99). Elsevier.
  2. 2.0 2.1 2.2 2.3 2.4 Nunes, D. Shoe Analysis - Finding the Right Fit Course. Physioplus. 2021
  3. 3.0 3.1 Bryant G. It's Not Always a Shoe Fault.[Internet]. 2020 [cited 07 December 2021]. Available from: https://www.runstore.co.za/its-not-always-a-shoe-fault/
  4. Welte L, Kelly LA, Kessler SE, Lieberman DE, D'Andrea SE, Lichtwark GA, Rainbow MJ. The extensibility of the plantar fascia influences the windlass mechanism during human running. Proceedings of the Royal Society B. 2021 Jan 27;288(1943):20202095.