F- Foot Type
What Kind of Arch Do You Have?
Before you choose footwear to improve plantar fasciitis, you need to know what kind of foot you have. In particular, you want to know what kind of arch you have. To find out, you can do a very simple test at home called the wet foot test or the paper test. Open out a brown paper bag or lay down some newspaper on the floor; tape the paper to the floor. Remove your shoes and socks and lightly wet the bottoms of your feet. Walk across the paper. You’ll leave a wet footprint. If you compare the outline to the ones in the diagram, you can see if you have a high, medium, or low arch.
It’s possible that if you have a low arch and you do wind up with a foot problem such as plantar fasciitis, you’re going to be slow to heal. In theory, that’s because your low arch puts excess strain on the soft tissues in your plantar fascia.
Based upon what you now know about your arch, you can choose the right type of athletic shoe for your foot. To be more precise, you can avoid buying the wrong type of shoe. Running shoe technology has advanced quite a bit over the years, but runners still get injured by their shoes. The evidence shows that getting a shoe that’s wrong for your foot type can cause a lot of problems. There’s not a lot of evidence to show that getting a shoe that’s “right” for your foot type will prevent problems, though.
Let’s say you have a really high arch and spend more time on the outside of your foot when you run. If you get a shoe that’s meant to push you that way, then you might over-correct yourself and wind up with a new injury. If someone who’s a supinator—the foot rolls away from the midline of the body with each stride—gets into an anti-pronator shoe, that would be the opposite shoe for their foot type. Pronators roll their feet toward the midline. When a supinator wears an anti-pronation shoe, they’ll get pain on the outside of their ankle or their foot, because the shoe is exaggerating what their foot wants to do. We want a shoe to either counteract what your foot wants to do or compliment it; that removes some of the strain on the soft tissues.
If you have a low-arched foot, you typically have a lot of mobility in your feet and you can absorb shock very well. Your foot type is adaptable to changing direction. If you have a really high-arched foot, typically your foot is very rigid. It doesn’t absorb shock very well and you wind up with more shock- related injuries. If you’re a normal foot, then your foot doesn’t pronate a lot, it doesn’t supinate a lot. It just moves a little bit in each direction, which is fine.
Running magazines are full of articles about how pronation is bad for you. That’s not really the case. It’s the normal movement for most people who have normal to low-arched feet, because it helps to reduce load when you walk or run. In some cases, pronation puts more strain on your foot, but having a super low-arched foot doesn’t predict a problem. I have some patients whose feet are so flat their full arch touches the ground, but they run Iron Man triathlons and are pain-free. My thinking for people with pain free flat feet isn’t give them orthotics as a first line treatment, it’s get them into the right footwear. Watch our video that explains this in greater detail here (Lin k)
Getting the Right Fit
Now that you understand what foot type you have, you want to find a shoe that fits your individual biomechanics. You want the right shoe for the activity. You want the overall size to be right, you want the heel to toe fit to be right, and you want the right width. If the shoe doesn’t fit well in any one of those areas, it’s not right for you. You’re going to injure yourself or end up with a sore foot.
Here’s what to look for in a good fit:
• Heel to toe. The longest toe should be accommodated, with approximately 7 mm, or about a pinky finger’s width, between the longest toe and the end of the shoe.
• Heel to ball (arch length). This aspect of fit is often overlooked, but it’s extremely important. Make sure that the widest part of your foot lines up with the widest part of the shoe (the “flex point”).
• Heel fit. The heel counters (the hard part that holds the heel) of shoes are made in different widths and back curves. If your heel slips even though you have laced the shoe properly, try an alternate style.
• Width. This can be subjective to your overall comfort. Too narrow, and you toes will go numb. Too wide, and the foot will not be adequately secure.
• Socks. When fitting shoes, be sure to wear the socks you will be using with them. Dress, work, and athletic socks can all be different thicknesses and may result in a difference in fit.
When buying shoes, I recommend doing it toward the end of the day, when your feet are a bit swollen from the day’s activity. You’ll get a better fit that way.
The height of the heel—the offset between your heel and your forefoot—in activity shoes can range anywhere from a zero drop to 12 mm. Shoe manufacturers have now started offering lower heel heights so that you strike less on your heel and more on the middle of your foot. If you have plantar fasciitis, you may want to elevate your heel a bit to decrease the pull from your Achilles tendon and take some of the pressure off your heel. We typically recommend a heel height between 10 and 12 mm to keep your heel elevated a bit. Lower heel heights may be more appropriate if you have forefoot pain (like a morton’s neuroma or osteoarthritis of the big toe) . Here’s where things go crazy. You want to say, “But dude, I love my barefoot shoes.” That’s OK—keep wearing them. By now I think you get the point that we’re all different and what works for one won’t work for all. I’ve seen some cases where people have improved with the use of barefoot shoes. But I’ve seen more cases where people have gotten stress fractures from barefoot shoes. Overall, we don’t advocate for barefoot shoes if you have foot pain.
Getting the Right Category (Or avoid the wrong one!)
When you go to the shoe store, use your knowledge of your arch type to figure out what shoe category you fit into. You’ll probably fall into one of four categories: cushioning, stable neutral, stability, or motion control.
• Cushioning shoes offer ample cushioning and a little bit of support. This is appropriate for someone who has a normal foot type to a higher-arched foot and is a bit of a supinator. The shoe will give you a lot of cushioning but not a lot of support.
• Stable neutral shoes still have lots of cushioning, but provide a bit more support for the inside part of your foot. If you have a normal to low-arched foot, you might do well in a stable neutral shoe.
• Stability shoes have moderate amount of stability and a little bit of cushioning. Stability shoes usually have more support on the inside part of the shoe. The material itself is usually 10 to 15 percent stiffer on the inside part of the shoe. It’s meant to resist pronation.
• Motion Control control shoes have firm support on both the inside and the outside of the shoe. They’re typically completely filled in on the bottom. These are the stiffest shoes you can get, which also means they’re among the heaviest shoes you can get. These shoes can give you so much support that you overcorrect your foot, which can lead to a new and different injury. Most people don’t need motion control shoes. If you think you do, talk to a foot specialist or go to a specialty shoe store first.
A note on minimalist shoes. These became very popular when barefoot running became a craze. Now that the benefits of barefoot running have become more controversial, these shoes are less popular. They don’t have much cushioning. They have very thin midsoles, so you’re closer to the ground overall. Minimalist shoes are very, very flexible, so if you’re a super pronator, the shoe will allow you to continue to pronate. If you’re a real supinator, it’s going to allow you to continue to supinate. The shoe is really just meant to be a layer between your foot and the ground to provide some protection from the elements and the running surface.
If you’re shopping at a large athletics store with a big wall of shoes, the salespeople may be able to help you narrow down the choices, but it can be hit or miss. Some larger shoe stores train their staff on the features and benefits of shoes, not how to individually fit them and match foot type to footwear. We advocate for the smaller speciality store, where the salespeople have more expertise.
Want to test them yourself? To see if a shoe is cushioning or stability, do three tests.
1. Pick it up by the heel and toe and try to wring it out like a wet towel. If you’re able to
twist it so much that the top is now the bottom, it’s not a stability or motion control shoe;
it’s probably a cushioning shoe. Next,
2. Hold the shoe at the heel and forefoot and flex it back. If it only flexes at the toe but
doesn’t flex at the arch, it probably has more stability or motion control characteristics. If you flex it back and the shoe bends right at the arch, it’s a cushioning shoe.
3. Feel the mid sole, the cushy part of the shoe. If you feel a firm bar on the inside or the
outside by the heel, the shoe has stability or motion control characteristics. If it’s the same density the entire way around, and you don’t feel any firm plastic bars or posts, it’s a cushioning shoe.