Bunions. Shin splints. Plantar fasciitis. Hammer’s toes. (Not to mention blisters, corns and athletes foot.) Even thinking about foot ailments makes most people’s toes curl. The good news is that there are dedicated specialists who consider these ailments every day. Better yet, they help alleviate such conditions by developing better-fitting and better-performing footwear.
Leading podiatrists, biomechanists, and shoe designers are working around the clock to devise new solutions to foot health problems that plague today’s athletes. Many common foot problems and injuries, such as runner’s knee, plantar fasciitis, Achilles tendonitis, sesamoiditis, and even bunions can be alleviated with an athletic shoe that fits properly. Kids who have improperly functioning feet, and who get into more demanding sports later in life, will typically get injured more frequently as adults. And for adults, there is empirical evidence that improper foot function can lead to hammer toes, bunions, and arch and heel pain which, if neglected, can lead to foot deformities that require surgery.
Biomechanics is the study of human motion and the forces associated with a particular activity, and footwear biomechanics is a rapidly growing field. Ray Fredericksen, M.S., Sports Biomechanics, Inc., supervises research in the Runner’s World Shoe Lab in Lansing, MI. There, foot arch structure and type (normal, high or low) are analyzed, as are shoe wear patterns, foot and lower leg alignment, and joint mobility.
The lab engages other techniques, as well, to determine a subject’s peak pressures and topography when walking or running, and testing equipment includes force plates and in-shoe pressure profile systems such as Protect and Tekscan. There are also high-speed kinematic video systems that measure joint range and rates of angular accelerations to assess movement patterns; machines that measure shock absorption; and flex test apparatuses that measure the design and material structures of shoes. Here, researchers can explore the differences in the biomechanical dynamic profiles of women versus men, leading to better-performing women’s models. The result is better-fitting shoes, enhanced performance, and healthier feet.
Fredericksen believes that much can be done to drive the development of healthier footwear through the analysis of how runners’ feet work. He notes that when a runner’s foot strikes the ground, the impact force is three times his or her body weight. Since walking involves heel-toe contact (bio-pedal), theses forces are much lower, about 1.5 times body weight. Footwear design affects how these forces will enter the body, and therefore create an adaptation in the movement pattern when the foot strikes the ground. The more efficiently a person moves biomechanically, the less likely it is that he or she will be predisposed to certain injuries or ailments.
“Proper footwear and shoes designed for the activity can greatly enhance the comfort, protection and functional performance to the wearer,” contends Fredericksen. “Proper footwear is critical in promoting healthy feet”
Bob Rich, director of research projects at Reebok, notes that shoes change the way forces are applied to the foot during movement. In some circumstances, the shoe acts as a lever that forces the foot to move unnaturally, resulting in discomfort or injury.
“Good shoe design can reduce this unintended levering and create a more comfortable shoe for the athlete,” says Rich. “It all starts in the heel, where a well-designed heel bevel or compliant [soft] material will provide a natural landing of the heel and a smooth transition to the forefoot.”
According to Rich, new fabrics, as well as advances in technology and design features, can promote healthy feet. For example, Reebok’s Kinetic Fit System incorporates stretchable panels in the shoe’s upper that allow the shoe to move naturally in relation to the foot.
Moreover, many shoes now offer breathable mesh uppers and/or anti-microbial materials that create a better thermal environment inside the shoe to keep feet cooler and drier. These new materials, when combined with improved wicking linings, keep feet cooler on hot days by “air conditioning” the foot’s environment to reduce moisture that creates friction and, eventually, blisters. The materials also provide an anti-microbial function to reduce fungus-related conditions, such as athlete’s foot, that thrive in moist environments.
In colder temperatures, waterproof/breath able fabrications help keep feet warmer and dryer. Some shoes also incorporate insoles and inner linings made with copper or silver threading to thwart fungus-friendly conditions.
In addition to new materials, last shapes and footbeds, unique innovations such as memory foams, heat-moldable insoles, and seamless uppers are making for a more comfortable, pain-free fit.
Also new on the market are thermally welded overlays that support the shoe upper, reduce stitch lines, and are better-positioned to reduce irritating friction at key pressure points on the foot. Stretch fabrics–including Asics Bio-Morphic and Reebok Kinetic Fit System–enhance the ergonomic fit of the shoe and relieve pressure that can lead to bunions or calluses.
Experts agree that there are several foot problems–such as blisters, caused by friction between the foot and the shoe–that properly constructed and fitted footwear can help alleviate. Properly fitted footwear can also be used to address plantar fasciitis–a common condition that involves the inflammation of the plantar fascia, a thick, tough band of connective tissue that originates on the heel bone and travels the entire length of the foot to insert on the small bones of all five toes. Footwear with motion control features, such as a proper heel counter and a dual-density midsole, as well as good underfoot cushioning and midfoot support, can help reduce the stress on the plantar fascia.
New, more consistent, longer-lasting shock-absorbing midsole compounds–such as Brooks MoGo, Adidas ad-PRENE, Asics Solyte, and New Balance Abzorb–have been designed to provide longer-lasting protection from the impact forces associated with foot strike. These innovative midsole cushioning compounds also help lighten shoe weight. Plus, highly resilient thermal plastics are now replacing conventional density foams to support the arch and keep the foot better aligned with the shoe sole to reduce injuries associated with over-pronation or other foot abnormalities.
Shane Downey, New Balance’s national product training supervisor, contends that footwear choice is critical because many times, improper footwear can lead to injuries.
Get Rid of a Pre-Existing Injury
“You can have injury prevention or get rid of a pre-existing injury. Shin splints, plantar fasciitis, and bunions all can be derived from footwear,” explains Downey. “For example, for consumers with plantar fasciitis, you can put the customer into a stable shoe with cushioning in the heel, and that will help alleviate that type of issue.”
At New Balance, says Downey, “One thing we are doing to improve fit is to use a denser, memory foam heel collar that fits the Achilles tendon. The material can reduce friction and make for a softer feel. You’ll see softer materials in the tongue and a bigger, open mesh material throughout the upper, which will increase breathability and decrease blister potential.” He adds, “We also have closed, versus open, stitching, with a seamless lining. The stitching is closed inward to eliminate friction points. [Other] nice things are cushioned insoles in shoes, in contrast to cheap foam, as well as a cushioned board and a layer of cushioning that sits on top of the midsole. Then it is a fit-and-feel feature that somebody will notice when they try on the shoe, and when they wear it.”
Regarding the development of footwear that promotes healthy feet, Fredericksen points to a new trend in shoe design that focuses on strengthening the smaller intrinsic musculature of the foot. Barefoot running product (such as the Nike Free line), as well as footwear designed to improve balance and posture (offered by vendors including Earth, MBT, Orthotebb Health Shoes and Foot Solutions’ Chung Shi brand) are all part of the foot health movement. However, Fredericksen warns that these shoes should be used with caution as an added training modality since they all incorporate a pivot point and can be unstable for first-time wearers. Also, new on the design front is Nike’s “wellness shoe” that targets Native American youth who have the propensity to develop diabetes.
The consensus is that a good shoe will solve a minor problem. But when a problem becomes more moderate, the shoe might require some alteration. A shoe does not impact foot health very much in terms of being recuperative, but there are products that can help people recover from injuries–such as an insole to increase arch support following a foot-flattening injury.
From a footwear standpoint, if a person has been participating in a lot of activity in an ill-fitting shoe, getting that person into a supportive shoe might help encourage recovery.
Foot Care Products
In terms of after-market accessories, an insole might be added to enhance the function of the foot. However, foot care specialists emphasize that insoles need to correctly match the shoe design profile to ensure a proper fit. For minor and moderate problems, over-the-counter insoles generally are effective. But when problems are more severe, custom orthotics might be needed.
Jim Clough, D.P.M., based in a Great Falls, MT, has developed the Cluffy Wedge that works to unlock the big toe, allowing it to move normally.
“Shoe R & D labs have been very effective in addressing rearfoot problems and issues of supinating and pronating, but not much attention is given to what happens with the ball of the foot and forefoot,” explains Clough. “If that is not addressed, the foot will still malfunction. What we are trying to do is identify the proper function of the foot–studying how it supports normal body function, then trying to minimize the risk of injury, and slow or stop the development of foot pathologies. If we can support the foot in the normal way it should work, we can improve on athletic performance, reduce the risk of injury, and reduce the risk of foot deformities down the line.”
In his 22 years of practicing podiatry, Clough notes that footwear has improved “significantly.” He adds that shoe designers and manufacturers are increasingly aware of foot biomechanics and realize what is needed to support the foot and its function.
“We have a more athletic population,” observes Clough. “Most athletes are more educated on shoe fit and foot function. Additionally, there’s a lot of Internet use and different websites [offer information] about foot problems, so many patients have already tried remedies such as bunion pads and insoles. They arrive in the podiatrist’s office better-educated and are much savvier about footwear options.”
“Everyone has potential foot problems,” says Dr. Arnold Ravick, D.P.M., a Washington DC-based podiatrist who specializes in sports medicine and foot surgery. “There are a lot of issues. Can you control disease by changing someone’s footgear? No. But we try to lesson the trauma to feet by utilizing shock absorption, and to keep pressure down by minimizing pressure points.”
Ravick notes that athletic shoes have advanced by light years in the past quarter-century. They are lighter, more shock-absorbent and are better able to wick sweat efficiently, fight bacteria, and help propel the body forward.
“But people need to spend a decent amount of money on their shoes,” says Ravick. “Things are much superior to the original Chuck Taylors, but they cost more, too. People ask, ‘What is the perfect shoe?’ I ask, what is perfect foot? Eye candy is OK–such as current fashion styles–but you want to have common sense. Foot pain is not normal. If your foot is bothering you, you should get an evaluation. You might not need surgery, custom insoles or orthotics–maybe just education on footwear choice.”