1. Andrew Bernhard
Kent State University College of Podiatric Medicine
St. Joseph Medical Center – Houston, TX
2. • Shoes have been
around since at least
7500 BCE
• Otzi the Iceman died
around 3300 BCE with
shoes on
• Romans wore sandals
similar to todays around
the beginning of the
common era.
• Modern shoes, with
sewn-on soles, have
been produced since
the 17th century
3. • This is the modern athletic shoe.
• It’s composed of three major parts, with
variable components for each.
4. • Male Shoes
• Oxfords or Balmorals
• Derbys or Bluchers
• Monk Shoe
• Slip-On Shoes
• Female Shoes
• High Heels
• Mules
• Slingbacks
• Ballet Flats
5. • Very common
footwear, especially
down here.
• They extend up the
leg and can be for
men or women.
• Types:
• Work boots
• Cowboy boots
• Hiking boots
• Snow boots
• Dress boots
6. • These do not really fit
into any major
category
• They are currently
very common in the
US, though
• Clogs
• Sandals
• Boat Shoes
• Slippers
7. • These shoes stand to
offer the best in
fit, comfort, and
control
• Can sometimes not be
worn due to
restrictions at work or
in social situations
• Can be easily
modified with orthotic
inserts
• Are designed to be
sport-specific
8. • Determined by an
individuals
needs, including level
of
activity, appearance, a
nd pathologies
present.
• Some need more
control while others
need more support.
• Most people will do
best in an athletic
shoe, from the
9. • Shoes should be fit on
two basic
considerations: arch
type and motion
available
• Arch types include
rectus, pes cavus, or
pes planus
• Motions are generally
described in regards to
the subtalar joint:
• Overpronators, Pronators,
and Underpronators
• There are three basic
shoe constructs for
these foot types:
10. • These shoes are best
for patients with pes
planus, those who
overpronate, and
those who are
overweight.
• The shoes are more
stable, rigid, and are
bulkier.
• They may offer a
medial post to provide
suppor along the arch.
11. • These are best for a
“normal” foot; a rectus
foot that pronates
normally.
• The shoe is moderately
rigid, especially at toe-
off, with adequate
cushioning.
• It is not designed to
control motion or
provide cushioning, but
simply walk the line.
12. • These shoes are
probably the least used;
a small percent of the
population has a cavus
foot.
• With a lack of
pronation, there is more
force on the plantar
lateral foot.
• These shoes tend to
have flexible outsoles
and extensive shock
13. • By checking wear patterns, we can accurately
and easily determine a patients gait pattern.
14. • Selecting the perfect
shoe may not be
important for everyone.
• Patients presenting to a
podiatry
clinic, however, will
have benefit from
proper shoegear.
• Diabetes, arthritis, plant
ar fasciitis, and fat pad
atrophy are just some
conditions that highlight
the need for specific
shoes.
15.
16. • Cheskin MP, Sherkin KJ, Bates BT. The Complete Handbook of Athletic
Footwear. Fairchild Publications. 1987.
• Dutra T. “Chapter 3: Athletic Foot Types and Deformities” Athletic
Footwear and Orthoses in Sports Medicine. Werd MB, Knight EL (eds.).
Springer Science and Business, 2010: 37-46.
• Frederick EC. “Physiological and ergonomics factors in running shoe
design” Applied Ergonomics. 1984. Vol 15 (4): 281-287.
• Gould N. “Shoes and Shoe Modification” Disorders of the Foot. Jahss
MH Ed. Saunders. 1982: 1745-1782.
• McPoil TG. “Athletic footwear: Design, performance and selection
issues” Journal of Science and Medicine in Sport. 2000. Vol 3 (3): 260-
267.
• Smith LS. “Athletic Footwear” Clinics in Podiatric Medicine and Surgery.
1986. Vol 3 (4): 637-647.
• Subotnick SI, King C, Vartivarian M, Klaisri C. “Chapter 1: Evolution of
Athletic Footwear” Athletic Footwear and Orthoses in Sports Medicine.
Werd MB, Knight EL (eds.). Springer Science and Business, 2010: 3-17.
• Yamashita MH. “Evaluation and Selection of Shoe Wear and Orthoses
for the Runner” Physical Medicine and Rehabilitation Clinics. 2005. Vol
16: 801-829.
Editor's Notes
Sandals have been found around the base of Oregon’s Mt. Mazama volcano, which preserved them for millenia. Most early shoes weren’t so well preserved. Leather shoes have been found from 5000 BC and on Otzi the Iceman, who died around 3300 BC. What are described as modern shoes, with soles sewn to the upper, have been around since the seventeenth century, while what I would consider modern shoes, those most of us wear today, have been around since the mid 20th century.
The major parts of a shoe include the upper, midsole, and outsole. Other parts are seen in just about every shoe type as well, including the tongue, insole, vamp, collar, and throat. Each part can have modifications or additions as well. These can include foxing, air or gel cells, padding, achilles notches, pull tabs, and lace keepers.Obviously, not all shoes look like this. While some may lack laces, toecaps, or tongues, they all have the three basic components.
In men, these are generally characterized by how the shoes are closed around the foot and ankle. The difference between dress and casual shoes is mostly stylistic.Oxfords, or Balmorals, have closed lacing, where the shoelace eyelets are stitched underneath the vamp. Derby shoes are the opposite. They have open lacing with the eyelets on the outside of the vamp. Monk shoes are generally those closed with a buckle, while slip-on shoes are those without laces or buckles, most often described as loafers.Additionally, these shoes can be plain-toed, cap-toed, or be wing-tips or Brogues. These are mostly, again, style choices. They can be found in any of the above styles. Female shoes tend to be easier to classify. High heeled shoes have high heels. They can be further broken down into thing like wedges, pumps, and stilletos. Mules are shoes without backs while slingbacks have a strap that goes behind the heel to secure the foot. Ballet flats lack a heel and have a short vamp, showing off the dorsal foot or instep.
These are the Asics Gel Kinetic 3s. They are a straight forward running shoe offering a stable heel counter and a straight last construction. They are stiff through the midfoot, with the addition of plastic on the outsole. The insole is removable, like most athletic shoes, which allows for orthotic management.These happen to be running shoes, so they are more supportive in the sagittal plane. Sports which have more side-to-side motion, like racquetball and tennis have specific shoes which provide more lateral stability.
Yamashita published an article in 2005 covering this topic fairly well. Most other references seem to be either anecdotal or fairly dated. One from 1984, by Lloyd Smith in Clinics of Podiatric Medicine and Surgery, offered in depth analysis of sport specific shoe gear, but it talked about new technology like cushioning. Both, though, are worth the read.
This shoe is the Mizuno Wave Renegade 4. Fitness magazine lists it as the best current motion control shoe. It has a wide tread pattern with a reinforced medial longitudinal arch.
This is the ASICs GT 2150. It is lightweight, offers midfoot stability, and gel cushioning in the heel. The forefoot is designed to be flexible at the ball of the foot to allow for propulsion.
The Asics Gel Cirrus 33 is an ideal cushioned type shoe. It uses asics’ impact guidance system to promote a natural stride, a guidance line on the outsole to separate the lateral and medial columns, and most importantly their most extensive application of gel cushioning, extending down the entire lateral column.
A fair amount.Since we have to be experts of the lower extremity, it is important to know how to evaluate how a shoe has been worn. It is also important to be able to tell a patient what type of shoe is best. Broadly, any good shoe should not be overly flexible in the midfoot, should have a rigid heel counter, and should resist torsional forces.
Shoes should be worn for plantar protection, traction, motion control, and attenuation of impact. It has been shown that those who grew up without shoes are less likely to need them, however this is not the case for most Americans. Specific pathologies, like diabetes, plantar fasciitis, and fat pad atrophy are more likely to absolutely necessitate the use of specifialized shoes.
