Dr. Gangemi,

I run about 15 miles a week or so...longest runs are 6 miles...mostly on a treadmill.
 
I went to a running specific store and got "suited up" with some Brooks with serious "support" for my "high arches". They were great for a few weeks but now I have a list of pains...I feel like there is too much support in the inside back that's causing me to roll outward over the front...leading to bleeding toes!!! Then the top of my foot started aching when I put my shoes on...and then the bottom muscles in my feet.  And there were also some crunchy knee sounds.  Ouchhh!!!! 

 
I don’t wear high heels often, am barefoot when I can be, and just want to find good running shoes that aren't going to over support anything to cause pain elsewhere...
 
Recommendations????

-April

Hi April,

This is a common issue many people experience when going into a running store these days. Most people are told that they overpronate and need more support in their shoe. This is sometimes true due to muscle imbalances in the foot, lower leg (calf muscles), and even the thigh and low back/hip muscles, but ‘supporting’ the foot more with a running shoe is a bad idea. It limits normal joint mechanics of the foot and disrupts a person’s gait – the way you walk, jog, and run. Ultimately a shoe with too much support will either support your problem, make it worse, or cause some other problem, such as knee pain or lower back pain. This is very similar to the problem orthotics cause, as I discuss here. Sounds like you’re already getting knee problems caused by the shoes.

All footwear, running & exercise shoes included, should serve one major purpose – foot protection. You don’t want to wear a shoe that provides too much support, stability, motion control, or any other fancy product-name that’s out there these days used to make the consumer think they will perform any better by wearing certain shoes. The shoes should be very flexible, and keep your foot close to the ground. The further away from the ground (higher than 1”) your foot is, the more you will pronate in…this will cause the “overpronation” so many are told they have…and they will get the recommendation to use a shoe that prevents this, by wearing a shoe that stabilizes the inside of the foot. Essentially the shoe is made to create a problem (too thick = overpronation), and correct it at the same time.Remember, [normal] pronation is the way your body absorbs shock so it is not transferred elsewhere, such as up to your knees or hips.

High arches, as you say you have, are often caused by some muscle imbalances in the foot – typically the calf muscles or the muscle directly behind the tibia (shin bone), the posterior tibialis. An imbalance of this muscle will also cause pain on the top of the foot causing a person to “feel as though their laces are tied too tight”. The laces aren’t the problem – the foot is. Though the type of shoe worn could be causing or provoking the problem.

Most of the muscles supporting the lower leg and foot are related to the adrenal glands. I discuss the adrenals much throughout this website. (You can use the search bar in the upper right corner to find more info.) The posterior tibialis muscle is directly related to the adrenal glands and supports the main arch of the foot. So too much stress, whether it be dietary/nutritional, emotional, or physical factors, will alter adrenal gland function and create a problem in the posterior tibialis muscle and next thing you know you’ve got arch problems, shin splints, plantar fasciitis, or too much pronation  – and you’re given a shoe to try to support that. Rather, you need to address the stress issue(s) and strengthen your feet – and you strengthen your feet typically by doing the exact opposite of what most podiatrists or running shoe “experts” have told you - you go barefoot as much as possible and wear shoes that offer little support, so you can begin using all the muscles of your foot, ankle, and lower leg to create strong, healthy feet.

The photos below are a pair of my Nike Free 5.0 running shoes. I believe Nike came out with the shoes back around 2004 as they realized that wearing such a shoe helps create strong, powerful feet. Of course they don’t want you to stop wearing all their other over-supportive shoes, so they recommend only using them periodically for very low mileage (a few miles at most). I like to run long distances in them, up to marathon distances during an Ironman triathlon race and pretty much do all my training in them, unless I'm on trails because there isn't much traction. This scares the hell out of the running store shoe employees as most think I am going to destroy my ligaments & tendons while few others think I’m lucky to have strong feet. The latter is the case as I have built up my feet over the years to become strong and healthy, directly via the muscles and indirectly via the organs that support such muscles.

If your feet hurt or ache at the end of the day or after running, it may be from improper shoes, but it most likely is from weak feet – or both. Here are some things to look for next time you go shoe shopping:

1)      Look for a shoe that keeps your foot close to the ground – pay close attention to the heel and try to keep it under one inch.

2)      Make sure the shoe is flexible. Notice in the photo of my Nike Frees I can fold them in half. This is not because they are old or worn. The flexibility allows my foot to go thru its normal motions. So make sure you can bend it - especially in the middle as I am doing.

3)      Stay away from any shoe that supports your foot too much – that includes arch supports and the famous ‘overpronation’ supports.

4)      Measure your foot. Most people wear shoes that are too small. Some of you reading this who are patients of mine now know that often people wear shoes that are one-half to two sizes too small! It’s amazing how you can get used to a shoe feeling ‘snug’ though it is way too small for your foot and you’re causing a lot of toe and foot damage. Take your insole out and step on it. Does your foot hang over the end? Your insole should be larger than your foot, not vice-versa.

5)      Once you find some shoes you like, buy a few pair. This is especially true for running shoes as fads come and go. By next season your shoe could easily be discontinued and you’re back in the hunt again.

-Dr. Gangemi