Every day in clinic I make footwear recommendations to my patients and inevitably some of them will say to me, “Why are you recommending running shoes? Im not a runner.” I explain to them that no other shoes offer the features that running shoes do and they dont have to be a runner to benefit from them. Running shoes offer therapeutic benefits that other types of footwear just cant match. I dont care if a patient is 99 years old or weighs 400 pounds and has never run a step in their life. I can usually recommend at least a handful or running shoes that would suit their particular needs.
This is not to say that I dont appreciate the features that walking shoes or cross trainers offer. There are some excellent shoes in those categories and I do occasionally recommend them. But for people in my clinic who are there to be treated for some type of foot or lower extremity condition, I find running shoes often at the top of my list when recommending shoes. And I do not recommend them just for walking workouts, but for everyday activities as well. For example, if I am treating someone with plantar fasciitis, I want them to wear their most supportive and comfortable shoes as much as they possibly can not just during a workout.
Cross trainers, to me, are the classic jack of all trades, but master of none. I rarely recommend them unless a patient needs one shoe for a variety of activities such as racquetball, weightlifting and cardio cycling. Walking shoes often cost more, have a less durable outsole, a less breathable leather upper and weigh more than comparable running shoes. Many walking shoes lack a carbon rubber outsole, which also makes them less resistant to wear than running shoes. Having said that, I know that plenty of my patients are perfectly content and comfortable in these types of shoes and I would not switch them out of something that is working well for them. But I dont think that is it a coincidence that companies like Brooks, Asics and New Balance offer walking shoe versions of some of their popular running shoe models.
No other shoes are made to withstand comparable impact forces. Running shoes are made to withstand impact forces approaching 3 times bodyweight and can last up to 500 miles. This durability offers significant benefits for walkers and those who are experiencing foot pain when walking. For example, for a patient who has a painful condition of the forefoot called metatarsalgia, I might recommend a running shoe with lots of forefoot cushioning such as the adidas Supernova or the Nike Pegasus. Or, if I am treating an overweight patient who needs a shoe that can hold up to their weight, I might recommend the Brooks Beast or Mizuno Renegade.
No other footwear option offers so much support and cushioning in such a lightweight package. Running shoes are much lighter than cross trainers or basketball shoes or most walking shoes. The lightweight feature is important for some of my older patients who may have weakness in their legs or poor balance. Motion control shoes are the heaviest of running shoes, so I can recommend almost any other running shoe from the stability or cushioning category for patients who need a shoe that is relatively lightweight.
Breathability is another important advantage of running shoes. The mesh uppers allow for better air movement and moisture management than leather or synthetic uppers. This is important not only for comfort but also for those who are prone to athletes foot or other skin conditions. When a patient is recovering from an injury I often recommend that they wear their most comfortable shoes as much as possible even around the house. Wearing a leather shoe all day, everyday can contribute to sweaty feet and foot odor. The only running shoes that are less breatheable than leather are those with waterproof or water resistant uppers.
No other types of footwear combine cushioning with stability as well as some running shoes do. As I have written previously in this column, I do not often recommend more cushioning for running injuries but I do recommend cushioning for some foot injuries if related to walking. The destabilizing effects of cushioning are less significant when walking than when running, so I am less concerned about the consequences of excessive cushioning. As a very general rule though, I go one step down in stability when recommending a running shoe to a walker. For example, I might place a flatfooted walker in a stability running shoe instead of the motion control category or a moderate overpronator might do just fine in a cushioned running shoe for walking, when I would normally steer them toward a stability shoe if they were a runner. I have found through experience, that for walking, motion control devices and straighter lasts may not be as necessary as they would be for running, which makes sense when you consider that a walker lands with 1-1.5 times their bodyweight and a runner with 3 times body weight. The impact forces are considerably smaller.
The sheer volume of running shoe models makes it easy to recommend them for someone who is seeking comfort. There is a huge variety of running shoe variety in terms of fit, stability and cushioning options. Running shoes come in so many shapes and sizes that practically anyone who takes the time and has the right recommendations can find the right shoe for them. For example, if I have an overweight, middle-aged female patient with wide feet and arthritis in her ankle, who tells me she can never find shoes that fit comfortably, I might recommend something like the Brooks Dyad or the New Balance 882.
Many forefoot conditions such as bunions, hammertoes or rheumatoid arthritis, conditions common in the aging population, require shoes that allow adequate room for alignment changes of the toes as well as for swelling. Running shoe brands such as Saucony and New Balance offer running shoes that have a round, roomy toebox, wide forefoot with a snug midfoot and heel, which is perfect for these patients. In addition, more manufacturers are offering width sizing in their most popular models.
What was once revolutionary is now taken for granted in running shoes and that is the removable insole. Running shoes were the first type of footwear that did not glue in the insole and now many types of shoes offer this convenient comfort feature even many dress shoes. The beauty of a removable insole is that it can easily be replaced by a more supportive insole or custom orthotic. I tell all of my patients with foot pain that as a general rule of thumb when buying shoes of any kind, they should look for shoes that have removable insoles so that the shoe can be modified later on if necessary.
A few words of caution: I always warn my patients that running shoes are not appropriate for basketball, or racket sports because they lack stability in side-to-side movements. The elevated midsole makes it more likely that the ankle will roll off the shoe and cause an ankle sprain during quick direction changes or jumping. But for straight line motion and walking there isnt another type of athletic shoe that offers such a combination of features.
