A doctor's guide to choosing the right athletic shoe

Now that summer is here, it’s time to make the most of it by moving your physical activity outdoors. It’s also a good time to take stock of your footwear. Whether you’re a casual walker or runner, training for a marathon or a pickleball or hiking enthusiast, the shoes you wear matter – not just for performance, but for keeping the other joints in your body healthy, too.

Factors to consider when choosing an athletic shoe

It’s important you choose the right shoe for the activity to avoid aches and pains, or worse, a stress fracture. Stress fractures are hard to see on routine X-rays and require weeks of immobilization in a walking boot or even surgery. Here’s some advice for finding the right athletic shoes to keep your feet and body functioning properly.

Comfort

A comfortable shoe can help minimize “hot spots” that could develop on your heel, in your arch, or at the toe joints. These are all high-risk areas for annoying skin blisters. Blood blisters under the toenail may be a frustration for runners. Planter fasciitis and stress fractures are also common overuse injuries that are frustrating.

Type of activity 

Having multiple pairs of shoes, specific for each type of sporting activity, is important. Each shoe’s structure – the arch, tread, ankle support and the heel-to-toe drop ratio – is different. These biomechanics are super specific for the type of activity you’re doing.

Foot type

Understanding whether you have flat feet or high arches, or run on your insoles (called overpronating), is important when looking for a shoe to meet your needs. We all have asymmetries within our bodies. An anatomic abnormality does not necessarily equate to the causation of pain. If you experience pain while running, you will want to seek help from your physician or podiatrist. If you are unsure about your foot anatomy, go to a local running shoe store. They have the time and expertise to properly fit you.  

6 characteristics to look for in athletic shoes

When shopping for a new running shoe, or really any athletic shoe, these characteristics are universally important.

1. Firm soles

Just like your house needs a solid foundation, so do your shoes. Look for shoes that have a firm, but slightly flexible sole. You shouldn’t be able to bend the shoe in half or twist it 180 degrees. If you can, then it won’t provide the necessary support. A slight bend is what you want. If you’re hiking, a firm sole is critical because it will protect you from the sharp rocks and rough terrain. Remember these will be heavier weight shoes as well.  

2. Cushion

All athletic shoes should have a good amount of cushion, but long-distance runners often need added cushion for shock absorption.

3. Arch support

Local running stores or your physician can examine the anatomy of your foot to determine if you have high or low arches and help determine if insoles are needed. Off-the-shelf insoles can be a less expensive option, but they only last a few months. If you’re looking for something that lasts a year or more, a podiatrist can help fit your foot with custom inserts.  

Also, there is a specific type of carbon fiber foot plate being worn inside the “super shoes” of elite endurance athletes. While worn by people breaking world record times, these shoes transfer the forces to joints not routinely experiencing it, therefore increasing the risk for stress fractures. Typically, avoid running in these shoes for “everyday use” and reserve only for race day.

4. Heel-to-toe drop

The height drop from the heel to toe matters. The lower the drop, the less force will be transferred through the metatarsal phalangeal joint (where the bones in the forefoot meet the bones in the toes). Over time, coupled with genetic predispositions, this type of stress can contribute to bunion formation.

5. Breathability

This is important to keep your feet cool and prevent overheating. It also will help keep your feet dry which will stave off blisters and fungal infections like athlete’s foot. An often-overlooked contributor to breathability includes socks! Try cotton or wool to promote moisture wicking.  

6. Toe room

This is especially important for runners. A shoe that is too tight in the toes may lead to blood blisters under the toe (subungual hematoma) or even loss of toenails. Generally, allow 3/8 inch to 1/2 inch between the end of the shoe and your longest toe.

When to toss your worn-out shoes

There are lots of variables to consider when looking to replace your shoes.

Mileage and use

Running shoes typically need to be replaced every 300-500 miles. If you run 15 miles a week, that’s about every 5-8 months. The caveat: not all surfaces or terrain are created equal in terms of wear and tear. Look at the bottom of the show & tread wear for a clue.  

Shoe rotation

If you wear your athletic or running shoe for everyday use as well, that will further shorten their lifespan. Alternating between several pairs of running shoes will help them last longer.

Terrain

The surface you run or walk on can also impact a shoe’s longevity. Treadmill running is less abrasive than a road surface or gravel/dirt paths in a park, so indoor use typically lengthens a shoe's lifespan.

Shoe quality

Generally speaking, higher quality shoes last longer (the 500 miles) or have more durable fabric, but the tread and arch support are the things to watch. If treads are worn significantly or your arches are aching, it’s probably time to replace them. Tears in the heel can also lead to blisters, so that’s also an area to watch.

A person’s weight 

If you notice less cushion or discomfort in the bottoms of your feet, it’s likely time to replace the shoe. Also, a heavier weight is more likely to “wear out” the shoes quicker, thereby reducing its cushion lifespan.  

Different movements need different shoes

Running shoes don’t work for pickleball and vice versa - because pickleball requires a lot of lateral movement, quick stops and direction changes, running shoes are not recommended. Running shoes are designed for forward, repetitive strides only and require a great deal of cushion. The best shoe for pickleball is a tennis or “court” shoe.

Get help from an expert

Deciding on a shoe can be difficult as there are so many options to choose from. I recommend visiting your local running store and trying on different types. Using their expertise and time or talking to a podiatrist will help you find the shoe that best fits your foot.  Every foot is unique. Running, walking and hiking aren’t gear intensive sports, so invest in quality shoes designed for a particular activity as it’s the main way to protect your feet from injury. Your feet – plus knees, hips and lower back – will thank you.