Whether walking or running, the right amount of support and cushioning goes a long way. Most high quality shoes utilize different densities of foam to support the foot through the gait cycle. Rigid but comfortable heel counters and torsional stability make these supportive recommendations the best for your athletic activity.

The athletic shoe industry in the last three decades has made great strides in the understanding of shoe construction as it relates to injury prevention. Nike’s introduction of “air” placed air pockets in strategic locations in the midsole of their athletic shoes was in an effort to increase the cushioning characteristics of their shoes. The goal of this increase cushioning was to decrease stress related injuries in athletes including stress fractures. “Nike air” revolutionized the modern day athletic shoe and its success spurred many other athletic shoe manufacturers to focus on cushioning systems in their shoes.

 Ethyl Vinyl Acetate (EVA) is a closed cell foam material that provides most of the cushioning in today’s running and athletic. This foam material has a limited life span and provides most of its protective cushioning over a short period of time. As a general rule walkers and runners are recommended to replace their shoes after 300-500 miles of use due to the EVA losing its cushioning properties.

 Shoe manufactures in developing an athletic shoe attempt to find balance between the cosmetic design elements that help the shoe sell and the research and development that focus on the features of the shoe that help with injury prevention. In shoe design the midsole section of the shoe is probably the most important aspect of the shoe that will aid in injury prevention.

 The two general types of injury patterns seen in the lower extremity are stress related and motion related:

 Stress related injuries include stress fractures involving the bony structure of the lower extremity. Stress fractures are clearly influenced by the cushioning systems that are placed into the shoes and are certainly related to training techniques as well as surfaces that are run on.

 Motion related injuries relate to the inherited motion of the foot called supination and pronation. Oversimplified, supination refers to the high arch foot and pronation refers to the low arch or flat foot. Both of these are motions that occur in the foot during normal walking and running. Pronation is the motion that allows the foot to adapt to different foot plant surfaces and tends in excess to put the foot at greater risk for injury including many forms of tendonitis, joint pain and heel pain most commonly termed plantar fascitis.

 The dilemma that shoe manufactures are faced with in the development of a shoe is that increased shoe cushioning facilitates an increase in motion of the foot. An excessively cushioned shoe may be good for preventing stress injuries but may not provide enough support to control the pronation of the foot. Finding the correct amount of cushioning and support is the ultimate goal in this process.

 The athletic shoe culturally has superseded any other shoe in its frequency of use. Much to the liking of the athletic shoe manufacturers athletic shoes are being used in mainstream day to day activities as well as sport. The typical person wearing these shoes daily doesn’t appreciate the limited life span that a shoe should be worn for. Most people feel that if a shoe looks in good condition cosmetically that it is still alright to wear. Clearly the midsole materials of these shoes will wear excessively before the shoe looks cosmetically worn.

 The athletic shoe industry has had such a profound impact on shoe manufacturing techniques that the non athletic shoe manufactures have adopted many of the similar manufacturing techniques as well as materials used. The push for cushioning in shoes clearly makes shoes a part of the wardrobe that must be replaced with increasing frequency. For example a dress casual style shoe with a leather outsole will last much longer than one that is fabricated from foam. There is a continued perception that dress casual shoes will last a long time without need for replacement.

 Increased incidence of foot pain may be related to many variables including an aging population. One is left to wonder however what influence excessive cushioning or excessive wear on the development of foot pain as it relates to abnormal foot pronation. If your foot pronates excessively and you wear a shoe with excessive cushioning your foot will leverage off this soft foam material and pronate even more thus increasing your risk for pronation related injury.

 The basic understanding that support and cushioning are two key components in shoe construction that can have an influence in the development as well as recovery from injury are important when selecting a shoe. Having your physician recommend a specialty retail shoe store that is comfortable with providing expertise in shoe selection and fit is critical when purchasing shoes. Although you may pay more for a shoe at a specialty retail shoe store the ability to make the correct purchase for you and your specific foot condition will expedite your recovery and the return to all of the activities that you are missing.