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Your PTs Guide to Running Shoes

A Physical Therapists Guide to Running Shoes

by, Dr. Hanna Sattler


Hey all you runners, weekend warriors, walkers and go getters! Looking for new shoes can be exciting, but also a little overwhelming. There are so many brands and variables to consider that it can seem a little daunting of a task. In this post I'm going to mention the 3 most important variables research has found to contribute to not only your foot health, but your overall running pattern and injury prevention! This applies to everyone, from ultramarathoners to those of you just going on your Hot Girl walks!


 

DROP

You may have heard of this term before. The heel-to-toe drop refers to the difference in height between the heel and the forefoot of the shoe. It is broken into 4 categories:


  1. Zero drop (0mm) 

  2. Low drop (1-4mm) 

  3. Mid drop (5-8mm)

  4. High drop (8+ mm)


Zero drop is like you're standing barefoot. You can think of having a drop like wearing heels. The greater the drop, the higher the heels. In medical terms, zero drop allows your ankle to be in a neutral position, or 0 degrees of dorsiflexion/plantarflexion. Any other amount of drop puts your foot into some degree of plantarflexion.


Most running shoes on the market have a mid drop, unless specifically marketed otherwise. It is my recommendation that most people gradually (key word!) work towards a zero drop shoe. It allows for the most natural gait and running pattern that targets the appropriate musculature to prevent tendinopathies and other overuse injuries.


This needs to be a gradual process to multiple reasons:

  1. You may need to change your gait pattern if you have learned bad running habits. How you contact the ground with your foot and where it is in relation to the rest of your body is extremely important. Most of us are heel strikers and take too long of strides. Doing this in a zero drop shoe can cause achilles and plantar fascia pain and issues.

  2. You need to address your calf length. After years of wearing shoes with a drop, your body will interpret zero drop as a stretch to your tissue. Therefore, increasing your ankle range of motion and eccentric strength is essential prior to running in zero drop shoes

  3. Walk before you run! LITERALLY. You need to first wear these shoes around the house, running errands and going for walks before you go for runs. Adjusting to the new environment is crucial. No "ripping off the bandaid" here!


It may be hard to find the level of drop on many shoes, so going to a running store and asking the fitters to guide you is recommended. Especially to test the shoes out in the store!

Some of my favorite zero drop brands I enjoy running in:

  1. Altra - almost monopolize the zero drop world, and are truly amazing!

  2. Flux - online only, but I like them just as much as my Altras!

You may wonder why I haven't put VivoBarefoot or Merrell here. These are minimalist shoes. I like them for everyday wear (errands, short distances) due to the lack of cushioning. Those who have really trained their feet for many years enjoy running in these, but I wouldn't recommend for the average runner or long distances.


 

TOE BOX

This is an easy one: get a wide toe box!


"But Dr. Hanna, I have narrow feet!"


Wide toe box is DIFFERENT than wide shoes! This just means the forefoot of the shoe has enough space for your toes to spread the appropriate amount during movement. If you stand up barefoot and go up onto your toes, you will notice how much more spread out they are than when you're sitting. This is what your toes need to do while exercising, walking and running. Conventional shoes taper at the toe and create a crowded environment, leading to bunions, blisters, calluses and plantar fascia problems.


Some of my favorite wide toe box brands I enjoy running in:

  1. Altra - almost monopolize the zero drop world, and are truly amazing!

  2. Flux - online only, but I like them just as much as my Altras!

Are you surprised they're the same brands as zero drop??


If you're wondering which wide toe box shoes I like training and lifting in, stay tuned! That will be another post.


 

CUSHION

This depends on mostly distance and preference. However, I will say if you have issues with ankle stability, I would heir on the side of caution when it comes to too much cushion. It is much easier to misstep and roll your ankle with more cushion. Your body needs to be able to interact with the changes in the surface you are stepping on in order to respond appropriately. Only get as much cushion as NEEDED vs WANTED for your runs!


When in comes to trail running, you want a trail specific shoe. This will give you more support vs cushion so that your foot and ankle can respond to all the variable surfaces. The upper of the shoe is also most stable so your foot doesn't slide around when you stop on rocks and roots or go up and downhill.

If you will be getting shoes for longer walks on paved surface and/or standing for long days at work, you can get more cushion as long as you still feel stable.



 

I hope this blog post is a helpful guide for you to pick the best shoes for you! I am happy to answer any questions you may have since I have run in most of the popular shoe brands and have even changed my running form to switch to zero drop shoes. I no longer have achilles or plantar fascia pain, and am now only limited by my cardiovascular system and muscle endurance vs pain and discomfort!


 

Check out our instagram post for bonus shoe tying videos!


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