What Type of Healthcare Provider Should I See?
In most cases, your primary care provider is the first one to go to with running-related pain issues. Depending on your condition and how it responds to treatment, you may be referred to a specialist:
- Orthopaedic physicians treat musculoskeletal issues like joint problems and bone disorders.
- Podiatrists specialize in problems of the foot, ankle, and the muscles and tendons involved in foot function.
- Sports medicine physicians are doctors with specialized training in caring for athletes and other active people. They treat sports-related musculoskeletal conditions, promote fitness, and encourage injury prevention.
- Athletic trainers are licensed health professionals specializing in the diagnosis, treatment, and prevention of musculoskeletal injuries.
- Physical therapists are licensed health professionals who evaluate and treat injuries to reduce pain, restore function, and prevent disability.
by Beth Shepard, M.S., ACE-CPT, ACSM-RCEP, Wellcoaches Certified Wellness Coach
Staying physically active takes effort and determination. Whether your fitness program is just beginning, or you’ve been at it for years, the last thing you need is to be sidelined by pain or injury. Selecting the right shoe can go a long way toward helping you stay in the game.
Claims and Controversies
The sheer number of athletic shoe types and styles available is staggering and the marketing claims attached to most shoes make each one sound like the best one. Health and medical experts disagree on whether or not people should even wear modern athletic shoes, go barefoot or wear one of the new minimalist shoe styles.
Barefoot walking and running does strengthen foot and ankle muscles, but it’s not for everyone, for all sports or for all the time. For more information about going barefoot, check out these training tips from the Harvard University Skeletal Biology Lab.
Rock and Roll
When your heels hit the ground, your feet naturally roll inward, or pronate:
- If you have flat arches, you may over-pronate, and this can lead to knee pain, or patellofemoral syndrome. Shoes with stability and motion-control features help reduce excessive movement.
- With high arches, you may under-pronate. Too little motion is problematic because pronation helps absorb shock. As a result, the impact is sustained by a smaller area of your foot, and this can lead to leg pain and injuries. Cushioned shoes with a softer midsole may be helpful.
- If you have normal arches, you probably pronate normally — and a shoe offering moderate amounts of cushioning and stability may work well for you.
The wet test, or analyzing a wet footprint, is a popular, at-home method for selecting running shoes based on arch type. However, a recent U.S. Army study questions the value of this practice in preventing injuries. Prior to basic combat training, approximately 1500 male and female recruits selected motion control, stability or cushioned running shoes based on the wet test. A control group of the same size all received stability shoes. During training, there was no significant difference in injury risk between the two groups, even after controlling for known risk factors such as age and fitness level.
You can still do the wet test to get a general idea of recommended shoe type, but visiting an athletic shoe store that offers gait analysis may give you more accurate information. Or, ask a friend to film you on a treadmill and take a look for yourself.
Wear and Tear
Another way to determine the best shoe type is to examine your old shoes. If they’re worn out around the outside edges, you’re probably under-pronating. Shoes that sag inward indicate excessive pronation. And an even pattern of wear points toward normal pronation.
Even if they still look great on the outside, running and walking shoes should be replaced about every 300-400 miles — that’s 3-5 months if you’re averaging 20 miles a week. If you’re heavy-set or have a higher weekly mileage, replace your shoes at the shorter end of the range. Wearing shoes that no longer offer the right amount of support and cushioning puts you at risk for pain and injury.
Matching Shoes to Sports
If you wear your running shoes to play tennis, or sport them at step class, you may be sorry — because running shoes don’t offer much lateral support. For activities that involve a lot of side-to-side movement, opt for cross-trainers or sport-specific athletic shoes like court shoes.
For persistent pain that doesn’t resolve with a change of shoe style, talk to your health care provider because your shoes may or may not be the problem. Some people benefit from off-the-shelf or custom orthotic inserts, and others need medical or surgical treatment. The right care and the right shoes will help you get back on your feet and back out there — working up a healthy sweat.
- Pribut, S, Selecting a Running Shoe, American Academy of Podiatric Sports Medicine http://www.aapsm.org/selectingshoes.html
- Foot Pain, Medline Plus, U.S. National Library of Medicine, http://www.nlm.nih.gov/medlineplus/ency/article/003183.htm
- Running and Your Feet, American Academy of Podiatric Sports Medicine, http://www.aapsm.org/running.html
- Athletic Shoes, American Academy of Orthopedic Surgeons, http://orthoinfo.aaos.org/topic.cfm?topic=A00318
- Shoes, American Academy of Orthopedic Surgeons, http://orthoinfo.aaos.org/topic.cfm?topic=A00143
- Foot Health Facts, Cavus Foot (High-Arched Foot), American College of Foot and Ankle Surgeons, http://www.foothealthfacts.org/footankleinfo/cavus-foot.htm
- Wegener C, Burns J, Penkala S. Effect of neutral-cushioned running shoes on plantar pressure loading and comfort in athletes with cavus feet: a crossover randomized controlled trial. Am J Sports Med. 2008 Nov;36(11):2139-46. Epub 2008 Jun 24.
- Knapik JJ, Swedler DI, Grier TL, Hauret KG, Bullock SH, Williams KW, Darakjy SS, Lester ME, Tobler SK, Jones BH, Injury reduction effectiveness of selecting running shoes based on plantar shape, J Strength Cond Res. 2009 May;23(3):685-97.
- Foot Health Facts for Athletes, American College of Foot and Ankle Surgeons, http://www.foothealthfacts.org/Content.aspx?id=1143