Dr Rajiv Desai

An Educational Blog

FOOTWEAR

FOOTWEAR:

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Section-1

Prologue:   

Shoes are a product of everyday use that everyone in the world owns; there are more than 20 billion pairs of shoes manufactured each year. Shoes have come a long way in the thousands of years since primitive man first donned bark and animal skins. Originally used to protect feet from harsh temperatures and rough land, shoes have evolved into an article of high fashion and style, a sartorial reflection of class, rank, and wealth. Most people think that wheel invention was the greatest event of the ancient time, but shoemaking takes a very high position on that list too. As they say, “you are what you wear.” And there’s a lot that shoes can tell us about a person. Shoes make the man, they say. Throughout human history, we’ve improved, embellished and refined footwear. We’ve created shoes that impress and inspire, and shoes that protect and enhance performance. We obsess, we collect and we keep changing it up. Shoes have served as status symbols in the courts of Europe and on the streets of New York. They’ve defined fashion and fitness movements, made statements on film and TV, and provided a functional form of self-expression for cultures across the globe. Although the human foot has remained unchanged for thousands of years, what people have worn on their feet shows incredible diversity. It is in this diversity that some of the most interesting aspects of culture are revealed. It is true that shoes have moved on from being just a means to protect feet; today they imitate style, individuality, social class, and gender recognition. Whether dancing, running, skiing, jumping, or presenting a cultivated self-image, our footwear is an indispensable part of our lives. Chic and attractive shoes express your taste and artistic sense, while untidy and mismatched shoes show your lack of a fashion sense. 

Shoe height has historically reflected nobility, authority, and wealth. France’s King Louis XIV (1638-1715) was only 5 ft 3 in (1.6 m) tall until he donned specially-made high-heeled shoes with curved heels constructed of cork and covered with red-dyed leather, with the red color symbolizing nobility. On special occasions, his 5 in (12.7 cm) high heels were ornamented with hand-painted scenes of his military victories. Today, curved heels preserve his legacy and are known as Louis or French heels. Other heel-wearers used their footwear to boast of their wealth; the heels were so high that servants had to break them in, so to wear high heels also proved one could afford servants for this task. Today, heels are blessed for the elegance they lend to the wearer’s appearance and cursed for the damage they inflict on ankles, calves, and backs. 

The human foot is quite complex and consists of 26 bones, 33 joints, 19 muscles, tendons, ligaments, and a network of blood vessels, nerves, skin and other soft tissue. It is quite a complex – and flexible – structure providing the body with support, balance, and mobility. Considering the complexity of the human foot, it is rather amazing that anyone can walk into a shoe store and find shoes that fit (reasonably) well. Generally, there are 5 characteristics of a standard retail footwear: a moderate to low heel (<2 inches); a cushioned midsole; breathable, comfortable uppers; adjustable fastening (laces, straps, etc.); and a stable heel. There are, obviously, a great many variations on these characteristics and there are many styles that are missing some (or all!) of these characteristics! These 5 characteristics are what are recommended for the most comfortable (and least damaging) day-to-day footwear.

The average adult will walk almost 75,000 miles over their lifetime – the equivalent of travelling around the world three times. This equates to around 6800 steps each day on average. This just emphasizes the need of wearing the appropriate, comfortable, right footwear. We often end up buying shoes because they look nice, are stylish, and not because they are comfortable. While most of the population is tempted to just put their feet in a pair of shoes they find aesthetically pleasing, great-looking footwear is often not the best choice for either proper foot function or overall health. In fact, happy and healthy feet are the very foundation of overall wellbeing. More importantly, the consequences of wearing poorly fitting shoes can be painful and debilitating, leading to a variety of foot disorders like blisters, callouses, bunions, hammer toes, circulation problems. It can also lead to changes in the skeletal system and the muscular structure that it supports and even change a person’s posture and the way they walk. Over a lifetime, our feet will walk the equivalent of three times around the world, so it is important that we invest time in choosing the right shoes. Choosing the right shoe can prevent or alleviate foot pain; the wrong shoe can exacerbate or cause foot problems. For maximum performance and comfort, the functional elements of today’s highly specialized shoes must be correctly matched with a person’s foot type, body type, and activity level. The various designs, materials, and technologies used affect the function and fit of a given shoe. Footwear plays an essential function in protecting the foot from mechanical trauma, but has a much broader impact on daily life due to the influence of fashion, occupational requirements, performance enhancement and its role in the prevention and treatment of musculoskeletal neurological disorders. 

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The true importance of shoes can be determined from the quotes that we’ve been hearing for long, such as:

“A Woman with good shoes is never ugly”

-Coco Chanel

“Give a girl the right shoes, and she can conquer the world”

-Marilyn Monroe

“You can always tell a man by the pair of shoes he wear”

-Jeanine Teega

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Abbreviations and synonyms:

PU = polyurethane

TPR = thermoplastic rubber

MBT = Massai Barefoot Technology

TPU = thermal plastic unit

EVA = ethylene vinyl acetate

PVC = polyvinylchloride

ROM = Range of motion

GRF = ground reaction force

COP = center of pressure

COM = center of mass

BOS = base of support

IT = iliotibial

HA = high-arched

LA = low-arched but LA also means longitudinal arch so check context.

MC = motion control

CT = cushioning training 

RFS = rear-foot strike, with the heel landing first

MFS = mid-foot strike with the heel and ball of the foot landing simultaneously

FFS = forefoot strike

AFT = advanced footwear technology 

OS = orthopedic shoes 

RRI = running-related injury

IP = impact peak

LR = loading rate

MTPJ = metatarsophalangeal  

3D = Three-dimensional.

Shod = wearing shoes

Unshod = barefoot = not wearing shoes

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Shoe Jargon:  

Cushion:

These shoes use soft material in the midsole and are intended for people with high arches that do not collapse. Cushioning is a term used to describe a specific type of athletic shoe. These shoes have a cushioned base, with light support under the arch. They are intended for people with higher arches and little to no pronation (under-pronators)

Stability:

Stability shoes are best for runners with normal arches and only mild control problems. The extra stability these shoes offer comes from extra arch-side supports and high-density foam. Stability shoes are typically built with a gentle arch from front to back that provides rear-foot stability and forefoot flexibility.

Motion Control:

The midsoles of these shoes are made with denser material along the medial side of the shoe (under the arch) to help support the foot. Intended for flat feet or moderate to heavy pronators, depending on the size of the individual (height and weight) and intended activity. The extra rigidity in these shoes prevents the heel from turning out and the foot from overpronating.

Rocker Sole:

As its name suggests, the basic function of a rocker sole is to literally rock the foot from heel strike to toe off without bending the shoe. The actual shape of a rocker sole varies according to the desired effect or purpose of the rocker sole and the patient’s specific foot problems.

Metatarsal Support:

Many people require additional support in the forefoot, at the metatarsal arch, to alleviate pressure. Some shoes and many over-the-counter arch supports can provide this additional support.

Heel drop:

Heel to toe drop is the difference in height between heel and forefoot in an athletic shoe. It’s measured in millimeters, going from 0 to 14mm in running shoes. It’s also called heel lift, shoe drop, shoe offset, heel differential, toe drop, pitch, gradient.  A zero- to 4mm-drop platform renders a more natural foot position. But most runners find a higher drop more comfortable, and some feel tightness in their tendons or muscles when changing from a higher to a lower heel drop. 

Extra Depth:

These shoes are more generous with space inside the shoe; they are deeper and provide additional room for orthotics or arch supports, as well as for bunions and other fitting challenges.

Energy return:

The amount of bounce or spring inside the shoe after your foot lands on the ground. A higher percentage gives you a bouncier feeling; however, other factors affect a shoe’s responsiveness, dependent on the individual, including the runner’s weight, gait, and form.

Running economy:

Running economy is defined as the energetic cost of running at a specific velocity. Runners with better running economies may be more likely to maintain faster running speeds for longer periods than compared to those with inferior running economies. 

Last:

The last is a manufacturer’s model that mimics foot shapes. Most shoes are constructed on a last; the shape of the last determines the shape of the shoe and the type of foot or function best suited to that shoe. There are three kinds: curved, semi-curved, and straight. Curved are intended for people with high arches that do not collapse. Straight are intended for flat feet or moderate to heavy pronators. The majority of shoes are semi-curved for normal arch. The term last also applies to the methodology of shoe construction.     

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Inversion/eversion and supination/pronation terminology:

In short, inversion/eversion are frontal plane motions of the ankle, whereas pronation/supination are triplanar motions of the foot/ankle complex.  Inversion/eversion are components of supination/pronation. Inversion (i.e. – inversion ankle sprains) is often used interchangeably with supination, as is eversion with pronation, but they aren’t exactly the same. 

Inversion occurs at the hindfoot (heel) as the calcaneus/heel moves in the direction such that the bottom of your foot faces inward. When this happens in excess, an inversion sprain and/or an injury somewhere up the chain is likely to occur.

Eversion also occurs at the hindfoot, but instead of the heel facing inwards, it faces outward.  And like with inversion, an injury may occur with excessive movement and/or stress in this direction.

The thing is, these motions rarely, if ever, occur in isolation so the terms pronation/supination may be more applicable when discuss closed kinetic chain movement(s) at the foot/ankle.

Supination is made up of inversion of the hindfoot, adduction of the forefoot, and plantarflexion of the talocrural (ankle) regions.

Pronation is made up of eversion of the hindfoot, abduction of the forefoot, and dorsiflexion of the talocrural (ankle) regions.

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Section-2

Introduction to footwear: 

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All footwear, due to its characteristic position between the human foot and the environment, acts as an Artificial Interface. In this sense, footwear is not limited to shoes but also refers to orthotics, insoles, socks, and others like bandages or tapings as seen in the figure below:

Figure above shows footwear as an artificial interface between the foot and the environment.

As an artificial interface footwear influences actual locomotion and movements of its wearers, as well as respective perception during daily life and sports activity. Thereby, the foot with its anatomical and physiological structures and the footwear with its construction characteristics exhibit a mutual interplay and form a common system, which determines the functional benefit of a shoe for its wearer during its interaction with the environment. 

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Footwear isn’t a polite or more formal word for shoes. Footwear is a term that covers all things worn on feet. Clogs, flip-flops, sandals, trainers or sneakers, shoes, boots, etc. Shoes only covers shoes. Full cover footwear that isn’t above the top of the foot. Pumps, loafers, brogues, plimsolls, decks shoes. The difference is like clothes or pants. All pants are clothes, like all shoes are footwear. Not all clothes are pants, like not all footwear are shoes. Footwear is a term that covers all things worn on feet. Shoes implies footwear that encapsules/covers all parts of the feet till the ankle at least. Shoes again come in various forms, with ankles – called as boots, sports shoes etc. A footwear shop will have all kinds – from shoes to flip-flops. However, a shoe shop will have only shoes. Clothing doesn’t include shoes because they are considered as accessories. Fashion accessories can be loosely categorized into two general areas: those that are carried and those that are worn. Traditional carried accessories include purses and handbags, eyewear, hand fans, parasols and umbrellas, wallets, canes, and ceremonial swords. Accessories that are worn may include jackets, boots and shoes, cravats, ties, hats, bonnets, belts and suspenders, gloves, muffs, jewelry, watches, sashes, shawls, scarves, socks, and stockings.

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Footwear refers to garments worn on the feet, which typically serves the purpose of protection against adversities of the environment such as ground textures and temperature. Footwear in the manner of shoes therefore primarily serves the purpose to ease locomotion and prevent injuries. Footwear can also be used for fashion and adornment as well as to indicate the status or rank of the person within a social structure. Socks and other hosiery are typically worn additionally between the feet and other footwear for further comfort and relief. Cultures have different customs regarding footwear. These include not using any in some situations, usually bearing a symbolic meaning. This can however also be imposed on specific individuals to place them at a practical disadvantage against shod people, if they are excluded from having footwear available or are prohibited from using any. This usually takes place in situations of captivity, such as imprisonment or slavery, where the groups are among other things distinctly divided by whether or whether not footwear is being worn. In these cases the use of footwear categorically indicates the exercise of power as against being devoid of footwear, evidently indicating inferiority.

In some cultures, people remove their shoes before entering a home. In many Asian countries outdoor shoes are exchanged for indoor shoes or slippers. Bare feet are also seen as a sign of humility and respect, and adherents of many religions worship or mourn while barefoot. Some religious communities explicitly require people to remove shoes before they enter holy buildings, such as temples. In several cultures people remove their shoes as a sign of respect towards someone of higher standing. In a similar context deliberately forcing other people to go barefoot while being shod oneself has been used to clearly showcase and convey one’s superiority within a setting of power disparity.

Practitioners of the craft of shoemaking are called shoemakers, cobblers, or cordwainers.

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Footwear can be classified based on distinctive combinations of features into types such as sandals and boots. Outdoor footwear requires features that protect the foot from the external environment, but has further requirements to promote lower limb health and mobility. Such requirements include: adequate width, depth and length to accommodate the foot; a soft, flexible and protective upper; low heel height; stable heel counter and limited available torsion for overall shoe stability; adequate outsole grip to prevent slipping; and being fit for purpose. Footwear also has individualized psychosocial requirements, as choice of footwear type is also influenced by sociocultural, psychological and other health factors.

Footwear is worn to the office or workplace for a long duration. It is usually worn between 4 to 14 hours. Always remember to take off your shoes if working from desk for a long time so that you allow the feet to breathe and the muscles to relax. As in terms of keeping the feet healthy and free from injuries, footwear are recommended for a particular work or activity. But even with the proper footwear a human is bound to get injuries. Shoes are easy to clean and maintain as all it takes to clean them is a wet piece of cloth.

For some populations complying with recommended footwear features can be challenging, such as older people and those with arthritis. For example, foot deformity may change the shape of the foot causing difficulty in fitting standard prefabricated footwear. Such constraints in footwear choices have also been shown to affect individuality, well-being and quality of life.

Footwear can impact lower limb health and general mobility both positively and negatively across the lifespan. Different footwear features have an effect on the biomechanics of standing and gait and hence can influence musculoskeletal function and dysfunction. As a result, footwear is of relevance to a diverse range of population groups. Certain footwear can contribute to the development of pain, complications of diabetes including ulceration, and imbalance that increases the risk of falls. Accordingly, footwear displaying certain features are often recommended in the prevention and management of these conditions in specific populations.

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Discover the A, B, C of what makes footwear GREAT!

Aesthetically Appealing

Biomechanically Engineered

Comfortable Beyond Words

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Shoes are an accessory worn by people on their feet for warmth and comfort. They are used by people of all ages and both sexes. In fact, an individual wears them all his life right from the time he learns to walk on earth. A shoe is an item of footwear intended to protect and comfort the human foot. Shoes are also used as an item of decoration and fashion. The design of shoes has varied enormously through time and from culture to culture, with appearance originally being tied to function. Though the human foot is adapted to varied terrain and climate conditions, it is still vulnerable to environmental hazards such as sharp rocks and temperature extremes, which shoes protect against. Some shoes are worn as safety equipment, such as steel-soled boots which are required on construction sites.

Additionally, fashion has often dictated many design elements, such as whether shoes have very high heels or flat ones. Contemporary footwear varies widely in style, complexity and cost. Basic sandals may consist of only a thin sole and simple strap and be sold for a low cost. High fashion shoes made by famous designers may be made of expensive materials, use complex construction and sell for hundreds or even thousands of dollars a pair. Some shoes are designed for specific purposes, such as boots designed specifically for mountaineering or skiing, while others have more generalized usage such as sneakers which have transformed from a special purpose sport shoe into a general use shoe.

Traditionally, shoes have been made from leather, wood or canvas, but are increasingly made from rubber, plastics, and other petrochemical-derived materials. The shoe industry is $200 billion dollar a year industry. 80% of shoes end up in landfills, because the materials are hard to separate, recycle or otherwise reuse. The first shoe soles were made from natural materials, such as leather and bark. In the modern era, there’s a much wider variety of materials available for shoe-making. Shoe and boot soles are most commonly made with rubber, polyurethane (PU), leather, thermoplastic rubber (TPR), plastic or fabric. Some soles are even made with straw or rope. Modern technology and the material used are highly researched today in the footwear industry. A gait analyzer is used to study the walking pattern and other deformities and accordingly the footwear is researched with different materials like leather, canvas, etc. for a particular activity or sport. The footwear industry today is a multibillion-dollar industry which has given rise to stiff competition and research.

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Footwear affects sensory information to the foot and control postural stability through the touch and proprioceptive system. The tactile stimulation is detected by the cutaneous mechanoreceptors of the plantar surface of the feet and gives information of plantar pressure distribution to the central nervous system. Kennedy et al.  reported the presence of 104 cutaneous mechanoreceptors located in the foot sole. Furthermore receptor distribution was primarily where the foot is in contact with the ground, and when the foot was unloaded no background activity was found. Cushioning, arch supports, restrictive toe boxes and raised heels are all features of modern conventional footwear. Highly structured and supportive shoes may limit the sensory input to the brain and affect the control of gait, as the foot is not as susceptible to changes in shape, pressure and touch as walking barefoot. The type of Footwear and their modifications, including foot orthoses, shoe inserts, and insoles can stimulate tactile as well as proprioceptive systems, and stimulation of the cutaneous mechanoreceptors can enhance postural stability. The maintenance of static and dynamic balance is a vital to reduce risk of injuries in any sports. Type of footwear may influence the sensory feedback quality from the feet. Footwear are often designed to give support and stability to the foot, therefore, potentially affecting balance and function of the foot. Studies found postural instability in the elderly population who has poor footwear type and poor footwear characteristics. In addition, Keegan et al. reported an increased risk of a foot fracture from a fall in individuals using slip-on shoes and sandals. Furthermore, Murphy et al. had suggested that the shoes were an important element in the development of human posture.

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Consider different factors for different shoes:

Athletic shoes: There are four types of running shoes: motion control, stability, neutral/cushioning, and minimalist. The correct shoe for you is based on arch type and biomechanics. One way to test the shoe is to walk and jog in it. You can also balance on one leg and do a one-legged squat. The shoe should feel comfortable right away and these tests should feel easier in the right shoe.

For court sports, a sport-specific shoe is better than a running shoe because it will provide more side-to-side support. For cleats, it can be helpful to pick a shoe that allows you to add an arch support.

Minimalist shoes are used for forefoot running to simulate “barefoot” running. To avoid injury, it’s best to slowly add time and to get guidance for proper form. 

Sandals: Flip flops are good for short distance walking only. Choose sandals with straps that cover more of the foot and/or wrap around the ankle.

Boots may fit loosely and not provide adequate foot support. Adding arch support can improve comfort.

Women’s dress shoes are often detrimental to feet, knees, and spines. Heels alter whole body posture and can cause pain. If you wear heels, pick a lower heel shoe, a wider heel or wedge, and a heel that does not curve in.

Wearing high heels have been shown to have the following effects (among others): changing the posture & putting weight on the toes; increasing the pelvic tilt; changing the gait; increased activity of lower spine muscles & lower back pain; muscle fatigue and pain; corns & bunions; deformation of the toes; and increased risk of ankle sprains. Benefits? Supposedly the calves look slimmer and the feet look smaller.

Take time to tie and untie your shoes:

Your shoe will work best when it fits snugly and acts as an extension of your foot, without sliding around. Pulling off your shoe without untying it will cause the support in the shoe to break down much faster.

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Difference between a shoe and a boot: 

The debate over whether a type of footwear is a shoe or a boot isn’t a new one. The root of the word shoe comes from the word for a metal plate that was put on a horse’s hoof. The root word for boot referred to a covering for the foot and lower leg. A distinction between the two words emerged as early as the 1400s, according to Etymology Online. The basic definition of a shoe is that it is not tall enough to cover the wearer’s ankle. A footwear design that covers the ankle is a boot. However, even within these parameters, there are some distinctions. High-top sneakers, for example, cover the ankle but are still considered to be shoes. Hiking shoes in the same style as high-top sneakers, however, might be called hiking boots. In some modern designs, the two words are used interchangeably.

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Highest quality shoes:

The cost of a shoe doesn’t necessarily reflect the quality of the shoe. Neither does the brand name. Even the highly expensive, well-known brand names can be poor-quality footwear. Remember that shoemaking is such an art form, it was once all done completely by hand.  Pay attention to the quality of the materials used to make the shoe and the way the shoe is made. Look carefully at the specifications of the shoe and how it’s put together inside and out. Look for stitching around the sole, which can indicate how well the shoe is put together. Look at the sole and the uppers of the shoe. What are they made from?  Look also at the features of the shoe. Are they waterproof? Insulated? Do they have arch support and insole padding? Look at all the little details and you’ll know whether you’re looking at something high quality and well-made or something much poorer in quality.

Most expensive shoes:

There are a great many expensive shoes in the world because some designers are so highly in-demand. The most expensive shoes ever bought, however, are all very specific shoes that have some special history. Among the most expensive shoes in the world are the actual ruby slippers from “The Wizard of Oz,” the Air Jordans that Michael Jordan himself wore while sick with the flu when he played an amazing game, some diamond-encrusted high heels made by famous designers for fun and fortune and a pair of stiletto high heels made with gold and diamonds that cost $17 million. The most expensive shoes that people can actually own, however, aren’t quite as famous as Dorothy’s ruby slippers but they still have a lot to offer. The most expensive pair of shoes that have been produced more than once are probably the Testoni shoes. They retail for about $40,000, according to Money Inc. They’re made from alligator leather and have a gold and diamond buckle. These shoes are a lace-up oxford style and they definitely do look like money. The most expensive casual shoes in the world that were produced multiple times are probably the Nike Air Mag Back to the Future 2016 shoes. Yes, they are a replica of the shoes shown in “Back to the Future 2.” Nike made only 89 pairs and raffled them off for $10 a ticket in 2016. Their estimated worth now is $26,000 a pair.  If you want something a little more affordable but still ridiculously expensive, turn your gaze to Aubery Diamond shoes. These gorgeous loafers are made for luxury and they’re available in multiple leather colors for a cool $4,500 per pair. 

Most popular shoe:

Moccasins have been worn the longest. Boots may have the most practical uses. High heels completely changed fashion for everyone. But when you get right down to it, one type of footwear is more epic, more iconic, more worn and certainly more purchased than any other: sneakers. The humble sneaker is probably history’s most popular type of footwear to date. People from all walks of life own a pair of sneakers, from the world’s greatest billionaires to the starving artists who have given up money to focus on nature. They are worn by men, women and children of all ages and they are worn for every imaginable activity, from Olympic-worthy athletic training to casual grocery shopping. Sneakers are the most ubiquitous footwear out there, though other types of footwear have been worn for many, many more years. The Nike Air Max 270 is quite simply the most popular men’s sneaker of 2021. 

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With the introduction of cushioned running shoes in the 1970’s, running experienced a “Running Boom”. Recreational running has steadily gained in worldwide popularity ever since and is the primary exercise modality for many individuals of all ages (State of the Sport, 2014). According to Running USA 54 million people ran at least once during 2013. Of those approximately 30 million ran at least 50 days during 2013. Additionally nearly 19 million people completed organized road races in 2014 (State of the Sport, 2016).

With more American’s participating in competitive and recreational running, the incidence of injuries has increased with nearly 80 percent of runners experiencing at least one lower extremity injury (Van Gent, et. al., 2007). It has been proposed that a change in footwear may have an impact in the reduction of injury. Two possible solutions in footwear alterations include decreasing the cushioning in the shoe to better mimic barefoot running or increasing the cushioning to help absorb impact forces on the runner.

Barefoot and minimalist footwear have been researched showing alterations in the gait cycle and impact forces (Bonacci, et.al. 2013, Shih, Lin and Shiang, 2013, Willy and Davis, 2014). These results may indicate that these “natural” running styles may assist with reducing injury; however, these results often show conflicting kinematic changes depending on the experience of the runners. For example, it is, has also been shown that minimalist shoes may increase the knee flexion with runners lacking experience in minimalist shoes (Shih, et. al., 2013, Willy and Davis, 2014) however, another study shows that footwear does not affect knee angles. In addition, data is lacking on the joint kinematics in highly cushioned shoes. Thus, more research is needed to understand the effects of these footwear designs. 

Newer trends in footwear design have been towards increasing the cushioning in running shoes. The limited research on highly cushioned footwear have shown a possible increase in the vertical average loading rate compared to traditional shoes with no other differences in variables related to ground reaction force (Ruder, Atimetin, Futrell, and Davis, 2015).

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Over the past 50 years, running shoes have experienced tremendous changes. That is, from very minimal to highly supportive and cushioned shoes, and then to very minimal and finally back to highly cushioned shoes (Krabak et al., 2017). Shoes with various functionality were released because of technological advancements (e.g., structural and material engineering) used in running shoe development, such as cushioned, stability and minimalist running shoes. Although cushioned midsoles can theoretically reduce the impact forces, the reported injury rate and performance of running have not remarkably improved over the years (Nigg, 2001). Therefore, reducing injuries and improving performances by using running shoes have become a focus in both sport industries and academia.

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Running shoes are designated to improve shoe comfort, enhance running-related performance and reduce the injury potentially. To identify the appropriate functionality of running shoes, research has examined different shoe constructions, which included shoelaces (Hong et al., 2011), midsole (TenBroek et al., 2014), heel flare (Stacoff et al., 2001), heel-toe drop (Malisoux et al., 2017), minimalist shoes (Fuller et al., 2015), Massai Barefoot Technology (MBT) ((Boyer and Andriacchi, 2009), heel cup (Li et al., 2018), shoe upper (Onodera et al., 2015), and bending stiffness (Stefanyshyn and Wannop, 2016).

For one example, shoelace regulate the tightness of the shoe opening to allow a geometrical match between the foot and the shoe based on the individual’s preference. Good fit is considered a prerequisite for shoe comfort (Ameersing et al., 2003). A shoelace system, heel counter or any other systems that can secure the foot within the footbed should be integrated in running shoes. 

For another example, the midsole is an important shoe component for cushioning and shock absorption of running impacts. Midsole thickness is considered important to influence plantar sensations and alter foot strike pattern for shod and minimalist shoes running (Chambon et al., 2014). A wide range of heel-toe drops used in running shoes (e.g., 0 mm to 12 mm) has been shown to influence foot strike pattern and injury risk (Malisoux et al., 2016). Technically, minimalist shoe is defined as the footwear with high flexibility and low shoe mass, stack height and heel-toe drop (Esculier et al., 2015). The minimalist shoe index is the combined scores of shoe quality, sole height, heel-toe drop, motion control, and stabilisation techniques, flexibility, longitudinal flexibility and torsional flexibility (Esculier et al., 2015). Recently, forefoot bending stiffness has received more attention because it has the potential to influence both running-related injury and performance (Stefanyshyn and Wannop, 2016). Softer and thicker running shoes (Sterzing et al., 2013; Teoh et al., 2013) were claimed that reduced impact in order to reduce impact-related injuries. However, Theisen et al., (2014) found that there was no difference in running-related injury between softer and harder shoes. Such a relationship between biomechanics and injury not well established in the literature. While different shoe constructions showed the remarkable changes in running biomechanical and performance-related variables, no consistent findings on running biomechanics can be found for most shoe constructions. 

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There are several factors that determine whether a shoe will offer good support:

HEEL COUNTER

The heel counter is the hard piece in the back of the shoe that controls the foot’s heel motion from side to side when you move. A strong heel counter increases stability providing better support for the foot. To quickly test the effectiveness of the shoe’s heel counter, place the shoe in the palm of your hand and put your thumb in the mid-portion of the heel counter and try to push the back of the shoe. If the heel counter does not bend very much it is strong.  

TORSIONAL STABILITY

This checks for how easily the shoe twists. The shoe should have some flexibility, but if it bends very easily it is too flexible. The torsional stability of the shoe prevents the foot from being twisted or turned when in motion, helping to reduce muscle fatigue from compensating for the instability. If you hold the toe of the shoe in one hand and the heel in the other, twisting it in opposite directions with each hand should be quite difficult.

MIDFOOT BEND TEST

The shoe should not bend in the middle (arch region). It should only bend at the ball of the foot, which matches where the foot would naturally bend. To test for this, hold the shoe in both hands at opposite ends, and try to bring your hands together. If the shoe bends very easily in the middle, as very soft-soled shoes often do, the shoe will not provide good stability to the foot.

REMOVABLE LINERS

Shoes with removable liners are more versatile than those without them. Removable liners enable a knowledgeable footwear and foot orthotic expert to modify the shoe, if required, to help improve the function and fit of the shoe. A removable liner could also be replaced by a custom-made foot orthotic or an over-the-counter device, if necessary without greatly altering the fit of the shoe.

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Wrong choice of footwear can lead to injuries:

With the increase in online shopping, there is always a possibility to buy ill-fitted shoes. The ill-fitted shoes can cause corns, bunions, and other toe deformities such as hammertoes, or heel spurs that may require surgery. To help avoid foot injuries, it is important to choose well-fitting shoes.

The Shoe Test:

When you go out to buy your next pair of shoes consider the following: Before trying to squeeze your foot into a new shoe, hold the sole of the left shoe against the sole of your bare right foot (or vice versa). Now judge for yourself if the new shoe’s surface area would take the shape of your whole foot. Spread the toes – the toe part of any shoe should be wider than the ball area. A well-fitting shoe has enough room for the toes to spread while weight bearing in walking, jumping and running. Such a shoe is hard to find.

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The Shoe Industry misinformation:

-1. Shoes will hurt until you “break them in.” Sorry, you are not “breaking in” a shoe. If a shoe hurts when you first try it on, it is the shoe that is breaking your foot with severe long-term damage in the form of bunions, hammertoes and poor stability.

-2. A shoe salesman will tell you that good shoes have to “support” the feet, or your feet will “spread.” Ask yourself: Why? Your feet do not need support if they are allowed to do their job unimpaired. The only reason the shoe industry condones such nonsensical information is to make people’s feet so uncomfortable that they need to keep buying more new shoes.  

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Next time you go shopping for shoes, the Australian Podiatry Association recommends you keep the following in mind:

-1. The shoes should be long enough and deep enough to avoid any pressure on the tips or the tops of the toes. (The shoe length should be the width of your finger longer than your longest toe.)

-2. A low broad heel is preferable; it will reduce the pressure on the front of the foot and increase stability.

-3. The shoes should have a firm fastening device around the instep (a bar, a lace or a velcro-strap). This is to hold the foot back against the heel and to prevent the foot sliding forward and the heel slipping out of the shoe.

-4. The toe box should be round and wide to avoid cramping of the toes. It should be deep enough to accommodate any toe deformities or any insole that may be required.

-5. The shape and the width of the shoes should be more or less the same as your feet.

-6. The sole of the shoes should be made up of non-slip resilient materials.

Now this doesn’t mean throwing out those stilettos. (In any case it’s unrealistic to advise women to do this as they are such an ingrained fashion item) But if you want to get to old age without foot pain and postural problems, it’s probably a good idea keep stilettos (and other poorly fitting shoes) in the wardrobe as much as you can, and only bring them out on special occasions when you won’t be walking around too much.

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Shoe drop:

The drop of a shoe is the difference in height between the heel and forefoot. The greater the drop, the steeper the angle between your heel and forefoot. For example, when barefoot, the heel and forefoot touch the ground at the same level: drop is 0.  Zero-drop shoes help people walk and run more naturally and efficiently. Many people claim that it helps with the prevention of injuries. It helps people naturally land on the midfoot where the arch is located and it may help prevent some knee injuries. 

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Shoe drop (also known as pitch) is a popular discussion point among the running footwear industry, sports medicine clinicians & runners, with differing opinions on its impact on injury & performance. The ‘drop’ of a running shoe is essentially the difference between the height/thickness of the midsole under the heel compared to the same measure under the ball of the foot. It is best visualized as how much of a heel the shoe has, so in the same way a pair of high heels could be referred to as being “your 6 inch heels”; all of your running shoes could be thought of similarly, although the measure will usually be in millimeters.

Historically most road running shoes would be manufactured with a 10mm drop, but present day you will find running footwear can range from ‘zero drop’ (where the shoe has no heel differential at all) up to 12mm. It is worth noting that the drop refers only to the difference in thickness between the front and back of the shoe, and is not a narrative on the magnitude of the thickness — do not assume if a shoe has a very thick and very cushioned midsole that it will have a high drop. Most manufactures will now provide the information on what the drop of each of their shoes are, either marked up on the shoe itself somewhere, or easily available with a brief internet search.

Is the drop important?

There is no such thing as the perfect or ideal drop. This has been studied in depth by a team of scientists in Luxembourg who have looked at the potential relationship between shoe drop and injury prevention/risk and also running biomechanics/performance. Their findings published in the British Journal of Sports Medicine and the American Journal of Sports Medicine made it clear — there is no magic formula.

What we do know is that human tissues can be sensitive to sudden changes in the way they are loaded, and that it is biologically coherent (and in keeping with the laws of physics) that differing shoe drops may load certain tissues differently. As such, if you are currently uninjured there is no justification for changing the drop of your shoe, but should you want to then be mindful of allowing the body time to adapt to such changes (although many runners may be able to interchange between shoes of different drops but it is better to be over cautious if this is not something you have done before). In the context of current pain/injury then it could be that a certain drop may be beneficial in reducing sensitivity and complementing your overall management strategy (e.g., you may find a higher drop shoe is sensible if you have an irritable achilles tendon, whereas a lower drop shoe is a better choice if you have a posterior ankle impingement).

If you are pain free and running well, it may be useful to keep track of what sort of drop you have run in historically, and consider this when purchasing new shoes. Changing the drop of your shoes (or using multiple shoes which have varying drops in a rotation system) is not to be discouraged or feared, but be sure your body’s tissues can tolerate this, and are given the necessary time to adapt and attain the capacity if needed. With respect to the ideal or perfect drop — it does not exist on a population level and is instead better thought of as being an individual and contextual consideration.

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Importance of shoes: 

The importance of having a good and comfortable pair of shoes cannot be underestimated. Whether you’re wearing shoes as a fashion statement or to serve a specific purpose like running, walking or hiking, good shoes form the basis of proper posture and save you from hours of pain and discomfort.

-1. Health benefits:

Going barefoot puts humans at risk for hookworm, tick bites and injuries. Stepping on broken glass or rusty nails, have a nasty encounter with a prickly bush or winding up with an itchy rash from poison ivy are also concerns. In the early 1900s, there was an epidemic of hookworms in Mississippi and other rural American states. Improper sanitary facilities in combination with the lack of foot protection led to the parasitic worm being able to bore itself into a foot in a corkscrew-like manner. Severe illness would ensue after a hookworm infection with anemia being the biggest health concern. However, an educational health campaign reinforcing the importance of wearing shoes and sanitary public facilities helped make hookworms virtually unheard of in the affected areas. While the hookworm epidemic is no longer a concern in the U.S., today the need for proper footwear is still critical as a way of reducing the risk of certain parasitic diseases and foot infections in third world countries where for almost 1 billion people even one set of adequate footwear would be a blessing.

Diabetics are also susceptible to foot infections in the form of ulcers and can lead to amputation. It is important to have proper footwear to minimize diabetic foot infections and to provide support to feet for comfort and proper healing. Other foot conditions, like bunions, Charcot foot, and corns can also be alleviated with proper foot wear.

Shoes not only help our feet to heal but can also aid in support and stability of our foot. Not all feet are perfect, so properly fitting shoes can help align your feet, ankles, knees, hips and back to correct your gait and improve posture. Without supportive shoes, the biomechanics of the body are off causing unnecessary impact and stress on parts of your feet and knees that aren’t meant for shock absorption or pressure. This can eventually lead to back, knee and foot pain.

It is important to note that poorly fitted shoes can have a negative impact on your foot health. Cheap generic shoes will negatively affect your posture and cause feet and back pains in the long run. There is a reason why shoe manufacturers like Adidas and Nike spend billions of dollars in research and development. Not all shoes are created equal and more often than not, generic shoes will do you more harm than good. Accounting for the foot length and width can help prevent any foot development disorders. Keep in mind that growth spurts in children are rapid so a proper foot measurements on a regular basis is important. Replacement of shoes that no longer serve your feet as intended is necessary to maintain optimal foot conditions and protection for your feet.

-2. Shoes are a symbol of style and fashion:

There’s no denying that there is a lot to be said about a person based purely on the type of shoes they wear. Shoes come in a variety of styles and price points. On the high-end of the spectrum, we have designer shoes like Buscemi, Balenciaga, and Gucci, while on the more practical side, we have your standard Adidas, Nike, and Reebok. Depending on financial status, you can buy a few pairs to go with all your outfits and give it that much-needed flair and panache. Made out of a plethora of materials and colors, today’s trendy footwear makes a bold statement about your style and fashion choices. When picked correctly, shoes can not only compliment your outfit, but they also give you an air of confidence and authority. Whether you’re a smart-shoe-wearing Wall Street banker or a Yeezy toting hipster, a pair of good kicks can earn you a well-deserved round of compliments from those around you. When paired correctly, shoes can be a versatile utility that forms an integral part of your wardrobe. It’s normal (and practical) these days for an individual to have multiple pairs of shoes in different colors to keep things fresh.

-3. Your footwear can impact your performance:

Specific footwear is design for specific sports meaning the shoe is designed to protect against certain movements and support the places which need it. For example, basketball shoes will be designed for heavy impact for jumping and also have good ankle support for quick turns. Having a shoe which knows your needs means you can play or workout more efficiently knowing that you already reduced the risk of injury. At the end of the day, footwear is worn to protect you! Choose your shoe depending on the type of activity you will be most involved with as it will be designed to handle those movements.

-4. Cultural importance of Shoes:

The types of shoes worn differs from culture to culture, however, in most cultures, shoes are representative of social status or an extension of one’s self. Shoes can affect our perception of others as well as ourselves. Certain shoes can be seen as an item of decoration for fashion and can have less to do with functionality. In the Western World, high heels or stilettos can be expressive of a women’s adulthood and sexuality. The shoes offer a sleek design while elongating their legs and changing their stance as a means for look and attraction. Footwear is also used as a for ceremonies or religious devotions in various cultures. As part of the Indian culture, shoes are lavishly designed with embroidery, inlaid with precious stones and metals, and adorned with bells and tassels. The Indian culture praises the feet, so in ceremonious occasions, feet are clothed in beautiful garments for celebration and honor. However, there are a wide range of cultural views of feet, while in America the idea of walking barefoot outside can symbolize freedom and attaching to one’s youthfulness, people in Japan perceive feet as a body part that must remain clean, so wearing shoes outdoors in necessary in their society.

-5. Access to Educational Opportunities:

Kids need good shoes in order to attend school in many countries. When children are without footwear, they can become stuck in a cycle of poverty from which it’s hard to escape. The shoes sitting in the back of the closet that your children outgrew or no longer enjoy wearing could transform the life of a child in another part of the world.

-6. Increased Economic Opportunities:

Several organizations collecting shoes, such as GotSneakers, repurpose what they receive and use it as inventory for microenterprises in areas where economic stability is uncertain. The entrepreneurs in charge of these small operations are provided with a product their communities need and are able to support their own families on the income from their sales. The result is a stronger local economy and a healthier population.

-7. Boost of Confidence:

Fashion isn’t an industry in a lot of areas of the world, but everyone enjoys having something nice to wear. For adults who have never had adequate footwear, an attractive pair of shoes can give them a sense of self-assurance and well-being. Kids putting on good shoes and heading off to school for the first time can grow in confidence as their education progresses.

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Pros and cons of shoes:         

Shoes help people by protecting them from harmful sun rays, surfaces, objects, and weather. Shoes can also cause foot, ankle, and knee problems for people. Your shoe type and how you wear them will make a significant difference in how good or bad shoes are for you.

Most of the world uses footwear of some kind. It protects their feet, provides some comfort, and adds fashion for many. In general, footwear helps meet our needs, but some caution should be taken depending on your situation. On the other hand, going barefoot can have some health benefits. But it is not practical or acceptable for most people to go barefoot around town or work. The best thing to do is to weigh the benefits and drawbacks of wearing shoes. Find ways to keep your feet healthy and still wear the shoes you love. Let’s find out more about how shoes help and hurt our feet.

Pros:

Shoes have been helping people around the world for many thousands of years. People have used grasses, plants, leathers, and wood to protect their feet and provide some comfort. At the same time, many civilizations have gone barefoot most of the time. So, in some circumstances shoes were not necessary, but in others they were important.

-1. Shoes Protect

Shoes have been helping people in colder climates protect their feet from the cold since thousands of years. If the temperature is too hot or cold, shoes can protect feet from environmental and weather hazards. Shoes are good for protecting our feet from the rain, the sun, sharp objects, and supporting our feet so they are less likely to get injured. Shoes help stop cuts and scrapes, bacterial infection, disease-causing microbes, and fungus. They make it more difficult for the spread of health problems from person to person.

-2. Shoes relieve stress on Joints

If you have any problems related to joint pain, you’ll likely want to find the relief that comes with a cushioning comfortable shoe. Shoes can relieve some of the pressure put on the joints as we walk and run. Getting the right support for your arch type will play an important role in stress relief.

-3. Shoes help support Arches

The arches of each individual are different and many shoes can help support varying types of arches. Some arches require additional support and orthotic inserts can be used in shoes to give the individualized support a person might need. If you have high arches or low arches, shoe inserts might work to align and support your arch for good foot health. The best shoes for plantar fasciitis are shoes with arch support, that fit your arch type, and cushioning for your heel and the ball of your foot. Having plenty of cushioning and support will help reduce pain.

-4. Shoes help with Sports

If you like running, you’ll likely rely heavily on running shoes to provide the cushion and support for your feet, so you can continue running and not receive any injuries. Runners, hikers, and other sports players rely on their shoes to perform well and give them the competitive edge they are looking for.

While shoes have been helping people for thousands of years, each individual is different and so are their foot needs. Shoes provide support and comfort, but shoes are not specifically designed for each person, so foot health is often compromised.

Cons:

What happens over time when someone wears a shoe that isn’t healthy for their foot? They start to change the amount of pressure in different areas of the foot. Their feet and joints try to compensate for these unhealthy pressures, and this causes problems eventually. Runners have a variety of shoe styles that they use because some evidence supports the idea that running barefoot can be healthy for your foot and having too much cushioning can weaken your foot.

While shoes are helpful, wearing the wrong kind and not giving your feet enough time with your shoes off, will likely cause problems.

-1. Shoes control foot Position

Suppose your deck shoes have no arch support and little cushioning. If you walk for an hour in deck shoe, it will not likely cause any long-term problems. If you continue to use these shoes every day, all day, then the results will be that your feet will start to adjust to the new shoe. You will start to feel your plantar fascia (that connects the heel to the ball of the foot) stretch or pull more than normal, and it will get painful.

Shoes control the position of your foot and natural walking positions are not available in most shoes. Your shoes control a foot’s angle, cushioning, pressure points, and arch support. Normally your foot would take on these jobs and help you develop strength and support in your feet and legs.

-2. Improper arch support

Shoes are good at some types of protection but lack the customization required that some people need. Arches can help some individuals with problems, but might not help the general population who don’t. For example, arch support help absorb energy in those with high arches, but may not absorb as much energy with those who have normal arches. Arches may help with balancing in those with flat feet, but not help with balance in other foot types.

Arch support in shoes doesn’t always make a difference. For example, when running, the shoe’s arch can sometimes dampen that energy return that the foot would normally give. Arch support doesn’t always mean pressure relief because the arches in your feet are meant to absorb energy. If you’re running and let the shoe arch do the absorbing, research testing shows that they are less effective than your own arch when barefoot running.

-3. Shoes don’t always Protect

High heels are an example of shoes that cause harm over time. High heels and other shoes, that place the feet in an unnatural position for long periods, can cause increased pressure on the feet.  To have less of an impact on your foot you might opt for shoe heels that are less than two inches tall.

Some women’s’ flats can hold the foot in a flat position, not allowing for a natural range of motion. This prevents the arch from doing its job and can lead to joint problems. Flip-flops and sandals can lead some people to have problems too. They cushion the foot but are flat. This may not allow the foot to get stronger because the cushioning absorbs energy instead of the foot and there is less arch support during impact.

-4. Shoes can squish your Feet

When shoes squeeze your toes together you’re going to end up with foot problems. These shoes put your foot in an unnatural position and the tendons will start to stretch over time. Your bones are pulled out of alignment and it can create what is known as a bunion.

-5. Shoes can be Too Small

If you’ve worn shoes that are too small, even for short periods, you know how uncomfortable they can be. The problem is they tend to squeeze your toes, place unhealthy pressure on your foot, and cause rubbing. These types of shoes eventually lead to foot problems including blisters and possibly arthritis. Many people are trying to find the best-looking shoe, disregard the level of discomfort or problems that may be occurring. It’s important to take time to measure your foot, as it will change over the decades. Find shoes that fit comfortably and give your toes plenty of wiggle room without slipping while you walk.

-6. Your Shoes might be Too Soft

If you have shoes that are providing too much cushioning, the foot tends to have heavier impacts. This is because the foot is looking for signals to get the sense of hitting the ground. As a result, the padding that should be helping your joints stay protected may not be adding as much help as you may need.

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Why do experts say that it’s best to implement a no outdoor shoes indoors rule?

For a number of reasons actually, not just because it’s kinder to floors. It’s better for your health. According to a study conducted by the departments of microbiology and environmental sciences at the University of Arizona, that studied the bacteria on the bottom of shoes, 93% of them will contain dangerous bacteria, including E coli and fecal matter on the bottom of them after just a month of regular wear. If those shoes are then worn indoors, even briefly, that bacteria are then tracked into the home. And while for most people it won’t be enough to make them very sick; for small kids (who tend to spend a lot of time close to the floor) or people with compromised immune systems it can become quite a health hazard. The study even took a special look at flip-flops. If they are worn both outdoors and indoors, dirt and bacteria tend to cling especially hard to the ridges on the soles while you are walking outside but is then fairly easily dislodged by the soft fibers of a carpet.

If you do want to implement a no shoes in the house rule in your home – but don’t want to upset or inconvenience guests too much – you can try taking a leaf out of the book of many homes in Japan, where the hosts keep a stock of inexpensive ‘one size fits most’ slide slippers on hand for visitors to slip into.

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Footwear choices reflect your Personality:

The University of Kansas study in 2012 has shown that we can judge a person by their shoes. The participants were shown photos of individuals wearing different kinds of shoes and were asked to guess their age, gender, income, social status, political views, personality, etc. The result has shocked researchers. About 90% of respondents gave the correct answer!

Shoes make one of the most essential items of your outfit. They not only bring out your mood for the occasion, but also tell a lot about your personality. Yes, shoe gazing is a real thing and it can allow the person to identify the wearer’s personality just by looking at them.  If you want to be known for more than what meets the eye, picking the right shoes is imperative for your lifestyle. There is a well-researched criterion of finding people’s personalities from their footwear choices, and most of the times it turns out to be accurate. For example, expensive shoes are worn by high-earners, flashy and colorful shoes are generally owned by extroverts, and ankle boots belong to people with more aggressive personalities. Similarly, people with calm personalities choose uncomfortable-looking shoes while brand new and well-maintained shoes were found with people who had “attachment anxiety”.

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Shoe fetishism:

Shoe fetishism is the attribution of attractive sexual qualities to shoes or other footwear as a matter of sexual preference, or an alternative or complement to a relationship with a partner. Individuals with shoe fetishism can be erotically interested in women’s shoes.  Although shoes may appear to carry sexual connotations in mainstream culture (for example, women’s shoes are commonly sold as being “sexy”), this opinion refers to an ethnographic or cultural context, and is likely not intended to be taken literally. Another fetishism, which sometimes is seen as related to shoe fetishism, is boot fetishism. Boot fetishism is a sexual fetish focused on boots. Boots have become the object of sexual attraction amounting to fetishism for some people and they have become a standard accessory in BDSM scenes (where leather, latex and PVC boots are favored) and a fashion accessory in music videos.  Boots are seen as perhaps the most fetishistic of all footwear and boots may be the most popular fetish clothing attire.  Hsu and J. Michael Bailey (2019) argue that there is little evidence for “sexual conditioning” explanations of boot fetishism, since only a small minority of men who have seen attractive women in boots develop boot fetishes. They also say that “boot fetishes would not occur in a world without boots, and in a world where men and women switched boots, different patterns of fetishes would likely develop”. They argue that random developmental processes which are still poorly understood make some men more prone to developing paraphilias and fetishes.

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Section-3 

Anatomy of footwear:

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Parts of a shoe: 

Knowing the parts of a shoe is essential since most of the time, our feet are placed inside the shoe. The comfortableness a shoe gives is more important for the well being of our body. Improper wear of the shoe can cause some serious problems like spinal issues, ankle pain, and much more. Therefore, choosing the right shoe can maintain your body posture while walking and reduce leg pain. You must make an informed decision of what type of shoe suits you and which shoe will give excellent comfort. Once, take a chance and know these parts, analyze the comfort you require, and buy a shoe. Understand the difference; then, you will know the importance of knowing the parts of a shoe.

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According to McPhoil (1988) the structure of a shoe can be divided into two parts: an upper and lower (or bottom part). Sections of the upper are made up of the vamp, quarter, toebox, throat, insole board, and topline. The sections of the lower shoe consist of an outsole, shank and heel. With seemingly endless styles of shoes, they all have a very similar basic structure with two parts: a lower and upper. A welt is a strip of material that joins the upper to the lower. The majority of shoes are welted by Goodyear-welt construction, although some welts are only decorative. Many shoe parts have more than one name, and many shoes don’t contain all parts. 

Figure above is a diagram of a typical dress shoe. Note that the area labeled as the “Lace guard” is sometimes considered part of the quarter and sometimes part of the vamp.

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The basic anatomy of a shoe is recognizable, regardless of the specific style of footwear.

Figure above shows cutaway view of a typical shoe.

All shoes have a sole, which is the bottom of a shoe, in contact with the ground. Soles can be made from a variety of materials, although most modern shoes have soles made from natural rubber, polyurethane, or polyvinyl chloride (PVC) compounds. Soles can be simple—a single material in a single layer—or they can be complex, with multiple structures or layers and materials. When various layers are used, soles may consist of an insole, midsole, and an outsole. 

The insole is the interior bottom of a shoe, which sits directly beneath the foot under the footbed (also known as sock liner). The purpose of insole is to attach to the lasting margin of the upper, which is wrapped around the last during the closing of the shoe during the lasting operation. Insoles are usually made of cellulosic paper board or synthetic non woven insole board. Many shoes have removable and replaceable footbeds. Extra cushioning is often added for comfort (to control the shape, moisture, or smell of the shoe) or health reasons (to help deal with differences in the natural shape of the foot or positioning of the foot during standing or walking).

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The Outsole:   

Typically made of rubber, the outsole is the bottom of the shoe. The outsole provides traction and contributes to how soft or firm the shoe “rides” as well as its torsional rigidity and flexibility. The outsole is the layer in direct contact with the ground. Dress shoes often have leather or resin rubber outsoles; casual or work-oriented shoes have outsoles made of natural rubber or a synthetic material like polyurethane. The outsole may comprise a single piece, or may be an assembly of separate pieces, often of different materials. On some shoes, the heel of the sole has a rubber plate for durability and traction, while the front is leather for style. Specialized shoes will often have modifications on this design: athletic or so called cleated shoes like soccer, rugby, baseball and golf shoes have spikes embedded in the outsole to improve traction.

Carbon Rubber – This durable rubber compound makes up the majority of running shoe outsoles.

Blown Rubber – Air-injected rubber that is lighter, softer, and more flexible than traditional rubber. Blown rubber is most commonly found in the forefoot. It provides a great feel but is less durable than carbon rubber.

Outsole-Grade EVA – EVA foam that is designed for ground contact. It is lighter and more flexible than rubber, but it may be less durable over time.

Shape – Outsoles range in shape from curved to straight. Curved shoes tend to be less stable, and are best for neutral runners and supinators, while more rigid, straight shoes are best for overpronators.

Depending on whether the shoe is meant for the road or trail, the outsole will either be highly segmented (a flatter tread with flex grooves) for smoother transitions on pavement, or have a more aggressive lug pattern for grip on rugged terrain.

-Footbridge: Also called a shank, it’s located between the heel and forefoot. It provides stability by reducing twisting.

-Beveled heel: A heel that’s rounded, or angled, in the back to lessen heel impact and allow you to land smoothly.

-Rock plate: Made of plastic typically, these protective pieces (that dark gray layer) are placed between some trail shoes’ midsole and outsole for extra defense on rocky, rooty trails.

-Decoupled heel: A split heel that absorbs shock and provides a smooth transition when the heel lands on pavement.

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The Midsole:  

Located between the upper and the outsole, the midsole is the part of the shoe where the cushioning and pronation control technologies are located. The midsole is the core of the shoe and provides cushioning and energy return.  A shoe’s midsole is typically made of plastic materials that feel and behave like foam or rubber. Midsole composition dictates the durability or longevity of the shoe, as well as the quality of the ride. The midsole is the layer in between the outsole and the insole, typically there for shock absorption. Some types of shoes, like running shoes, have additional material for shock absorption, usually beneath the heel of the foot, where one puts the most pressure down. Some shoes may not have a midsole at all.

Compression-Molded EVA – The most common insole material. EVA stands for “ethylene vinyl acetate,” a combination of two types of plastics.

Polyurethane – Another type of material that behaves like plastic or rubber and is used in midsoles. Polyurethane is not as commonly used as EVA because it tends to be heavier and firmer.

Thermal Plastic Unit (TPU) – Thermal plastic is used in the bottom of the midsole at mid-foot to replace or support the midsole material. Thermal plastic units can also be used in the midsole to reduce overpronation.

Durometer – Midsole resistance to indentation is indicated in durometers. The higher the durometer, the stiffer and more resilient the midsole. The Shore durometer is a device for measuring the hardness of a material, typically of polymers, elastomers, and rubbers. Higher numbers on the scale indicate a greater resistance to indentation and thus harder materials. Lower numbers indicate less resistance and softer materials.

Cushioning Devices – Cushioning devices are placed in the heel and forefoot to absorb shock and resist compression. Each shoe manufacturer produces its own unique types of cushioning devices, but the function of these devices is similar across brands.

Dual-Density or Multi-Density Midsole – A midsole that features two different densities of material is dual-density, and a midsole with more than two densities is multi-density. Shoes that are designed to prevent overpronation usually have dual- or multi-density midsoles.

Stability Technologies:

Medial post: A wedge of firm foam located below the ankle bone, in the shoe’s midsole. It’s made out of a denser material, usually EVA. The post changes the distribution of force underneath your foot as you run, reducing the stress on your ankle and causing your foot to roll inward less.

Guide rails: Plates located on the sides of the shoe, inside the midsole. The guide rails couple the heel’s rotation with the knee’s (meaning the ankle’s and knee’s rotation sync with each other), thus providing support and making the runner more efficient. Brooks recently introduced guide rails to several models, including the Adrenaline GTS 19.

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Last:

Most shoes are manufactured using a last—a general model of a foot. The term comes from Old English, laest, which means barefoot. Lasts were originally carved out of wood, but today they are plastic or metal. They are made for manufacturing purposes. Lasts provide a working structure by which the shoe is made. Manufacturers say there are two kinds of feet, and therefore two general forms of lasts exist, a straight and curved last. Straight lasted shoes are straighter in appearance, and curve lasted shoes more curved overall.

The term last also applies to the methodology of construction. A slip lasted shoe has the upper part wrapped around the lower sole and glued, and is more like a sock. It is usually softer, but also more flexible especially in the sole. The more traditional shoe style, especially dress shoes, is board lasted which is stapled, tacked or sometimes glued to the sole. A board lasted shoe is more rigid, especially the sole. Some shoes are slip lasted in the front and board lasted in the back, with other variations used in manufacturing today.

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Heel:

The heel is the bottom rear part of a shoe. Its function is to support the heel of the foot. They are often made of the same material as the sole of the shoe. This part can be high for fashion or to make the person look taller, or flat for a more practical and comfortable use. On some shoes the inner forward point of the heel is chiselled off, a feature known as a “gentleman’s corner”. This piece of design is intended to alleviate the problem of the points catching the bottom of trousers and was first observed in the 1930s. A heel is the projection at the back of a shoe which rests below the heel bone. The shoe heel is used to improve the balance of the shoe, increase the height of the wearer, alter posture or other decorative purposes. Sometimes raised, the high heel is common to a form of shoe often worn by women, but sometimes by men too.

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The Upper:

As its name suggests, the upper is the combination of materials that wrap around the top of the foot. The upper holds the foot in place and prevents excessive movement from side to side or up and down. The upper covers your foot to ensure a snug, secure fit, while providing stability. The upper helps hold the shoe onto the foot. In the simplest cases, such as sandals or flip-flops, this may be nothing more than a few straps for holding the sole in place. Closed footwear, such as boots, trainers and most men’s shoes, will have a more complex upper. This part is often decorated or is made in a certain style to look attractive. The upper is connected to the sole by a strip of leather, rubber, or plastic that is stitched between it and the sole, known as a welt.

Most uppers have a mechanism, such as laces, straps with buckles, zippers, elastic, velcro straps, buttons, or snaps, for tightening the upper on the foot. Uppers with laces usually have a tongue that helps seal the laced opening and protect the foot from abrasion by the laces. Uppers with laces also have eyelets or hooks to make it easier to tighten and loosen the laces and to prevent the lace from tearing through the upper material. An aglet is the protective wrapping on the end of the lace.

The vamp is the front part of the shoe, starting behind the toe, extending around the eyelets and tongue and towards back part of the shoe.

The medial is the part of the shoe closest to a person’s center of symmetry, and the lateral is on the opposite side, away from their center of symmetry. This can be in reference to either the outsole or the vamp. Most shoes have shoelaces on the upper, connecting the medial and lateral parts after one puts their shoes on and aiding in keeping their shoes on their feet. In 1968, Puma SE introduced the first pair of sneakers with Velcro straps in lieu of shoelaces, and these became popular by the 1980s, especially among children and the elderly.

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Toe Box:

The toe box refers to the front part of the shoe, above where your toes rest. Don’t confuse this with the vamp, which refers to the entire front portion of the shoe. The Air Jordan above would allow you to clearly see where the toe box is. The toe box is the part that covers and protects the toes. People with toe deformities, or individuals who experience toe swelling (such as long-distance runners) usually require a larger toe box.

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Features of a walking shoe:

Achilles tendon protector. Reduces stress on the Achilles tendon by locking the shoe around the heel.

Heel collar. Cushions the ankle and ensures proper fit.

Upper. Holds the shoe on your foot and is usually made of leather, mesh or synthetic material. Mesh allows better ventilation and is lighter weight.

Insole. Cushions and supports your foot and arch. Removable insoles can be laundered or taken out to dry between walking sessions.

Gel, foam or air midsole. Helps cushion and reduce impact when your foot strikes the ground.

Outsole. Makes contact with the ground. Grooves and treads can help maintain traction.

Toe box. Provides space for the toes. A roomy and round toe box helps prevent calluses.

How a shoe is built makes a difference in its fit and function. Knowing the basic parts of a walking shoe can help you sort through the many available styles and brands.

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Components of Running Shoes: 

This section describes the components of the running shoe and their significance for the runner. The emphasis is on finding the right shoe, from a biomechanical and a fit standpoint. One part of the equation without the other could lead to injury. When purchasing shoes, remember that the cost of the shoe does not ensure its success. For one runner, an expensive shoe may only deplete his bank account without aiding performance; for another, the shoe may be expensive and perfect. Your foot type, shape, and biomechanics determine what is best when it comes to shoes.

Upper:

The upper of a running shoe (figure below) is the material that covers the top and the sides of the foot. It can be made of multiple pieces of fabric sewn or glue-welded together, or it can be made of a one-piece, seamless material. All current running shoes are of human-made materials (e.g., nylons) for breathability, comfort, and weight reduction. Leather is no longer used because of its lack of breathability, nonconforming shape after repeated use, weight, and cost.

Figure above shows lateral view of shoe: upper, midsole, and outsole.

The front of the upper is referred to as the toe box of the shoe. It takes its shape from the last of the shoe (the form the shoe is built on), but its style is determined by the shoe designer to meet the needs of the shoe wearer. The toe boxes of many of the shoes built recently are wider and deeper to accommodate the higher-volume feet that seem to have become more prevalent as the second running boom has corralled more recreational runners with larger frames into the sport. The midfoot of the shoe’s upper can be designed in conjunction with or independently of the lacing system (e.g., ghillie lacing) to allow for various upper fits. Occasionally, companies will attempt a nonsymmetrical lacing pattern ostensibly designed to improve the fit of the upper and remove “hot spots” (pre-blister-forming areas) from developing on the foot during running.

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The design of the upper of the shoe determines the fit of the shoe—not the length of the shoe, but how the shoe envelops the foot. This is important because if the shoe fit is improper, the biomechanical needs of the runner may not be met. Only when the fit of the shoe is spot-on can the function (be it stability, motion control, or cushioning) work as designed. For example, if the fit of the upper is too baggy in the midfoot, excessive pronation can occur despite the presence of a medial support. The lack of a proper fit renders the stability device ineffective in combating the pronation it was designed to limit. Injuries can occur—in this case, tibial pain—even if a runner wears a shoe that is the correct category for his or her foot type.

This scenario often leads to disenchantment when purchasing shoes because of the confusion resulting from following the suggestions and guidelines and still not getting relief from pain. Here is a general point when purchasing shoes: If the shoe doesn’t fit your foot well, it isn’t the best shoe for you, regardless of whether its biomechanics are matched to your foot type. For example, it could be argued that for a mild overpronator, a cushioned shoe that fits perfectly is more stable than a mild stability shoe that is too roomy.

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The Heel Counter is intended to link the heel of the foot to the shoe. In conjunction with proper fit, a heel counter embedded in the upper material ensures a secure, mildly stable ride when running. Heel counters (figure below) are hard plastic devices that stabilize the rear foot, helping the foot through the normal cycle of heel strike, midfoot stance (avoiding excess pronation), forefoot supination (the outward rolling of the forefoot), and toe-off from the smaller toes of the foot. Heel counters can be removed in shoes manufactured for underpronators, but the possibility of Achilles tendinitis is increased because of the increased movement of the calcaneus and the subsequent pulling on the Achilles tendon.

Figure above shows heel counter and heel cleft.

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Midsole: 

The midsole of a running shoe is made of EVA (ethylene vinyl acetate) or rubberized EVA used to cushion or stabilize the ride of the shoe during foot strike. Developed in the early 1970s as a cushioning material to rival polyurethane (which is denser and heavier), EVA has been combined with other proprietary cushioning materials such as air and gel as well as engineering designs like wave plates, footbridges, cantilevers, and truss systems to minimize impact shock generated during the foot strike and to guide the foot through its normal path.

The holy grail of midsole technology has been to find a material that provides a moderately soft ride and has the durability to withstand compression, which limits the life span of the shoe. A reasonable expectation for a running shoe’s life is 350 to 500 miles. The development of a midsole that could provide 750 miles of consistently comfortable running would be a boon both to runners and to the manufacturing company that patented the material.

The current crop of rubberized midsoles provide dramatically better cushioning than their “sheet” EVA predecessors from the 1970s, but there is an environmental cost associated with producing the material. Traditional EVA midsoles take approximately 1,000 years to entirely biodegrade. Some running shoe manufacturers are marketing eco-friendly “green” midsoles that are touted as environmentally sound because they degrade 50 times faster in a traditional landfill environment.

Most runners look at the outsoles of their shoes to determine whether the shoes need to be replaced. Unfortunately, when the outsole of a running shoe has worn away enough to show significant wear, the midsole has been long compromised in providing cushioning. Because midsoles provide cushioning, they also absorb and dampen the shock of impact. During a 30-minute run, each shoe lands on the ground approximately 2,700 times. That is multiplied by an impact force of three to four times a runner’s body weight, so it’s amazing that no more than a two-inch-thick wedge of EVA can withstand approximately 150 of these training runs before being replaced.

The midsole is also the part of the shoe that contains the various stability devices designed to prevent pronation. These devices are always placed on the medial side of the shoe, usually between the arch and the heel. The devices are located in this area to counter the effects of pronation, which is mainly controlled by the subtalar joint that is located in the area of the foot closest to this part of the shoe. Occasionally a shoe will be produced with forefoot posting (to prevent late-stage pronation of the forefoot), but this is a nontraditional method of design. Posting of the lateral side of the shoe is rarely done because increasing the rate and degree of pronation is problematic for pronators (leading to increased tibia discomfort) and needless for underpronators (a cushioned shoe allows for the foot to pronate as it needs to).

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Outsole:

The outsole of a running shoe (figure below) has evolved dramatically from a materials standpoint from the gum rubber of the 1908 Spalding marathon trainers. The outsole (the part of the shoe that actually touches the road) is made of carbon and blown rubber composites used jointly to make for a durable yet appropriately flexible ride. Most runners strike the lateral heel of the foot upon impact. Hence, manufacturers place the most durable carbon rubber in this area of the shoe to ensure longevity of the outsole. Despite the added durability of the carbon rubber, excessive wear will still appear in that area of the shoe for most runners. This is to be expected and does not indicate a proclivity toward overpronation or underpronation. It simply means the runner is a heel striker.

Figure above shows Outsole.

If the outsole is completely worn through in the forefoot of the shoe, the midsole cushioning was compromised long before, and the shoe is worthless as a shock-absorbing entity. Because the outsole of the shoe lasts much longer than the midsole cushioning, using outsole wear as a guide for when to replace your running shoes is erroneous. The best method of measuring the life of a shoe requires little work. Pay attention to the mileage on your shoes by keeping a log or quick estimation of miles per week multiplied by weeks of training, and after approximately 350 miles, replace your shoes when you begin to have aches or pains in your legs that you did not have for the first 350 miles of the shoe’s life. Normally, if a shoe model is not correct for a runner’s biomechanics, weight, flexibility, or foot shape (all factors that determine the best shoe), discomfort or injury will occur within the first 100 miles of running. Thus, the wrong shoe should rarely be confused with an old shoe.

Shoe manufacturers are constantly altering the strike path of a shoe’s outsole and the surface pattern of the rubber to improve comfort and durability. Although these aims of the manufacturers seem to be worthwhile, the role of aesthetics in shoe design cannot be ignored. At every phase of design and development, the aesthetics of the shoe, its attractiveness to the consumer, must be weighed against the practicality of building the shoe and the effectiveness of the shoe for running purposes. Often the aesthetics of the shoe take precedence, and a much-hyped shoe proves to be a performance dud—albeit a dud with an expensive advertising campaign.

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Functions of the Insoles:

The insoles are for everyone, for everyday life and all sports activities. In the past, the function of insoles was just a cushion, but in modern technology, the function of insoles has been upgraded to a component of auxiliary shoes. Modern high-quality insoles can provide the following functions:

-1. Prevent the foot from sliding in the shoe

The shoe bed inside the shoe is flat, but your sole is not, so the sole will slide in the shoe when walking, which makes every step of walking take a little more effort, and long-distance walking is easier to increase all kinds of trauma. The use of three-dimensional insoles can fill the space between the sole and the shoe bed, and reduce the sliding of the sole in the shoe.

-2. Enhance arch support

Your insoles are designed to provide support to the foot arch in order to prevent it from flattening on to the ground. This is beneficial in the treatment of flat feet which should ideally involve a combination of arch strengthening exercises and insoles.

By supporting the foot in its most optimal position, your insoles help to enhance the strength of your arch muscles which are then able to function efficiently. Research conducted by Seo et al. for the Journal of Physical Therapy Science proved the effectiveness of insoles in relieving tension in the sole muscles while maintaining a normal arch level.  The authors found that the use of insoles for people with flat feet helped in restoring near-normal motion in the feet during walking. This can prevent the development of a number of painful foot conditions such as plantar fasciitis and bunions. Insoles have a therapeutic effect on the ligaments in the foot that have been damaged by improper foot movement and need healing. With insoles in your shoes, the plantar fascia has a better chance of healing as the arch is held in position and does not collapse during movement.

-3. Shock Absorption

There are two kinds of shock absorption insoles, one is the use of hard cup-shaped heel bracket, because the thick muscle of human heel is a natural shock-absorbing function, as long as a suitable radian of hard rubber bracket is owned, it can play a good shock-absorbing function, suitable for some stable and lasting activities, such as fencing, vigorous walking, hiking and so on. The other is to assist other soft materials, such as Gel, air cushion to absorb the impact of heel landing, suitable for running, basketball and other high-jump movements.

-4. Correction of walking and standing posture

It sounds amazing, but this is the function of orthopedic insoles. When standing, the spine and leg bones are not 100% vertical, or when walking, they swing left and right, causing various kinds of bone and joint injuries in the long run, which is born with or for the sake of other reasons for not few people. With orthopedic insoles, they can correct the posture of walking and standing, thus reducing the trauma. 

When we buy a sneaker or any other street shoe, the insoles supplied are in standard format. But a foot is unique and a standard insole is not necessarily suitable for all feet. When the foot is not well adjusted in the shoe, the unwinding of the walk or the running can’t be optimal. An adapted insole will help to better transfer the supports of the foot towards your shoe. Not every runner needs an orthotic insole (a.k.a. sockliner or insert). There is no evidence that every person with a certain type of foot needs a correction. For example, not all flat-footed runners overpronate and need extra stability. However, if persistent injuries—shin splints, stress fractures, plantar fasciitis—won’t pass, give an orthotic a test run. And don’t forget to take out the shoe’s insole first.

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Shoe Accessories: 

Foam tap: a small foam pad placed under the ball of the foot to push the foot up and back if the shoe is too loose.

Heel grip: used to prevent the shoe from slipping on the heel if the fit is not perfect

Overshoes or galoshes: a rubber covering placed over shoes for rain and snow protection.

Shoe bag: a bag that protects shoes against damage when they are not being worn.

Shoe brush and polishing cloth: used to apply polish to shoes.

Shoe insert, insole or inner sole: orthopedic or regular insert of various materials for cushioning, improved fit, reduced abrasion or to keep shoe fresh and increase its durability. These include padding and inner linings. Inserts may also be used to correct foot problems.

Shoe polish: a waxy material spread on shoes to improve appearance and glossiness, and provide protection.

Shoe stretcher: a tool for making a shoe longer or wider or for reducing discomfort in areas of a shoe.

Shoe tree: placed inside the shoe when user is not wearing it, to help maintain the shoe’s shape.

Shoehorn: can be used to insert a foot into a shoe by keeping the shoe open and providing a smooth surface for the foot to slide upon.

Shoelaces: a system used to secure shoes.

Snow shoe: a wooden or leather piece that increases the area of ground covered by the shoe.

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Section-4

History of footwear:   

While early humans living in cold northern climates may have begun covering up their feet to insulate them as early as 500,000 years ago, protective footwear comparable to modern-day shoes is thought to be a much later innovation. Spanish cave drawings from more than 15,000 years ago show humans with animal skins or furs wrapped around their feet. The body of a well-preserved “ice-man” nearly 5,000 years old wears leather foot coverings stuffed with straw. Shoes, in some form or another, have been around for a very long time. The evolution of foot coverings, from the sandal to present-day athletic shoes that are marvels of engineering, continues even today as we find new materials with which to cover our feet.

It has been difficult for archaeologists to determine exactly when humans stopped going barefoot because the plant and animal materials used to make prehistoric shoes is highly perishable. “The oldest shoes in the world are about 9,000 years old, and they’re from California,” said Professor Trinkaus, of Washington University in St Louis, US. But by examining the foot bones of early modern humans (Homo sapiens) and Neanderthals (Homo neanderthalensis) dating from 10,000 to 100,000 years ago, Professor Trinkaus says he has determined the period in which footwear became the norm. He found Neanderthals and early moderns living in Middle Palaeolithic times (100,000 to 40,000 years ago) had thicker, and therefore stronger, lesser toes than those of Upper Palaeolithic people living 26,000 years ago. A shoe-less lifestyle promotes stronger little toes, says Professor Trinkaus, because “when you walk barefoot, you grip the ground with your toes as a natural reflex”. Because hard-soled shoes improve both grip and balance, regularly shod people develop weaker little toes.

To test the theory that the more delicate toes resulted from shoe use, the Washington University researcher compared the foot bones of early Native Americans, who regularly went barefoot, and contemporary Alaskan Inuits, who sported heavy sealskin boots. Again, he identified chunkier toes in the population that routinely went without shoes. The research suggests shoe-wearers developed weaker toes simply because of the reduced stresses on them during their lifetime; it was not an evolutionary change.

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Back in the early days when our civilization was primitive, the Earth was believed to be flat and man was nothing more than a traveling nomad, people fashioned their shoes out of animal skin and wood. Even our ancestors knew that proper footwear was essential for survival. By avoiding cuts, bruises and other debris that could cause an infection, our predecessors had a higher probability of living a longer and healthier life simply by having a better, sturdier pair of shoes. They also served as a status symbol amongst the elite and the practice of judging someone based on their footwear is quite an old tradition. Shoes were also the first thing that was looted from the bodies of defeated soldiers.

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It’s hard to imagine what life was like when shoes weren’t discovered yet. Everything started because of a real and practical need to protect the feet from outside effects. This seemingly simple human need turned into a quickly growing industry in which design was just as important as functionality. Although the main qualities of footwear have remained unchanged, looking back at the long and interesting history of shoes, you can see that the colors, materials and designs did change. Before, shoes used to be made by craftsmen. But today, they are part of a factory industry earning huge amounts of money each year.

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During different eras there were different views of the world, different understandings of culture and art, different economic and political factors which played an important role in the materials, shapes and style used in people’s wardrobe. The discovery and capture of new lands, new technologies and different understandings of the world changed the style and fashion of footwear.

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Primitive footwear, popular during Prehistory, was changed by sandals which grew in popularity during Antiquity because of the formation of social classes. During the Middle Ages, which are characterized by humility and feudalism, the first footwear structures were formed and the heel was discovered and widely used. During the Early Modern Times were the eras of Renaissance and Baroque during which hints of modern footwear can be spotted. During this time, men’s and women’s shoes were very similar. The models of shoes varied depending on social classes. Also, during the Middle Ages when feudalism was present, society was divided into classes deciding not only different jobs and responsibilities but also different clothes and footwear. Peasants and non-noble townspeople wore heavy and dark leather boots with a heel. Meanwhile, the noble wore more fancy footwear which often had a wooden heel.  Prints, ornaments and other decorative elements were worn only by the noble. They would order these shoes from a shoemaker. Every shoe was different and decorated according to the mood and wishes of the customer, so every single pair of shoes was unique and different. The Modern Times changed the understanding of fashion and drastically altered the decades-long shoemaking traditions. This happened because of new opportunities in technology which made the whole shoemaking process much more easy and simple.

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1991 is an important date in the history of footwear because this is the year when, at the border of Austria and Italy, archeologists found a naturally mummified human named Oetzi from the Stone Age who died about 3300 years before our era. This Alpine traveler was wearing shoes made from deerskin with a sole made from bearskin and stuffed with hay. This is how it’s thought that the Stone Age footwear production technique was like: the fewer stitches, the dryer and warmer the legs, therefore, they wrinkled the leather. The stitches were small and they were not very reliable given the tools people had at that time.

Above-Chalcolithic leather shoe; ca. 5000 BCE

Below -An artist’s impression of Ötzi’s right shoe. Ötzi is a male mummy found in the Italian Alps in September 1991 in remarkably well-preserved condition.

There isn’t a certain pair of shoes marking the beginning of the history of footwear. This is because there were very different shoes for different climates and different materials used for shoes were available in different regions. In Northern regions, the footwear was made from thick leather and warmed up with fur and hay. Meanwhile, in the Southern regions, there were mostly sandals made from palm leaves or papyrus fiber. Despite the climate, people needed footwear to protect their feet from natural outside effects.

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Many changes and perfected footwear models emerged during the Migration Period (4th- 6th centuries) and during the Crusades (11th- 13th centuries) when Europeans marched to the East. During that time, Europe was flooded with Egyptian sandals and pointed shoes. Soon, the heel was discovered and the western fashion of footwear began to develop, which in the spiritual and rigorous world of the Middle Ages was worn depending on the person’s social class. The most unique and popular trends flourished in Italy and Spain, the countries where the strongest seaports of Europe were located, the craftsmen’s shops and merchants were developing at rapid speed, and the first financial centers were established. So these countries were a true cradle of footwear and attire fashion. Modern footwear designers often look back at history for new ideas, inspiration and creativity. Footwear production methods, sewing structures, leather washing, burning and painting almost hasn’t changed since the end of the 19th century.

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The history of footwear during the Old Times and Antiquity (1250 BC – 476 BC)

The first sandals emerged in ancient Egypt. They were made from palm leaves, papyrus fiber and raw leather. These sandals were stretched and tied at the end of the foot. At first, only clerics and the Pharaoh were able to wear them but later sandals were worn by all ancient Egyptians and the different colors symbolized a certain social class. It’s also worth mentioning China. China’s trends are difficult to understand by many Western countries. For many decades, a canon of beauty in China was golden lotus feet which mostly grew in popularity during the 10th- 11th centuries. Golden lotus feet refers to breaking and bending the toes so that the feet would fit properly into special shoes. Small feet were considered true beauty in the Eastern world.

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Classic Antiquity dates back to the Greek and Roman periods of culture when the early stage of footwear production began to thrive. Fragments of the development and evolution have remained in paintings and drawings. The first and one of the most popular Greek and Roman shoe models were sandals. Unlike with the Egyptians, these sandals were long, went halfway up the knees and had many laces. In both countries, footwear wasn’t divided into men’s and women’s. Everybody wore them in the same way but there were some regulations. In Greek, sandals could only be worn by free citizens who could easily be distinguished from slaves. In ancient Rome, clothes and shoes were a symbol of power and civilization, so the shoes were worn according to the person’s position in society and their social class. Here’s an example: Roman soldiers wore sandals. The more laces the sandals had and the thinner the sole, the higher rank the soldier is.

Figure above shows Ancient Greek and Roman sandals

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The Middle Ages (476 – 1453)

Although the Middle Ages are considered the dark ages, it was during this time that a lot of new footwear trends and fashion appeared. The heel was discovered and was only worn by men at first. Also, pointed shoes, the first footwear structures and a primitive Goodyear structure appeared. At the beginning of the Middle Ages, espadrilles came to Central Europe from the Pyrenees and became very popular. These shoes were made from jute canvas, were light and comfortable but were to be worn in a warmer climate which is why they didn’t reach Northern Europe.

Northern and Central Europe produced leather boots that were turned inside out and sewn up with the shoe sole. It was a nearly seamless structure as the seams remained inside the shoe, thus protecting and strengthening the shoe, but this design could only be used with soft and flexible leather. A benefit of these shoes is that they could be worn during different times of the year by adding some hay or fur inside the shoe during the cold period.

During the Gothic period, unusual footwear with long and pointed tips, called poulaines thrived. Sometimes, the tips of these shoes were as long as half a meter. The length of the tip represented status. Some of these shoes were so long that they needed to be tied to the legs with special laces so that it would be possible to walk properly. This type of footwear was made from different materials, such as velvet, and it was decorated with fancy elements.

Figure above shows Middle Ages footwear and Vic Matie model

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The Middle Ages saw the rise of high-heeled shoes, also associated with power, and the desire to look larger than life, and artwork from that period often depicts bare feet as a symbol of poverty. Depictions of captives such as prisoners or slaves from the same period well into the 18th century show the individuals barefooted almost exclusively, at this contrasting the prevailing partakers of the scene. Officials like prosecutors, judges but also slave owners or passive bystanders were usually portrayed wearing shoes. During the Middle Ages, men and women wore pattens, commonly seen as the predecessor of the modern high-heeled shoe, while the poor and lower classes in Europe, as well as slaves in the New World, were usually barefoot. In the 15th century, chopines were created in Turkey, and were usually 7-8 inches (17.7-20.3 cm) high (figure below). These shoes became popular in Venice and throughout Europe, as a status symbol revealing wealth and social standing.

Popularized by courtesans in Venice, the chopine (a clog-like platform shoe) elevated their wearer’s height by up to twenty inches. It was a simple social equation: the taller the chopine, the more important the person. While they were extreme in height, the construction was relatively simple. Their sturdy soles were usually composed of wood or cork and the upper section of fabric or leather. The vertical impact embodied a new trend – one that we know all to well in our modern times – the shoe as a medium for a woman’s joy and an expression of her passion. 

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Early Modern Times (1453– 1918)

Men’s and women’s fashion was different during this period and until the end of the 18th century, it was mostly dictated by men. Men were the first to wear shoes with heels. Up until the end of the 18th century, men’s legs were considered to be the standard of beauty. Although women also wore fancy shoes, they were hidden under long skirts. So men were the ones to dictate fashion, footwear fashion in particular.

Earlier, fashion changed much slower and shoe trends and production started in countries in a good economic situation and with quickly developing art and aesthetics. For example, Spain and Italy played a great role in costume design in the 16th century. Shoes that were made in these countries later spread widely across Europe. They had the fanciest decorations and patterns and were made using the newest and most fashionable materials of that time.

During the Renaissance period, kings in Europe often wore shoes with very high heels in order to demonstrate their supremacy. Also, they could calmly walk straight through puddles as their heels were as high as 30 cm. These shoes were prototypes of modern platform shoes. King Louis XIV of France, also known as Sun King, played an important role in spreading the popularity of high heels. Even now, fashion historians refer to men’s high heels as French shoes. During the Renaissance period, pointed shoes were swapped with footwear called duck-billed with wide, squared noses. Meanwhile, women began to wear platforms. It was during the revival of culture and aesthetics that the noble knights thrived. They were the first to start wearing ankle boots because they were comfortable for horseback riding and fighting.

In the 17th century, men began to wear boots with fancy socks coming from them. Footwear became more important to women, so Baroque shoes that used to be modest now had various embroidery and decorative elements. Baroque was replaced by Rococo (late Baroque). The main accent of Rococo is the buckle and the Louis heel for women’s footwear.

It wasn’t until 1818, that the right shoe was invented. Until that time, there was no distinction between shoes made for left or right feet. The first pair of right and left footed shoes were made in Philadelphia. Obviously, shoes weren’t made for comfort up to this point. Only in the beginning of the 19th century did men’s and women’s shoes begin to differ in style, color, heel and shape of the front. During the Napoleonic era, fabric footwear became very popular elite shoes. Meanwhile, the classic height of the men’s footwear heel formed which was 2.5 cm. The era when men wore higher high heels than women came to an end.

However, the biggest breakthrough in footwear production was during the Industrial Revolution. Inventors and craftsmen in the United Kingdom and North America invented a modern footwear sewing machine and began mass fabric-made footwear production. Jan Ernst Matzeliger developed a shoemaking method which allowed about 700 pairs of shoes to be made each day. Footwear became accessible to everyone and finally, from the middle of the 19th century, shoes for the left and right foot became different!

In the 19th century, laced shoes began to grow in popularity after Americans began to harden the ends of shoelaces during the end of the 18th century. Laced shoes which were above the ankles became some of the most popular standard shoes for men.

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Modern Times (1918 – these days)

There was a huge breakthrough in footwear in the second part of the 20th century with the establishment and prosperity of American pop culture which was associated with the desire to be different, unique and to be part of a certain subculture. Cheaper raw materials, new structures and a different lifestyle changed the image of gentlemen and ladies. Fancy and high-quality footwear was changed by trendy, constantly changing colorful footwear. Hollywood actors and singers greatly influenced the formation and popularity of this new footwear. The band Beatles popularized Chelsea shoes, actress Audrey Hepburn popularized kitten heels, and schoolgirls wore Mary Jane shoes in the 5th decade.

With the increasing number of working women, high-heel trends began changing. Platforms popular in the 7th and 8th decades lost their popularity and were changed by low heeled shoes in the 9th decade.

Sports shoes had the greatest impact on further footwear fashion. The first step towards the revolution was the invention of sports shoes for basketball players by “Converse” in 1917. These were the very first steps toward trendy sports shoes.

At the end of the 19th century, in 1892, the “U.S. Rubber Company” created a modern, comfortable, beautiful fabric-made sports shoe model with a rubber sole. This is how “Keds” were born. After about 25 years, once these shoes were perfected and patented, mass production began. From the middle of 1940, a visible revolution in sports shoes and clothes began and the era of ladies and gentlemen ended. Comfort, style, improvisation and creativity.

The name “Sneaker’’ came from the English word “sneak”. Henry Nelson McKinney, an advertising agent for N. W. Ayer & Son, was the man who came up with the term “sneaker.”  This was a brilliant marketing idea for the newly invented rubber soled shoes.  He said that the rubber soles made the shoes “stealth” like so he termed them sneakers. The first sneakers were Keds and they were invented in 1917. Sneakers went international in 1923 when a German man made a sneaker and named it after himself. The sneaker is Adidas, named after Adi Dassler. This brand has been the world’s largest seller of athletic shoes.  Adidas, became famous after Jessie Owens won 4 Gold Medals, while wearing Adidas, during the 1936 Olympics.  

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The history of footwear is interesting and intriguing. It reveals the strict division of society into classes, the changing of fashion in different eras. Unlike these days, fashion changed every 10 or even 100 years, not every season. There were times when women couldn’t wear heeled shoes, slaves didn’t have any footwear in order to distinguish them from other people, and the noble competed with each other in terms of how fancy and sophisticated their shoes were. Today, in the free market and society with no laws restricting human rights, we can wear whatever our hearts desire. We can follow fashion trends and find different footwear for each situation and occasion according to our moods or dress code. The amazing 21st century and technological opportunities allow us to have the highest quality, durable and fashionable shoes. And not just one pair but a whole closet full of fashionable shoes!

The only shoe museum in North America is located in Toronto, Ontario. This museum showcases shoes spanning over 4,500 years. The Bata Shoe Museum has compiled exhibits by Sonja Bata.

While times have changed, we can see from history that much is still the same. We can make more shoes with modern machinery and synthetic materials, but despite our understanding of biomechanics, they still influence the foot more than any other single factor, and probably all other factors combined. More importantly, shoes are the cause of most foot problems. 

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Section-5

Types of footwear:  

There are different ways to classify footwear. Open Toe and Closed Toe footwear. Indoor and Outdoor footwear. Men and Women footwear. Slip-on and Lace-up shoes. Yet another way is to classify according to uses. Invariably the styling and design of footwear vary according to users too like for gents, ladies, and children. Climatic requirements in different seasons of the year, price, comfort, locally available materials all these affect the styles and designs. Broadly we may classify footwear as follows. 

Casual wear

Dress wear

Sports footwear

Children’s wear

Industrial wear

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Difference between shoes and boots: 

Boots are footwear that covers not only the feet but also the ankles and sometimes even the lower leg. Shoes cover and protect the feet but generally stay below the ankles. Some dress shoes cover the ankle; they are referred to as high-topped shoe or high tops.

Boots versus Shoes comparison chart

 

Boots

Shoes

What is it?

Footwear that covers the whole foot and lower leg.

Footwear shaped to fit the foot (below the ankle) with a flexible upper of leather or plastic and a sole and heel of heavier material.

Purpose

Originally it was for protecting foot and leg from water, snow and hazardous industrial materials and arduous work. It may cover the ankle, calf or the complete leg. Now it is used for style and fashion also.

It is to protect and comfort the foot while doing day to day activities.

Types

Hip boot, knee-high boots, thigh-length boots, wedge boots, chap boots

Dress and casual, Athletic Orthopaedic, Dance, Work

Styles

Chelsea boots, Mukluks, Wellington boots, Cowboy boots, Gumboots, Rigger boots, Russian boots, Valenki

Oxfords, Blüchers, Monk-straps, Slip-ons, Brogues, High-heeled footwear, Mules, Slingbacks, Ballet flats, Court shoes, Moccasin, Espadrilles

Accessories

Spats, Boot jack, Boot hooks

Shoehorn, Shoe tree, shoe insert, heel grip, foam tap

Made using

Traditionally made from leather or rubber. Now suede, plastic and several other materials

Originally made from leather, wood or canvas. Now made from rubber, plastics, and other petrochemical-derived materials.

Usage: 

Boots are commonly used for work wear, industry, mining, military, riding, walking in snow, skiing, snowboarding, and ice skating. However, with boots now being available in smooth and soft material, it is fashionable for women to use boots with dresses.

Shoes are commonly used for jogging, running, walking, golf, bowling, dancing, and for formal occasions like weddings and at work.

Hiking shoes and hiking boots are both available.

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Types of shoes and boots:

Types of Footwear and their uses are also different. For instance, the shoes are different for home wear. They are made of rubber so as to give your feet the kind of rest it needs at the end of the day. Rubber Slippers are extremely useful for home wear and house work because they don’t get ruined even if you work in water wearing them. The types of footwear are also different for different occasions. The types of footwear have further sub categories that might also include different types of shoes. Although shoes imply full covering of feet not above ankle, partial covering of feet like slippers, sandals etc. are also classifies as shoes by most authors. There are many types of shoes and boots. Some of the main ones are:

ballet shoes: a lightweight shoe designed specifically for ballet dancing. It can be made from soft leather or canvas and has a flexible, thin sole. Ballet shoes don’t have a raised heel.

brogues: a strong leather shoe often with a perforated pattern in the leather. They are traditionally worn by men.

clogs: shoes that are completely made of wood (these are more traditional clogs) or that have a thick wooden sole and a leather top.

cowboy boots: a leather boot with a high heel and generally a pointed toe. The top part of the boot goes halfway between the knee and the ankle and often has decorative stitching. These boots do not have laces. Originally these boots were worn by cowboys or when riding horses.

dress and casual: dress shoes are characterized by smooth and supple leather uppers, leather soles, and narrow sleek figure. Casual shoes are characterized by sturdy leather uppers, non-leather outsoles, and wide profile.

flats: An informal way of saying women’s shoes that have a very low heel.

flip flops / thongs: A plastic or rubber sole with a strap that goes between your big toe and the one next to it. The name comes from the “flip flop” sound they make when you walk in them. In New Zealand they are called jandals.

football boots / soccer boots: a leather shoe with studs on the bottom of it and used for playing football/soccer. Studs are pieces of metal or hard plastic on the bottom of a shoe that stop it from slipping while playing a sport. In some countries, studs are called sprigs.

high heels: women’s shoes that have the heel (the back part of the shoe) raised high off the ground that makes the wearer appear taller. They are mostly used with elegant/formal clothes. Sometimes they are called high-heeled shoes or just heels.

hiking boots: a sturdy boot that covers the foot and ankle. They are designed for long walks in the countryside and are suitable for walking over rough terrain. A hiking boot has a thick, rugged sole to stop the wearer from slipping on certain surfaces.

knee-high boots: These are boots where the back part (that normally covers the ankle) rises to cover the leg up to the knee, either just over the knee or just under it. This part of the boot that covers the leg above the ankle is called the shaft.

kolhapuri chappals: kolhapuri chappals are leather footwear with outer soles of leather, and uppers which consist of leather straps across the instep and around the big toe. 

loafers: a leather shoe shaped like a moccasin, with a slight heel. You can slide your foot into it and they don’t need fastening as they don’t have laces. Sometimes a loafer is called a slip-on shoe.

moccasins: a shoe (without a heel) that is made from soft leather and has large stitches at the top around the front. Normally the sole and the sides of the shoe are made from the same piece of leather, though nowadays they have an additional more sturdy sole. Sometimes moccasins have laces or tassels.

mojari: mojari is a kind of footwear which originated from the Mughal Empire. They were initially embellished with gems, stones, beads etc. They have embroidery over them too. Mojaris give a very royal look to the outfit.

platform shoes / boots: a type of shoe (or boot) with a high, thick sole. They raise the entire foot off the ground.

rubber boots / Wellington Boots: these are waterproof boots made of rubber. They are commonly used for agricultural activities (such as gardening or farming) or on rainy days when there is a lot of water or mud. These are also known as Wellingtons or Wellies for short. In some countries they are called gumboots.

sandals: a light shoe mainly worn in warm weather. It consists of a bottom part (sole) that is held to the foot by straps. Sandals are open so you can see most of the foot and its toes.

slippers: soft, comfortable shoes that keep your feet warm inside the house. They are easy to wear footwear that are light in weight, with no heels and made of soft fabric. You don’t wear slippers outside. Please note that such footwear should be with open heel and without functional laces, buckles or fasteners.

sneakers / trainers: a type of light, comfortable shoe that is typically worn when you play sport, however they can also be used as casual wear. The sole is usually made of rubber. Sneakers (American English) – trainers (British English). Some other names for this type of shoe include runners, running shoes, and tennis shoes.

snowshoes: a pair of flat frames that you attach to the bottom of your shoes so that you can walk on deep snow without sinking into it. Snowshoes work by distributing the weight of a person over a larger area so that the person’s foot does not sink completely into the snow.

stilettos: a type of high heel shoe where the heel part is very narrow and at the ground part has a diameter of no more than 1cm (less than half an inch).

wedges / wedge shoes: a shoe with a high heel forming a solid block with the sole (bottom part of the shoe).

Of course, you normally wear socks with your shoes.

socks: an item of clothing made from soft material (wool, cotton, etc.) that covers your foot and sometimes the lower part of the leg. Socks make your shoes more comfortable to wear. Socks come in pairs and you often lose one of them when you do the washing.

A pair of…

Before all of these words, you can say “a pair of” because there are two of them. e.g., a pair of shoes, a pair of boots, a pair of slippers, a pair of socks etc.

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Difference between sandals and slippers: 

If you’re looking for a pair of shoes that’s easy to slip on, both slippers and sandals may come to mind. Aside from being easy to slip into, they both often lack adequate arch support. However, these two forms of footwear differ in many notable ways.

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Slippers first came into vogue during the 12th century.  Royal families wore them to protect their palaces’ expensive flooring. To this day, slippers offer a sense of luxury and comfort that both royals and regular consumers alike can appreciate. By definition, slippers are soft shoes that are meant to be worn in the home. They are usually made of cozy, plush materials, such as suede, terry cloth, or faux-fur. They can keep your feet warm and toasty, even on the coldest winter mornings. Some slippers have soft soles, whereas others have hard, rubber ones. The latter can be worn outside for short excursions, such as taking the dog out, grabbing the morning paper, or checking the mail. The types of slippers are: Slip on slippers, Slipper boots, Novelty slippers, Sandal slippers, Moccasins, Closed Slippers, Soft-soled slippers, Ugg slippers, Slipper socks and so on. Not all shoes with a soft fluffy interior are slippers. Any shoe with a rubber sole and laces is a normal outdoor shoe. In India, rubber chappals (flip-flops) are worn as indoor shoes.

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Sandals are a type of footwear that leaves the front of your feet exposed. The sole is usually thin and adheres to your foot through the use of one or several straps. The main strap typically goes over your foot’s instep. If there’s more than one strap, the others can go over the instep too, plus your ankles. Flip flops, espadrilles, stilettos, and slides all fall into sandal category. Because sandals keep the majority of your feet exposed, most people prefer to wear them in hotter weather. Doing so provides two benefits: it circulates cool air around your feet, plus moisture is allowed to dissipate. When you have good air circulation for your feet, you regulate your body temperature and also lowers your likelihood of getting athlete’s foot. Unlike slippers, sandals are meant to be worn outside.

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Flip flops (figure above) are usually characterized by the toe post that slips between the first and second toes of the foot and the open-backed, flexible sole that, when you walk, makes the characteristic ‘flippy’ sound that gives them their name. They are some of the most lightweight footwear choices available and popular with men, women and kids alike. They are great for the beach, the pool and casual summer gatherings. They are also often some of the cheapest footwear choices out there, as, as most people know, it’s the rare dollar store that does not have shelves full of flip flops in the summer! 

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Shoe Styles:

There are generally considered eight different shoes styles, with a variety of combined styles. These are listed below. Some shoes today represent a combination of styles:

-1. Boots. These are shoes that extend above the ankle. They can be casual or dress.

-2. Clogs. These are made with a thick wooden or cork sole and backless. They probably originated in rural Europe in the 1300s. They can be casual or dress.

-3. Lace-ups. These traditional shoes, such as the Oxford, are for casual wear, dress and formal. They use laces for a better fit. Many sports shoes are considered lace-ups.

-4. Moccasins. Perhaps the first shoe ever made, along with sandals. The name is from the Algonquians of North America. Imitation moccasins originated in Norway and are popular today as loafers. They are usually casual, but some are dressy. The loafer is a type of shoe that is easily slipped on and off the foot without any laces to worry about. Loafers traditionally never have any types of laces, while moccasins can be seen adorned with tassels or laces for purely a decorative element rather than tying.

-5. Monks. These are similar to lace-ups but instead of lacing have a strap that comes over the top of the shoe to adjust the fit. They can be for casual or dress. Some sports shoes are made with this style.

-6. Mules. These are backless shoes, with or without heels. The flat soft versions are slippers. They can be for very casual to very formal.

-7. Pumps. These are the traditional elegant high-heeled shoes with open front tops or toe boxes, often with long spiked heels. These are usually for dress or formal.

-8. Sandals. Some have heels, others are flat, some are thongs while others have fancy lacing up the leg. Wooden sandals (geta) are of Japanese origin. Sandals can be casual or dress.

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Classic Types of Men’s Shoes:

Most classic men’s shoe types were designed in various European fashion capitals during the 19th century. The impetus: the rise of the first fashion journals and a sort of competition among European shoemakers between 1880 and 1889. The shoe types created then have stood the test of time, although, in keeping with trends, they’ve undertaken slight modifications over the years. Classic types of men’s shoes don’t merely differ from one another in appearance, but also in closure and decoration. Shoes are usually classified by their types of closure. Classic types of men’s shoes include lace-up shoes (oxford, derby, blucher, budapester, men’s boots), buckled shoes (monk strap), and slip-on shoes (loafer, moccasin, boat shoe).

When it comes to the manufacturing process behind these high-quality men’s shoes, top-grade leather is indispensable. Shoe history shows that shoe construction and production methods have hardly changed over the years: the craft remains steeped in tradition. Shoe care regimens and shoe-centric dress codes have also remained largely unchanged. In terms of their outward appearance, classic shoes offer aesthetes a real feast for the eyes. Meanwhile, their interiors boast high-quality materials that support healthy feet by ensuring an optimal shoe fit.  

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Women’s shoes:

There is a large variety of shoes available for women, in addition to most of the men’s styles being more accepted as unisex. Some broad categories are:

High-heeled footwear is footwear that raises the heels, typically 2 inches (5 cm) or more above the toes, commonly worn by women for formal occasions or social outings. Variants include kitten heels (typically 1+1⁄2–2 inches high) and stiletto heels (with a very narrow heel post) and wedge heels (with a wedge-shaped sole rather than a heel post).

Mules are shoes or slippers with no fitting around the heel (i.e., they are backless)

Slingbacks are shoes which are secured by a strap behind the heel, rather than over the top of the foot.

Ballet flats, known in the UK as ballerinas, ballet pumps or skimmers, are shoes with a very low heel and a relatively short vamp, exposing much of the instep. They are popular for warm-weather wear, and may be seen as more comfortable than shoes with a higher heel.

Court shoes, known in the United States as pumps, are typically high-heeled, slip-on dress shoes.

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High heeled shoes:

High heels are a type of shoe in which the heel is significantly higher off the ground compared to the toes. High, or elevated, heels are anything over 3.5 cm and can be as much as 18 cm or more in the case of ballet boots. High heels make the wearer appear taller, accentuate the muscle tone in their legs and make their legs appear visibly longer. 

There are many types of high heels, which come in different styles, colors and materials, and can be found all over the world. The first known pictorial evidence of high heels comes from 10th-century Persia (Iran) where they were worn by men in combination with stirrups for horse riding. Heels have had significant cultural and fashionable meanings attached to them over the past 1,000 years, especially regarding the social construction of gender in the West. Although in the 17th century high heels were the sign of masculine power and social status by the 21st century narrow high heels represented femininity and “erotic capital” although a thick high heel was still acceptable for males in some situations. Wearing high heels is associated with health risks such as a greater risk of falls in the elderly, musculoskeletal pain, developing foot deformities and developing varicose veins.

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Though there are many variations in both heel and upper design, most high heels are made up of the same common parts, as shown in figure below. 

Figure above shows the structure of a high heeled shoe.  

The many parts which make up a high heel can each dramatically affect the performance of the shoe including its comfort and the pressure distribution experienced on the plantar surface, and therefore the way in which we should describe the shoe. Past research has shown that increasing heel height changes the mechanical behaviour of the foot, including its dimensions (such as length), movement, and its damping characteristics (by making the foot stiffer which inhibits its ability to dissipate loading across the plantar surface). Due to the effects of raising the heel height it is logical to classify the height of the heel as “high” or “low” by its expected influence on the foot. For example, assuming dorsiflexion of the first toe engages the windlass mechanism model, a shoe might be classed as ‘high heeled ‘, when it increases first toe dorsiflexion and thereby increases the engagement of the windlass mechanism (i.e., increases tension in the plantar fascia). The windlass mechanism is thought to become engaged when the toes are extended. For an average ball length of the female foot, we can assume that the windlass mechanism is engaged when the difference between the height of the base of the heel and forefoot is 7cm (which would extend the toe). This serves as an example of how a functional effect of a high heeled shoe (engagement of the windlass mechanism) could be used to define the shoe as “high”.  

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Insolia:

Insolia is a component in the design of the high-heeled shoe designed by New Hampshire podiatrist Dr. Howard Dananberg. It reduces the pain associated with wearing high-heeled shoes by adjusting weight distribution back toward the heel through altering the geometry of the insole, rather than with padding.

Figure above shows visual of weight concentration shift.

With ordinary high-heeled shoes, the body weight is concentrated to the toes; this can make the wearer uncomfortable. The Insolia design shifts some of this weight back to the heel in an attempt to reduce high heel foot pain. The weight shift is accomplished by altering the geometry of the insole.  

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Elevator shoes are shoes that have thickened sections of the insoles (known as shoe lifts) under the heels to make the wearer appear taller, or “elevate” them as the name suggests. Unlike high-heeled shoes, the component of elevator shoes that increases the wearer’s height is inside the shoe, hiding it from observers. An elevator shoe, like the platform shoe’s heel, can be made from different soles like plastic, wood, or rubber. Shoes with thickened soles are also used in cases of orthopedic problems, although the term “elevator shoe” is not usually used for these.

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Dance footwear:

A wide variety of footwear is used by dancers. The choice of dance shoe type depends on the style of dance that is to be performed and, in many cases, the characteristics of the surface that will be danced on.

Pointe shoes are designed for ballet dancing. These have a toe box that is stiffened with glue and a hardened sole so the dancer can stand on the tips of their toes. They are secured by elastic straps and ribbons that are tied to the dancer’s ankles.

Ballet shoes are soft, pliable shoes made of canvas or leather, with either continuous or two-part sole (also called split-sole), used for ballet dancing. The sole is typically made of leather, with thicker material under the ball and heel of the foot, and thinner and thus more flexible material under the arch so that the foot can be easily pointed. They are typically secured by elastics across the top of the foot.

Ghillies are soft shoes that are used in Irish dance, Scottish country dance, and highland dance.

Jazz shoes typically have a two-part rubberized sole (also called split-sole) to provide both flexibility and traction, and a short heel. They are secured to the foot by laces or elastic inserts.

Tango and Flamenco shoes are used for tango or flamenco dancing.

Ballroom shoes fall into two categories: Ballroom and Latin American. Both are characterised by suede soles. Men’s ballroom shoes are typically lace-ups with one-inch heels and patent leather uppers. Ladies’ ballroom shoes are typically court shoes with two-inch heels, made of fabric that can be colored to match the dancer’s dress. In contrast to the low Ballroom heel, which evenly distributes weight across the foot, Latin American shoes have higher heels designed to shift weight onto the toes. Latin shoes are also more flexible than ballroom shoes. Men’s Latin shoes typically have 1.5- to 2-inch high, shaped heels, while Ladies’ Latin shoes have 2.5-inch to 3-inch heels. Ladies shoes are typically open-toed and strapped.

Dance sneakers are lightweight sneakers with reinforced rubber toes that allows dancers to briefly stand on their toes. These are known by various trademarked names, such as dansneakers.

Foot thongs are slip-on, partial foot covers that cover the ball of the dancer’s foot so as to reduce friction while executing turns, thus making it easier to perform turns and also protecting the foot from skin abrasions. From a distance, flesh colored foot thongs give a dancer the appearance of having bare feet. They are known by various names depending on the manufacturer, including dance paws, foot undies, and foot paws.

Tap shoes have metal plates mounted to the bottoms of the toe and heel. The metal plates, which are known as taps, make a loud sound when struck against a hard performance surface. Tap shoes, which are used in tap dancing, may be made from any style of shoe to which taps can be attached.

Character shoes are leather shoes with one- to three-inch heels, usually with one or more straps across the instep to secure it to the foot. They may be soft-soled (suede) or hard-soled. They may be converted to tap shoes by attaching taps.

Ballet boots:

The ballet boot is a contemporary style of fetish footwear that merges the look of the pointe shoe with a high heel. The idea is to restrict the wearer’s feet almost en pointe, like those of a ballerina, with the aid of long, slender heels (Dori shoes). When upright, the feet are held nearly vertical by the shoe, thus putting nearly all of the body’s weight on the tips of the toes. However, a properly tight fit (firmly laced) will hold the shoe to the wearer’s instep and heel, thereby reducing the weight on the wearer’s toes.

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Crocs:

Crocs, Inc. is an American company based in Broomfield, Colorado that manufactures and markets the Crocs brand of foam clogs. Crocs is a brand and Clogs are one type of shoes that is produced by Crocs. Please do not misunderstand these clogs from original Clogs footwear which is partly or wholly made from wood. Born in 2002, the shoe was initially intended as footwear for boating, with its nonslip tread and waterproof tendencies. “The product was originally produced in Canada in clog-form,” says co-founder Lyndon V. Hanson, III, vice president of Crocs. “We added a strap for utility, and gave it some flair.” Crocs are certified by the U.S. Ergonomics Council and the American Podiatric Medical Association. These shoes were designed specifically to eliminate plantar pain and achy feet. They also help people with injured feet, bunions, and diabetes. You’ve got a lot of inner support, heel cups and massaging heel nubs, and arch support. They’re ideal for people with foot problems.  Crocs offer more protection for your feet than flip-flops. Flip-flops don’t provide a lot of arch support; they’re open-toed so you can stub your toe and hurt yourself. Crocs offer more protection and comfort than that.

Dr. Megan Leahy, a Chicago-based podiatrist with the Illinois Bone and Joint Institute says: “Unfortunately Crocs are not suitable for all-day use”. She added that though Crocs “offer nice arch support,” it should not be worn over longer periods because “these shoes do not adequately secure the heel. When the heel is unstable, toes tend to grip which can lead to tendinitis, worsening of toe deformities, nail problems, corns and calluses. The same thing can happen with flip flops or any backless shoes as the heel is not secured.” 

Dr. Alex Kor, the president of the American Academy of Podiatric Sports Medicine says: “The only two types of patients that may benefit from wearing Crocs are patients that have a very high arch or those who suffer from excessive edema of their legs and ankle. But, under no circumstances can I suggest wearing Crocs 8 to 10 hours per day.” 

According to Dr Pradeep Moonot, an orthopedic surgeon from Mumbai, “Such shoes do not provide ample support to the feet. When a person walks, his/her footwear should be properly attached to the foot. If you wear footwear like crocs, it’s your feet holding the shoes. Every time you wear them you hold and tighten up all the muscles. It’s fine to walk in them for a short distance or wear it at home.”

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Sneakers:

Sneaker is a term that has become very common among people these days as they use it for sports shoes as if it is a synonym for them. People refer to all sorts of shoes with rubber soles as sneakers though it is not correct. The reason why these shoes got their name was because they made very little noise while walking because of their rubber soles. You could sneak up to someone else while wearing these shoes and hence the name. Today there is a huge variety of sneakers available in the market and you can have one for use in the gymnasium while there are also sneakers for jogging as well as running. Sneaker is a term that is mostly used in North America while the term for similar shoes in England and Australia is joggers and trainers. According to the World Footwear Yearbook, over 24 billion pairs of shoes are produced annually with sneakers accounting for the largest share.

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Are Sneakers Shoes? Yes, but with difference.

  • Shoe is a generic term for all footwear worn by men and women while sneaker is a term reserved especially for athletic shoes.
  • Not all athletic shoes are sneakers.
  • Sneaker is a term used mostly in America, whereas these shoes are referred to as joggers in Britain.
  • While shoes can be made from many different materials, sneakers are generally made from synthetic fabric with rubber soles only.
  • Sneakers are meant for comfort and physical activities and considered casual shoes whereas those made with leather are considered formal.

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Leather sneakers:

Canvas sneakers originated in France nearly 100 years ago, for wearing during tennis matches. Both canvas and synthetic sneakers are now manufactured for all kinds of activities from basketball to trail running and skateboarding. They are also extremely popular just for fashion. But when it comes to a balanced combination of style, comfort, and longevity, leather sneakers rule.

Long-Lasting Durability:

Canvas is basically made from cotton, which is a wonderful textile. But cotton cannot compete with real leather when it comes to wear and tear. For protecting your feet and giving them the added ergonomic support they need, expertly crafted leather sneakers are far superior. Unlike synthetic or canvas sneakers, those constructed from fine leather will also conform to the shape of your foot over time, for an even better fit. They’ll last for years or decades, not just for a season or two.

Weathering the Elements: 

Dirty sneakers may be fine for a fishing trip or game of Frisbee, but as a fashion statement they can send the wrong message. That’s particularly true with lighter colors like white that are so popular for sneakers. Maybe you can clean with brush and wet cloth but the stains may not come out, even after repeated attempts. But leather is easy to maintain and protect. If they get dirty you can use a slightly damp cloth to clean them. For stubborn dirt, work in some saddle soap lather or leather conditioner. Then wipe them dry and polish. They will be better protected from stains and moisture and keep looking like new.

Styles and Colors:

Leather sneakers come in a wide range of styles and colors, too. The Belvedere Angelo, for example, combines the lines of a chukka boot and a mid-top sneaker. Made of genuine caiman and Italian calf, the Angelo is available in black, red, or white. The leather lining feels buttery smooth, in case you want to wear them without socks. Another superb leather sneaker is the Paulo, made of soft calf and genuine ostrich in an assortment of colors. Ostrich is known for being soft and supple, but it is also a leather that boasts exceptional durability.

Athletics and Aesthetics:

You play lots of roles and make lots of different scenes, and your sneakers need to be just as adaptable and flexible. If they are made of stylish leather, you can hit the streets in them and stop off for a pickup game of hoops. Wear them to the office and you can totally rock them with business casual attire. But they are handsome enough to wear after hours as well, for a night on the town. That’s one of the coolest things about beautiful leather sneakers. They are extremely versatile everyday kicks that go great with whatever you decide to wear. So if your activities and wardrobe needs change spontaneously and unexpectedly, you won’t have to run home to change your footwear.

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Breathable Shoes:  

Breathable shoes are shoes made of materials that allow air and water vapor to escape from inside the shoe, while also allowing cooler air from outside to enter. This prevents sweat from accumulating inside the shoe, which can lead to fungal or bacterial infections of the foot.

If you’ve ever had a moment when you take off your shoes after a long day of work and the smell overwhelms you… you’re not alone. We’ve all been embarrassed by smelly shoes in our lives. Most shoes are made of rubber, which traps heat and moisture, resulting in smelly shoes. To combat this, a gentleman in Italy invented shoes with breathable soles that allow the trapped odor and heat to escape. This new range of shoes not only releases any stink, but also releases heat, keeping your feet comfortable all day. Mario Moretti Polegato, an Italian entrepreneur, developed the concept of breathable shoes. He belonged to a family of winemakers, not cobblers, and during a visit to a wine fair in Nevada, USA, in the early 1990s, he had a Eureka moment. During the fair, his shoes overheated due to their rubber soles, and as a result, he made holes in the bottom of his shoes to let them “breathe”. That simple solution led him on a path to let shoes breathe all over the world. He committed himself to developing a technology that could provide shoes with a breathable sole containing holes, while still being waterproof.

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Fabrics like cotton are great during the summer, as they let air move through their tiny pores. Cooler air from outside can enter inside, while warm air can move outside, giving you some level of comfort. This property is known as the breathability of a fabric. The fabric does not trap any heat and, as a result, provides a cool feeling, even if worn for many hours.

Shoes, on the other hand, are made from materials like rubber and or plastics, including polyurethane or polyvinylchloride (PVC). These materials are particularly prevalent in the soles of the shoes. Unlike cotton, rubber and plastics are non-breathable materials. They trap the sweat and bacteria, as well as heat, inside the shoe.

Breathable shoes, on the other hand, have a waterproof porous membrane on the upper sole that allows heat to escape. The upper membrane of the shoe is made of a breathable, waterproof and microporous film of polytetrafluoroethylene (PTFE) or expanded polytetrafluoroethylene (e-PTFE). The e-PTFE microporous membrane has over a billion pores per square centimeter. This is smaller than even the smallest water droplet, but several times larger than a water vapor molecule. As a result, water droplet cannot enter the membrane, but any water vapor that is formed due to sweat can easily escape the membrane.

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Section-6

Foot, arches and gait:  

The foot and ankle form a complex system which consists of 28 bones, 33 joints, 112 ligaments, controlled by 13 extrinsic and 21 intrinsic muscles. A study of 2,000 adults found they each typically stroll 6,839 steps a day – amounting to 2,496,235 a year and 75,000 miles in a life time. The foot stands 3-4 times body weight during running. 

The ankle or tibiotalar joint constitutes the junction of the lower leg and foot. The osseous components of the ankle joint include the distal tibia, distal fibula, and talus. The anatomic structures below the ankle joint comprise the foot, which includes:

Hindfoot: Hindfoot, the most posterior aspect of the foot, is composed of the talus and calcaneus, two of the seven tarsal bones. The talus and calcaneus articulation is referred to as the subtalar joint, which has three facets on each of the talus and calcaneus.

Midfoot: The midfoot is made up of five of the seven tarsal bones: navicular, cuboid, and medial, middle, and lateral cuneiforms.  The junction between the hind and midfoot is termed the Chopart’s joint, which includes the talonavicular and calcaneocuboid joints.

Forefoot: The forefoot is the most anterior aspect of the foot. It includes metatarsals, phalanges (toes), and sesamoid bones. There are a metatarsal and three phalanges for each digit apart from the great toe, which only has two phalanges. The articulation of the midfoot and forefoot forms the Lisfranc joint.

Foot functions as a rigid structure for weight bearing and it can also function as a flexible structure to conform to uneven terrain. The foot and ankle provide various important functions which includes:

-Supporting body weight.

-Providing balance. 

-Shock absorption.

-Transferring ground reaction forces.

-Compensating for proximal malalignment.

-Substituting hand function in individuals with upper extremity amputation/paralysis.

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Arches of foot:

The foot has three arches: two longitudinal (medial and lateral) arches and one anterior transverse arch. These arches are formed by the tarsal and metatarsal bones and are supported by the ligaments and tendons in the foot. The arches shape is designed in a similar manner to spring; bears the weight of the body and absorbs the shock that is produced with locomotion. The foot’s flexibility conferred by the arches is what facilitates everyday loco-motor functions such as walking and sprinting. The energy-sparing spring theory of the foot’s arch has become central to interpretations of the foot’s mechanical function and evolution. The metabolic energy saved by the arch is largely explained by the passive-elastic work it supplies that would otherwise be done by active muscle.

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Figure above shows transverse, medial longitudinal and lateral longitudinal arches of the foot.

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Longitudinal Arches: 

There are two longitudinal arches in the foot – the medial and lateral arches. They are formed between the tarsal bones and the proximal end of the metatarsals.

Medial Arch

The medial arch is the higher of the two longitudinal arches. It is formed by the calcaneus, talus, navicular, three cuneiforms and first three metatarsal bones.

Lateral Arch

The lateral arch is the flatter of the two longitudinal arches, and lies on the ground in the standing position. It is formed by the calcaneus, cuboid and 4th and 5th metatarsal bones.

Transverse Arch:

The transverse arch is located in the coronal plane of the foot. It is formed by the metatarsal bases, the cuboid and the three cuneiform bones.

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The foot’s anatomy allows it not only to serve as a flexible lever to help absorb energy during the first half of ground contact, but also to become a rigid lever to push the body into the next step during the second half of ground contact.

During the first half of ground contact, the foot pronates, a combination of inward rotation along the length of the foot (eversion), upward rotation of the foot toward the shin (dorsiflexion), and outward rotation of the foot relative to the tibia (external rotation). Muscles pulling on the foot act eccentrically (pull while getting longer) to control the rate and extent of pronation. The second half of ground contact is a reversal of the pronation. During this phase, the foot supinates, a combination of outward rotation along the length of the foot (inversion), downward rotation of the foot away from the shin (plantarflexion), and inward rotation of the foot relative to the shin (internal rotation). Muscles pulling on the foot act concentrically (pull while getting shorter) to cause the supination.

Pronation is a critical part of absorbing energy, and supination is a critical part of generating energy, and the two actions of the foot are coordinated with the flexion and extension occurring at the knee when running. The amount of pronation and supination differs among individuals, because of differences in skeletal structure, muscle strength and endurance, and running style.

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It’s important to learn the structure of your feet, specifically your arch, as it provides some hints as to what the best shoe might be for you. A simple test, called the Wet test, will help determine your arch type.

The wet test process:

-1. Dipping the soles of your feet into water.

-2. Stand on a piece of paper.

-3. When you step off, you should see an imprint of your foot which will show you your arch type.

Seeing half of your arch (the middle portion of your foot) indicates a normal arch, while seeing the majority of your arch on the paper indicates you have flat feet (or a low arch). Conversely, seeing minimal arch indicates a high arch.

There are three different foot types: neutral arch, low arch, and high arch. The height of your arch affects the direction and severity of the way your foot rolls – or pronates. Here are the three types and how they most likely roll:

-1. Neutral arch typically causes the foot to roll to a healthy spot.

-2. Low arch typically causes the foot to roll excessively inward, or overpronate.

-3. High arch typically causes the foot to roll in only slightly at impact, or underpronate (supinate).

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Gait – the manner or style of walking.

Gait speed: 

Normal walking speed primarily involves the lower extremities, with the arms and trunk providing stability and balance.

Faster speeds – body depends on the upper extremities and trunk for propulsion, balance and stability with the lower limb joints producing greater ranges of motion.

The gait cycle is a repetitive pattern involving steps and strides.

A step is one single step

A stride is a whole gait cycle.

Step time – time between heel strike of one leg and heel strike of the contralateral leg.

Step width – the mediolateral space between the two feet.

The demarcation between walking and running occurs when periods of double support during the stance phase of the gait cycle (both feet are simultaneously in contact with the ground) give way to two periods of double float at the beginning and the end of the swing phase of gait (neither foot is touching the ground). 

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Cadence: 

In running, cadence is often defined as the total number of steps you take per minute. One easy way to measure your cadence for running is to count the times your feet hit the ground in 60 seconds. Cadence is one of the two factors that make up a runner’s speed. The other is stride length. Good runners usually have a higher cadence because they usually go faster than beginners. Top marathoners typically run with a cadence above 90, whereas most beginners will run at 78–82.

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Foot strikes:

How a runner land on the foot each time the runner takes a step is called the foot strike. Pronation is a natural movement of the human body which is characterised by the way a person’s foot roll inwards for the impact distribution upon landing phase of running.

Foot strike can be classified as:

Forefoot: In this foot strike, the weight of impact is on your toes and ball of the foot. The heels rarely hit the ground between steps.

Midfoot: In this foot strike, the center of your foot lands on the pavement to evenly distribute the shock of impact.

Rearfoot: In the rearfoot or heel strike, runners hit the pavement with the back of your foot. It is the most common foot strike among recreational runners.

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Walking is associated with first striking the heel, whereas a running gait involves landing farther forward on the foot—a midfoot strike in most cases with more forefoot landing as running speed increases.

Making contact with the ground imparts impact forces—the foot literally collides with the earth on each step. While impact is often seen as a negative aspect of running, equating to trauma and injury, a proper gait is potentially associated with better bone density and improved muscle and tendon function, better circulation, and other healthy benefits associated with exercise. With proper gait, colliding with the ground is well compensated for—humans have evolved an effective gait mechanism.

Phases of the gait cycle in walking are seen in the figure below:

Impact forces during walking are relatively minor. But heel striking while running can be a significant loss of energy, a common example of an improper gait producing stress from impact. The overall mechanics of the foot, ankle and leg, and many body areas above are stressed with abnormal heel striking compared to the runner who lands farther forward. Mid- or forefoot running is associated with a more optimal gait that’s usually not impact impaired. 

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The Running Gait Cycle:

Stride or a Gait cycle is defined as a period when one foot meets the ground to when the same foot gets in touch with the ground again.

Each stride is broken into two phases: The Stance Phase and the Swing Phase.

The Stance Phase: 

The phase when the entire time one foot is in touch with the ground and the other leg is swinging forward. The periods in the Stance phase are as following:

Loading response begins with initial contact. Imagine your left leg is out in front of you and about to touch the ground. The instant the left foot touches the ground, the stance phase begins with the period known as loading response. Your right foot behind you is in the swing phase during this period.

Midstance or single support phase begins when one leg is directly under the hips taking the maximum load and the body passes over it. The ankle and knee are bent to the maximum. This is the single-limb support phase.

Terminal stance begins when the center of gravity is over the supporting foot (left) and ends when the right foot contacts the ground. Pre-swing begins at the right foot’s initial contact and ends at toe-off which corresponds to the gait cycle’s period of double limb support.

The Swing Phase:

The phase when the entire time both feet are off the ground.

The periods in Swing phase are as following:

Initial swing begins at toe-off and continues until maximum knee bend (up to 60 degrees) occurs. The left leg is far behind and the heel starts to lift off.

Mid swing is the period from maximum knee bend until the shin is vertical or perpendicular to the ground.

Terminal swing begins where the shin is vertical and ends at initial contact of right foot. Once one knee crosses from under the hips, the lower leg unfolds. It prepares once again for initial contact marking the end of swing phase.

The following image sums up the biomechanics of running well.

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Running is similar to walking in terms of locomotive activity. However, there are key differences. Having the ability to walk does not mean that the individual has the ability to run.  In walking, the gait cycle is one third longer in time, the ground reaction force is smaller in the gait cycle (so the load is lower), and the velocity is much slower. In running, there is also just one stance phase while in walking there are two. Shock absorption is also much larger in comparison to walking. Running, a natural extension of walking, involves increased velocities, joint range of motion, forces, muscle activity, joint moments, and joint powers as compared with walking. These differences not only stress the mechanics of the body to a greater extent but also contribute to the development of injury due to overuse.

Running requires:

-Greater balance

-Greater muscle strength

-Greater joint range of movement

There is a need for greater balance because the double support period present in walking is not present when running. There is also the addition of a double float period during which both feet are off the ground, not making contact with the support surface.

The amount of time that the runner spends in float, increases as the runner increases in speed. The muscles must produce greater energy to elevate the head, arms and trunk (HAT) higher than in normal walking, and to support HAT during the gait cycle. The muscles and joints, must also be able to absorb increased amounts of energy to control the weight of HAT. 

During the running gait cycle, the Ground reaction force (GRF) at the center of pressure (COP) have been shown to increase to 250% of the body weight.

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The unique plantigrade alignment of the human foot results in a distal-limb structure that can adapt to a variety of conditions. The less mobile and more robust tarsal bones are shaped and aligned to accept and transmit large loads during the early phases of stance (initial contact and loading response phases of walking, and inadvertent heel strikes during running). The tarsals of the midfoot, which are smaller and shorter than the hindfoot tarsals, appear well oriented to transmit loads between the hindfoot and forefoot; this is necessary for load transfer and locking of the foot complex into a rigid lever for late stance phase. Conversely, the midfoot bones and joints also allow for the transmission of loads and inter-joint movement that unlocks the foot to create a loosely packed structure which renders the foot highly compliant over a variety of surfaces. In this configuration, the foot is able to absorb and damp the large loads encountered during heel strike and early weight acceptance. The forefoot, with its long metatarsal and relatively long phalanges, transmits loads during the end-of-stance phase that facilitate the push-off and transfer of forward momentum. The forefoot also serves as a lever to allow balance during standing and jumping. In addition, the arches of the foot that span the hindfoot, midfoot and forefoot play a critical role in the nature of transformation of the foot from a rigid lever to a flexible weight-accepting structure.

With a running gait, the foot-loading order is usually the reverse of walking. The foot strikes the ground with the ball of the foot, and then the heel drops. The heel drop elastically extends the Achilles tendon; this extension is reversed during the push-off.

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The medial longitudinal arch (the arch) plays a critical role in shock absorption and propulsion of the foot while walking. To comprehend the function of the medial arch, the gait cycle must be understood. There are two phases in the gait cycle, the stance phase and the swing phase. As the heel strikes the ground, the foot is supinated, and then it enters the stance phase. During mid-stance, the medial longitudinal arch is lengthened and flattened due to protonation of the forefoot. Elastic tendons and ligaments that become stretched during this phase store mechanical energy. Once the medial arch reaches its maximum length, it then begins to shorten until the heel leaves the ground during terminal stance. The medial arch becomes shortened and heightened just before the toes leave the ground due to the supination of the hindfoot and elastic recoil of tissue (arch recoil). During this phase, the mechanical energy that was stored is released back to the body as power for propulsion of the foot during the gait cycle. The anterior pillar of the medial longitudinal arch (the medial three metatarsal heads) acts as a springboard during the takeoff of the foot. The Lisfrac joint also plays a role in propulsion by allowing minor plantarflexion and dorsiflexion. While the foot is in the air, it is in the swing phase.

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The Windlass Mechanism:

Hicks originally described the foot and its ligaments as an arch-like triangular structure or truss. The calcaneus, midtarsal joint, and metatarsals (the medial longitudinal arch) formed the truss’s arch. The plantar fascia formed the tie-rod that ran from the calcaneus to the phalanges. Vertical forces from body weight travel downward via the tibia and tend to flatten the medial longitudinal arch. Furthermore, ground reaction forces travel upward on the calcaneus and the metatarsal heads, which can further attenuate the flattening effect because these forces fall both posterior and anterior to the tibia.

The plantar aponeurosis originates from the base of the calcaneus and extends distally to the phalanges. Stretch tension from the plantar fascia prevents the spreading of the calcaneus and the metatarsals and maintains the medial longitudinal arch.  The plantar fascia prevents foot collapse by virtue of its anatomical orientation and tensile strength.

A “windlass” is the tightening of a rope or cable. The plantar fascia simulates a cable attached to the calcaneus and the metatarsophalangeal joints. Dorsiflexion during the propulsive phase of gait winds the plantar fascia around the head of the metatarsal. This winding of the plantar fascia shortens the distance between the calcaneus and metatarsals to elevate the medial longitudinal arch. The plantar fascia shortening that results from hallux dorsiflexion is the essence of the windlass mechanism principle.  

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Foot Type & Pronation:

When you run, you naturally land on the outside of your foot and roll inward. This inward rolling is called pronation. When running, your foot will typically land on the outside edge and roll inward. This inward roll is known as pronation. There is a widely held belief that excessive pronation leads to injuries, and that running shoes can reduce the pronation and prevent injuries.

Pronation refers to the way your foot rolls inward for impact distribution upon landing. Understanding your pronation type can help you find a comfortable running shoe.

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Types of Gait Patterns: 

In general, there are three types of gait patterns:

-1. Normal: Pronation is the natural movement of your foot as you walk or run, with your foot rolling in slightly with each step.

-2. Overpronation: Here, the ankle rolls more inward and downward with each step and continues that motion when the toes should start to push off. Common in those with flat feet, overpronation creates a twisting motion with the toes doing most of the work, which can be associated with knee pain and shin splints.

-3. Underpronation: Also called supination, this gait causes your foot to roll outward with each step, putting more pressure on the outside edge of your foot and small toes. It’s most common in people with high, rigid arches and can be associated with iliotibial (IT) band syndrome and stress fractures.

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How to determine your pronation type:

-1. Video gait analysis

A video is taken of a runner’s feet while running on a treadmill. The video footage is slowed down and analyzed in detail by expert at a specialty running store, podiatrist, or physical therapist, who will explain your running type and help you select the right pair of running shoes.

-2. 3D foot mapping

The most advanced version of video gait analysis is 3D foot mapping, which, in addition to video, uses both lasers and micro cameras to create a highly detailed 3D image of the foot. A range of information is obtained from the scan, such as arch height and alignment of the Achilles with the leg. This is used to determine the right running shoe and provide additional insight into what may be causing recurrent injuries.

-3. Check wear pattern on your shoe

Wear patterns won’t provide the full picture of gait analysis, but they can give additional clues about the impact on your feet. This can give you an idea of where you may need extra support and cushioning in your running shoes.

There are three basic types of foot patterns:

-1. Normal foot pattern: For someone with a normal foot pattern, the bottoms of your shoes would show wear on the middle of the heel (where your foot first hits when you walk) and on the middle of the balls of your feet (where you push off when you step).

-2. Overpronator: The bottoms of the shoes of overpronators show wear on the inside edges of your heels and on the inside edges of the balls of your feet (the side toward the big toe).

-3. Supinator: Supinators show wear on the outside edges of your heels and on the outsides of the balls of your feet (the side toward the pinky toe).

The appearance of wear patterns on shoes may take several weeks, or even months, of use to appear.

What sorts of problems are associated with abnormal foot patterns?

For overpronators, the problem is that their foot is too flexible. The feet of overpronators collapse too much and don’t get a good, rigid push-off when they step because their foot is rolled in onto their arch. This can lead to problems such as soft-tissue damage, hip pain and tendonitis.

Supinators have the opposite problem – they have feet that are too rigid.  Supinators have arches that are raised too much, so they don’t absorb shock very well when their feet first hit the ground. This can lead to stress fractures, IT band syndrome (a tightening of the ligaments connecting the pelvic and shin bones that can cause hip and knee pain) and bone injuries.

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Three Types of Running Shoes:

Now that you know your foot type, it’s time to find the right shoe. Shoes are generally placed into three categories. These categories are not always clearly labeled on the shoe or box, so be sure to ask a salesperson or do your research online. Most brands have this information on their website.

Stability Shoes:

Stability shoes are best for runners with normal arches and only mild control problems. The extra stability these shoes offer comes from extra arch-side supports and high-density foam. Stability shoes are typically built with a gentle arch from front to back that provides rear-foot stability and forefoot flexibility.

Motion Control Shoe:

Motion control shoes are great for flat-footed and heavy runners who tend to overpronate. These shoes typically have rigid devices made out of plastic, fiberglass, or high density foam. The arch area on motion control shoes is filled in for increased stability which is why there is a different color at the midsole. The extra rigidity in these shoes prevents the heel from turning out and the foot from overpronating.

Cushioning Shoes:

Cushioning shoes support people with high arches and rigid feet who tend to underpronate. This highly flexible shoe is built on a curve and made of lightweight materials that provide minimal rigidity with optimal cushioning.  Underpronators (supinators) need a lot of cushioning to avoid impact injuries.

There is good evidence to support the widely held belief that injury rates among runners are quite high, with estimates of injury rates varying between 20% and 80% of runners.  It is widely assumed that impact forces and excessive pronation cause running injuries, and that running shoes are designed to alleviate these problems. This leads to the common recommendation that different types of shoes should be recommended based on a runners arch height. In fact, REI, Zappos, Runners’ World, and Road Runner Sports all include this advice.

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Anti-Pronation devices in Shoes:  

Shoe manufacturers use several techniques in an attempt to reduce pronation. These measures are generally ineffectual, as even motion control shoes (the category with the most extreme anti-pronation measures) only reduce pronation by around 2%.

-1. Medial Post. Running shoes attempt to reduce pronation primarily by using firmer foam on the inside edge of the shoe, just in front of the heel.

-2. Heel counter. To try to bind the rear of the shoe to the heel of the foot, the part of the upper that goes around the back of the shoe is often made of a much stronger material. 

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Wearing proper footwear is one aspect of daily life that people tend to pay very little attention to. Most of the pain that people have throughout the day such as back pain and shin splints may start at the feet. Yes, everyone has 10 toes but not every foot is the same. Feet run narrow and wide. Some people’s feet pronate and some peoples supinate. If your foot pronates it means your ankle roles toward the inside of your foot. If your foot supinates it means that your ankle roles toward the outside of your foot. This has to do with having high or low arches in your foot. Shoes are made in all different types but some shoes are made to correct that slight tilt inward or outward. These shoes balance out your feet and align them with the rest of your body. If your feet are thrown off, the rest of your body will be as well. So know your feet before you go buy a shoe.

How do you tell if your foot pronates or supinates? 

There are two simple ways to check. You can wet your foot and step on a piece of cardboard to see the outline of your foot, or simply just take the insole out of one of your older shoes. With either method, look at how your footprint is outlined on you imprint. If your insole is worn down more on the inside of your shoe, then you most likely pronate. If your insole is worn down on the outside of the foot then you most likely supinate. If the wear is even, than you have a neutral foot. Once you know your wear pattern, go to the shoe store with a purpose. Ask for shoes that fix a pronation or supination. Also go to the store later in the day. Feet swell as the day goes by, so a shoe that fits before physical activity might not fit after running a mile. Remember that walking shoes are not the same as running shoes. Walking shoes are made stiffer and have less cushioning, running shoes are more lightweight and flexible with more cushioning to absorb more shock. 69% of people with stress fractures in their foot came from not having enough cushions in their shoes. If you don’t want to go buy a whole new shoe but need more cushioning, get an after-market insole such as a total support or a preform, either will give you that little extra support and cushioning. If you know you have problems with your feet and they bother you, go to a specialty store. The level of employee knowledge will be more advanced than a normal shoe store.

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Why Wear Running Shoes?

Running shoes work for running because they are designed and manufactured to meet the demands of bearing three to four times the body’s weight on impact, are designed for the biomechanics of running and are biomechanically (and, to a lesser extent, terrain) specific.

Running shoes are designed on lasts, or forms that are models of the human foot. These lasts have shapes ranging from curved to straight with variations on the degrees of the curve, which make the shoes appropriate for the various foot shapes of runners. The term last also applies to the methodology of construction. A combination-lasted shoe stitches the upper fabric underneath a cardboard heel to provide stability. A slip-lasted shoe stitches the upper directly to the midsole, ensuring flexibility. A full-board-last (cardboard from heel to toe) shoe is the most stable lasting technique but currently is almost nonexistent in shoe manufacturing.

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Theoretically, curved slip-lasted shoes are designed for higher-arched, rigid feet, whereas straight combination-lasted shoes are designed for flatter, more flexible feet. Because flat feet tend to pronate (the inward rolling of the rear foot, controlled by the subtalar joint) more than high-arched feet, straight-lasted shoes, with the aid of stability devices embedded in the midsole, help limit the rate and amount of pronation. Conversely, runners who underpronate should wear curved to slightly curved slip-lasted shoes, which allow the foot to generate as much pronation as possible to help aid in shock absorption.

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Many runners err in choosing shoes because they do not know what foot type they have. If an underpronator trains in stability shoes, predictable injuries like calf pain, Achilles tendinitis, and iliotibial band syndrome will occur. If an overpronator trains in a cushioning-only shoe, stress injuries (including fractures) to the foot, tibia, and the medial knee likely will occur. For most runners, a qualified employee at a running specialty store can evaluate foot biomechanics, possibly by using a treadmill and a video camera, and successfully recommend multiple shoe models that, in theory, will prevent injury and provide a pleasurable ride. Occasionally, evaluating the foot becomes tricky due to motion not seen clearly by the naked eye, and a slow-motion camera may be needed to ascertain true foot movement. This is rare and usually not found in recreational runners due to lower training volume and velocity. Understand that biomechanics can change; what was once corrected may no longer be a problem, and new problems can arise.

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The Healthy People 2010 initiative encourages Americans to engage in regular exercise throughout their lifetimes. Running is a popular form of exercise that has observed a drastic increase in participation recently. Unfortunately, with this increase in popularity, running injuries have become more common. The only equipment a runner has to protect against overuse injuries sustained during running is a pair of shoes. However, there are many types of shoes from which to         choose. Choosing the appropriate shoe may be more crucial for high-arched (HA) and low-arched (LA) individuals because these individuals have been reported to have an increased incidence of injuries compared with individuals with average arch structure. Running injuries are often related to either excessive motion or excessive shock.  These injuries have been attributed, in part, to the foot type of the individual. According to Williams et al, runners with LA feet are more likely to sustain soft tissue injuries, such as posterior tibialis tendinitis, whereas HA runners are more likely to sustain bony injuries, such as stress fractures. These differences in injury risks may be related, in part, to increased eversion excursion observed in LA runners and higher loading rates experienced by HA runners. It has been suggested that foot orthoses can reduce the risk of sustaining overuse injuries. Similarly, it may be that running in the appropriate shoe may be able to alter the mechanics that are associated with injury in such a way that the risk of injury would be reduced.

Motion control (MC) and cushioning training (CT) running shoes are designed to accommodate LA and HA feet, respectively, with the aim of reducing injuries. A study by Knapik examined the influence of matching arch height with shoe type on injuries. Injuries were recorded at the physical therapy clinic for a period of 6 months before and 6 months after the shoe recommendation program. These authors reported a 50% reduction in lower extremity and back injuries after the implementation of the shoe recommendation program. Although these results are impressive, the mechanisms behind the apparent injury reduction were not explored and thus remain unknown.

It is possible that injuries were reduced because of the influence of the footwear on lower extremity mechanics. Several studies have been conducted comparing rearfoot mechanics when running in shoes with different midsole stiffness values. These studies have reported that stiffer midsoles reduce peak eversion and eversion excursion. Midsole geometry can also influence rearfoot mechanics. Perry and Lafortune reported that rearfoot eversion was increased by incorporating a valgus wedge into the midsole and was decreased when adding a varus wedge. They also noted that the varus wedge increased tibial shock, impact peak, and vertical loading rates compared with both the valgus wedge and neutral insole condition. Thus, although MC shoes (which typically incorporate stiffer midsoles and a varus wedge) reduce rearfoot motion, they may also increase lower extremity shock and ground reaction forces compared with a CT shoe (which typically incorporate more compliant midsoles).

Changing midsole hardness can also decrease the magnitude of the lower extremity shock that one experiences. However, results of studies on the effect of midsole durometer on shock have been contradictory. As expected, bench-top impact studies have revealed that both force and shock decrease with decreasing midsole durometer. Conversely, some studies have suggested that the vertical impact peak actually increases when subjects run in shoes with softer midsole materials. Therefore, it appears that there is a runner-footwear interaction that is not apparent in the bench-top studies. The increase in impact peak on the softer surface suggests that runners increase their lower extremity stiffness when running on a compliant surface. This adaptation is further supported by Ferris et al, who reported that runners adjust their lower extremity stiffness when landing on a new surface of a known stiffness. Runners increased their lower extremity stiffness when landing on a soft surface and decreased their lower extremity stiffness when landing on a hard surface. Thus, it appears that runners may adjust their landing in response to the type of surface on which they are running.

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Section-7

Biomechanics of foot & footwear:   

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Footwear has undergone a significant evolution from the Paleolithic period to modern times. The origins of footwear emphasized protection from the environment. During the Egyptian, Greek and Roman eras, the need for military shoes drove the development of footwear. It was not until the 19th century that specific footwear for athletic performance was designed. Footwear were improved significantly during the first half of the 20th century but it was not until the latter portion of this century that biomechanics truly had an influence on footwear design. The intersection of biomechanics, injury risk factors and footwear development paralleled the growth in lower extremity research.

More recently, the interest in barefoot running has driven the development of minimalist footwear.  Current developments in footwear evolution have centered around the ‘barefoot’ running and minimalist shoe craze. The discussion actually began with a criticism of the existing footwear. Existing footwear were criticized for being ‘overbuilt’. That is, they had a thick midsole, particularly in the heel, a firm heel counter and considerable arch support (Robbins et al., 1988; Liebermann et al., 2010). It has been claimed that these shoe characteristics have forced runners to contact the ground initially on the heel thus making them rearfoot runners. It was suggested that this rearfoot footfall pattern limited plantar proprioception and led to ‘excessive’ eversion and plantar fasciitis. However, there is no research in the literature that has verified these claims.

Barefoot running advocates have made many claims (e.g., strengthen the intrinsic foot muscles) that have accelerated the barefoot running craze. The conclusion is that shoes may not necessary because we have ‘natural’ means to accomplish what shoes do. It was suggested that ancient homo did not wear shoes and habitually ran barefoot (Liebermann et al., 2010) and so barefoot running may be best for modern man. Barefoot running has been adopted by a small but very vocal minority. These advocates have claimed that changing to a forefoot footfall pattern, almost necessary in barefoot running, reduces the risk of injury, is more economical and results in a healthier foot. None of these claims have been substantiated by researchers. In fact, several researchers have reported studies that indicate that barefoot running is not more economical and may not reduce the risk of injury (Gruber, 2012; Hamill et al. 2011).  Footwear manufacturers have responded to this craze by developing ‘minimalist’ footwear. This category of footwear is theoretically as close to barefoot running as possible while still wearing shoes.

There are many aspects of the biomechanics of human movement and of footwear that are still poorly understood. In the past, it was thought that designing footwear involved understanding a few simple movement principles based on the mechanics of the lower extremity. However, footwear research has shown that it is not that simple. The paradigms on which athletic footwear were based were clearly flawed. For example, the relationship between injury and calcaneal eversion has never been shown definitively. Biomechanists are now challenging these old paradigms used in developing footwear and are presenting new paradigms based on their research (Nigg, 2010). These newer paradigms include a better understanding of the individual. We do know that there is considerable variability inherent in human movement that confounds group studies indicating that we have to concentrate on the individual. With these new paradigms, biomechanics will definitely continue to influence the development of athletic footwear. However, it is hoped that new paradigms will drive footwear innovation rather than the paradigms of the past.

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Biomechanics of running:

If you are a runner, you are probably aware of the popularity of the book “Born to Run” by Christopher McDougall. The book discussed how the Tarahumara Indians of Mexico were able to run so many miles barefoot on very rugged terrain very well and not get injured. The fact that these people did not get injured without padding when the author’s own feet hurt even with padded running shoes intrigued McDougall. The author came to the conclusion that barefoot or almost barefoot running was able to keep the form in biomechanical alignment. The point of having good form is to be both efficient and economical and not get injured.

Running has become very popular in the last 30-40 years. Thousands of people around the world run on a regular basis, for recreation, pleasure, or competition. Research and surveys show that nearly 75%-80% of the runners suffer from recurring injuries. Though the top most reason for injuries is overtraining, many of these could be avoided through proper running biomechanics. Years of research and studies have gone into figuring out what is the correct running form and it’s still a work in progress. Numerous innovations have been done around foot placements, foot strikes, running gear (shoes), arm movements etc. Host of opinions, recommendations and facts exist but everything comes back to the same point – “If it feels normal and natural to you and doesn’t hurt, stick to it”.

Biomechanics is traditionally divided into the areas of kinematics which is a branch of mechanics that deals with the geometry of the motion of objects, including displacement, velocity, and acceleration, without taking into account the forces that produce the motion while kinetics is the study of the relationships between the force system acting on a body and the changes it produces in body motion.  Biomechanics of running is basically the study of how our body moves (running kinematics) and the relationship between those movements and the forces that causes them (running kinetics).

If we want a deeper understanding of our running form, or what is causing the running-related injuries (if any), or if we want to make any improvements in our running economy, runners should have a basic understanding of the biomechanics of running. Once you have this understanding, you will be able to make more sense and appreciate what you read further about running styles, footwear (shod running vs barefoot or minimalist running), running-training programs, running injuries and what causes them, effect of strength and conditioning on the running economy.

Every runner has his/her own unique running style which is predetermined by the individual running biomechanics. Once we understand what a good running form is, the energy saved by doing minor tweaks in our running form can make a big difference. The energy saved by running efficiently can be used for running fast and running long with more ease and less tension.

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Biomechanics of Running Shoes:

Running is a sport that has grown in popularity over the years due to its ease of access and the fact that it is relatively inexpensive. Most kinds of physical exercises are beneficial for remaining healthy, but many people prefer running over other forms of physical exercise. Beside physical exercise, the ability to run fast is crucial in many sports for passing a defender, catching a ball, or developing enough take off velocity for a jump. Running is also one of the most intense physical activities, constantly involving impact between foot and ground. In the long run, the impact can cause injuries and pain. The impact force depends on the type of the collision, which can occur in 3 ways: a rear-foot strike (RFS), with the heel landing first; a mid-foot strike (MFS), with the heel and ball of the foot landing simultaneously; and a forefoot strike (FFS), with the ball of the foot landing before the heel. Approximately 80% of contemporary shod distance runners are rear foot strikers whereas most professional sprinters are forefoot strikers. Most of the remainder are characterized as midfoot strikers.

For distance runners, the goal would presumably be to minimize impact forces. But it’s worth noting that the opposite is true for sprinting. The primary way people run faster is by striking the ground harder: the more force you can plow into the ground, the faster you’ll go. In this regard, minimizing impact and loading rate is directly in conflict with increasing speed. That’s one reason training shoes and racing shoes are so different.

Each person’s foot is different and each person runs in a different way. Each time an average runner’s foot strikes the ground, the vertical component of its momentum reduces to zero. To reduce the stress of this load on the leg and foot of the runner, the time of impact has to be increased. The midsole, which is sandwiched between the insole and outsole is the most important part of the shoe. It cushions the foot increasing the time of impact and absorbs part of the force on the runner’s body.

With recent developments in shoe technology, it has become indispensable for any dedicated runner to possess a pair of running shoes, which provides a well-shaped fit tailored to one’s foot. The cushioning material in a running shoe protects the runner against the effects of repeated impacts. Whether running shoes are necessary has received some heated debate over the past year, with studies emerging questioning the need for expensive running shoes.

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Ground Reaction Force (GRF):  

‘For every action, there is an equal and opposite reaction.’ – Isaac Newton

According to the 3rd Law of Motion, each time your foot hits the ground while walking, standing or running, a ground force is produced. This force can have a significant impact on the walking stride of a person, and measuring it can help in identifying walking problems. Understanding ground forces can help individuals, especially athletes, know more about balance and posture and how these are affected by external factors.

Understanding Ground Force:

When a person stands motionless, they exert a contact force on the ground which is equal to their bodyweight. In the same manner, an equal but opposing ground force, is exerted back. This acts like a mirror of the force the person exerts on the ground. This is the reason why ground force can be used to examine the force a person exerts. It can help identify and correct any problems in walking stride, running form, jumping technique and other movements that involve the feet. Measuring the ground force can be beneficial in designing active rehab programs for athletes.

Below is typical example for someone running barefoot and landing on their heel:

The key feature to notice is the little spike on the left side of the curve. That’s your heel slamming into the ground, a split second before the full force of the rest of your body presses into the ground. The dominant view among biomechanists is that it’s not the overall size of the force (which tops out at about 2.4 body weights here) that determines how likely you are to get injured; instead, it’s how quickly the force is applied, otherwise known as the loading rate.

Of both the phases and periods of Gait cycle, the one where the feet are in touch with the ground needs to be focused more. Only one leg bears the body weight, and the impact of the ground reaction forces can lead to injuries and impact running performance, if not done properly. The muscles and tendons store the elastic energy during stance phase which recoils in the swing phase to re-accelerate the body. Research shows that at least 50% of the elastic energy comes from the Achilles tendons in the foot. This cyclic behaviour permits efficient force production and is critical for avoiding mechanically costly high-energy collisions during foot–ground contact.

Foot Posture and Ground Force:

When there is healthy distribution of force to the feet, the foot muscles are able to function properly with the least amount of work. However, with improper distribution of force, there is imbalance in the foot muscles. This can lead to abnormal movements of the feet which may affect the postural alignment of the lower body.

Improper distribution of force to the feet can be caused by a weak foot posture. With flat feet, the foot arch flattens on the ground, causing misalignment and imbalance in the foot. This causes the shin and thigh bones to twist inwards, stressing the ankles, knees and hips as a result. Poor stability and added stress on the lower body, increases the risk of injury and developing chronic conditions.

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The principle biomechanical concerns for protecting runners against injury were the need for: 1) cushioning; 2) rearfoot mediolateral control; and 3) forefoot stability (Winter & Bishop, 1992). In order to study these concerns, biomechanists used force platforms and tibial accelerometry for the former and cine or video motion capture for the latter. Force platform analysis determined that during heel-toe running (the most prominent footfall pattern), there was an initial peak (often referred to as the ‘impact or passive peak’) and a second peak (often referred to as the ‘push-off or active peak’) (Figure below).  

Figure above illustrates the vertical ground reaction force component showing the impact and push-off peaks.  

The impact peak ranged from 2 to 3 times body weight during running and this shock travelled through the skeletal system to the head. This meant that the body had to attenuate the shock using either passive structures (i.e., bones, cartilage, etc.) or via altering the body geometry (i.e., altering lower extremity joint angles). It was thought that footwear should have some cushioning ability to aid in attenuating the foot-ground collision. Therefore, cushioning materials such as ethyl vinyl acetate (EVA) and polyurethane (PU) were used in the midsole as cushioning materials. Unfortunately, it was discovered that a softer midsole was not functionally different from a harder midsole so there was no immediate effect of the shoe on shock attenuation and no real solution to the cushioning problem.

The second major biomechanical concern was controlling the medio-lateral motion of the rearfoot. This action is referred to as calcaneal eversion. The foot contacts the ground in an inverted position and rolls medially to an everted position (Figure below). 

Figure above illustrates the rearfoot positions at initial foot contact (inversion) and at maximal eversion. The shaded area in each position is referred to as the rearfoot angle. 

It was thought that too much eversion or ‘excessive’ eversion caused a running related injury and so footwear were designed to control eversion. However, since there is no clinical definition for ‘excessive’ eversion, it is not known how much eversion is considered excessive. The most common technique used for controlling this motion of the foot was to create a firmer midsole. By altering the midsole density, the medial border of the midsole of the shoe should not collapse thus controlling the amount of foot eversion. Other features of footwear used to accomplish the control of the rearfoot were stiffer heel counters, different lacing systems and midsole plates. The method generally employed to evaluate foot eversion was to place markers directly on the shoe. However, it was later reported that such a technique was not a true evaluation of foot motion. In fact, the foot actually moved less than the shoe did (Reinschmidt et al, 1997).

It then became a problem to try to reconcile these two biomechanical concerns. Many techniques such as dual density midsoles (soft on the lateral border and firm on the medial border), materials in combination (e.g., EVA + encapsulated gases), midsoles with structural bars were used to accomplish both tasks and midsoles with mechanical structures. Other developments in footwear resulting from biomechanical studies involved optimal metatarsophalangeal flex grooves, increasing midsole forefoot stiffness to improve sprint performance (Stefanyshyn & Fusco, 2004), the Adidas computerized shoe and the concept of energy return.

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Impact & Injury: 

The relationship between impact and injury is less clear than one might suppose. It has been suggested that while excessive impact can result in injury, lower levels of impact are the stimulus for improved strength and performance.

There are various ways of evaluating impact, and not all studies use the same metric or are not clear on which metric is used. 

  • Active Peak is the greatest force or acceleration detected during foot strike.
  • Peak Impact is the greatest force seen during the initial landing.
  • Loading Rate is how rapidly the forces build up and can either be averaged over parts of this section of the graph or an instantaneous peak can be used. (That would be peak rate of change of impact, not peak impact.)
  • Where the impact is measured from may be important. Impact can be measured as force between the foot and the ground using a pressure plate, the acceleration of the foot/shoe, or the acceleration of the tibia.
  • Impact is sometimes normalized to body weight, but not always.
  • Not all studies have evaluated impact when the subjects have had time to adapt to a particular shoe (or lack of shoes). It seems reasonable that a runner’s impact levels will be different in unfamiliar footwear.

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Effects of Running Shoes on biomechanics:

Much of the early research on running shoes focused on the ability of the running shoe to absorb shock for the runner during the support phase of running. In 1980, Cavanagh and LaFortune, from the Penn State Biomechanics Lab, studied 17 trained runners who ran at 4.5 m/sec (5:58 mile pace) over a force plate. These researchers were the first to categorize runners as being either rearfoot strikers (12/17 subjects), midfoot strikers (5/17 subjects), or forefoot strikers (0/17 subjects). Not only was the vertical ground reaction force (GRF) found to be approximately 2.8 times body weight, rearfoot striking runners and midfoot striking runners had very different shapes to their GRF versus time curves. Cavanagh and LaFortune, in 1980, discovered that most of their experimental subjects had rearfoot foot strike during running.

According to classic running biomechanics research by Cavanagh and LaFortune in 1980, runners landing on the proximal third of the running shoe sole are rearfoot strikers, runners landing on the middle third of the sole are midfoot strikers, and those runners landing on the distal third of the sole are forefoot strikers.

In the rearfoot striking runners, there was an initial high-frequency impact peak that corresponded to when the heel struck the ground, followed by a lower frequency propulsive peak that corresponded to when the body’s center of mass (CoM) moved over the planted foot (Figure below). 

Figure above shows Rearfoot strikers demonstrate a different shape in their ground reaction force versus time curves during running compared to midfoot strikers. Rearfoot strikers have a high frequency impact peak that is caused by initial contact of the heel of the running shoe with the ground that is followed by a lower frequency propulsive peak caused by the center of mass of the runners passing over the planted foot. Midfoot strikers only demonstrate the propulsive peak during running due to a lack of heel strike. The midfoot striking runners did not have the high-frequency impact peak but only had the lower- frequency propulsive peak in their GRF versus time curves due to landing on arch. However, according to a new study, the little spike is still there; it’s just obscured by the bigger one. Back in 2014, Weyand, Clark, and Ryan proposed what they called a “two-mass model” to explain how these sorts of force curves vary under different conditions. In this model, the force curve always consists of two distinct components: a small spike that corresponds to your foot and lower leg smacking into the ground and almost immediately jarring to a halt; and a bigger, slower spike that corresponds to the rest of your body reaching the lowest point of its up-and-down motion. The overall force is simply the sum of those two spikes. If there’s one thing we’ve learned, it’s that we should be cautious about looking at force curves in the lab and assuming we understand how they translate into real-world outcomes like injuries and race times. 

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In order to reduce the impact forces inherent in running, shoe manufacturers began to design their running shoes, in the early 1970s, with a shock-absorbing layer of material within the shoe sole known as the midsole. The midsole is sandwiched between the insole board/ fabric and the outersole of the running shoe. The hardness of the various midsole materials is measured in durometer, with lower durometer midsoles being more compressible and soft, and higher durometer midsoles being less compressible and hard. The outer-sole is a relatively thin material which provides traction and is relatively resistant to abrasion when contacting the ground during running. The midsole is a relatively thick and cushioned material sandwiched between the outer-sole and the insole board/fabric of the running shoe.

In 1985, Benno Nigg, while director of the University of Calgary Biomechanics Laboratory, reported on 13 subjects running at 3.5 m/sec (7:40 mile pace) in seven running shoes, which were identical in construction except for the rearfoot portion of their midsoles, which had durometer values of 20, 30, 35, 40, 45, 50 and 55. Drop impact tests were also performed where a 5 kg mass was dropped onto the rearfoot midsole of the running shoes to measure the impact forces registered with each shoe midsole. Even though, as expected, the drop impact tests measured less impact force in the midsoles with lower durometers, the softest running shoes midsoles (i.e., 20 and 30 durometer) caused the runners to experience more impact force than did the hardest midsoles. Also, the vertical impact forces measured by the subject running over the force plate did not significantly increase from the 35 to the 55 durometer midsole, even though the midsole was getting progressively harder. 

Nigg explained the paradoxical results as being partly due to a bottoming out effect that occurred when the runners wore the softest midsoles (i.e., 20 and 30 durometer). Bottoming out was thought to occur when the midsole material was so soft that the midsole compressed relatively fast and then suddenly stopped compressing, which resulted in higher impact forces. The authors also thought that having a shoe with a very soft midsole may do more harm than a harder midsole running shoe. Another important point from this research was that even though the GRF impact peak may be a good approximation of the internal impact forces experienced by the runner’s body, the drop impact test, using a machine to measure midsole cushioning, was considered to be “not relevant with respect to impact force reduction in running”.

Nigg and co-workers also published important running shoe research in 1987 on how running velocity and midsole hardness affected the impact forces of rearfoot-striking runners. In their experiments on seven male recreational and seven male competitive runners, three pairs of identical shoes that had three different midsole durometers (25, 35, and 45 durometer) were worn by the subjects as they ran over a force plate at four different running velocities, 3 m/sec (8:56 mile pace), 4 m/sec (6:42 mile pace), 5 m/sec (5:22 mile pace) and 6 m/sec (4:28 mile pace).

Even though the impact force decreased slightly as the runner ran in harder midsole running shoes, the change was not significant. However, the vertical impact force did significantly increase with faster running velocities, demonstrating that running velocity increased the impact peak of running more than did altering running shoe midsole hardness.  Frederick and colleagues had also noted, six years earlier, an increase in vertical impact force peaks with increased running velocities.

In a review of their research findings that vertical impact force peaks do not change appreciably with variations in running shoe midsole hardness (unless the midsole is so soft that it bottoms out), Nigg and co-workers noted that “common sense” would predict that smaller impact force peaks would occur while running on softer midsoles. However, the reality was that the subjects reacted differently than expected to variations in midsole hardness. Each runner, by using central nervous system (CNS) control, modified their landing strategy during running, depending on the midsole hardness “to keep the external impact force peaks constant”. Therefore midsole softness does not always reduce impact forces during running.

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Forces in an Athletic Shoe: 

Power for an athletic movement comes from the body interacting with the ground. We push on the ground, the ground pushes back allowing us to move. It is a basic law of physics.  Athletic shoes are the interface between the body and ground. Thus, the push we apply to the ground and the push-back by the ground is through the shoes. Like all mechanical systems, the shoes do not perfectly transfer the forces between the body and the ground. There are loses.

For example, when we stand in a shoe, we create a vertical force vector that causes the sole of the shoe to compress.  When we lift our foot up, the sole of shoe decompresses. The compression and decompression of the sole is not perfect; it requires energy (force over a distance). Thus, the force at which the ground is pushing back on us is less than the force we applied to the ground due to the energy being absorbed by the sole of shoe.         

We lose even more energy in the horizontal direction when we’re making a lateral movement (e.g., making a cut in football, basketball, baseball, tennis, etc.) or when we’re making a rotational movement (e.g., swinging a golf club, a baseball bat, a tennis racket, etc.).

Athletic shoes include two horizontal forces: a friction force between the outsole of the shoe and the ground and a horizontal reaction force between the foot and the inside of the shoe. Tread or cleats on the outsole of athletic shoes provide the friction force between the outsole of the shoe and the ground. In many instances, this keeps the shoe from slipping during lateral movements and/or during rotational movements. When we avoid slipping, we generally say the shoes have good traction.        

Many athletic shoes, however, provide little horizontal reaction force, which keeps the foot from sliding horizontally (e.g., medial to lateral) within the shoe. For instance, lightweight shoes use very lightweight uppers to reduce the overall weight of the shoe. This, however, reduces the horizontal reaction force of the shoes and allows to foot to slide even more.  As the foot slides within the shoe, body position is adjusted to maintain balance.  For example, when the foot moves in the shoe (we call this roll out), the body sways in the direction the foot is moving to maintain balance. The body then has to recover from this sway. In golf, tennis, and baseball, the sway can cause timing issues and loss of power.  The slipping of the foot within the shoe increases with better traction. The shoe stops moving, but the foot doesn’t. This is like an unsecured object in the car, which keeps moving when the car stops. To stop the object as the car is stopping, it has to be firmly secured to the car. Similarly, to keep the foot from sliding in the shoe, it has to be held firmly in the shoe. This is accomplished by providing a sufficient amount of horizontal reaction force. For instance, a sufficient amount of horizontal reaction force is created by re-enforcing the lateral wall and by providing optimal athletic positioning (OAP).  OAP includes a conventional heel to toe slope on the lateral side of the shoe and a slightly greater heel to toe slope on the medial side of the shoe. This allows the foot to be firmly secured in the shoe during lateral movements and/or rotational movements.

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Spring-like function of foot and shoes:

The human foot is the interface between the body and the ground. The unique structure of the foot allows force produced by muscles of the lower limb to be transmitted to the ground, to support body weight (BW) and also generate forward propulsion. A pronounced structural feature of the human foot is the longitudinal arch (LA), which allows the foot to function in a spring-like manner in series with the entire lower limb. The LA compresses during early stance, absorbing mechanical energy as the ground reaction force (GRF) increases. Presumably, the energy absorbed is stored within elastic structures supporting the arch. In late stance, when GRF decreases, the LA recoils, returning elastic energy to deliver power for propulsion. Stiffness of the LA is provided by passive ligamentous structures acting in parallel with the intrinsic foot muscles whose relative contribution is continually adjusted by the central nervous system (CNS) in response to mechanosensory stimuli. This elegant arrangement allows the mechanical characteristics of the foot to be rapidly adapted to loading or task demands and is thought to improve the efficiency of human running, returning between 8% and 17% of the mechanical energy required for one stride, via passive mechanisms alone.

Research has identified elastic leg behaviour as critical to terrestrial locomotion. During running, the leg undergoes compression in the first half of the stance while gradually decelerating the body and then recoils in the second half of the stance to reaccelerate the body. This cyclic behaviour permits efficient force production through a stretch-shortening muscle action and is essential for avoiding mechanically costly high-energy impacts during foot–ground contact. The elastic leg behaviour during running can be described as a simple spring-mass system, where a leg-spring supports the point mass representing the runner’s center of mass (CoM).

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Footwear has provided mechanical and thermal protection for human feet when running, for thousands of years. The contemporary running shoe, however, was not invented until the 1970s and has evolved in parallel with the surge in popularity of running as a recreational pursuit. A defining characteristic of the modern running shoe is the thick viscoelastic midsole that is designed to compress and rebound when cyclically loaded and unloaded during running. This design feature, generally referred to as cushioning, allows the shoe to function in a similar ‘spring-like’ manner to the lower limb and foot, absorbing the potentially harmful impact transients that are encountered when the foot impacts with the ground, while also returning some of this energy to aid power generation for propulsion. Another key feature of the modern running shoe is the contoured midsole, designed to provide external support and reduce excessive strain on the muscles and ligaments of the LA.

However, despite the huge financial investment in the development of running shoes, running injury rates remain relatively unchanged over the last 40 years, leading some to question the efficacy of modern running shoes in preventing injury. Some scholars have gone as far to suggest that cushioned midsoles may actually hinder our running performance. These scholars have speculated that a thick cushioned interface between the runner and the ground impairs mechanosensory feedback and therefore, the inherent capacity of the CNS to contend with large impact force transients via adjustments in leg- and foot-spring stiffness. Furthermore, it has been speculated that an apparent reliance on the shoe to attenuate impact and provide mechanical support for the LA may reduce the required contributions from the foot and ankle musculature, precipitating foot and ankle muscle weakness and predisposing a runner to injury. While there is some evidence that runners tend to land differently when they run without shoes, there is no evidence that shoes have a detrimental influence on the spring-like function of the foot, or the contributions to this function from foot and ankle musculature.

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Effects of Running Shoes on the Metabolic Cost of Running: 

The capacity to store and return energy in legs and feet that behave like springs is crucial to human running economy. Important in understanding the influence that running shoe midsole hardness and midsole thickness may have on the metabolic cost of running (i.e., the metabolic energy required to run at a given pace) is the concept that running is commonly modelled as being equivalent to a mass (representing the CoM of the body) being bounced along the ground by a lower extremity spring (figure below). This “spring-mass model” of running allows the effective transfer of potential and kinetic energy during running to increase the metabolic efficiency of running locomotion.

In the spring-mass model of running, the runner’s body is modelled as a mass supported by a lower extremity spring. The elastic muscle-tendon elements in the lower extremity of the runner are first compressed, like a spring, from initial contact with the ground to the middle of mid-support storing potential energy. This potential energy is then released as kinetic energy from the middle of mid-support to toe-off of running. The running shoe midsole, due to its elasticity, may also act as a spring in synergy with the spring of the lower extremity to decrease the metabolic cost of running. 

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Another critical factor that affects the metabolic cost of running is the concept that this lower extremity “spring” has a variable stiffness that is controlled by the CNS. Thomas McMahon and Peter Greene, of Harvard University, were the first to propose that the lower extremity may be modelled as a variable stiffness spring-like structure during running that adapts its stiffness depending on the stiffness characteristics of the running surface. McMahon and Greene’s ground-breaking experiments involved constructing a single-lane running surface made of plywood boards supported by wooden rails that could be moved to alter the track stiffness. The goal of the researchers was to “tune” the stiffness of the running surface to best improve performance and reduce injury rates in runners. In their experiment, they used eight male subjects that ran at five to eight different running speeds on four track surfaces: concrete, a “pillow-track” made up of foam-rubber pillows, and two board tracks of intermediate compliance.

Their research found that having a running surface with very low stiffness (i.e., pillow track) resulted in a marked reduction in the runner’s performance. However, on tracks of intermediate compliance (i.e., the two board tracks), their model predicted a slight speed enhancement with a decrease in foot contact time and an increase in step length, which was confirmed by their experimental findings. Mc- Mahon and Greene’s research on running surface stiffness tuning led to the construction of the first-ever indoor “tuned track” at Harvard University in 1977. The Harvard indoor “tuned track” ultimately allowed collegiate running athletes to shave five seconds from their mile times and reduce their rate of injuries.

Soon after McMahon and Greene’s landmark research on using springy surfaces to improve the metabolic efficiency of running, running shoe companies started to attempt to incorporate these “energy return” features into their running shoes. In 1980, E.C. Frederick and colleagues, from the Nike Sports Research Laboratory, performed research to discover whether shoes could be designed to reduce the metabolic cost of running. The researchers had 11 subjects run in both non-air-soled and air-soled type running shoes. The air-soled shoes, with midsoles containing an inflated air bladder under pressure, required 2.8% less metabolic energy than conventional EVA midsole running shoes. Subsequent studies by Frederick, et al. showed significant improvements in metabolic efficiency when running in airsoled- style shoes.

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Comparisons of shod and barefoot running have led to suggestions that modern running shoes may actually impede leg and foot-spring function by reducing the contributions from the leg and foot musculature. In 2012, Jason Franz and colleagues, from the University of Colorado Boulder Locomotion Lab, researched the metabolic cost of running in lightweight cushioned shoes versus running barefoot. They studied 12 male experienced barefoot runners at 3.35 m/sec (8:00 mile pace) running both barefoot and in lightweight cushioned running shoes (150 g per shoe). Small lead strips were attached to the shoes to determine the oxygen cost of mass being added to the feet of the runners. They found that the oxygen cost of running increased by approximately 1% for each 100 grams of mass added to the foot, whether barefoot or shod. Barefoot and shod running did not differ in oxygen cost. However, the researchers did find that for experimental conditions with equal mass added to the foot, shod running required 3-4% less metabolic energy than running barefoot.

Additionally, in 2014, Tung and co-workers used a unique experimental design to explore whether running shoe cushioning could, by itself, have an effect on the metabolic cost of running. They studied 12 midfoot-striking runners under four conditions: running barefoot on a normal treadmill, running in lightweight, cushioned running shoes on a normal treadmill, and also running on a treadmill with two “cushioned- belt” treadmill conditions, one with a 10 mm thick layer of ethylene vinyl acetate (EVA) foam attached and another with a 20 mm EVA foam layer attached to the treadmill belt. Interestingly, running barefoot on the 10-mm-thick foam treadmill belt required 1.63% less metabolic energy than barefoot running without the foam cushion on the treadmill. The researchers also found that running with shoes and running barefoot on the treadmill with a normal belt required equal metabolic demands and hypothesized that the beneficial energetic effects of shoe cushioning was counterbalanced by the added mass of the shoe on the runners’ feet.  It is now commonly believed that the CNS of the runner will adjust the stiffness of their lower extremities to optimize it for the stiffness of the surface that they are currently running on. As noted above, McMahon and Greene first demonstrated this concept in 1979 in their experiments with running tracks with different surface stiffnesses.

In addition, Daniel Ferris and colleagues from the University of California Berkeley Locomotion Lab showed that runners were able to adjust their lower extremity stiffness on their first running step onto a surface with a different surface stiffness. The runners in their experiment were also found to smoothly transition between different surfaces so that the path of their CoM during running was unaffected by the change in the stiffness of the surface they ran upon.  Other researchers have also confirmed that runners will optimize lower extremity stiffness in response to running on surfaces of varied stiffness, whether the surface is part of the running shoe (e.g., running shoe midsole) or the surface is outside the running shoe (e.g., concrete, grass, track, or treadmill). This CNS-controlled mechanism of lower extremity stiffness optimization is most likely responsible for the changes in the metabolic cost when running on surfaces and/or shoes of varied stiffness.

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Nowadays, lots of studies are being done to investigate how running shoe properties alter running economy and biomechanics. Some of these results include that the optimal stiffness in running shoes is speed dependent (Day & Hahn, 2020), (Mcleod et al., 2020) and that running in stiffer shoes redistributes the positive work from the knee to the MPTJ (Cigoja, 2019). In a recent review, Benno Nigg summarizes six main parameters which have shown to influence running economy, and at what magnitude. They are: Shoe weight, midsole material, heel thickness, longitudinal bending stiffness (flat sole shape), longitudinal bending stiffness (curved sole shape), and muscle mechanics. Contrary to popular belief, Nigg claims that the midsole material does not matter all that much, as the energy which is put into midsole during landing is returned at the wrong time. Studies have consistently shown that heavier shoes reduce running economy. Each 100g/3.5oz added to the weight of each shoe reduces running economy by about 1%.  A well cushioned running shoe can improve Running Economy by an estimated 2-3.5% compared with a weight matched un-cushioned shoe. Note that running shoes provide less cushioning in colder temperatures. There are indications that a highly flexible shoe that is modified with a springy carbon fiber plate might be more efficient than a highly flexible shoe on its own.

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The effect of footwear on running performance and running economy in distance runners, a 2015 study:

The effect of footwear on running economy has been investigated in numerous studies. However, no systematic review and meta-analysis has synthesized the available literature and the effect of footwear on running performance is not known. Of the 1,044 records retrieved, 19 studies were included in the systematic review and 14 studies were included in the meta-analysis. No studies were identified that reported effects on running performance. Individual studies reported significant, but trivial, beneficial effects on running economy for comfortable and stiff-soled shoes [standardized mean difference (SMD) <0.12; P < 0.05], a significant small beneficial effect on running economy for cushioned shoes (SMD = 0.37; P < 0.05) and a significant moderate beneficial effect on running economy for training in minimalist shoes (SMD = 0.79; P < 0.05). Meta-analysis found significant small beneficial effects on running economy for light shoes and barefoot compared with heavy shoes (SMD < 0.34; P < 0.01) and for minimalist shoes compared with conventional shoes (SMD = 0.29; P < 0.01). A significant positive association between shoe mass and metabolic cost of running was identified (P < 0.01). Footwear with a combined shoe mass less than 440 g per pair had no detrimental effect on running economy. 

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Importance of pressure in footwear: 

Pressure is defined as force over area. Pressure is directly proportional to the force and inversely proportional to area. This inverse relationship in an important concept when it concerns the immensity of pressure.

-1. Different styles of shoe can cause different pressures due to their area. Flat shoes spread the force over a large area, reducing the pressure.

-2. Snow shoes have a much larger area than feet to spread the force over a larger area and reduce the pressure on the snow – this stops people sinking into the snow.

-3. High heeled shoes or boots transfer the force through a much smaller area, causing a much greater pressure. The significance of the high heel comes into play because it has such a minute area. Due to this fact, the pressure under that high heel is extremely large. This is approximately 40 atmospheric pressures. Now you realize the full potential of the high heel. It will hurt more if a person steps on someone’s foot in high heels than if they are wearing flat shoes.

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Foot plantar pressure:

Feet provide the primary surface of interaction with the environment during locomotion. Thus, it is important to diagnose foot problems at an early stage for injury prevention, risk management and general wellbeing. One approach to measuring foot health, widely used in various applications, is examining foot plantar pressure characteristics. Foot plantar pressure is the pressure field that acts between the foot and the support surface during everyday locomotor activities. Researchers use various foot regions for plantar pressure distributions. In one study, the normal group yielded plantar pressures of 61.0±21.2 (kPa) in the FM (forefoot medial), 76.4±14.2 (kPa) in the FL (forefoot lateral), and 116.4±30.2 (kPa) in the heel in standing posture. Foot plantar pressure increases substantially while running as seen in the figure below.

Information derived from such pressure measures is important in gait and posture research for diagnosing lower limb problems, footwear design, sport biomechanics, injury prevention and other applications. The analysis of foot plantar pressure distributions to reveal the interface pressure between the foot plantar surface and the shoe sole has multiple applications including footwear design, sports performance analysis and injury prevention, improvement in balance control, and diagnosing disease.

Plantar pressure measurements look at the pressure distribution between the foot plantar surface and the supporting surface. Recent advances enable us to measure the pressures between the shoe or insole and the plantar foot during various activities. This was proven useful in the diagnosis and management of pressure related foot problems. Footwear contributes greatly to the pressure distribution on the plantar surface of the foot. Insoles and appropriate footwear were shown to reduce pressure and prevent plantar ulceration.

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Locomotor effects of shoes:  

Locomotor effects of shoes are the way in which the physical characteristics or components of shoes influence the locomotion neuromechanics of a person. Depending on the characteristics of the shoes, the effects are various, ranging from alteration in balance and posture, muscle activity of different muscles as measured by electromyography (EMG), and the impact force. There are many different types of shoes that exist, such as running, walking, loafers, high heels, sandals, slippers, work boots, dress shoes, and many more. However, a typical shoe will be composed of an insole, midsole, outsole, and heels, if any. In an unshod condition, where one is without any shoes, the locomotor effects are primarily observed in the heel strike patterns and resulting impact forces generated on the ground.  

-1. Insoles and inserts:

The foot provides the sensory information to the central nervous system through cutaneous afferent feedback, which originates from the special mechanoreceptors within the plantar surface of the foot. This afferent feedback has a strong influence on postural stability and balance correction during standing and walking. Since sensory feedback from the foot may be influenced by the interaction of the foot with the insole surface, different types of insoles and shoe inserts have been used to try to enhance postural stability.

Textured inserts:

Textured Inserts are regular shoe inserts that have a raised textured surface on the side that acts to provide enhanced mechanical contact and pressure on the plantar surface of the feet. Providing a textured surface of the shoe insert leads to significant changes during gait in ankle joint kinematics and in EMG amplitude of ankle flexor and extensor muscles. Textured inserts mostly affect ankle motion in the sagittal plane, where plantar flexion of the foot is increased. As for muscle activity, textured inserts decrease the activation of soleus and tibialis anterior muscles during standing and walking.

Insoles with ridges:

One of the most pervasive effects of aging is the loss of cutaneous and pressure sensation, which has been correlated with impaired balance control and increased risk of falling. This is because for an upright stance, the center of mass (COM) of the body must be positioned over the base of support (BOS) established by the feet. Cutaneous feedback from the feet is necessary to provide the central nervous system (CNS) with the information about the proximity of the COM to the BOS limit, which is an important parameter for the maintenance of balance and stable gait.

Since plantar pressure sensation aids in balancing reactions in stepping movements, insoles with raised ridges along the edges can enhance stimulation of cutaneous mechanoreceptors that help to define the BOS. Most of the time, the ridges are made so that stimulation only occurs when the COM nears the BOS limit.  Insoles with ridges appear to reduce the likelihood that the COM motion will exceed the BOS limit in the lateral direction, thereby resulting in a stabilizing effect on gait. Furthermore, the magnitude of this effect did not diminish with time, which suggests the CNS did not habituate to heightened cutaneous stimulation. Therefore, insoles with ridges can aid in reducing the fall rates among elderly populations.

-2. Midsole:

The midsole is between the outer sole (bottommost) and the insole (topmost) parts of the shoe sole. It can be made of a variety of materials to give the shoe different mechanical characteristics of cushioning, support, and flexibility. Polyurethane midsoles are denser and more supportive while ethylene vinyl acetate is used to make lighter and more compliant midsoles.

Density/stiffness:

By changing the material hardness of the midsole, one will be able to change the EMG activity in various lower extremity muscles such as rectus femoris, biceps femoris, medial gastrocnemius, and tibialis anterior. Especially when running with the stiffer midsole, the EMG amplitude for tibialis anterior have shown to be significantly greater before the heel strike and lower following the heel strike than compared to the neutral midsole. Furthermore, walking in shoes with stiffer midsole appears to significantly reduce the energy dissipated at the metatarsophalangeal joints and aid in improving jumping performances and running economy. However, the underlying mechanisms that can be attributed to this improvement are still not fully understood.

Midsole wedging:

With the increasing number of injuries associated with excessive pronation of the foot, much research has been conducted with different types of midsoles that could possibly aid in prevention of such injuries. The varus-wedged shoes, which have a medial incline, seem to decrease pronation during stance time. The valgus-wedged shoes, which have a lateral incline, are designed to accentuate pronation and have the opposite effect as the varus-wedged shoes. Also when walking in valgus-wedged shoes, it may lead to an increase in calcaneus eversion and up to 58% of energy absorption in the frontal plane of the body.

-3. Heel curvature:

Rocker bottom shoes have thicker-than-normal soles with rounded heels, and most varieties of the shoes are constructed such as to shift the wearer’s body weight to behind the ankle, therefore finding the balance requires more effort.

-4. Heel height:

Shoe heel height can have significant biomechanical effects on the shoe wearer that can be detrimental or beneficial.

High heels:

High heels are shoes where the rearfoot (the heel) is positioned higher than the forefoot (toes). High heels of various heights are worn by men and women on a daily basis. The main reason many people wear high heeled shoes is for aesthetic purposes, where high heels are believed to enhance the wearer’s physical appearance. These same high heeled shoes, however, can have undesirable biomechanical effects.

During gait, high heeled shoes are shown to affect the ankle joint, causing significantly increased plantarflexion. This, in turn, increases the metabolic costs of walking and leads to faster muscle fatigue. Accelerated muscle fatigue may then increase the likelihood of ankle sprains and or falls due to impaired foot and ankle stability. Wearing high heels can also lead to shorter stride lengths, greater stance time, unstable posture and gait, and a decrease in lumbar flexion angles.

Changes to muscle activity are also observed with high heeled shoes, mostly affecting the tibialis anterior and erector spinae muscles. The increase in plantar flexion of the foot causes the EMG amplitude of tibialis anterior to increase. The high heels also lead to an increase in the lumbar flexion angle due to a compensatory mechanism to prevent one from falling forward.

In addition, increased heel height may lead to numerous foot problems including:

calluses

foot pain

blisters

hammer toes

bunions (hallux valgus)

Morton’s neuroma

metatarsalgia

ankle sprain

shortened Achilles tendons

high heel cords

osteoarthritis in the knee.

In contrast, moderate heel elevation has also been used as a conservative treatment for plantar fasciitis to decrease strain in the plantar fascia.  Although various locomotor effects of heels are prominent, the practical health implications are still debatable.

-5. Negative heels:

Negative heeled shoes, which are also known as earth shoes, are shoes that are designed to mimic uphill walking to increase the resistance training effect on the leg muscles during normal walking. The forefoot(toes) of the shoe is 1.5 cm higher than the heel of the shoes, creating an approximately 10 degree angle of dorsiflexion at the ankle during stance on level ground.

Walking in negative heeled shoes leads to a faster cadence and shorter stride length, resulting in a significantly shorter stride cycle time than when walking with a natural cadence. The range of the ankle motion is also significantly greater in the negative heeled shoes, remaining in dorsiflexion longer throughout the stance and swing phases of gait. The increased duration of dorsiflexion leads to lengthening of the gastrocnemius and soleus muscle-tendon units and the length of the moment arm of the Achilles tendon.  A similar post-operative exercise effect involving increased dorsiflexion is often desired after surgeries involving the gastrocnemius and soleus muscles or Achilles tendon. The purpose of the exercise is to increase the range of motion in the ankle joint and strengthen the gastrocnemius and soleus muscles and the Achilles tendons. Wearing negative heeled shoes, therefore, may offer an alternative method for post-operative rehabilitation in these situations. Although dorsiflexion of the ankle may be beneficial, it also causes the center of gravity to shift backward, which can cause instability and difficulty in propelling forward during gait.

When walking in negative heeled shoes, muscle activity of gastrocnemius and tibialis anterior muscles are similar to that observed in uphill walking. The duration of the EMG activity is longer and the EMG amplitude is higher for the calf and the biceps femoris muscles than compared to normal shoes. Also the EMG readings for the rectus femoris and biceps femoris indicate an enhanced co-contraction of the two muscles, and therefore the negative heeled shoes may be helpful in exercising these muscle groups.

-6. Barefoot (unshod):

Unshod condition is where one is without any shoes, or is barefoot. Much of the research on unshod locomotion has been conducted on barefoot running. However, some of the learned principles may apply to both running and walking.

Foot strike patterns:

Barefoot runners run very differently from typical shod runners. Shod runners tend to heel strike due to the designs of the modern shoes, which have thick heels to reduce the impact force from the ground. When running barefoot, however, some runners tend to shift to a forefoot striking pattern to avoid such impact, which is equivalent to 2-3 times the body weight. The forefoot strike is where the forefoot lands first, followed by the heels coming down. The midfoot strike is characterized by the heel and the ball of the foot landing at the same time, and heel strike is where the heel lands first followed by the forefoot.

Impact forces:

In barefoot locomotion, the impact force (impact transient) on the ground is diminished compared to shod running. It has been suggested that unshod runners are better able to take advantage of elastic energy storage in the Achilles tendon and arch of the foot, and can avoid potential injury due to repetitive impact of the heel bone (calcaneus) due to heel striking.  However, the long-term and actual health benefits of unshod running are still not well understood and remain an area of active research.

Those who wish to approximate the experience of running barefoot, but would prefer some protection, can resort to shoes that mimic barefoot locomotion. Such shoes as water socks, running sandals, moccasins, huaraches, dime-store plimsolls, Vibram Five Fingers footwear and other minimal running shoes have relatively thin soles but provide some protection. However minimal shoes do not give runners the same feedback from the plantar mechanoreceptors. Because of the greater protection they offer in comparison to barefoot running, minimal shoes may also interfere with the development of a gentle foot strike, toughening of the soles of the feet, and awareness of road hazards.  

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Biomechanics of flip-flops & sandals:  

Thong style flip-flops and slip-on sandals (i.e., one strap across the distal-dorsal foot) have become increasingly popular due to their light-weight, convenience, and comfort. In an observational study of 1,000 women at a large U.S. shopping mall, 43% were wearing flip-flops while 21% were wearing athletic shoes. In addition, a four-fold increase in men’s flip-flops sales in department stores have been documented from 2002 to 2006 as reported by the NPD Group in Port Washington, US.

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Research studies suggest that wearing light-weight and minimally supportive footwear such as flip-flops and sandals during childhood has an effect on foot arch development. Rao et al. showed that habitually unshod children had a lower prevalence of flat-foot and higher rate of normal arches compared to habitually shod children. Sachithanandam et al. showed that adults who began to wear closed-toe shoes before the age of six had a higher prevalence of flat feet compared to those who began wearing shoes only after the age of six. Although minimal open-toe footwear (e.g., flip-flops, sandals) worn at a young age may be more beneficial in developing normal foot arches in adulthood compared to closed-toe shoes, their long-term effects in adult populations are still relatively unknown. Comprehensive biomechanical data on wearing flip-flops and sandals in walking compared to shod and barefoot walking are very scarce in the literature.

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A number of studies have investigated the biomechanical implications of walking in flip-flops compared to barefoot and/or closed-toe footwear. Shroyer et al. showed that walking in flip-flops resulted in a shorter stride length, a shorter stance time, a smaller braking ground reaction force (GRF) impulse, and a larger ankle contact angle compared to running shoes in both men and women. Shakoor et al.  compared barefoot, flip-flops, flat walking shoes, stability shoes (with a stable 50 mm heel), and clogs (i.e., slip-on footwear with a 50 mm heel) in knee osteoarthritis patients during level-walking and showed smaller sagittal plane ankle range of motion (ROM), peak knee internal abduction moment, and peak ankle dorsiflexion moment in flip-flops compared to the flat walking shoes. In addition, the authors reported greater peak vertical GRF and knee ROM in flip-flops compared to barefoot. A recent study on kinematic characteristics of children showed that a thong-style flip-flop produced greater ankle dorsiflexion angle at heel strike compared to barefoot during walking and running. The ankle angle stayed more dorsiflexed during early stance in flip-flops compared to barefoot walking. However, because these previous two studies used knee osteoarthritis and children populations, it is difficult to generalize their findings to a healthy adult population.

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Gender differences in lower extremity biomechanical variables appear to exist in flip-flop walking. Shroyer et al.  showed significant gender effects on several variables. Therefore, the effects of flip-flops and other minimal footwear should be examined in only men or women to avoid any confounding gender effects. Many differences in methodology such as gender, age, musculoskeletal diseases, type of footwear, and a lack of control of walking speed make it difficult to draw clear conclusions from the current literature. In addition, no biomechanical data of GRF, center of pressure (COP), and joint kinetics in open-toe footwear during level-walking in healthy populations are available in the literature. Furthermore, biomechanical analyses have only been conducted to compare flip-flops with barefoot and various types of closed-toe footwear.

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Running, injuries and cushioning shoes:    

Running is an increasingly popular form of physical activity. From a public health perspective, the promotion of leisure-time running might be a powerful strategy to combat the pandemic of physical inactivity worldwide, and its consequence on non-communicable diseases. Although regular running activity has a massive beneficial impact on health, it also generates a relatively high number of injuries, especially at the lower limb typically result from repeated loading of the musculoskeletal system. The risk of sustaining a running-related injury (RRI) cancels out part of the benefits of running practice, since the long-term consequences of injury might include, among others, increased risk of osteoarthritis, a reduction of physical activity, as well as an increase in healthcare costs.  RRI incidence has remained high during the last 40 years, with an overall incidence rate ranging between 18.2% and 92.4%. The role of footwear on RRI risk has been strongly emphasized ever since jogging became popular in the 1970s, but there is currently no evidence that developments in running shoe technology and new concepts regularly emerging on the market have helped to tackle the RRI burden.  

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Most RRI are overuse injuries, as they develop progressively over the kilometers run. The etiology of these injuries is multifactorial, which implies that to understand the mechanisms leading to injury, a holistic approach is warranted, including the study of a large set of potential risk factors. These factors could be classified as being related to training characteristics, running mechanics and anatomy of the runners. Some authors suggested that anatomical and biomechanical factors influence the tolerance to physical strain and thus the relationship between training load and injury occurrence.

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Biological tissues such as bones, muscles and tendons can endure a certain amount of stress, provided that the product of stress level (e.g., intensity and external load) and the number of repetitions within a certain time period (e.g., strides and training sessions) remains below a threshold that is specific to each structure. In running, the ground reaction force is the main external stress that acts on the body. When the foot hits the ground, the magnitude of the vertical ground reaction force impact peak (IP) and loading rate (LR) have been linked to the risk of running injuries so the study of running injury prevention has primarily focused on the management of impact loading. Vertical ground reaction force (VGRF) is a biomechanical factor that has been extensively studied in running. A recent meta-analysis found that the loading rate of the vertical ground reaction force was higher in patients with a history of stress fracture. High impact-related variables were shown to increase the risk of bony and soft tissue injuries. Moreover, running retraining interventions have proven their efficiency in modifying some VGRF parameters and decreasing pain, which suggest that running retraining represents an interesting paradigm to treat RRI. Other biomechanical factors such as step length, step frequency or leg stiffness have previously been suggested as potential biomechanical risk factors for RRI, yet no causal relationship has been established.

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Body mass index (BMI) has been associated with injury risk in novice as well as in recreational runners, though other results suggest a protective effect of BMI. It is common belief that individuals with higher BMI have a higher injury risk, because of the increased physical stress that results from extra body weight. Surprisingly, body mass as such has hardly ever been considered as a potential risk factor for running injury.

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Since running biomechanics are associated with injury risk, any effect of shoe features on the running pattern and VGRF parameters deserve attention. Given that repetitive loading of the musculoskeletal system is an injury risk factor, cushioning has been one of the most extensively investigated shoe features. The shock absorption properties of footwear mainly result from the materials used in the sole (i.e., their type, density, structure and combination) as well as from the geometry of the shoe (i.e., the midsole thickness and the design of inserts). One of the most popular approaches has been to change the hardness of the shoe midsole. In order to reduce the risk of running-related injuries, running shoe manufactures have added cushioning to shoe soles aimed at reducing impact loading.

For midsole hardness, the increase of midsole hardness from Asker C40 to Asker C70 would reduce the impact peak (Baltich et al., 2015), minimize energy loss (Stefanyshyn and Nigg, 2000) and increase the contact time (Willwacher et al., 2013); whereas other studies found that the impact peak increased (Chambon et al., 2014) while contact time did not change (Sterzing et al., 2013) across different midsole hardness. These inconsistent results may be due to the different tested speeds (3.3 ± 0.1 m/s vs. 3.5 ± 0.18 m/s) (Willwacher et al., 2013), hardness (0.6-17.10 N/mm vs. 40-65 Asker C vs. 47.1-62.8 Asker C) (Baltich et al., 2015) across the included studies.

Only a few longitudinal studies examined the relationship between midsole and running injuries. Theisen et al. (2014) randomly assigned soft (Asker 64C) and hard (Asker 57C) midsole shoes to 247 runners to wear for five months. The same injury rates were found between soft and hard midsole shoes used in training. However, Dixon et al. (2015) found that shoes with hard lateral stiffness (Asker 70C) had larger peak knee abduction moment and peak loading rates than softer midsoles (i.e., 52 and 60 Asker) during running, suggesting the increase the risk of running related injuries (Dixon et al., 2015).

Overall, the studies investigating the effect of shoe cushioning on VGRF did not provide consistent results. In theory, peak impact forces should be reduced by softer or more compliant shoes, which was indeed confirmed in some in vivo studies. However, studies show no evidence of reduced running injury rates with increasing amounts of cushioning. The explanation for this counterintuitive finding may lie in the well-recognized, but poorly understood phenomenon that highly cushioned shoes have a limited ability to reduce impact loading. In fact, some studies have noted even a slight increase in impact loading when running in shoes with a compliant versus a hard midsole. These findings counter the impact attenuation theory and the results of in vitro mechanical impact tests, both of which indicate a significant reduction in impact loading with increased cushioning.

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Acute effects of different cushioned footwear on the biomechanics of running, a 2017 study:  

The purpose of this study was to investigate how different footwear (highly cushioned, standard, minimalist shoes) affect peak ground reaction forces, average loading rates and joint kinematics during running. Nine participants ran at a self-selected speed across all shod conditions, minimalist, highly cushioned and standard running shoe. Vicon Nexus was used to analyze joint kinematics of the ankle and knee, a Bertec Instrumented Treadmill was used to analyze the average loading rate and peak ground reaction forces. Results show consist of reductions in ankle and knee joint motion in the minimalist shoe during the stance phase with the standard and highly cushioned shoe being more similar to each other. The goal of the current project was to examine the acute changes in joint kinematics at the ankle and knee and ground reaction forces that occur with changing footwear. It appears as if much of the alterations in joint kinematics of the ankle and knee, at least in the initial adaptations to a new shoe, may be greater in a minimalist shoe than those of cushioned shoes. However, it does not appear, at least in the short term, that footwear alone will reduce injury rates in regular runners.

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Running in highly cushioned shoes increases leg stiffness and amplifies impact loading, a 2018 study:

Running shoe cushioning has become a standard method for managing impact loading and consequent injuries due to running. However, despite decades of shoe technology developments and the fact that shoes have become increasingly cushioned, aimed to ease the impact on runners’ legs, running injuries have not decreased. To better understand the shoe cushioning paradox, authors examined impact loading and the spring-like mechanics of running in a conventional control running shoe and a highly cushioned maximalist shoe at two training speeds, 10 and 14.5 km/h. They found that highly cushioned maximalist shoes alter spring-like running mechanics and amplify rather than attenuate impact loading. This surprising outcome was more pronounced at fast running speed (14.5 km/h), where ground reaction force impact peak and loading rate were 10.7% and 12.3% greater, respectively, in the maximalist shoe compared to the conventional shoe, whereas only a slightly higher impact peak (6.4%) was found at the 10 km/h speed with the maximalist shoe. Authors attribute the greater impact loading with the maximalist shoes to stiffer leg during landing compared to that of running with the conventional shoes. These discoveries may explain why shoes with more cushioning do not protect against impact-related running injuries.

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Perception of cushioning: 

Design of modern athletic footwear addresses the needs for a shoe to be comfortable while providing energy absorption and rearfoot stability. The latter factors, energy absorption and rearfoot stability, have been identified as important in the prevention and progression of a variety of gait-related injuries to the lower extremity and low back. Clinicians dealing with individuals with degenerative joint disease frequently advise such patients to continue or to adopt a walking program to maintain cardiovascular fitness while recommending use of shoes with superior cushioning effects to reduce the impulsive loading that has been associated with the onset and progression of joint degeneration. However, selection of the appropriate shoe is usually left to the patient, who may depend on advice from a variety of sources during selection.

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Footwear designers incorporate a variety of midsole materials and mechanical systems to cushion shock while controlling rearfoot motion. To market shoes, advertising copy and the claims of salespeople often extol the benefits of the materials and design incorporated in a shoe. This marketing strategy is common, as evident from a perusal of a fitness magazine, in spite of a paucity of unbiased biomechanical testing of the validity of many of these claims, and a lack of understanding of how such claims may influence the gait behavior of a purchaser of a pair of shoes.

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The role of subject perception to expectations of energy absorption by the shoes has often been overlooked when evaluating energy absorbing characteristics of shoes. Shoe design and material construction is frequently evaluated by comparing an experimental “energy-absorbing” shoe with a standard lab shoe. In addition, the instructions provided to the subject may follow the format of “this shoe is designed to absorb more of the shock at contact.” Shoes designed for energy absorption may include an insert at the heel, consisting of various materials, or simply a different hardness of the material used to construct the midsole. These modifications are visible and/or perceivable by the subjects.

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The role expectancy plays in the effectiveness of clinical treatments is often examined through administration of a placebo. Placebos are used to alter response expectancies and may affect a change in those to whom they were administered. The essential ingredient to a placebo treatment is the belief by the subject that they are receiving treatment and the anticipation that some effect will occur. By use of words or actions, a subject must be led to believe that the placebo will cause the desired effect. Knowledge of shoe construction characteristics or the specific instructions given to a subject may cause adoption of a gait pattern in accordance with the expectation of the energy absorption provided by the shoe. A form of placebo testing was used by Robbins and Waked to alter expectations of a cushioning material. To evaluate the influence of investigator comments regarding cushioning material, subjects stepped barefoot onto a force platform covered by identical shoe sole material that had been modified to appear different. Subjects had been provided with false advertising copy that provided different descriptions of the materials supposedly used in each condition. The advertising copy ranged from a warning that the material did not provide cushioning to the use of graphs, tables, and athlete endorsement suggesting superior impact absorption. The results indicated the impact ground reaction force varied as a function of the advertising message. When subjects were informed that a particular surface provided additional cushioning, impact ground reaction force data were higher (121% of body weight) than when subjects were provided with a warning message (110% of body weight). The results were interpreted as suggestive of subjects moderating impact in accordance with the expected cushioning of the material. That is, subjects were less inclined to use a landing strategy that would reduce impact force if they had been told that cushioning would be provided by the surface material. The study raises the question of how subjects would respond if the cushioning characteristics of a shoe, rather than a landing surface, were altered, because a shoe represents a more personalized aspect of the foot/ground interface.

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In laboratory testing of shoes, subjects have been asked to quantify their perception of shoe cushioning. Using a 15-point rating scale, Hennig et al. had subjects classify running shoes from very, very hard to very, very soft. Ground reaction force data were collected after subjects quantified shoe cushioning. The authors reported that the peak vertical force at footstrike was lower when subjects wore harder shoes. The authors suggest that subjects may alter the kinematic pattern of gait to reduce the peak ground reaction force encountered during the support phase in such a way as to reduce both peak and impulse values. However, an increase in loading rate magnitude was associated with a rating of increased shoe hardness. In accordance with expectation theory, making judgments about a shoe before testing may have led subjects to unknowingly alter lower limb mechanics to adjust for perceived cushioning. Comparisons of ground reaction forces (GRF) during gait are not typically conducted with blinding of the varied shoe characteristic, raising concerns related to the existence of a placebo effect, or a subject response based on a perceived expectation of change.

In a study of perception of shoe cushioning when running, Hennig and Milani reported that most subjects have the ability to judge impact severity in experimental situations, but it is unknown to what extent these perceptions are affected by a subject’s expectation of the testing environment. Robbins and Waked demonstrated that subjects may be deceived into accepting higher forces during landing if provided with misleading information regarding the energy absorbing characteristics of the landing. Because of research suggesting a possible cause of lower impact peaks in harder shoes to be an intrinsic avoidance mechanism, it may be theorized based on expectancy theory that influencing someone to believe that one shoe can absorb more energy than another may result in different ground reaction force values. Contrary and sometimes confusing findings in the literature emphasize the need for further study in the area of perception and energy absorption.

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Studies on biomechanics of footwear:

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-1. Interaction of Arch Type and Footwear on Running Mechanics, a 2007 study:

Background: Running shoes are designed to accommodate various arch types to reduce the risk of lower extremity injuries sustained during running. Yet little is known about the biomechanical changes of running in the recommended footwear that may allow for a reduction in injuries.

Purpose: To evaluate the effects of motion control and cushion trainer shoes on running mechanics in low- and high-arched runners.

Study Design: Controlled laboratory study.

Methods: Twenty high-arched and 20 low-arched recreational runners (>10 miles per week) were recruited for the study. Three dimensional kinematic and kinetics were collected as subjects ran at 3.5 ms-1 ± 5% along a 25-m runway. The motion control shoe evaluated was the New Balance 1122, and the cushioning shoe evaluated was the New Balance 1022. Repeated-measures analyses of variance were used to determine if low- and high-arched runners responded differently to motion control and cushion trainer shoes.

Results: A significant interaction was observed in the instantaneous loading rate such that the low-arched runners had a lower instantaneous loading rate in the motion control condition, and the high-arched runners had a lower instantaneous loading rate in the cushion trainer condition. Significant main effects for shoe were observed for peak positive tibial acceleration, peak-to-peak tibial acceleration, mean loading rate, peak eversion, and eversion excursion.

Conclusion: These results suggest that motion control shoes control rearfoot motion better than do cushion trainer shoes. In addition, cushion trainer shoes attenuate shock better than motion control shoes do. However, with the exception of instantaneous loading rate, these benefits do not differ between arch type.

Clinical Relevance: Running footwear recommendations should be based on an individual’s running mechanics. If a mechanical analysis is not available, footwear recommendations can be based empirically on the individual’s arch type.

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-2. Effects of different shoe-lacing patterns on the biomechanics of running shoes, a 2009 study:

In the present study, authors examined the influence of shoe lacing on foot biomechanics in running. Twenty experienced rearfoot runners ran in six different lacing conditions across a force platform at a speed of 3.3 m. s (-1). Foot pronation during contact, tibial acceleration, and plantar pressure distribution of the right leg were recorded. The test conditions differed in the number of laced eyelets (1, 2, 3, 6 or 7) and in lacing tightness (weak, regular or strong). The results show reduced loading rates (P < 0.05) and pronation velocities (P < 0.01) in the tightest and highest lacing conditions. The lowest peak pressures under the heel and lateral midfoot (P < 0.01) were observed in the high (seven-eyelet) lacing pattern. Regular six-eyelet cross-lacing resulted in higher loading rates (P < 0.05) and higher peak heel pressures (P < 0.01) than seven-eyelet lacing, without any significant differences in perceived comfort. The low lace shoe conditions resulted in lower impacts (P < 0.01) and lower peak pressures under metatarsal heads III and V (P < 0.01), which is probably induced by the foot sliding within the shoe. A firm foot-to-shoe coupling with higher lacing leads to a more effective use of running shoe features and is likely to reduce the risk of lower limb injury.

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-3. Cushioned heel running shoes may alter adolescent biomechanics, performance, a 2013 study:

Many of today’s running shoes feature a heavy cushioned heel. New research presented today at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that these shoes may alter an adolescent runner’s biomechanics (the forces exerted by muscles and gravity on the skeletal structure) and diminish performance.

Researchers recruited 12 adolescent competitive athletes from local track teams, and asked them to run on a treadmill in large heel trainers, track flats and without any shoes (barefoot) at four different speeds. Biomechanics — stride length, heel height during posterior swing phase and foot/ground contact — were measured with a motion capture system. The researchers found that shoe type “dramatically” altered running biomechanics in the adolescent runners. When wearing cushioned heel trainers, the athletes landed on their heel 69.8 percent of the time at all speeds. With the track flats, the heel was the first point of contact less than 35 percent of the time; and when barefoot, less than 30 percent of the time. Shoes with cushioned heels promote a heel-strike running pattern, whereas runners with track flats and barefoot had a forefoot or mid-foot strike pattern.

What authors were trying to evaluate is whether or not the foot strike would change in an adolescent — who doesn’t yet have a permanently established gate — when they changed their shoe or running speed. What they found is that simply by changing their footwear, the runners’ foot strike would change. When they ran in the cushioned heel or an average running shoe ─ even when running a 5-minute mile ─ the athletes landed on their heel first. Many adolescent runners train in cushioned heels and compete in track spikes, which may give them less of a (performance) advantage in competition.

A 2010 study found that heel strike running distributes more energy to hips and knees, running in flat- soled shoes that promote a forefoot strike may present a healthier foot strike for runners over a lifetime, possibly resulting in fewer hip and knee problems.

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-4. A comparison of gait biomechanics of flip-flops, sandals, barefoot and shoes, a 2013 study:

Flip-flops and sandals are popular choices of footwear due to their convenience. However, the effects of these types of footwear on lower extremity biomechanics are still poorly understood. Therefore, the objective of this study was to investigate differences in ground reaction force (GRF), center of pressure (COP) and lower extremity joint kinematic and kinetic variables during level-walking in flip-flops, sandals and barefoot compared to running shoes.

Methods:

Ten healthy males performed five walking trials in the four footwear conditions at 1.3 m/s. Three-dimensional GRF and kinematic data were simultaneously collected.

Results:

A smaller loading rate of the 1st peak vertical GRF and peak propulsive GRF and greater peak dorsiflexion moment in early stance were found in shoes compared to barefoot, flip-flops and sandals. Barefoot walking yielded greater mediolateral COP displacement, flatter foot contact angle, increased ankle plantarflexion contact angle, and smaller knee flexion contact angle and range of motion compared to all other footwear.

Conclusions:

The results from this study indicate that barefoot, flip-flops and sandals produced different peak GRF variables and ankle moment compared to shoes while all footwear yield different COP and ankle and knee kinematics compared to barefoot. The findings may be helpful to researchers and clinicians in understanding lower extremity mechanics of open-toe footwear.

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-5. Physics of Running Shoes – Impact Force vs. Types of Shoes, a 2014 study:

A runner’s foot collides with the ground around 1000 times per mile which can cause a running injury that is primarily caused by repeated force on the lower leg and foot. The human body naturally distributes force through the biomechanics of running (ankle, knee, and hip all help to distribute and absorb force). Modern running shoes provide factors that alter the body’s natural biomechanics (cushioning, arch size, heel rise). These factors can lead to the impact force not being appropriately absorbed, eventually causing injury. The purpose of this study is to find whether the changes in foot strike patterns produced by various shoe types have an effect on the impact force produced by the foot or not.

Results and Conclusions:

Results showed difference in force produced with different types of running shoes and indicated the value of force changed with type of shoes.  This can lead to the impact force not being appropriately absorbed, eventually causing injury. The change in biomechanics that shoes cause may be a leading factor in impact force injuries.

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-6. Running shoes and running injuries: mythbusting and a proposal for two new paradigms: ‘preferred movement path’ and ‘comfort filter’, a 2015 study:

In the past 100 years, running shoes experienced dramatic changes. The question then arises whether or not running shoes (or sport shoes in general) influence the frequency of running injuries at all. This paper addresses five aspects related to running injuries and shoe selection, including (1) the changes in running injuries over the past 40 years, (2) the relationship between sport shoes, sport inserts and running injuries, (3) previously researched mechanisms of injury related to footwear and two new paradigms for injury prevention including (4) the ‘preferred movement path’ and (5) the ‘comfort filter’. Specifically, the data regarding the relationship between impact characteristics and ankle pronation to the risk of developing a running-related injury is reviewed. Based on the lack of conclusive evidence for these two variables, which were once thought to be the prime predictors of running injuries, two new paradigms are suggested to elucidate the association between footwear and injury. These two paradigms, ‘the preferred movement path’ and ‘the comfort filter’, suggest that a runner intuitively selects a comfortable product using their own comfort filter that allows them to remain in the preferred movement path. This may automatically reduce the injury risk and may explain why there does not seem to be a secular trend in running injury rates.

The preferred movement path paradigm as follows:

The skeleton of an individual athlete attempts for a given task (e.g., heel–toe running) to stay in the same movement path, the ‘preferred movement path’. Muscle activity is used to ensure that the skeleton stays in this path. It may be, however, that the amplitude of this path varies. For instance, when running barefoot, the initial dorsiflexion of the ankle joint is reduced. However, the actual movement path stays the same. If this paradigm is correct, the definition of a ‘good’ running shoe may have to change. A ‘good’ running shoe would be a shoe that allows the skeleton to move in the ‘preferred movement path’. A ‘good’ running shoe would, therefore, demand less muscle activity than a ‘bad’ running shoe to ensure that the skeleton moves in the correct path. The assessment of whether or not a shoe supports the preferred movement path may be difficult. Since the paradigm states that the movement does not change, assessment of movement does not help in the assessment of this question. Any assessment of a shoe with respect to the preferred movement path paradigm using movement assessment is, therefore, per definition inappropriate. It is proposed that other indirect ways should be chosen to make such an assessment (e.g., muscle activity, energy demand or others). It is proposed that the ‘preferred movement path’ may be one paradigm that could replace the inappropriate paradigms of cushioning and pronation for the primary prevention of running injuries.

The comfort filter paradigm as follows:

When selecting a running shoe, an athlete selects a comfortable product using his/her own comfort filter. This automatically reduces the injury risk and may be a possible explanation for the fact that there does not seem to have been a trend in running injury frequencies over time. Stated differently, it is not that footwear could not have an influence on running injuries. On the contrary, footwear does appear to influence the frequency of injuries since we already choose the most comfortable shoe and avoid uncomfortable and potentially harmful footwear.

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-7. Effect of Running Shoes on Foot Impact During Running, a 2016 study:

Running is part of almost every sport, and requires a great amount of stamina, endurance, mental toughness and overall strength. At every step, the foot experiences ground reaction forces necessary to support the motion of the body. With the advancements in shoe technology, running shoes have grown in popularity among runners, as well as non-runners, because they reduce the risk of injuries from the impact felt by the foot. The purpose of this report is to analyze the effect of running shoes on impact forces on the foot. This is achieved through the use of three force pads fixed at different locations on the foot. The force measured by each sensor is then used to estimate the vertical ground reaction force, using the sensors’ calibrations equations. Based on the ground reaction force, the effective mass corresponding to the momentum change occurring during the transient phase of the impact is estimated. The results show that running at 9 miles per hour without running shoes generates an effective mass of Meff = (14.9±4.8) % Mbody while running at the same speed with running shoes generates an effective mass of Meff = (7.8±1.5) % Mbody. The values highlight a significant reduction in the risk of pain or injuries accomplished by wearing running shoes. Although the approach adopted proves that running shoes do reduce the risk of injuries and pain, it raises the question of how runners struck the ground before the invention of modern running shoes. In order to answer this question, one would analyze the foot kinematics and impact transients in long-term habitually barefoot runners and compare them to shod runners.

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-8. Effect of footwear on standing balance in healthy young adult males, a 2018 study:

Objective:

The present study aimed to evaluate the effect of footwear on standing balance in healthy young adult males.

Methods:

Thirty healthy male participants aged 20-30 years were tested for standing balance on the Balance Master on three occasions, including wearing a sandal, standard shoe, or no footwear (barefoot). The tests of postural stability include; “Modified Clinical Test of Sensory Interaction on Balance” (mCTSIB), “Unilateral Stance” (US), and the “Limits of Stability” (LOS). The balance scores (mCTSIB, US, and LOS) was analyzed.

Results:

There was a significant effect between footwear conditions for mCTIB with eye closed on a firm surface (p=0.002). There was a significant effect between footwear conditions for the US with eye open and closed (p<0.05). There was a significant effect between footwear conditions for LOS reaction time during forward movement (p=0.02). Similarly, there was a significant effect between footwear conditions for LOS reaction time during left side movement (p=0.01).

Conclusions:

Wearing sandals compared to bare feet significantly increased postural sway and reduced stability in healthy young adult males. However, wearing a standard shoe compared to bare feet did not significantly affect balance scores in standing.

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-9. Systematic Review of the Role of Footwear Constructions in Running Biomechanics: Implications for Running-Related Injury and Performance, a 2020 study:

Although the role of shoe constructions on running injury and performance has been widely investigated, systematic reviews on the shoe construction effects on running biomechanics were rarely reported. Therefore, this review focuses on the relevant research studies examining the biomechanical effect of running shoe constructions on reducing running-related injury and optimizing performance. Searches of five databases and Footwear Science from January 1994 to September 2018 for related biomechanical studies which investigated running footwear constructions yielded a total of 1260 articles. After duplications were removed and exclusion criteria applied to the titles, abstracts and full text, 63 studies remained and categorized into following constructions: (a) shoe lace, (b) midsole, (c) heel flare, (d) heel-toe drop, (e) minimalist shoes, (f) Masai Barefoot Technologies, (g) heel cup, (h) upper, and (i) bending stiffness. Some running shoe constructions positively affect athletic performance-related and injury-related variables: 1) increasing the stiffness of running shoes at the optimal range can benefit performance-related variables; 2) softer midsoles can reduce impact forces and loading rates; 3) thicker midsoles can provide better cushioning effects and attenuate shock during impacts but may also decrease plantar sensations of a foot; 4) minimalist shoes can improve running economy and increase the cross-sectional area and stiffness of Achilles tendon but it would increase the metatarsophalangeal and ankle joint loading compared to the conventional shoes. While shoe constructions can effectively influence running biomechanics, research on some constructions including shoe lace, heel flare, heel-toe drop, Masai Barefoot Technologies, heel cup, and upper requires further investigation before a viable scientific guideline can be made. Future research is also needed to develop standard testing protocols to determine the optimal stiffness, thickness, and heel–toe drop of running shoes to optimize performance-related variables and prevent running-related injuries.

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-10. The influence of midsole shear on running smoothness, a 2021 study:

Increased shear force between the foot and ground has been shown to contribute to sports-related injury (Lorimer & Hume, 2014). Therefore, running-related research has modified footwear midsole cushioning to allow for greater anterior foot shift and reduce shear force during early stance. Early footwear innovation and modifications have resulted in lower peak braking forces and reduced muscle activity around the ankle joint during running (Wunsch et al., 2017).

With these biomechanical changes, a smoother running pattern may also occur by avoiding uncontrolled body motion and adapting muscle tension during stance. Running smoothness can be quantified by evaluating the jerk (or time derivative of acceleration) of the running pattern and has been related to injury and performance (Hreljac, 2000). However, the effects of manipulating the midsole shear in footwear on running smoothness has yet to be evaluated.

The purpose of this study was to compare the (1) anterior foot shift and (2) jerk of the foot, sacrum, and head between two footwear conditions with different midsole shear designs during treadmill running. 

Twenty male participants performed a six-minute treadmill run in two different footwear conditions, where kinetic, kinematic, and inertial measurement unit (IMU) data were collected in the final two minutes of the run.

Two professionally constructed pairs of running shoes were provided by adidas AG (Figure below).

The midsole of the prototype condition (Shear) was designed to allow for greater anterior foot displacement during early to mid-stance compared to the control condition (Control).

Improving running smoothness by limiting the body’s exposure to maximum jerk may improve performance and/or reduce the risk of injury. In this study, runners in the Shear condition experienced lower jerk at the foot, sacrum, and head. This may be related to better shock attenuation through the body’s kinetic chain during stance. It appears that midsole shear modifications that increase anterior foot shift results in smoother running patterns, but more work is needed to see how this directly relates to performance and injury.

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Footwear biomechanics breakthroughs:  

The footwear biomechanics industry and the related research has had an exciting decade. After many years of rather stagnant athletic footwear developments, in which many new materials, components and designs were introduced and marketed, but little impact was seen in either performance enhancement or injury reduction, we have witnessed an explosion of exciting advances over the last decade. Scientists, laboratories and industry representatives have been driving forces behind three major breakthroughs with significant repercussions for the footwear industry, the international running community and international elite racing.

-1. Firstly. Long-lasting paradigms still largely based upon early intuitive assumptions suggesting injurious consequences of pronation and high impact forces and loading rates have gradually been dispelled. This change in paradigms has only recently been more broadly accepted and a white paper relevant to the issue of pronation was published as an initiative of the ISB Footwear Biomechanics Group (Nigg et al., 2019). This paper indicated that ‘the exclusive causality between pronation and running injuries has been shown in neither cross-sectional nor longitudinal study designs with sufficient sample sizes’. Ideas that for many years were accepted as fundamentally established, were being questioned and opened for scientific debate.

-2. Secondly. We saw a significant international trend in minimizing the heel-to-toe drop, cushioning and stiffness in running footwear to approximate barefoot running with so-called minimalistic shoes. Or even barefoot running completely without shoes. This was promoted as the running form for which humans were inherently designed, based upon how the human race has run for thousands of years (Lieberman et al., 2010). A major international sales increase in such shoes was seen during the 2010s, during an often polarized debate between those promoting running in traditional, cushioned, thicker shoes and those striving towards barefoot running. This was accompanied by a flood of scientific research and publications exploring benefits and possible injury risks. A recent review article (Sun et al., 2020) found that minimalist shoes may improve running economy, but that they concomitantly increase the metatarsophalangeal joint and ankle joint loading when compared to traditional shoes. No clear consensus on which footwear is universally preferable is therefore likely, and the debate has recently receded and now resides on a positive pragmatical level of runners themselves choosing which footwear suits them, their ambitions and their running style best.

-3. Thirdly. Anybody interested in running cannot have missed the recent developments in advanced footwear technology (AFT), which have significantly contributed to improved results in all major elite international running races (Bermon et al., 2021). AFT is defined as distance running shoes with high stack height, high energy return midsole material and an often curved, stiff plate embedded within the midsole along the length of the shoe.  As early as 2006 scientists published results indicating improved running economy with external materials stiffening the metatarsophalangeal joint (Roy & Stefanyshyn, 2006) and in 2013 a pioneering study indicated a significantly decreased oxygen consumption related to ground-breaking new midsole cushioning material (Worobets et al., 2013). It is now a widely accepted fact that the incredible results being achieved in distance running are a direct result of AFT shoes, for example, Eliud Kipchoge ran a sub 2-hour marathon distance in October 2019, the first time this magical barrier has been broken. However, there is still some debate as to precisely which structural characteristics and possible energy return effects of AFT shoes actually facilitate such performance increases (Nigg et al., 2020). The international athletics governing body, World Athletics, has identified a necessity for regulating such performance enhancement and is at present working on a testing protocol for shoes, in order to compile rules for shoe compliance for international elite competition.

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Section-8

Footwear materials, construction and engineering:

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Footwear Materials:

Modern footwear is usually made up of leather or plastic, and rubber. In fact, leather was one of the original materials used for the first versions of a shoe. Since time immemorial, shoes have been made of leather. The luxury leather used in the finest men’s and women’s shoes is calf. The most versatile leather, used for many kinds of shoes, is side leather, made from cattle hide and called side because the large hide is cut down the middle lengthwise into two sides for handling. Kid leather, made from goatskin, is used for women’s dress shoes and men’s slippers. Sheepskin is used in linings and slippers. Reptile leathers (alligator, lizard, and snake) are used in women’s and some men’s shoes. Cordovan (a small muscle layer obtained from horsehide) is a heavy leather used in men’s shoes. Patent leather, usually made from cattle hide, is given a hard, glossy surface finish. Suede is made from any of several leathers (calf, kid, or cattle hide) by buffing the inner surface to produce a napped finish.

Though still dominant, leather is being replaced in shoes by rubber and man-made fibers and compositions, particularly for heels and other shoe components. Linings and uppers may be natural or coated fabrics. Welting, heels, and counters (heel stiffeners) may be plastic. Most inner and outer soles are now nonleather. The soles can be made of rubber or plastic, sometimes having a sheet of metal inside. A fabric base coated with a chemical surface finish can be made in a variety of textures and designs, many simulating the grain of leather. Synthetic patent and synthetic suede are also used in shoes. Such modern materials cost less and meet performance standards. Certain fabrics, including linen, satin, and silk, are also used in footwear. More recently, footwear providers like Nike, have begun to source environmentally friendly materials. 

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Most common materials used to make Shoes: 

Shoes come in different shapes, colours, designs and sizes; all of which are important when choosing a specific pair. However, besides these factors, the most important to consider when settling for a particular pair of shoe is the material used, which in turn also determines its durability and cost. The most crucial feature in shoe design is not the pattern used for the shape and look of the shoe but the fundamental material from which the shoe is made. Knowing the various materials most prevalent in shoes helps immensely in choosing the right shoes to match your needs at the time. The five materials most commonly used in shoe production are leather, textiles, synthetics, rubber and foam.

-1. Leather

Leather is one of the most common shoe material types.  Leather is a strong, flexible and durable material obtained from the tanning, or chemical treatment, of animal skins and hides to prevent decay. Leather is a by-product of the meat industry that is derived from the hide of livestock. Leather is flexible yet durable, as sturdy as it is supple. It’s elastic, so it can be stretched yet it resists tearing and abrasion. It’s a breathable material, and it insulates heat, helping to regulate temperature. This all makes leather shoes conform to the feet of the wearer like no other shoe material can. It’s no surprise, then, that leather is one of the most common materials that shoemakers use, particularly in making men’s dress shoes. Not only does leather give that high-end, sleek feel, but it is also very sturdy and durable, especially when taken care of properly. 

Drawbacks to leather shoes include:

-leather is expensive compared to other shoe materials

-leather is heavy

-leather can get very hot

-leather untreated can be vulnerable to water damage

Because leather comes from animal hide, leather shoes can also bear slight imperfections.

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-2. Textiles

Fabric is also quite commonly used for making shoes. Like leather, textiles are available in a wide array of colors and varieties. With textiles, the possible variations include different fibers, denier (or fabric weight), weaves and knits. With textile, you can be sure to find a unique shoe that fits both your style and design. One key advantage of textile shoes is their versatility in styles and designs. Each textile also has its own physical properties that must considered when choosing whether or not to own or wear it, such as variations in breathability, support and temperature control (i.e., hotness or coolness).

Some of the most common textiles used in the creation of shoes include:

Cotton- comfortable, lightweight, and easy to clean

Polyester- flexible, dries out quickly, and is resistant to shrinking

Wool- helps keep feet warm in the winter and cool in the summer

Nylon- durable, insulated, and cheap

Rayon- soft, comfortable, easy to color

Propylene- able to withstand pressure and resist chemicals

Lycra- elastic, able to stretch, and strong

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Canvas is a coarse cloth material made of hemp that is used in a number of things including sails, tents, boards (used for painting on, i.e., painting canvasses) and shoes. Modern canvas is usually made of cotton or linen, or sometimes polyvinyl chloride (PVC), although historically it was made from hemp. The canvas shoe is a very basic form of casual shoe or sneaker. It is constructed very simply with a canvas upper and a rubber sole. Most companies have adopted the use of canvas to make shoes since the material provides a myriad of options in terms of creativity and versatility. These shoe material types are easy to clean. They are also highly accommodating to dyes. Since they come in a variety of colours, you will be spoilt for choice when looking for a pair of canvas shoes. Besides, canvas does not stretch as much, which means your brand new pair of shoes will retain its shape without requiring the use of shoe inserts. Canvas shoes are cheap, adaptable and low-maintenance. This shoe, however, has one setback: it exposes you to ankle injuries since it does not offer ankle support. 

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-3. Synthetics

Synthetics are essentially fibers made by humans through chemical synthesis. There are many synthetic fibers but there are a few that are most often used in the crafting of shoes. For this process, the synthetic material makes up the external surface that is adhered to a polyester fabric. Synthetic materials go by many different names– PU leather or simply PU, synthetic leather or simply synthetics– but they’re all the same in being man-made composites of two layers: an external surface adhered to a backing layer composed of polyester fibers. All types of synthetics used to make shoes are also the same in making for supportive yet affordable sports shoes. Like their textile counterparts, synthetic materials also come in a variety of colors and textures.

The following fabrics are great for those who want to support vegan shoes:

Polyurethane-coated fabrics (PUCFs)- These are materials made to construct the upper part of the shoe that contain a cotton or polyester/cotton base with a thin coating of polyurethane on the top, which coats the entire piece of fabric. Polyurethane-coated fabrics are great for the imitation of leather and are also soft, light-weight, and comfortable to wear.

Polyvinyl-chloride-coated fabrics (PVC)- This type of material is a part of the upper construction of shoes that is most often made on a woven base that is then sprayed with a layer of plasticised PVC, which may have a solid or cellular structure. The benefit of these fabrics is that they are easy to clean, resistant to water, and less expensive, though they are reported to become misshapen over time and may be less comfortable on foot.

Poromeric coated fabrics- Another synthetic material that is often used for the construction of the upper part of a shoe is poromeric coated fabrics. Poromeric is a name given to synthetic material that possesses leather-like qualities and appearance. These fabrics are usually formed on a textile or polymer base with a thick and porous polyurethane surface layer. These materials are often water repellent and very easy to clean. 

Factors in the composition of the two layers comprising synthetic materials, such as whether the polyester used for the backing is woven or non-woven, or the method of adhesion used, whether a wet or dry process, determine the quality and durability of the resulting synthetic. Lower quality synthetics may not have a perfectly smooth surface, even possibly showing creases and wrinkles.

The advantage of shoes made from synthetics is that they tend to be comparatively quite inexpensive for both the manufacturer and consumer as compared with other types of shoes. Because the material is less durable than its leather and textile counterparts, however, synthetic shoes tend to degrade faster and need replacing more often.

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Plastic:

Believe it or not, but shoes are also commonly made out of plastic! Many components of modern shoes are made of plastic materials, from the soles to the uppers to the eyelets. Though some have argued against the use of plastic in shoes because of their potential for waste, some companies are actually beginning to recycle old thrown out plastic into woven fibers used for the creation of shoes. Polyester and plastic bottles are commonly made out of the same substance, polyethylene terephthalate. After going through a purification and cleaning process, clear bottles are shredded to form the fiber needed to create the shoes. Eventually, the fibers will go through a dying process which is why the clear bottles are most often used for the manufacturing of shoes. Due to the nature of plastic, shoes made from this material tend to be less breathable on foot.

Plastic material used in soles:

Material

Description

Use

PVC (polyvinyl chloride)

A versatile plastic that accounts for 20% of all plastics manufactured worldwide. 

In footwear, PVC is often found in outsoles as well as synthetic leathers and coated fabrics for a shoe’s upper.

PU

A rigid type of polyurethane plastic.

Used in outsoles because of its flexibility, resistance to abrasion, strength and durability.

TPU (thermoplastic polyurethane)

An elastic, flexible type of polyurethane plastic.

Used in outsoles because of its elasticity, flexibility and resistance to abrasion, impact and weather.

EVA Foam (ethylene vinyl acetate)

A tough but flexible plastic.

To provide a level of comfort in a shoe’s midsole.

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-4. Rubber

Natural rubber is produced naturally from the native Brazilian plant Hevea brasiliensis. Synthetic rubber is artificially produced from a variety of polymers which provides the rubber its properties. Rubber is popularly used in the sports industry to make soles for shoes. Among examples of shoes featuring rubber soles are tennis and running shoes. There are also many sustainable shoes made from natural rubber. Unlike leather-soled shoes, which are only ideal for the summer, rubber-soled shoes are suitable for all seasons. Irrespective of whether it’s snowing or raining, your rubber-soled shoe will get you to your destination in one piece. It is also more economical to wear a rubber-soled shoe than the leather ones. Besides, over the years, natural rubber has gained immense popularity over the traditional polyester due to its eco-friendly nature.

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-5. Foam

Foam is the most common material used to provide support in the uppers of shoes of all sorts, be they leather, textile, synthetic or even rubber. The different types of foam used for this purpose are innumerable, though they’re all generally divided into two categories: open and closed cell. All foam is made from plastic. In open cell foam, the material is permeable, allowing water and air to pass through; in closed cell foam, these open cells are sealed, preventing the gases inside them from escaping.

Open cell foam, also known as KFF or KF foam, is made of polyurethane plastic and tends to be softer than closed cell foam. Open cell foam can often be found in the collars and tongues of shoes. There are many different types of open foam, the most open of which is reticulated foam, frequently used to create ventilation features in shoes.

Closed cell foam is a denser material commonly used to make shoe midsoles. Types of closed cell foam include polyurethane and polyethylene, EVA foam, Neoprene and Latex. Each type of closed cell foam features its own properties, such as waterproofness or elasticity. 

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Materials for shoe soles:

In essence, a sole must:

-Give the shoe an appealing form, and therefore make it attractive to the buyer. The effect of the form on the consumer’s choice is nowadays even more pronounced with casual and sport shoes.

-Absorb impact. In other words, soles must impart a comfortable feeling to the foot.

-Have a good resistance to abrasion. The replacement of the eroded leather or rubber heels of street shoes and the protection of soles by rubbers is a vivid example. A tennis player expects shoes with soles which do not wear easily.

-Have a good resistance to flexure. Walking and running subject the soles to continuous flexing. Consumers expect their shoes to remain intact during the exercise whatever the temperature and extent of erosion of the soles.

-Have a good resistance to skidding. In other words, the extend of friction, or the coefficient of friction,

between the shoe material and various types of floors must be high.

-Special shoes like safety boots, must offer a certain degree of protection to the user. Depending upon the work environment, they must be resistant to solvents, oils, hydrolysis, static electricity, wear etc. Antistatic agents, fungicides, etc. are incorporated to the polymer in order to improve several of its properties.

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Materials used in the production of shoe soles:

Midsoles:

The most common materials used for midsoles are EVA (Ethylene Vinyl Acetate) and Polyurethanes (PU). EVA is also used as sole material for sandals.

EVA:

Is the most popular midsole material, because of its low cost and light weight. The solid copolymer of Ethylene and Vinyl Acetate is expanded during processing, by the incorporation of azo compounds or the injection of carbon dioxide. The resulting closed cells impart to the foam a pronounced cushioning effect. EVA can be injection moulded, compression moulded and extruded. Extruded sheets of several hardnesses or colours can be flame laminated to a desired thickness and cut to shape.

Polyurethanes:

Polyurethanes are open celled. They are not however as cheap and as light as EVA foams. Due to their open celled structure, their cushioning effect is not as pronounced as that of EVA foams. However, their compression set is lower than that of EVA, therefore they last much longer.

With regard to the material used, EVA and PU were widely used in footwear industry and related studies (Brückner et al., 2010). PU material exhibited lower relative changes of damping parameters than EVA and thus recommended as the alternative use of midsole material in running, even though PU material showed better durability than EVA (Brückner et al., 2010). From the running economy perspective, Wang et al. (2012) found that EVA shoes had higher capability of energy return than PU shoes at all running distances.

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Outsoles:

Outsole materials consist of leather, thermoplastics, vulcanised rubbers, thermoplastic elastomers, polyether polyurethanes.

Leather:

Despite its vulnerability it is the preferred soling material for fashion shoes. Soles from classical leather give extraordinary ease of shoes – unlike shoes with rubber sole. Shoes that looks outside as genuine leather can have a rubber sole.

Thermoplastics:

Compounded PVC is the most widely used, low cost material for solid as well as expanded soles for street shoes, casual shoes, sandals and slippers. Densities vary from 0.75 to 1.30, and hardnesses from 45 shore A to 95 shore A. When compounded with thermoplastic polyurethanes (TPU), PVC acquires flexibility and resistance to abrasion. PVC provides good protection against animal fats, many acids, alcohols, alkalies, bases, oils and petroleum hydrocarbons. PVC is not recommended for use in ketones, aldehydes and many solvents. Dry blending with Nitrile Rubber powder (NBR) imparts to the PVC polymer additional oil resistance, and, the compound, can therefore used in the moulding of soles for safety boots.

Vulcanised rubbers:

The structure of natural rubber (NR) is cis-1,4, polyisoprene. Its synthetic counterpart is called Isoprene rubber (IR). Its outstanding stretch characteristics and excellent low temperature properties allow the vulcanised material to stay supple in cold temperatures. It has superior slip, puncture and cut resistance compared to PVC. Rubber resists bases, acids, alcohols and diluted water solutions of most chemicals that are water soluble. It is a hydrocarbon and does not withstand constant contact with petroleum and oil based solvents. NR safety boots are used in food processing, transportation, utilities, construction, general industry, municipalities, agriculture.

Thermoplastic elastomers (TPE):

Whereas rubber vulcanisates acquire their structural strength from sulphur chemical crosslinks connecting chains at the double bond sites, the strength of thermoplastic elastomers results from crystallites which act as physical crosslinks between chains. In thermoplastic polyurethanes (TPU), the crystallites consist of MDI/chain extender agglomerates, whereas in thermoplastic rubbers (TPR), the crystallites result from the precipitation of one component (Polystyrene) from the polymer (Styrene butadiene) matrix.

Thermoplastic polyurethanes:

Poly(caprolactone), polyester based and butane diol extended MDI polyurethanes result in injection moulded elastomers with superior abrasion resistance. They constitute the preferred material for tennis, running, soccer, etc. shoe soles.

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Waterproof footwear:

There is nothing more uncomfortable than working, walking, hiking or participating in a sporting event with wet feet. Waterproofing your shoes and boots can be a major project, but luckily today there are many options in waterproof footwear thanks to innovations in waterproof materials.

Materials used in Waterproof Footwear:

Waterproof synthetic leather is a good option for people who like the look of leather but don’t like the upkeep necessary to make it waterproof. Modern synthetic leather presents a very convincing leather-like appearance and feel with the added attraction of durability and water resistance. In the past, imitation leather was inferior to the real thing. Today, it outshines leather in every way and is rugged enough for the construction of work and hiking boots and athletic footwear.

Gore-Tex is the go-to material for lining waterproof shoes and boots. It is also a component of many types of outdoor gear and wear. Gore-Tex is a durable synthetic fabric that is used to weatherproof all manner of outdoor wear. It has a micro-porous structure that allows good air circulation while blocking water and wind and retaining warmth. The company claims to be environmentally responsible in the manufacture of the product and provides data to back up their claim.

Rubber and/or polyvinyl chloride (PVC) materials are often used to manufacture the soles of waterproof footwear and to create galoshes and overshoes. Rubber materials protect against water and are more flexible and provide better traction indoors and outdoors. PVC materials provide protection against chemical spills and provide good indoor traction on wet floors.

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There are a couple types of construction used to make shoes or boots waterproof.

-1. In “full bootie construction” a sock-shaped waterproof membrane is built into the body of the shoe or boot.

-2. In “seam-sealed construction” sections of waterproof membrane are taped together to perfectly fit the interior of the footwear. This makes the shoe or boot completely waterproof.

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The Pros and Cons of Waterproof Shoes:

Pros

Feet generally stay warm and dry.

Lesser chance for getting cold feet or even frostbite.

Removes excuses for not running in bad weather.

Allows for uninhibited running in inclement weather conditions.

Cons

Feet can get too hot on sunny runs in mild weather.

Waterproof shoes typically aren’t as flexible as traditional models.

Costly than non-waterproof models.

Most waterproof shoes are slightly heavier than non-waterproof shoes.

Feet are still vulnerable to getting wet from moisture that enters at the sock.

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Plastic Shoes and health:

Health professionals agree that the dangers of plastic footwear are real—and, well, alive. According to Dr. Rock Positano, director of the Non-surgical Foot and Ankle Service at Hospital for Special Surgery in New York, their lack of breathability is certainly a harmful factor. “The foot by itself [without a sock] in a shoe, plastic or not, provides a perfect milieu for bacterial and fungal growth. It is moist, dark, and there is heat,” says Positano. “The combination of those three things make a foot inside a shoe a dangerous place.” That’s not including the fact that some people are allergic to plastic and may experience an allergic reaction, or rather, “hot foot”—a term that Positano uses to describe contact dermatitis, a skin irritation that can make the foot feel as if it is on fire.

Another deterrent to wearing plastic shoes is the fact that they are so rigid. “With a plastic shoe, you don’t have flexibility. They are very, very hard. Feet naturally swell in the afternoon, so a person can go from a size 7 to a size 9, and plastic shoes don’t expand with the foot,” he says. “A leather shoe has the ability to expand a little bit.”  Another factor to note, especially if the sole itself is made out of plastic, is the lack of shock absorption which, according to Positano, can lead to an array of issues—joint and bone pain chief among them—that can affect other parts of the body like the knees and back.

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Carbon Fiber Footwear:

We know carbon fiber is lightweight, especially compared to the metals it often replaces in automotive, aerospace, and industrial applications. And weight is valuable for speed in any race, which makes carbon fiber an important material in a racing bicycle. But running shoes nowadays are mostly made of lightweight foams and polyester fabrics, so what assistance does carbon fiber offer runners that these materials don’t?

Nike’s VaporFly ZoomX running shoes have been making headlines for their use of a carbon fiber plate that’s being attributed to faster marathon times, including the first marathon completed in under two hours. Carbon fiber is often a popular choice in sporting equipment because it’s lightweight and durable. Carbon fiber in a running shoe is generally a stiff plate that’s part of the sole of the shoe. It’s usually fixed in a lightweight foam with a shoe profile and heel height that vary from shoe to shoe, but are valuable for specific running styles. The plate doesn’t take up much of the sole. For example, in the Brooks Hyperion Elite, the carbon fiber plate is only one millimeter thick with a raised spine of 0.5mm through the midsole of the shoe.

Nike isn’t the only footwear provider adding carbon fiber to their running shoes. In fact, Brooks, New Balance, Saucony, and Hoka One One all have shoes available or in development with carbon fiber plate. Carbon fiber consumer products can often run at higher price tags than their counterparts, but these shoes generally cost between $140-$250, which is highly comparable to other professional-level running shoes.

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The concept of adding carbon fiber plates to midsoles is not new and goes back to the early 2000’s, when Stefanyshyn and Nigg showed that an increase in longitudinal bending stiffness (a material property which describes a shoe’s resistance to bending) lead to a higher vertical jumping height. A few years later it was found that stiffer shoes could also improve running economy by approximately 1%. However if the shoes were too stiff, this effect disappeared (Roy & Stefanyshyn, 2006). There are a couple of biomechanical mechanisms which explain how increased bending stiffness can improve running economy. The most pronounced effects are seen at the metatarsophalangeal (MTPJ) and ankle joints. Stiffening the shoe limits the bending of the MTPJ, which causes a reduction in negative work. This means that less energy is wasted at the joint, and more can be used for propulsion (Willwacher et al., 2013). Furthermore, running in stiffer shoes causes the point of application of the ground reaction force to shift more anteriorly, creating a longer lever arm around the ankle and MTPJ (Willwacher et al., 2014). A longer lever arm permits the muscle tendon units surrounding the joint to generate higher joint moments. As the ankle is responsible for propulsion during the end of the push-off phase of the gait cycle, you should be able to run faster in stiffer shoes as long as your calf muscles are strong enough. Up until this point, studies have been inserting flat carbon fiber plates in midsoles which could improve running economy by around 1%.

Traditionally, long distance racing shoes had been made to be as light as possible, with very minimalist designs. The shoe which completely changed this paradigm was the Nike Vaporfly. In 2016, the Nike Vaporfly, a unique running shoe with a combination of a super soft responsive foam called polyether block amide (PEBA) foam and a full-length carbon fiber plate, was introduced to the market. Due to the use of an extremely light weight PEBA foam for the midsole, this allowed Nike to significantly increase the stack height of the shoe without compromising for weight. This also gave more space to use a curved plate instead of a flat one. In a study done by Hoogkamer et al., which was published in 2017, it was found that this combination of a lightweight, resilient and compliant foam together with a curved carbon fiber plate improved running economy by 4% compared to the two fastest marathon shoes at that time (Hoogkamer et al., 2017). Nike named their commercial model of the Vaporfly after the results of this study: the Vaporfly 4%.

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The biggest contributor of energy return is the use of a curved, stiff plate. By using a curved plate instead of a flat one, this creates a so called ‘teeter-totter’ effect (see figure below). Because the point of application of the resultant ground reaction force is at the front of the foot during the second half of ground contact, a reaction force at the heel is produced in an upward direction at toe-off. This reaction force at the heel will propel the runner forward more than in conventional running shoes. When designing a carbon fiber plated shoe it is important to take into account both the stiffness and the curvature of the plate.  

Figure above shows schematic representation of the ‘teeter-totter’ effect. The force of the runner is applied at the front of the foot (black arrow) and creates a resultant force (red arrow) at the heel, propelling the runner forward (Nigg et al., 2020).

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The goal of using carbon fiber plates in athletic shoes is rooted in the idea of improving energy return, particularly at the “toe-off,” or where an athlete’s toe pushes off the ground. The carbon fiber plate is shaped with a curve at the arch that bends slightly downward under the ball of the foot. The intent is to store energy when the heel strikes the ground and release the athlete’s own energy back to them at the toe-off, giving a boost.

Additionally, scientists have found that the carbon fiber plate is beneficial for stabilizing the ankle joint, reducing the load on the calves, and keeping the toes straight—all important for a strong running form and lowering the risk of injury. In fact, Brooks Hyperion Elite shoe was built to improve support in addition to speed.

When it comes to running, increased energy return does improve speed with that extra boost on a runner’s toe-off. The foam and carbon fiber combinations also produce lighter shoes, with the lightest, the New Balance FuelCell 5280, weighing in at only 5.3oz (VaporFlys weigh 6.6oz). The improved speed is valuable for competitive long-distance runners where every second counts.

To conclude, carbon fiber plates have shown to improve running economy but simply adding a carbon fiber plate does not directly relate to better performance. The optimal stiffness for a running shoe is both, dependent on running velocity and individual biomechanical differences. It is an exciting time to be a runner, as shoe companies are pushing their boundaries to produce the tools for the best possible running experience and results.

Other sports can benefit from the shock absorption and increased energy return, too. The company, VKTRY, produces a line of carbon fiber shoe insoles that are suited for a variety of sports. Unlike the stiff plates in running shoes, VKTRY’s insoles are flexible and use layers of different lengths of carbon fiber arranged in different directions. VKTRY uses an algorithm to determine which insole will meet an athlete’s needs, based on their sport and physical attributes.

The increased energy return is beneficial for jumping athletes, like basketball and volleyball players, where they experience higher jumps and less force on landing. VKTRY originally concocted their insoles for bobsledders, using the energy return to give more force behind their running starts, but athletes in football, baseball, and beyond are finding improved performance with the flexible carbon fiber insoles. An independent study of the insoles found they provided a 9% rate of force development over not using them.

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Shoe construction:

History of Shoemaking: 

Shoes have been used for millennia to protect the feet and more recently as an item of decoration or fashion. The earliest forms of footwear were fabricated from bark, twine, and other nature-made materials. Leather shoes originated over 5000 years ago and were made from a single piece of cowhide, then fastened with a leather cord. Many modern-day shoes are still made from leather, but we also have a vast variety of other materials to choose from, and the methods for shoemaking have changed along the way.

The Turnshoe Method:

During the Middle Ages, the turnshoe method became commonplace for shoe manufacturing. Named for the literal method of construction, turnshoes were assembled inside-out and then turned once finished bringing the seams to the interior of the shoe. This method improved shoe manufacturing in several ways:

-the life of the shoe and water permeability were improved by turning the seams inside;

-toggled flaps and drawstrings were fashioned to improve fit; and

later on, closer to the 16th century, doubled soles were added for increased comfort and durability.

The turnshoe method is still used today for some specialty dance shoes and, of course, for historical reenactments.

The Welted Rand Method of Shoe Manufacturing:

Around 1500, the turnshoe method was largely replaced by the welted rand method, where the upper, insole, and outsole are stitched together. Welting is one of the oldest, most labour intensive, and most durable methods of shoe manufacturing still used to this day.

Until around 1800, most leather shoes were made without differentiation for the left and right foot. Despite having been used by the Romans, differentiation was not commonplace in shoe manufacturing until the industrial era.

Shoemaking became more industrialized in the mid-18th century, though most of the work was still being done by hand. With the introduction of the sewing machine in 1846, the mechanization of shoemaking began to advance. Other developments throughout the mid to late 18th century helped shift shoemaking into a factory setting.

The Stitchless Sole – Going for Glue:

The process for manufacturing a stitchless shoe was developed in 1910. Since then, various advances in materials, adhesives, and manufacturing processes have allowed manufacturers to move to what is now a very different process from where it started. Soles, which were once laboriously stitched on by hand, are now mass-manufactured and glued on by machine.

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The Modern Shoemaking Process:

Shoes have come a long way from their origins of grass and bark. With modern-day manufacturing and materials, the shoe industry has evolved from a traditional craft into a multibillion-dollar market with a myriad of materials, styles, and purposes. It goes without saying, we all deserve new shoes. But what allows certain designers to slap extra zero’s on their price tag without batting an eyelash? Elements such as brand name, leather or material quality and even the country of manufacture immediately come to mind. However, the largest differentiator comes down the construction quality. To put it simply, this is how the major fundamentals in the shoe’s anatomy come together.

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Last:

The first step in making a shoe is creating what is called the last. A shoe last is a wooden, plastic, or metal figure that portrays the shape of the shoe. It resembles the form of a human foot but more closely showcases the shape of the outside of the shoe.

Every shoe made requires both a left and a right last.

After you have come up with the shoe last, you have to make the shell pattern. The shell pattern consists of a flat shape that manufacturers can stretch over the last to form a 3D shape. Once you have the shell pattern, you can send the shape over to the design department, where they will make up the design of the shoe.

A manufacturer will have the click or cutting department that focuses on the top part of the shoe. During this part of the process, professionals cut out the various shapes of materials needed to craft the top portion of the shoe. Experts use a variety of tools and machinery for this process, including cookie cutters, computerized knives, lasers, water, and hand-cutting tools.

This department focuses on cutting out every component of the shoe, including outer materials, inner padding, reinforcements, and more.

As with all things in life, each method of sole stitching has its own advantages and disadvantages. The biggest difference is of course price. These days everything can be fully automated which means humans do not have to do much. This often has an impact on the quality of the end product. Cheap materials like glue or even synthetic leathers keep the price down in combination with low labor costs in Asian countries. On the upside, they are quick to make and produce. As humans and artisans get more involved, the price goes up but so does the quality. Hand Welted shoes are rare these days outside the bespoke world, but are a work of art and require hours of meticulous craftsmanship. While not a precise mark of quality, a welted shoe will almost always be better than your average cheap construction. Lastly, some methods have unique qualities that you should look for. Comfort, being lightweight or more waterproof are some of them.

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Methods of shoe construction:

There are of course several different methods of construction to put together a shoe.

-1. Cemented

The simplest, cheapest and worst type of shoe construction. The upper part of the shoe is glued with a strong adhesive to the sole. This means there is no stitching or welt and the result of that is a disposable shoe. Eventually they will fall apart and there is no other option than to throw them away or add a new outsole layer to prolong their life a little bit. Quite lightweight in nature, but also much lower quality since they are mass produced.

Almost everything you will see by fast fashion brands like H&M, Aldo, Ecco and even expensive luxury brands are cemented. On the plus side, it is a very common way to make sneakers and everyday shoes. The easiest way to identify such shoes is to simply look at the outsole. If there is no stitching, it means the shoes are cemented. Now, of course our friends in the marketing department are smart so they add fake stitching on the top. In that case, simply look at the bottom of the sole and if there is no stitching, bingo. Advancements in technology make it harder for us to distinguish and quite often the fake welt is believable. In that case, inspect the stitching up-close. You will notice that cemented shoes have embossed patterns that imitate the real threads. Please, stay away from any kind of cement shoes. They are not worth your time or money and there are so many affordable alternatives.

-2. Vulcanised

Probably the most widely known shoes that are made vulcanised are ‘All Stars’. It’s a method mainly used for sportive and casual footwear, but also for the original wellington boots and canvas shoes. It is a distinctive method because of the rubber ‘foxing’ (strip) that surrounds the shoe. On high quantities this is a very productive process as many shoes can ‘bake’ at the same time in the vulcanising chamber.

The upper is lasted over an aluminum last. Depending on the upper construction a filler or board / rubber layer is used. The foxing is attached to the upper and sole with glue. The shoe is vulcanised in a vulcanising chamber (Autoclave). The vulcanising process can take an hour or more depending on the materials that are used on the shoe.

-3. Moulded / Direct injection

Crocs, Jellies, PVC wellington (rain) boots are all examples of fully moulded footwear. The whole shoe is made by injection of material around a mould. It is also possible to only inject the soles directly onto an upper with the same principle for example to make safety boots or motorcycle boots.

The last with the upper is placed in a direct injection moulding machine and the bottom part of the shoe is injected at once. This is fairly quick and therefore cheap but it also doesn’t leave you with many options for the outsole as it is just one material. Tooling costs are high as you need moulds per size so this method is especially interesting in high quantities or by using existing tooling materials.

-4. Sewn-in-Sock / Ströbel

This method is mainly used in casual shoes and sport shoes, usually on shoes with a sole with a high edge. The construction produces a more flexible shoe (but also less strong). You can recognise this method by removing the footbed and/or insole cover (insock) and you will see the lining is stitched to the insole with overlock stitches (ströbel stitching).

The pattern has to fit perfectly over the last. With ‘normal’ lasting you play (a bit) to get the upper tight on the last but with this method the last is inserted in the sock by force lasting (not machine) and has to fit like a glove.

The upper is attached to the insole with a locking machine; this creates a ‘sock’. The sock is sometimes warmed on the inside by steaming machines. The last is inserted by force lasting. The shoe is roughed on the area’s where the outsole has to be cemented. This has to be very precise otherwise it’s very easy to get bonding problems. The outsole is cemented with glue and pressed.

Californian construction is very similar only an extra piece of material is stitched through the upper and folded over. This extra material is used to cover for example a wedge or a small piece of eva. This method is used for example for wedge sandals.

-5. Blake stitched

The simplest version of the sewn construction methods, which similar to a completely glued shoe is flexible and neat but with a seam for extra strength and added possibility of resoling. The Blake stitch, or McKay stitch as it’s also called, simply goes straight through the insole, uppers and outsole. The construction is not moisture resistant, since water can get straight through the seam into the shoe and there is also no protection from the side. If the channel in the sole where the stitch is made is closed it can withstand moisture a bit better.

-6. Bologna

Quite similar to the Blake construction with a seam that runs right through from the outsole to the insole, and shares many of its advantages and disadvantages. But the difference is that the Bologna constructed shoe has the uppers folded and stitched together like a sock, with a thin leather insole added, and just once the whole upper part is finished the outsole is attached. This allows for even softer shoes than Blake stitched ones.

-7. Goodyear welted

The most common construction method for quality shoes. A canvas rib is glued to the underside of the insole to which upper and a thin leather strip is attached, called welt, with a machine stitched welt seam. The outsole is then attached to the welt with a sole stitch. The construction makes a strong and relatively water resistant shoe that is easy to resole, since you can remove the sole stitch and outsole without insole and upper being affected. The shoe, however, is more rigid and less flexible than for example a Blake stitched shoe.

Cons of the Goodyear construction method that are usually brought forward is that the canvas rib, called gemming, is only glued to place, causing a risk (how large is widely debated) for it to loosen or break which needs the shoe to be back on its original last for a proper re-installment of the canvas rib to be able to be resoled. Also since the canvas rib is quite high, you have a large void in the middle of the shoe which you have to fill up with a thick layer of cork paste.

-8. Hand welted

As the name suggests, the method is basically identical to the aforementioned Goodyear construction, but the difference is that the welt seam is made entirely by hand and done directly to the insole. You carry out a holdfast in the insole (which due to this fact normally is thicker and of better quality than those used for many machine made shoe constructions) and do the welt stitches to that. This also makes the cavity in the middle of the shoe much smaller, so you can use much less cork paste or real cork, felt or leather instead making the construction more compact. A hand welted shoe can have both a machine- or handmade sole stitch. This is the finest construction method and is used by almost all bespoke makers, but also some Ready to Wear brands do it.

When hand welting a holdfast is cut out of the insole (except in Italy, where shoemakers usually do the stitching to the flat sole by digging the awl down and up) which the welt seams is stitched to, connecting uppers and welt.

-9. Blake/Rapid

Are sort of a mix of the Blake stitched and welted construction methods, which shares many of the latter’s advantages. Here a midsole is attached to the insole with a Blake stitch, and the outsole is sewn to the midsole with a sole stitch (Rapid is one of the largest makers of sole stitching machines, hence the name). This provides a shoe that is relatively waterproof and where it’s easy to replace the outsole without the need to influence the insole and upper part, it is done in the same way as on a welted shoe. Pros compared to Goodyear welted shoes is that there is stitching holding all the shoes parts together, not just glue in the canvas rib with Goodyear, and that there is a smaller void more similar to the hand welted construction. Cons compared to Goodyear is that you have stitches going through to the inside of the shoe, so it’s not an as “closed” construction method.

-10. Storm welted

Not really an own construction method, since exactly the same construction as the aforementioned Goodyear, hand welted or Blake/Rapid methods are used. But the difference is that you have a sturdier welt which has a rib that goes up above the stitching against the uppers. This prevents water to get into the shoe from the sides.

These are all similar construction methods with often small differences, sometimes more important one, but the problem is that different makers call things differently, so it’s very hard to define exactly what is what and what is correct. The base of all these methods is however that there is a stitch made from the insole towards the upper and out on the outside of the shoe, and a regular sole stitch. Some have the uppers pulled outwards, some has a welt/storm welt, some has extra row of stitching which attach a midsole, and so on. These methods are almost always made by hand, and often the stitches are braided in different decorative ways. They are quite sturdy constructions, and especially the ones where the upper leather is turned outwards are very waterproof.

-11. Norvegese Construction

This is a very famous (yet quite rare) type of shoe construction that comes with many names. Norwegian, Goyser, Bentavenegna or Norvegese are the most popular and surprisingly comes from Italy. It is quite a close relative to the Goodyear Welt System in principal but with a little twist. The uppers and the welt rib fold outwards to the exterior of the shoe instead of curving inside in a typical Goodyear construction. This creates a more waterproof shoe and is perfect for boots and chunkier country shoes. Another difference is the actual stitching. In the Norvegese construction there are at least two exterior visible stitches. The classic Rapid Stitch that connects the welt, uppers, midsole and outsole but also one that connects the welt and uppers directly to the insole.

-12. Veldtschoen

A method that reminds a lot of the Norvegese etc. construction methods. Here the upper is also folded outwards, but you have a regular welt which and a straight sole stitch which can be made by machine. The shoes are highly water resistant and therefore the method is most common among heavier boots. There are different variants of Veldtschoen construction, which is also called stitchdown, where the basic one is that the upper part is folded outwards and sewn directly into the outsole with a sole stitch. Some different takes are where you place a welt below the upper on the sole edge, and sometimes you also use an extra row of stitches attaching a midsole.

-13. Wood pegged, brass pegged

An old method that is not very common nowadays, where you attach insole, uppers and outsole with wood or brass pegs. Uppers are secured to the insole with small pins, before pegs are hammered in. It was used mainly because it’s a quick and simple yet strong construction method, but since all parts of the shoe get holes in it it’s not the most durable construction, and resoles are limited. What’s more common is the use of pegs, often of wood, for the waist. Instead of stitching the waist you wood peg it, making it easier to achieve a tight fitting waist, can also give some extra strength if done properly. But those shoes normally have welted sole parts, so they are essentially welted shoes and not pegged ones.

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Construction of running shoes:

While most footwear protects and supports the foot, the running shoe goes beyond what one would expect of the ordinary shoe. Its advantages have been the subject of intense scrutiny in recent years, a focus that results from an increasingly health- and leisure-conscious population in general, and from the popularity of running in particular. As more people have become involved in the sport, more and more varied equipment has become available to runners. Consequently, the running shoe has evolved quite dramatically over the past 15 years.

Raw Materials:

Running shoes are made from a combination of materials. The sole has three layers: insole, midsole, and outsole. The insole is a thin layer of man-made ethylene vinyl acetate (EVA). The components of the midsole, which provides the bulk of the cushioning, will vary among manufacturers. Generally it consists of polyurethane surrounding another material such as gel or liquid silicone, or polyurethane foam given a special brand name by the manufacturer. In some cases the polyurethane may surround capsules of compressed air. Outsoles are usually made of carbon rubber, which is hard, or blown rubber, a softer type, although manufacturers use an assortment of materials to produce different textures on the outsole.

The rest of the covering is usually a synthetic material such as artificial suede or a nylon weave with plastic slabs or boards supporting the shape. There may be a leather overlay or nylon overlay with leather attachments. Cloth is usually limited to the laces fitted through plastic eyelets, and nails have given way to an adhesive known as cement lasting that bonds the various components together.

Design:

The last 15 years have witnessed great changes in the design of the running shoe, which now comes in all styles and colors. Contemporary shoe designers focus on the anatomy and the movement of the foot. Using video cameras and computers, they analyze such factors as limb movement, the effect of different terrains on impact, and foot position on impact. Runners are labeled pronators if their feet roll inward or supinators if their feet roll to the outside. Along with pressure points, friction patterns, and force of impact, this information is fed into computers which calculate how best to accommodate these conditions. Designers next test and develop prototypes based on their studies of joggers and professional runners, readying a final design for mass production.

A running shoe may have as many as 20 parts to it, and the components listed below are the most basic. The shoe has two main parts: the upper, which covers the top and sides of the foot, and the bottom part, which makes contact with the surface.

As we work our way around the shoe clockwise, starting at the front on the upper part is the featherline, which forms the edge where the mudguard (or toeguard) tip meets the bottom of the shoe. Next is the vamp, usually a single piece of material that gives shape to the shoe and forms the toe box. The vamp also has attachments such as the throat, which contains the eyestay and lacing section. Beneath the lacing section is the tongue, protecting the foot from direct contact with the laces. Also attached to the vamp along the sides of the shoe are reinforcements. If sewn on the outside of the shoe these reinforcements are called a saddle; if sewn on the inside, they are called an arch bandage. Further towards the back of the shoe is the collar, which usually has an Achilles tendon protector at the top back of the shoe. The foxing shapes the rear end of the shoe. Underneath it is a plastic cup that supports the heel, the heel counter.

The bottom has three main parts, outsole, midsole, and wedge. The outsole provides traction and absorbs shock. The midsole is designed specifically for shock absorption, and the wedge supports the heel. Located inside the shoe, the insole also contains the arch support (sometimes called the arch cookie).

The Manufacturing Process:

The first step in running shoe manufacture involves die cutting the shoe parts in cookie cutter fashion. Next, the pieces that will form the upper part of the shoe are stitched or cemented together. At this point, the upper looks not like a shoe but like a round hat; the extra material is called the lasting margin. After the upper is heated and fitted around a plastic mold called a last, the insole, midsole, and outsole are cemented to the upper.

Shoemaking is a labor-intensive process, and the cost of producing the many components of the running shoe reflect the skilled labor necessary. Each phase of production requires precision and skills, and taking shortcuts to reduce costs can result in an inferior shoe. Some running shoes (known as sliplasted shoes) have no insole board. Instead, the single-layer upper is wrapped around both the top and the bottom portions of the foot. Most running shoes, however, consist of an insole board that is cemented to the upper with cement.

Quality Control:

Manufacturers can test their materials using procedures developed by the Shoe and Allied Trades Research Association (SATRA), which provides devices designed to test each element of the shoe. Once the shoe is complete, an inspector at the factory checks for defects such as poor lasting, incomplete cement bonding, and stitching errors. Because running can cause a number of injuries to the foot as well as to tendons and ligaments in the leg, another test is currently being developed to evaluate a shoe’s shock absorption properties.

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Handmade shoes:

With regards to handmade shoes, each pair is really a master piece. You are likely to surely love the style and design and want to own a pair of these shoes. There are numerous advantages of choosing these types of shoes, the most crucial being the quality. Compared to the machine made kinds you will observe that these shoes have an excellent finish with each minute detail taken care of. So practically nothing can beat their quality, style, appealing-ness and perfection.

Handmade shoes last longer compared to machine produced ones. So whenever you decide to buy the shoes which are made in bulk they might not have good finish and can wear out fairly fast. That is the main reason why you see lots of people often needing to buy new shoes each year. Whenever you take advantage of shoes crafted by hand, they’re constructed in such a way that they last long and stand up to any degree of wear and tear.

Whenever you wear shoes they have to be comfortable and enable you to walk around freely. At times the shoes that are machine manufactured may not fit properly on your feet and lead to discomfort. Due to the fact they’re manufactured in standard sizes, they will often not be a perfect fit for your feet. Men and women who cannot wear standard sizes can really look forward to utilizing these exclusively crafted shoes which fit snugly.

There’s nothing more exciting than getting individuality. By using handmade shoes you know that the design and style is one of a kind and can’t be seen on anyone else. And that means you can be different and stand above the crowd. The shoes which are produced with machines commonly appear in comparable patterns and styles with the only distinction being in the size of the shoes. You will see many people wearing the very same type of shoes.

There are actually particular drawbacks of using handmade shoes too. By far the most obvious aspect will be the cost. They are available with expensive prices. Everybody can’t buy these shoes, in contrast to the machine produced shoes that are made in bulk and may be purchased at less expensive prices.

One more factor is that the level of quality of the shoes is dependent on the level of quality of the craftsman. If he’s not a good craftsman the high-quality of the shoes will be affected. Nevertheless, the bulk produced shoes include sturdy and accurate stitches to produce a strong finish. From time to time the shoemaker may possibly use cheap quality supplies to cut back his costs. This will in addition impact the level of quality of the shoes. Only expert and good craftsmen will be able to produce fashionable footwear according to the latest trend. All these aspects can help you to decide the types of shoes you might want to buy.

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Bespoke shoes: 

Bespoke shoes are specially designed to fit a specific person. Getting the best fit and matching an outfit with a custom design are some benefits of choosing bespoke shoes over mass-produced ones. Shoe fit is important, especially for the millions of people who do not have feet that fall into the shoe industry’s standard sizes. In addition, designing one’s own shoes ensures that the design is unique. Of course, bespoke shoes also have disadvantages, like being expensive and the quality not being guaranteed. When choosing a shoemaker to craft tailored shoes, it is generally recommended to find someone reputable and well reviewed. Bespoke shoes for children may not be cost effective because their feet grow quickly.

Bespoke shoes are often completely custom made and can be designed to match the customer’s favorite outfits. Most shoemakers allow their customers to view pre-made designs to get a better idea of what they would like. A customer designing bespoke shoes can also bring in pictures of a desired design, and a shoemaker can usually work from there.

The significant expense is a major disadvantage of bespoke shoes. A skilled shoemaker does not come cheap, nor do the materials required to craft a high-quality shoe. Most well-known shoe brands mass produce their products, which greatly brings down production costs. When a shoe is produced in mass, there is no shoemaker cutting, stitching, and testing the shoe by hand. Instead, there is a machine performing this job for the thousandth time, and it will continue to produce shoes that look and fit exactly the same until the shoe is no longer in style.

While bespoke shoes in general tend to be high quality, not all shoemakers are especially good at their trade. For whatever reason, a shoemaker might not be capable of creating a shoe with the requested design or solid stitching. Like with tailoring, the final results will differ based on skill, effort exerted, and materials used. In fact, even the very best shoemakers can produce shoes that do not last as long or look as good as mass-produced shoewear if they cut material costs by using the most inexpensive components.

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Designer shoes:

A ‘designer shoe’ is one where a stylist employed by a ‘brand’ that is not concerned with manufacturing details a pattern/material/construction/price point/etc. and seeks out a manufacturer to make this shoe under their label. There is a wide selection of designer shoes for men; from office wear, to casual, to special formal dress shoes to boots, comfortable, driving, golf, slippers, knickers relaxing or even the exotic shoes. The advantage of buying designer shoes for men is that they are usually very comfortable compared to ordinary shoes. If you are concerned about the comfort of your feet and putting on the latest trends, you can go for designer shoes from a top designer. It’s mostly the kind and quality of material that makes them utmost comfortable. One disadvantage of wearing designer shoes for men is the increased chances of buying counterfeit items in the market. This is likely to occur when you buy designer shoes from a questionable source or even an unbelievably low price. In buying designer shoes for men, always look for something that is worth your money. Do not buy something that you get to wear only at a costume party because it’s too eclectic in design. Remember, designer or not, shoes must be really comfortable.

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Engineering behind Shoe Design:

Shoe design is a complex process that involves the collaboration of a variety of individuals, including runners, craftsmen, technicians, scientists, and doctors. Runners’ shoes affect their entire body, and consequently are considered their most valuable piece of equipment. It is essential to find the ‘right’ shoes. Small variations in shoe design have been found to cause ankle pain, back pain, and even headaches.

Shoe Engineers:

The primary goal of running shoe engineers is to achieve an optimal shoe design for the “average” athlete. Average, in terms of human biomechanics, is a very tricky concept, since all people are anatomically and functionally different. Each individual is unique; differences in structure, movement, and gait pattern require footwear to vary from person to person. Efforts to meet this concern are further multiplied by the critical factors to be considered in the design of each shoe: shock absorption, flexibility, fit, traction, sole wear, breathability, weight, etc. Due to the diversity of the human form, it is impossible to provide for the needs of every runner on the planet. Shoe designers manage this overwhelming demand by supplying some standard, user-defined, foot-ground interface.

Shoe engineers try to provide standard footwear (above) for the average athlete.

It is important to differentiate between shoe design and shoe fabrication. Shoe design involves the complicated task of finding the most versatile specifications to cover a broad spectrum of biomechanical requirements. In contrast, putting a shoe together once the specifications have been set is a very straightforward process. A typical shoe consists of three basic components: the outsole, the midsole, and the upper. Each of these components is comprised of materials that vary greatly in weight and density. A shoe’s durability is often determined by the hardness of the outsole rubber, the density and firmness of the midsole foam, and the strength of the upper materials.

As simple as the parts may seem, however, running shoe design requires the efforts of several academic fields. It is a very detailed application of podiatry, the study of human feet, and biomechanics, the study of the human body in motion. As Peter Cavanagh puts it, “Running shoes are worn on running feet, and running feet are attached to running legs. Trying to understand the design and construction of running shoes without a clear knowledge of what goes inside and above them would be difficult”. Hence, a comprehensive knowledge of human anatomy is key. The goal of biomechanists is to study complex forces as they act on the body, primarily by applying principles from mechanics and engineering. Applications to running include measuring the movements of limb segments, measuring the forces and pressures underneath the foot and the shoe, and calculating what muscle forces create the observed movements.

By studying the motions of an athlete engaged in a sports movement, biomechanical engineers can apply mathematical and engineering principles to derive functional criteria for the problems encountered by the human body in motion.

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Gait Analysis:

Biomechanists utilize a method known as gait analyses to evaluate human kinetics quantitatively. These studies are conducted in the laboratory using high-speed photography and a force-measuring platform. In high-speed photography, runners are filmed at speeds up to 500 frames per second. The film is then analyzed by a high grade projector, which moves the experimental film through one frame at a time. In most cases, markers are placed at specific ‘points of interest’ before filming takes place. This new technology is better known as ‘motion analysis.’ As the individual moves about the laboratory, a number of cameras scattered throughout the perimeter of the testing area detect the spatial locations of each of the markers. These markers are placed at locations where important measurements are to be taken, including the hip joint, the back of the shoe, and the back of the leg. A screen displays the markers as dots moving about in a three-dimensional plane. The detected signals are then converted to numerical data for mathematical analysis of each point throughout the running cycle.

The second important tool in gait analysis is the force platform. This device is specially geared to measure variations in forces under the foot during running. Data collected from force platform measurements allow scientists to visualize ‘invisible’ forces acting on the soles of the feet. It is from this device that we are able to observe, for example, that the reaction forces under the foot during running can rise up to two to three times body weight. Pressure distributions throughout the foot can be observed at given points in the running cycle.

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Shoe Testing:

Biomechanics also plays an important role in the shoe testing process. Before the advent of dynamic mechanical methods for evaluating shoe performance, the primary concern of the shoe industry was to test materials for adhesion, attachment, seams, and fatigue due to the structural breakdown of the shoe with use. Biomechanical testing concentrates on the shoe in action and the resulting stresses imposed on the runner.

There are several methods for shoe testing. In the general process, advanced technology is used to determine the shoe requirements of runners in motion. Results of the test are analyzed and the opinions and feelings of the runner are considered. These results are combined to produce a shoe that both tests and fits well. Factors tested both in and out of the laboratory include shock absorption, flexibility, heel counter stiffness, rearfoot stability, overall rearfoot control, sole wear test, traction, and permeability to water.

The image below provides a summary of selected running shoe features and corresponding design functions that have resulted from research.

 

Figure above shows results of extensive testing that yielded these requirements for running shoes.

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Shoe Fabrication:

The initial step in actual shoe fabrication involves the construction of the ‘last.’ The last is what gives a shoe its shape (and the individual his desired fit). It is the form over which the upper is pulled and molded over during manufacture. At the beginning of the design process, the manufacturer sends his specifications to the model maker, who then constructs a three-dimensional wooden model: the last. In shaping the last, the experienced designer is guided by six measurements.

Ball Girth

Waist Girth

Instep Girth

Long Heel Girth

Short Heel Girth

Stick Length (Overall heel-toe measurement on the last)

Most model shops contain tables that list the approximate values of these measurements for each shoe size. The model maker shapes, files, sands, and smooths until these measurements match and the product subjectively reflects the right appearance.

This handmade model is then placed onto a ‘copy lathe,’ which generates exact replicas of the same or different size. This device does complete size runs on the model and, in turn, generates plastic versions of the model onto which the shoes are actually made.

This design is now sent to the pattern maker, who measures the exact shapes of the various pieces of material comprising the shoe upper. This process begins with the sewing on of a ‘skin,’ or tightly fitting layer of material, which is sliced off according to the way the shoe will be made. He then makes precise drawings of these parts, including a little more space to accommodate seams. His drawings are sent to the manufacturer for use in cutting dies for the finished product.

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The Science of Footwear: a 2012 book:

Although we now have sophisticated algorithms and techniques for determining the shapes and sizes and for matching the fit between shoes and feet, few, if any, of the books currently available cover these new technologies until now. Bringing together high-quality and state-of-the-art contributions from designers, biomechanists, ergonomists, engineers, podiatrists, and scientists from industry and academia, The Science of Footwear provides an in-depth understanding of the technology and techniques involved in the design and development of a popular and demanding consumer product.

This book introduces the design, development, manufacturing, and marketing of footwear. The chapters contain data from past research and the state-of-the art methodologies. They not only cover every aspect of the product design, but also how the footwear industry caters to the wide-ranging needs of sophisticated and demanding customers.

The footwear industry has rapidly changed over the last 10 years. Mass production has changed to personalization and mass customization, areas that are not well-understood. This book explores these different concepts in a coherent way, drawing on differing views that give a holistic view of the science behind footwear. Collating information from different disciplines, the book provides the tools to develop the next generation of footwear.

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The use of 3D surface scanning for the measurement and assessment of the human foot:

A number of surface scanning systems with the ability to quickly and easily obtain 3D digital representations of the foot are now commercially available. Modern 3D surface scanning systems can obtain accurate and repeatable digital representations of the foot shape and have been successfully used in medical, ergonomic and footwear development applications. The increasing affordability of these systems presents opportunities for researchers investigating the foot and for manufacturers of foot related apparel and devices, particularly those interested in producing items that are customised to the individual. 

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The use of 3D surface scanning technologies to produce digitised representations of parts of the human anatomy has the potential to help change the way a wide range of products are designed and fabricated. Until recently, the anthropometric databases that are used by designers and manufacturers to guide the ergonomic form of their products have primarily been based on 1D and 2D measurements, for example leg length or waist girth. This approach results in approximations being made when designing to body areas for which an easily defined measurement is not available. Databases that draw upon 3D scans can offer far more detailed information on the contours of the body and potentially provide an insight into changes in anthropometric measurements associated with dynamic movement. Indeed, initiatives such as the CAESAR study (Civilian American and European Surface Anthropometry Resource) have been carried out with the aim of collecting this type of information. 3D surface scanning has the potential to play an important role in the development of customised products, i.e., devices and apparel that are designed for the individual using their precise anthropometric measurements.

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In the case of the foot, quantitative description of its shape is important for a number of different applications relating to the ergonomic design of footwear, foot orthotics and insoles, and for research into and clinical assessment of foot deformities, such as those associated with rheumatoid arthritis. Additionally, because the foot is a flexible and complex structure, a better understanding of how its shape changes in different situations, for example in the different loading phases of the gait cycle, may lead to improvements in the overall comfort and functionality of the footwear and devices that are been produced.

There are now a number of surface scanning systems available which can scan the plantar surface of the foot or the leg and foot (see figure below). This produces a 3D representation of its shape that can be viewed and analysed on a computer. Software programs which allow these 3D models to be used as the basis for shoe or foot orthotic design and integrate with computer controlled manufacturing systems are now widely available. This has meant that a number of footwear companies are now using integrated customisation systems to produce customer-specific shoes, and similarly there are now manufacturers providing customised foot orthotics that are based directly upon a scan of the patient’s foot shape. While the current volumes of these goods are relatively low, it is thought that as the price and lead times for these items fall their share of the market will increase.

Figure above shows 3D Scan of the foot taken using Easy-Foot-Scan from OrthoBaltic

While there may be improvements that could be made with regards to software designed to automatically take measurements from foot scans, it has been shown that the 3D scans produced by these systems are accurate representations of the foot and that the measurements taken from them are in general comparable to those that would be taken manually. The foot scanner’s role in orthosis and customised shoe design and manufacture has been established, where it provides time and cost advantages over traditional casting techniques in return for a greater initial outlay. Initial research suggests that foot orthotics designed from 3D scans of the foot are at least comparable with those made through traditional methods, although further research is required to confirm this.

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3D Printing in orthopedic footwear technology:

Bespoke orthopedic footwear typically takes several weeks to manufacture. One of the most critical time factors here is the custom fabrication of the lasts used to make the shoes. This lengthy step can be reduced dramatically with the help of additive manufacturing. Optimized fitting accuracy represents a further advantage, particularly in orthopedics. PROTIQ employs selective laser sintering (SLS) as the 3D printing process for manufacturing the resistant plastic object. The free shoe last configurator makes it possible to create individual 3D last models and integrates the modeling directly into the ordering process.

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Conventional methods of last production:

Generally, any shoe technician can manufacture lasts or have them manufactured. Until now, the following common methods have been employed for this purpose:

Lasts milled from wood or molded and foamed

Ordering molding blanks and sanding them to shape

Configuring and milling CAD lasts

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Accelerated last production using 3D printing:

Whichever one of these approaches a specialized orthopedic shoemaker chooses, customized last production usually requires a few weeks of lead time before custom manufacture of the individual footwear can begin. This massive lead time can be significantly reduced if the shoe lasts are created using additive manufacturing. Apart from orthopedic shoe technology, this method also provides numerous benefits for classic made-to-measure shoe production or for prototype construction in series production of shoe lasts.

TPU as a material for 3D-printed shoe lasts:

Conventional last manufacturing places high demands on the wood-based material used, as the material must withstand the heavy stresses it is subjected to in the shoe technician’s workshop. Thermoplastic polyurethane (TPU) has proven to be ideal for PROTIQ in the additive manufacturing of orthopedic shoe lasts. This is a synthetic plastic that advantageously combines the elastic properties of rubber with high resistance to mechanical stress. PROTIQ uses selective laser sintering (SLS), a 3D printing process, to fuse the material layer by layer. This process allows for significantly higher precision and robustness than can be achieved by, for example, fused deposition modeling (FDM).

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3D models of the lasts via CAD or 3D scan:

To prepare the groundwork for additive manufacturing, footwear technicians can manually collect all relevant measurements of the foot and construct a 3D printed model of the individual last using CAD software. Those without the necessary program or capability can also commission an external provider to create a 3D print file based on the foot data. A time-saving alternative is to generate the data using a 3D scan. Orthopedic shoemakers equipped with an appropriate scanner (e.g., a mobile foot scanner) use it to record either a footprint or directly the foot of their customer. This provides digital data very quickly, which can then be individually processed on the computer.

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Orthopedic shoe lasts from the 3D printer:

In the case of additive manufacturing, you can rely on the last coming out of the 3D printer exactly as it was modeled on the computer. Clients benefit from orthopedic footwear perfectly tailored to the size and shape of their feet, and which they can receive for fitting very quickly.

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3D printed lasts on the workbench:

The printed TPU lasts can be worked just as their wooden counterparts. The easy-grip surface guarantees a good and safe hold at all times and the low weight relieves the arms of the shoemaker. Nevertheless the lasts can withstand all of the typical working steps: They can be tacked or grinded without showing any signs of abrasion. Even under high pressure or when milled or drilled they keep their original shape. 3D-printed shoe lasts are therefore in no way inferior to traditional lasts, in many ways even superior to them.

Advantages of TPU material for orthopedic shoe lasts:

-Excellent mechanical properties

-Virtually wear-free

-Withstands stresses from gluing, grinding and drilling without problems

-Pliability facilitates the removal of the lasts from the finished shoe

-Reduced weight of lasts in comparison with conventional wooden models

-Easy-grip surface improves handling

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Benefits of additive manufacturing for orthopedic footwear:

-Very short production times

-High fitting accuracy thanks to computer-accurate last models

-Simple fitting options

-Reproducible last models that can be reprinted at any time

-All standard last pitches can be realized as required (2-part, 3-part, stair- or step-shaped and much more)

-Individual marking options for identifying the lasts

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Section-9

Athletic (sports) shoes: 

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Athletic shoes are specifically designed to be worn for participating in various sports. Since friction between the foot and the ground is an important force in most sports, modern athletic shoes are designed to maximize this force, and materials, such as rubber, are used. Although, for some activities such as dancing or bowling, sliding is desirable, so shoes designed for these activities often have lower coefficients of friction. The earliest athletic shoes date back to the mid-19th century were track spikes—leather shoes with metal cleats on the soles to provide increased friction during running. They were developed by J.W. Foster & Sons, which later become known as Reebok. By the end of the 19th century, Spalding also manufactured these shoes as well. Adidas started selling shoes with track spikes in them for running and soccer in 1925. Spikes were eventually added to shoes for baseball and American football in the 20th century.  Golfers also use shoes with small metal spikes on their soles to prevent slipping during their swing.

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The earliest rubber-soled athletic shoes date back to 1876 in the United Kingdom, when the New Liverpool Rubber Company made plimsolls, or sandshoes, designed for the sport of croquet. Similar rubber-soled shoes were made in 1892 in the United States by Humphrey O’Sullivan, based on Charles Goodyear’s technology. The United States Rubber Company was founded the same year and produced rubber-soled and heeled shoes under a variety of brand names, which were later consolidated in 1916 under the name, Keds. These shoes became known as, “sneakers”, because the rubber sole allowed the wearer to sneak up on another person. In 1964, the founding of Nike by Phil Knight and Bill Bowerman of the University of Oregon introduced many new improvements common in modern running shoes, such as rubber waffle soles, breathable nylon uppers, and cushioning in the mid-sole and heel. During the 1970s, the expertise of podiatrists also became important in athletic shoe design, to implement new design features based on how feet reacted to specific actions, such as running, jumping, or side-to-side movement. Athletic shoes for women were also designed for their specific physiological differences.

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Shoes specific to the sport of basketball were developed by Chuck Taylor, and are popularly known as Chuck Taylor All-Stars. These shoes, first sold in 1917, are double-layer canvas shoes with rubber soles and toe caps, and a high heel (known as a “high top”) for added support. In 1969, Taylor was inducted into the Naismith Memorial Basketball Hall of Fame in recognition of this development, and in the 1970s, other shoe manufacturers, such as Nike, Adidas, Reebok, and others began imitating this style of athletic shoe.  In April 1985, Nike introduced its own brand of basketball shoe which would become popular in its own right, the Air Jordan, named after the then-rookie Chicago Bulls basketball player, Michael Jordan. The Air Jordan line of shoes sold $100 million in their first year.

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As barefoot running became popular by the late 20th and early 21st century, many modern shoe manufacturers have recently designed footwear that mimic this experience, maintaining optimum flexibility and natural walking while also providing some degree of protection. Termed as Minimalist shoes, their purpose is to allow one’s feet and legs to feel more subtly the impacts and forces involved in running, allowing finer adjustments in running style. Some of these shoes include the Vibram FiveFingers, Nike Free, and Saucony’s Kinvara and Hattori. Mexican huaraches are also very simple running shoes, similar to the shoes worn by the Tarahumara people of northern Mexico, who are known for their distance running abilities. Wrestling shoes are also very light and flexible shoes that are designed to mimic bare feet while providing additional traction and protection.

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Many athletic shoes are designed with specific features for specific activities. One of these includes roller skates, which have metal or plastic wheels on the bottom specific for the sport of roller skating. Similarly, ice skates have a metal blade attached to the bottom for locomotion across ice. Skate shoes have also been designed to provide a comfortable, flexible and durable shoe for the sport of skateboarding. Climbing shoes are rubber-soled, tight-fitting shoes designed to fit in the small cracks and crevices for rock climbing. Cycling shoes are similarly designed with rubber soles and a tight fit, but also are equipped with a metal or plastic cleat to interface with clipless pedals, as well as a stiff sole to maximize power transfer and support the foot. Some shoes are made specifically to improve a person’s ability to weight train.  Sneakers that are a mix between an activity-centered and a more standard design have also been produced: examples include roller shoes, which feature wheels that can be used to roll on hard ground, and Soap shoes, which feature a hard plastic sole that can be used for grinding.

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Athletic footwear research has substantially evolved over the past decades, becoming a globalized field of work, thereby linking scientific and business demands. It comprises research approaches originating from a variety of academic, medical, podiatric, sports, commercial, and industrial backgrounds. The fundamental aim of athletic footwear research is to enhance the understanding of Footwear Functionality regarding its key purposes, comfort, performance and injury prevention of athletes. The described approach to examine shoe effects on these key purposes assumes that all footwear marks an Artificial Interface between the athlete’s foot and the environment. It further assumes that comfort, performance and injury prevention of athletes can be improved by optimization of the interaction of the shoe to the foot, and the interaction of the shoe to the environment. A comprehensive understanding of these interactions is complex, as material aspects of the shoe and of the environment, as well as biological and psychological aspects of the athlete, need to be considered. Enhanced knowledge of these interactions allows a more systematic creation of functional athletic footwear concepts, thereby contributing to the general performance of athletes, which marks a major goal of the field of work.  Athletic footwear research has evolved from various perspectives of different researchers over the past decades (Cavanagh 1980, Nigg 1986, Nigg 2010, Goonetilleke 2012). In depth analysis of athletic footwear effects on human locomotion is based on the mutual interaction of sport shoe researchers and manufacturers. Systematic modification of athletic footwear and tailored research methods allow the extraction and subsequent application of evidence-based knowledge to enhance sport shoe functionality. 

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Special features in construction will make athletic shoes more comfortable as well as help prevent injury:

-1. A slip-lasted shoe is made by sewing together the upper like a moccasin and then gluing it to the sole. This lasting method makes for a lightweight and flexible shoe with no torsional rigidity.

-2. A board-lasted shoe has the “upper” leather or canvas sewn to a cardboard-like material. A person with flat feet (pes planus) feels more support and finds improved control in this type of shoe.

-3. A combination-lasted shoe combines advantages of both other shoes. It is slip-lasted in the front and board-lasted in the back. These shoes give good heel control but remain flexible in the front under the ball of the foot. They are good for a wide variety of foot types.

If you begin to develop foot or ankle problems, simple adjustments in the shoes may relieve the symptoms. Many of these devices are available without prescription.

A heel cup provides an effective way to alleviate pain beneath the heel (such as plantar fasciitis). Made of plastic or rubber, the heel cup is designed to support the area around the heel while relieving pressure beneath the tender spot.

A metatarsal pad can help relieve pain beneath the ball of the big toe (sesamoiditis) or beneath the ball of the other toes (metatarsalgia). Made of a felt material or firm rubber, the pad has adhesive on its flat side. Fixed to the insole behind the tender area (closer to the heel or further from the toes), the pad shares pressure normally placed on the ball of the foot. This relieves pressure beneath the tender spot.

An arch support (orthosis) can help treat pain in the arch of the foot. Made of many types of materials, arch supports can be placed in a shoe after removing the insole (the removable inner sole) that comes with the shoe.

Custom arch supports may be necessary for chronic (long-term) and complicated problems, including severe flat foot, high arches, shin splints, Achilles tendinitis, and turf toe. Custom arch supports are specially designed inserts that concentrate relief on a particular area while supporting other areas. 

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Purpose of athletic footwear:

The general purpose of wearing athletic footwear is to improve comfort, performance and injury prevention during sport specific movements, referring to natural and intuitive demands of athletes (Lake 2000, Miller et al. 2000, Luo et al. 2009, Hennig & Sterzing 2010, Sterzing et al. 2012). Fostering but also balancing these demands during the creation of athletic footwear is a key task for improvement of overarching Footwear Functionality. Thereby, athletic footwear functionality describes the summed influence a sport shoe has on its wearer during execution of sport specific movements and is based on the collectivity of its construction features.

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Comfort of athletic footwear may differ from a general understanding of comfort in daily life. Certain types of athletic footwear require sport specific construction, which support good performance or injury prevention but which do not necessarily provide a good feeling of comfort in its original sense (Slater 1985). For instance, alpine skiing, climbing, sprinting or soccer shoes place athletes’ feet in a rather narrow space due to sport specific locomotion requirements addressing respective performance and injury prevention aspects. The space provided would probably not be considered comfortable by wearers in their general daily life. However, during execution of sport specific movements respective shoes are perceived comfortable by athletes. Thus, comfort of athletic footwear should always be directed towards its sport specific function and should be referred to as Functional Comfort. In this sense, comfort of athletic footwear resembles a function of objective factors like impact attenuation, in-shoe pressure, geometric fit, and others (Clarke et al. 1983a, Hawes et al. 1994, Hennig & Milani 1995, Eils et al. 2004, Witana et al. 2004, Kersting & Brüggemann 2006, Mientjes & Shorten 2011), but also a function of subjective factors like individual experience, expectations, demands, and preference (Handwerker 2000, Kouchi et al. 2005).

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Performance of athletic footwear is an inherent aspect in the sports world. For instance, soccer shoes enabling players to run and kick faster, or running shoes enabling runners to run at lower metabolic cost, are preferred over others (Bauer 1970, Frederick 1984, Sterzing & Hennig 2008, Luo et al. 2009). These or further performance aspects can be referred to for other sports as well. However, sports history documents that elite running performance may also be achieved when competing unshod as demonstrated by Abebe Bikila, olympic marathon champion in 1960, or by Zola Budd, 5000 m world record holder in 1984 (Sterzing et al. 2010a). Objective performance benefits of athletic footwear can be quantified by direct and straight forward measurements, indicating the competitive advantage one shoe has over others. Subjective assessment of athletic footwear performance and its interpretation appears more complex. It is based on the neurophysiological capacity of athletes to receive and integrate external sensory performance stimuli, while being linked to athletes’ expectations and prior experience. In this sense, subjective assessment of athletic footwear performance was shown to coincide with objectively measured performance but also to contradict it (Sterzing & Hennig 2008).

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Injury prevention manifests a further important aspect of athletic footwear, thus constituting a focus in sport shoe research regarding running footwear (Cook et al. 1990, Nigg 2001, Milner et al. 2006, Richards et al. 2009, Lieberman et al. 2010, Brüggemann et al. 2011), but also regarding soccer footwear and soccer surfaces (Ekstrand et al. 2006, Müller et al. 2010a, Müller et al. 2010b, Sterzing 2013). While there is general agreement that athletic shoes should contribute to the prevention of injuries, their opportunities to do so are judged diversely. For instance, the role of running footwear in injury prevention is still not fully understood. This is illustrated by ongoing controversial discussions about the potential and usefulness of impact attenuation and rearfoot motion characteristics of running shoes directed towards the decrease of injury occurrence in runners during heel-toe running (James et al. 1978, Clarke et al. 1983a, Clarke et al 1983b, Nigg et al. 1995, Nigg 2001, Nigg & Wakeling 2001, Nigg et al. 2003, Milner et al. 2006, Shorten & Mientjes 2011).

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The three major purposes of athletic footwear do not always complement each other but may impose mutual conflicts. For instance, certain performance related initiatives on shoe construction like weight reduction of running shoes may challenge injury prevention demands like running shoe stability. Performance initiatives on outsole configurations of soccer shoes like increase of stud dimensions may increase lower extremity loading and subsequently related injury risk. Furthermore, shoe manufacturing guidelines trying to balance comfort, performance and injury prevention demands can differ regarding the bodily predisposition of athletes. Sex, age, skill level and training status define athletes’ anatomical and physiological capacities and thereby frame their interaction characteristics with their footwear. Different athletes may respond in diverse manner to altered shoe construction features, which is to be considered in design, development and research of athletic footwear.

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Comprehensive evaluation of athletic footwear:

The evaluation of athletic footwear, including shoe prototype evaluation during the shoe creation process, marks an important field for ensuring its quality. Valid and reliable evaluation of athletic footwear is a precondition for the systematic enhancement of its functionality. It has been suggested to evaluate athletic footwear comprehensively from various perspectives (Hennig & Milani 1996, Lafortune 2001, Sterzing & Brauner 2010). Currently, objective mechanical, biomechanical and athletic performance procedures as well as subjective perception procedures are incorporated during comprehensive evaluation of athletic footwear of adequate standards as seen in the figure below.

Figure above shows objective and subjective evaluation of athletic footwear.

These procedures are supported by applying computer simulation methods allowing the reduction of human athlete dependent testing efforts. The different evaluation procedures have their unique characteristics and provide specific insight into the functionality of athletic footwear. Thereby, objective evaluation procedures indicate the actual alteration of human locomotion induced by shoe modifications, whereas subjective variables indicate how these modifications are perceived by athletes. Mechanical characteristics of sport shoes are regarded as the general origin for subsequent biomechanical, athletic performance, and perception alterations. Thus, the modification of mechanical characteristics needs to be accurately controlled and systematically arranged in order to increase the probability of extracting precise guidelines for enhancing athletic footwear functionality. The relation of objective and subjective evaluation parameters may show different patterns, which do not always follow intuitive expectations and which have not yet been systematically described.

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Wearing the appropriate athletic shoe for specific sports activities can improve comfort and performance and, most importantly, prevent injuries. Sports can place tremendous pressure on the feet, ankles, and legs. Running and jumping, for example, generate an impact force through the legs that is three to five times a person’s body weight.

Today’s athletic shoes are designed with specific activities in mind. If you participate in a single sport more than two times a week, you should purchase a shoe specifically designed for that sport — a running shoe, court shoe, cleats, or hiking shoe. If you are active in many different forms of exercise each week, a cross-training shoe may be the best choice.

Tips for finding the Right Athletic Shoe:

-1. Purchase shoes from a specialty store, if possible. The staff will provide valuable input on the type of shoe needed for your sport as well as help with proper fitting.

-2. Try on athletic shoes after a workout or run and at the end of the day when your feet are at their largest. Fit your shoe to your largest foot.

-3. Wear the same type of sock that you would wear for that sport.

-4. Re-lace the shoes. You should begin at the farthest eyelets and apply even pressure as you create a crisscross lacing pattern to the top of the shoe.

-5. Check the fit. When the shoe is on your foot, you should be able to freely wiggle your toes. Make sure you can fit at least one thumb between your longest toe and the end of the shoe’s toe box. The shoes should be comfortable as soon as you try them on. Don’t plan on them fitting better after “breaking them in.”

-6. Walk or run a few steps in the shoes and make sure they are comfortable.

-7. Check the heel. There should be a firm grip of the shoe to your heel and your heel should not slip as you walk or run.

-8. Consider a sport-specific shoe. This may be necessary if you participate in a sport three or more times a week.

-9. Change shoes regularly. After 300-500 miles of running or 300 hours of exercise, the cushioning material in a shoe is usually worn down and it’s time to replace the shoes.

-10. Make sure that the shoes have not been sitting on the shelf for an extended period of time. While the materials of an athletic shoe are designed to accommodate a lot of stress, the cushioning may become less effective over time, even without use.

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If you participate in a certain sport at least two to three times per week, you should wear a sport-specific shoe. Review the chart below so you know what to look for when purchasing athletic shoes.

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Types of Athletic Shoes: 

Athletic shoes can vary in design, material, and weight. These differences have been developed to protect the areas of the feet that are most stressed during a particular athletic activity.

-1. Running Shoes

Much of the recent research in athletic shoes has focused on the development and improvement of running shoes. The best way to determine if you are a supinator or pronator runner is to have a professional evaluate your foot. To determine your foot type on your own, view your footprint when you step out of the pool or shower. If you leave a wide, flat footprint, you have a pronated foot. If the footprint is missing the inside of the foot, where your arch did not touch the ground, you have a supinated foot type. While knowing what type of foot you have is a first step toward buying the correct shoe, the pronation/supination component may be magnified during running. A professional can perform a gait analysis to definitely determine how your foot functions while you are running. A running shoe professional can analyze your gait to help determine the best type of shoe for you.

Conventional thinking suggests that a good running shoe should have ample cushioning to absorb shock, but there are advocates for minimalist running shoes that have almost no cushioning. If you choose a cushioned shoe, look for overall shock absorption, flexibility, control, and stability in the heel counter area (a hard insert used to reinforce the heel cup of a shoe), as well as lightness and good traction. These features may help prevent shin splints, tendinitis, heel pain, stress fractures, and other overuse injuries.

Running shoes need to be replaced on a regular basis. The EVA starts to show structural damage after 120 miles. At 500 miles, the shoe has lost 45% of its initial shock absorption capabilities. A general rule of thumb is to take 75,000 and divide it by your weight in pounds to determine the number of miles that you can run before you need a new shoe. For example, if you weigh 150 pounds, your shoes should be replaced every 500 miles.

-2. Barefoot Running / Minimalist Shoes:

Running without shoes, or “barefoot running,” has become popular in the last decade.  The concept behind this technique is that it promotes a “forefoot” or “midfoot” strike versus a heel strike.  This change in how your foot strikes the ground reduces the compressive loads through your lower limb and can help to reduce the risk of injury.

A professional trainer can tell you if this type of running is a good choice for you and, if so, provide you with tips and exercises to help you safely and slowly transition from running in shoes to running barefoot. You can purchase shoes specifically designed for barefoot running that offer no support or cushion, but do provide some protection from sharp objects and uncomfortable surfaces.

Shoe companies have also designed “minimalist” shoes that are similar to barefoot running. A typical running shoe has a 10-12 mm heel to toe drop due to extra cushion in the heel. This cushion reduces the compressive load at heel strike. A minimalist shoe has less cushion and, therefore, a lower heel to toe drop (less than 8 mm). This causes the runner to strike with the front of the foot, rather than the heel.

Minimalist shoes are light, flexible, and don’t have much cushion. It’s not clear whether they’re better or worse than other shoes at preventing injuries. One study shows that pain and injury were more common in runners wearing minimalist shoes. Heavier people had a greater chance of getting hurt.

-3. Trail running Shoes

Do you like to jog off-road? You’ll want shoes that can stand up to dirt, mud, water, and rock. Trail shoes have a heavier tread than a traditional running shoe. They also have more heel and side-to-side support to keep you safe while you run on uneven surfaces.  A trail shoe is designed for those who prefer to run off road. This type of shoe has a deeper tread pattern for solid traction and offers more stability across the shoe than a normal running shoe.

-4. Cross Trainers

A cross-training shoe is designed to take you from sport to sport with one pair of shoes. Look for one that’s flexible in the forefoot if you’re going for a run but also has good side-to-side support for tennis or aerobics class. This type of shoe is not appropriate for someone who plans on running more than four to five miles a day. A cross trainer is usually made of a combination of mesh materials and strips of leather in the fabric. If the shoe has a “running” tread on the sole, it may be difficult to wear the shoe on a court for an exercise class or game.

-5. Walking Shoes

If walking is your activity of choice, look for a lightweight shoe with extra shock absorption in the heel of the shoe and especially under the ball of the foot. This will help reduce heel pain as well as burning and tenderness in the ball of the foot (metatarsalgia). A shoe with a slightly rounded or rocker sole (the entire part of the shoe that sits below the foot) also helps to encourage the natural roll of the foot during the walking motion. You should also look for a comfortable soft upper (the entire part of the shoe that covers the foot) and smooth tread (the part of the sole that touches the ground). Walking shoes provide stability through the arch, good shock absorption, and a smooth tread. Walking involves a heel-toe gait pattern, so you want to make sure that the shoe, and particularly the counter, is stable.

-6. Court Shoes

Court shoes include those designed for basketball, tennis, and volleyball. Most court sports require the body to move forward, backward, and side-to-side. As a result, most court sport shoes are subjected to heavy abuse. Court shoes have a solid tread and typically are made of soft leathers. They are designed to provide stability in all directions. They may have the traditional low upper cut below the ankle, or a high cut. The higher upper is commonly found on basketball shoes to offer increased stability to the ankle during jumping and landing.

-7. Cleats

Many sports, such as soccer, lacrosse, football and baseball, require the athlete to wear a cleat shoe. Shoes with cleats (also called “spikes” or “studs”) have multiple protrusions made of steel or hard plastic that provide additional traction on grass or soft turf.

There are different types of cleats for different sports, so it is important to consult with a coach or professional before purchasing a new cleat shoe. Cleats tend to run narrow — so if you wear an orthotic (a shoe insertion to provide added support), or plan on putting an extra insole in the cleat, you may want to purchase a brand that is known to have a wider cut.

Spikes are usually preferred on a grass or field turf surface, allowing a player to dig into the surface and resist forces that may stop forward movement. Removable cleats are advantageous because they can be switched out for different surfaces. They come in 1/2, 5/8, 3/4, and 1 inch sizes. Molded cleats are preferred on turf surfaces to provide more traction. A lineman may benefit from a high top cleat above his ankle, which provides more stability during lateral movements. A running back or wide receiver may prefer a low cut cleat providing greater agility on the field while performing cutting maneuvers.

-8. Hiking Shoes

A hiking shoe needs to provide stability as you walk across uneven surfaces, as well as comfort and cushion in the insole to absorb the shock from various impacts. Hiking shoes also should have a good tread on the sole to keep your foot firmly planted on the surfaces that you encounter. Most hiking shoes have a higher upper, providing added ankle stability.

Shoes or boots made for hiking give your feet a better grip on the trail to help you avoid falls. Pick a pair that matches your hiking plans:

– Lightweight shoes or boots are good for well-maintained trails or short hikes.

-Midweight boots are better for hiking on rocky terrain or uneven surfaces.

-Heavyweight boots are for people carrying backpacks over 35 pounds and walking on ice, snow, or rocks.

 -9. Other Sports Shoes

There are shoes designed for virtually every sport, including golf, ballet, skating, hockey, cycling, and skiing. As always, a professional can help you to purchase the shoe that is best for you and the sport you enjoy.

Skates and ski boots can be custom molded to fit your feet, providing extra stability. Golf shoes need to provide stability in the arch of the shoe as the game requires players to walk long distances on changing surfaces. If possible, it is best to purchase a golf shoe with a removable insole so that you can add an orthotic if necessary.

Cycling shoes are fit snuggly, without additional room for inserts. A cycling shoe with some cushion under the ball of the foot will help reduce any compression while you repetitively push the foot as it is securely attached to the pedal.

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High-Tops vs. Low-Tops: 

From the classic Chuck Taylors to the latest Air Jordans, basketball footwear has usually meant high-tops, whose higher cut ostensibly provides support against sprains. Over the years, basketball shoes have morphed from simple canvas footwear to an array of high-tech gadgetry and bold styles. As sneaker culture has flourished — manifesting as a complex intersection of fashion, capitalism, politics, culture, race and society — basketball shoes continue to be at the forefront of footwear technology. Whether it’s cushioning air cells in the sole, new types of rubber for better traction, lighter materials, or even the more gimmicky inflatable ankle support of the Reebok Pumps, the basketball shoe has always been a marriage of form and function.

In the beginning, high-tops ruled the basketball court. Adidas released the first low-top all-leather basketball shoe, the Superstar, in 1969. But over the 20th century, high-tops remained the standard. Then, in 2008, Nike released low-tops as part of its Nike Zoom Kobe line, and with the boost from the Los Angeles Lakers superstar’s endorsement, low-tops have since surged in popularity. Players cite greater freedom in movement with a lower cut. Today, about half of NBA players wear low-tops. The majority of college players also choose low-tops.

Conventional wisdom would say the prevalence of low-tops is a recipe for more injuries. But most ankle sprains happen when one player lands on another’s foot. The resulting forces are so high that no high-top could stop a sprain. There’s no evidence that different types of basketball shoes prevent ankle injuries. In general, study results are mixed. In particular, two of the more recent studies found no difference between high- and low-tops in how much an ankle turns and in the up-and-down motion of jumping and landing. According to the first study, high-tops might even delay the muscle’s reaction to an ankle turn, raising the likelihood of a sprain. Another suggested that wearing high-tops increased the forces, and injury risk, on the Achilles tendon. But those studies were biomechanical experiments, in which researchers measured the forces and movements in the feet of volunteers who ran, jumped, and cut in a lab. Because large-scale epidemiological studies of athletes playing basketball are difficult and expensive, they’re rare. And none have conclusively implicated high- or low-tops in ankle injuries. For example, a 1993 study surveying 622 college players found no difference in rates of ankle injury between high- and low-tops. In a larger study from 2001, researchers looked at more than 10,000 Australian basketball players, and didn’t find high- or low-tops to be major risk factors for ankle injuries. Instead, increased risk was linked to prior injuries, whether a player stretched before the game, and the presence of air cells in the shoe — like those in that era’s Air Jordans. But even the importance of cushioning is muddled. A 2008 study, which surveyed 230 collegiate players, focused on springlike cushioning, and found that rates of ankle sprains didn’t depend on shoe design.

But the purpose of basketball shoes has never been just to reduce injuries. For the top professional players, endorsement deals may be the biggest reason why they wear the shoes they do. Shoe companies also have big-money agreements with college teams, and have become embroiled in a scandal involving Adidas and multiple universities. For most people, shoes are about comfort and style. Footwear is a fashion statement, and for men, they have allowed expression in a way that preserves traditional masculinity. Shoes are also political. Dwyane Wade has worn a special Black Lives Matter edition of his signature shoes.  Sure, shoes protect your feet. But from social status to social justice, shoes have always meant something more — regardless of who’s wearing them.

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Running shoes:

Running is one of the best forms of exercise to improve health and life expectancy. It builds bone, muscle and cardiovascular strength. However, running also demands a lot of the body. It is one of the highest impact and intense forms of physical activity. When we run, our momentum generates a lot of force – up to 3 times our body weight. Each time our feet strike the ground, our weight-bearing joints have to absorb this force. That’s a very heavy burden (literally): The shock from this impact is felt in the feet and travels up our spine. This can cause stress and strain on the joints, which can lead to pain and injury over time.

As our body’s foundation, the feet play a crucial role in absorbing our body weight and force of impact when we run. They also keep us moving. So it’s important to make sure they’re protected. And there’s no better protection for your feet than shoes. Proper footwear can provide you stability and support to keep your body feeling its best. This will improve foot health, and increase the longevity of your activity level as you age.

Are Running Shoes necessary?

Yes. Running shoes are the only protective equipment runners have to safeguard themselves from injury. While they may not always make you run faster, they can help reduce pain and the repeated strain and stress of high-impact activity on the joints.

The way running footwear is constructed — a thicker heel to absorb impact and a heel-to-toe drop to match the natural gait cycle of running — is intended to complement the natural feel of your foot. Proper shoes should feel like an extension of your feet, just with the added proper protection.

Do Running Shoes really make a difference?

Yes, running shoes do actually make a difference. They are specifically made for running and the high-impact forces it generates. Proper running footwear serves multiple purposes. A snug fit means fewer foot issues, like blisters, while still giving you flexibility and comfort of movement. The structure helps ensure proper running form, which reduces the likelihood of joint strain. The build gives you longevity and the cushioning and material needed to withstand impact and repeated stress.

However, running shoes are not the whole story: 

Typically, your gait and biomechanics are more important. If you have poor biomechanics and running form, you may be injured despite wearing running shoes because you have not worn proper corrective running shoes. In fact, people who do not run and are inactive tend to experience more injuries than runners. Many injuries traditionally thought to be solely running-related (like “runner’s knee”) are not so much related to running in-and-of itself, but rather to poor biomechanics and underlying health conditions (i.e.: pre-existing arthritis).

If you do have biomechanical abnormalities or a pre-existing foot condition, then a proper running shoe is more important: different types of running shoes are constructed specifically for different foot types and running gaits to encourage proper running form and reduce joint strain. An orthotic insole can also help correct any biomechanical issues when you run.

That said, proper running shoes are only part of the solution: strengthening and conditioning our muscles in our legs and core-region is also essential for healthy biomechanics and injury prevention.

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Running shoes resemble the most extensively researched type of athletic footwear, paying tribute to the high number of runners worldwide but also reflecting the fundamental locomotion pattern present in other sports (Cavanagh 1980, Nigg 1986, Cavanagh 1990, Nigg 2010). The initial focus of running and running shoe research was on heel-toe running, presumably because it is the most common running style (Cavanagh & Lafortune 1980, Hasegawa et al. 2007, Larson et al. 2011, Breine et al. 2014). Additionally, research on barefoot running and barefoot running-related changes in running style has been carried out (De Wit et al. 2000, Divert et al. 2005, Lieberman et al. 2010, Sterzing et al. 2010a, Gruber et al. 2013, Tam et al. 2014). Following these studies, minimization footwear targeting running and training activities originated and received attention in athletic footwear research and development (Goldmann et al. 2013, TenBroek et al. 2013).

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Shoe construction for running shoes

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Running Shoes Categories:

Around 7-10 years back, the shoes were broadly classified based on the amount of foot control they offered. But innovation in shoe design continues to happen and now the companies have started altering the amount of cushioning in the shoes and have started offering minimalistic and maximal shoes. There are a vast number of running shoes available in the market today and sometimes it is overwhelming to decide which one to buy. They can be very broadly classified into the following categories:

-1. Motion control running shoes

-Provide high stability and durability.

-Recommended for runners with low arches, flat feet and moderate to serious over-pronation, which is the excessive inward rolling of the foot following a foot strike.

Shoes available in the market in this category are – Hoka One One Arahi 4, Brooks Adrenaline GTS 20, the Mizuno Wave Alchemy 12.

-2. Stability running shoes

-Recommended for the runners with normal running gait, normal shaped feet (normal arch/neutral feet) and neutral pronators (the feet roll inward in an efficient way). This shoe supports your natural stride.

Shoes available in the market in this category are – Asics GT 2170, Brooks Ghost 13, Mizuno wave rider 24.

-3. Cushioned Shoes or Neutral Padded Shoes

They are without a lot of corrective or supportive elements. They are recommended for runners with little to no pronation as they offer both shock absorption and protection with little to no extra support throughout the gait cycle. They can be further classified into Barefoot, Minimalist, and Maximalist running shoes depending upon the cushioning.

-Minimalist Shoes

Offer low midsole height, low heel-toe/zero drop (less than 8mm), high flexibility, and lower weight, no-arch support, thin sole with no motion control. Shoes available in this category are Saucony Kinvara 9.

-Barefoot Shoes

They create an ultra-lightweight, ultra-flexible from heel to toe, barely-there barefoot experience with heal drop of 0 mm and reduce energy wastage as there’s less weight to carry. There is minimum cushioning/stability, and the runners rely solely on the body’s natural shock absorbing mechanisms. Shoes available in this category are – Ultra Minimal Vibram Five-Finger, Vivo barefoot.

-Maximalist Shoes

They are also generally constructed with a low heel-toe drop but they contain substantially greater midsole cushioning from the forefoot to the rearfoot compared to a traditional shoe providing good shock absorption. They are heavier in weight. Shoes available in this category are – Hoka One One Clifton 4, Sketchers Go run Ultra R, New Balance Fresh Foam 980 Boracay.

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Training and racing shoes: 

Even with all the different styles, two main types of running shoes stand out: trainers and racers. Training shoes are meant for the bulk of your running leading up to race day, which is when you switch over to your racing shoes to help you run your fastest time yet. Classic training shoes, like the Brooks Ghost 12 and the Mizuno Wave Rider 23, are made to last up to 500 miles. Their burly outsole rubber resists abrasion and protects the softer midsole, while the foam withstands thousands of compressions without losing (much) spring. Race-day shoes (or racing flats) are designed to be lighter and faster than your everyday training shoe. Runners looking to set new personal records at a race will sometimes switch into a pair of racing flats for the big day. Racing flats historically featured less cushioning than a training shoe, and some used less outsole rubber to cut down on weight. The slimmer shoes and lighter materials also wear out faster than what’s used in training shoes. That means race shoes are something you should save for the race or for a couple hard workouts during your training cycle. But advances in technology mean that many racing shoes now boast the same amount of cushioning as some training shoes (or more) with a lighter weight. Take the Nike ZoomX Vaporfly NEXT% and the New Balance FuelCell 5280 for example. These new shoes employ the lightest materials, bounciest foams and most propulsive carbon fiber plates to give you an edge on race day.

Still, other modern-day race shoes blur the line between racing and training. The HOKA ONE ONE Carbon X is built for speed—a carbon fiber plate lends the shoe a propulsive feeling and an ultra-responsive foam adds bounce to your run—but there’s also a lot of foam, which remains soft and springy over hundreds of miles.

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Difference between Running Shoes and Walking Shoes:

Wearing the right kind of shoes is key to keeping your joints and muscles healthy when you embark on a run, walk or hike. You might think that simply buying a pair of good, expensive shoes allows you to do all, but that’s actually not accurate. Your body reacts differently to different types of exercise, especially running and walking, because you use your feet differently.

If you’re a runner, you might bring your foot down first on your heel and roll forward to the ball of your foot. You may also land on the ball of your foot first and then push off. Much depends on your style and comfort level. Running is a higher impact exercise and each time your foot comes down, your body absorbs approximately three times your body weight.

Conversely, walkers all walk much the same way, with the heel of the foot making contact with the ground first before the foot, and thus the body’s weight, rolls forward to the ball and then the toes. It’s a less impactful exercise, with your body absorbing about one and a half times your body weight. Walking also distributes the weight more evenly for your feet and your legs.

Running shoes tend to be lighter in weight but heavier in cushioning, especially for the heel and the toe. Since running is a more intense sport, runners tend to exert more energy. Your feet get hot, and most running shoes are made of mesh to allow air to move freely. This mesh also keeps the shoe lighter.

Walking shoes, which didn’t even exist until 1986, don’t need to be as light and breathable but they do need to provide good arch support. If you have a high arch on your food, you probably have less natural shock absorption so the walking shoe you choose should have more cushioning than less. If you have flat feet, you also have less support which can lead to muscle and joint stress. You need walking shoes that offer stability.

The American Academy of Podiatric Sports Medicine notes that good walking shoes and good running shoes both offer stability, cushioning and allow for a smooth stride.

Here are four main differences to keep in mind when considering each type of shoe:

The sole.

Running shoes will have a stiffer sole; walking shoes have more flex and blend.

Heels.

Running shoes have thick heel wedges to provide more cushion. A thick heel when walking can actually cause tendinitis or shin splints, and can even cause a walker wearing a running shoe to trip. Walking shoe heels are more beveled.

Motion control.

Because the rotation of the foot is more exaggerated when running, most running shoes offer motion control to keep the foot more neutral. Walking shoes tend to provide less stability because it’s not as necessary.

Weight.

Running shoes are lightweight for moving, hopefully, faster. Walking shoes aren’t necessarily heavy, but they’re always heavier than running shoes.

Both types of shoes will provide good support for between 300 and 500 miles. Walking shoes are generally heavier than running shoes. They’re built more for stability while running shoes are built for speed, faster movements and shock absorption. That said, running shoes can be suitable for walking, although this may wear out your running shoes quicker. If you walk a lot and continue to use the same pair of shoes to run, the shoes may break down faster.  

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Conundrum of science of running shoes:    

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Changes in running injuries over the past 40 years:

Running started to become very popular in the 1970s. Parallel to this development, runners started to get injured and scientific studies were published discussing the prevalence of running injuries. These studies showed a wide variety of results with relative running injury frequencies varying between about 15% and 85% of runners (figure below).  However, there seems to be no apparent secular trend (over time) for the frequency of injuries.

Figure above shows summary for the frequency of running injuries based on various studies.

Several reasons could explain this phenomenon. One is a change in the running population and the second is the definition of a running injury.

Possible differences in running population:

The runners in the 1970s and 1980s were different than the runners in the third millennium. The runners in the 70s were dedicated runners, aiming to win, skinny and primarily ran; 75% were male. The runners in the current millennium are primarily recreational runners who run a marathon to finish, some are overweight and most are involved in cross-training activities. Now a slight majority of runners are female (54%). Furthermore, the populations studied in various epidemiological studies were not the same. Some authors studied new runners while others studied competitive runners.

Definition of running injuries:

Definitions of running injuries varied widely in older studies. Some used a definition that required medical attention to be included as an injury. Other authors used a definition that used a defined time where the running activity could not be performed and the duration was not consistently the same. Other authors defined a running injury if there was any symptom about pain or discomfort. It is obvious that the injury frequencies for such different injury definitions could not be the same.

Based on these considerations (running population and definition of injury) the numbers of these studies can and should not be compared and conclusions about changes in running injuries over time or the effects of running shoes based on these data seem inappropriate.

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The design of most running shoes does not match the available science. The commonly held beliefs follow this logic: Runners get injured due to impact and excessive pronation, running shoes reduce impact and pronation, and therefore running shoes reduce injury. Unfortunately, every part of this rationale seems to be flawed. There are other aspects of shoe design, such as the raise heel or arch support that have even less evidence to support them. 

-1. Injuries due to impact:

There is surprisingly little evidence that impact forces cause injuries, and there is even some evidence that lower impact forces are associated with higher injury rates. It’s been suggested that excessive impact can result in injury, while more moderate impact can produce important adaptations that are necessary for improved performance.

There is evidence that increased cushioning does not reduce impact, and may even increase it.

  • A study of 14 runners using three different midsole hardnesses (25, 35, 45 Shore) at three different speeds showed no difference in impact measured with a force plate for the different shoes. The impact did increase with increasing pace, and these three shoes are relatively soft (most are ~45 Shore, with some Hoka shoes going as soft as 35 Shore).
  • Comparing shoes with the same midsole hardness but fore/heel heights of 0mm/4mm, 8mm/12mm, 16mm/20mm, plus barefoot found there were no impact changes between the shod conditions. The runners only had 5-10 minutes to adapt to each condition, and it’s unclear if any of the runners had barefoot experience. The impact for the barefoot condition was lower than shod, but the runners changed to a forefoot landing when barefoot.
  • There was no difference found in impact forces between two shod conditions where one type of shoe provided 50% more cushioning than the control shoe.
  • A study of 93 runners that compared three hardness shoes (40, 52, & 65 Shore) showed that the softer shoes had the greatest impact peak. The impact ranged from 1.70x Body Weight (BW) for the softest shoe, to 1.64x BW for the medium and 1.54x BW for the hardest. The impact was measured using a force plate and used the impact peak, not the active peak which is why the impact is much lower than other studies that report 2.0-2.4x BW. The study found that running increased their joint stiffness in the softer shoes, which may be the cause of the greater impact.
  • Highly cushioned maximalist shoes and conventional shoes may result in more knee stress than minimalist shoes. The study looked at 20 male runners and measured impact with a pressure plate while filming the leg movement. The leg movement was then used to estimate knee stress based on a model that used knee movement and angle. The maximalist shoes were Hoka, the minimalist shoes were Vibram Five Fingers, but the conventional shoes were not specified. The runners were not familiar with the non-traditional shoes, and only had 5 minutes familiarization. The study also found greater contact forces in the non-minimalist shoes.
  • Runners who normally run in shoes have greater impact forces when running barefoot initially, but this is reversed with as a runner becomes adapted to being barefoot.
  • In a study somewhat related to shoes and impact, a study looked at impact and running surface and found there were not impact differences between concrete, synthetic track, natural grass, and a treadmill. The study used a pressure sensor in the shoe’s insole and an accelerometer attached to the Tibia, with the runners wearing non-cushioned, minimalist shoes.

-2. Injuries due to over pronation:

The science around pronation and injury rates is quite mixed. Part of the problem is science does not generally look at pronation directly, but uses arch height with the assumption that low arches pronate more. There is some evidence that high or low arches have slightly higher injury rates, or that different arch heights have different patterns of injury.

  • An analysis of 29 studies showed that high or low arched feet had slightly higher risk of injury than normally arched feet.
  • There is also evidence for the opposite conclusion, where high or low arched feet have a lower risk of injury.
  • One study found that while injury rates are the same for different arch heights, the location of the injuries varies with arch height.
  • Another study found that while injury rates are similar for different arch heights, those with low arches had more expensive injuries. (This was a study in the military, where such expenditure is more easily tracked.)
  • A year-long study of 927 novice runners showed no correlation between arch height and injury rates.
  • A study of 1597 runners found that those with the lowest arches were 2.7x more likely to have knee (patellofemoral) pain than those with the highest arches. (Note that this study used navicular drop as an indicator of pronation, but other factors contribute significantly to navicular drop)
  • A retrospective study found that arch height was not different between runners who had previously been injured and those that had never been injured.

-3. Running Shoes & Pronation Control:

Motion control shoes (the highest level of anti-pronation) only reduce pronation by about 1.5% when compared with a simple cushioned shoe. It seems unlikely that this is enough to produce any real-world effect.

  • A meta-analysis of 5 studies showed that motion control shoes can reduce pronation when compared with barefoot or simple cushioned shoes, but only by about 2%.
  • A study compared a Motion Control shoe (MC) with a Cushioned shoe (CT) with 20 high arched (HA) and 20 low arched (LA) runners. The motion control shoe was the New Balance 1122 and the cushioned shoe was the New Balance 1022. The change in pronation (in degrees) is shown below.
 

CT

MC

Change

LA

7.9

6.3

1.6 

HA

8.0

7.4

0.6

  • A study of 10 male runners compared “normal” running shoes with and without a 10 degree orthotic wedge showed the orthotic reduced pronation by 6.7 degrees.
  • A study of 25 inexperienced, over-pronating female runners looked at differences in pronation in motion control and cushioned shoes, before and after a 1.5 Km (~1 mile) run. These runners only averaged 2.1 Km (1.3 miles) per week and had pronation of more than 6 degrees. The Motion Control shoes reduced pronation by 3.3 degrees before the run, but after just this short run the Motion Control shoes made no difference. The motion control shoes were Adidas Supernova Control and the cushioned shoes were Adidas Supernova Cushion. The results are shown below:
 

CT

MC

Change

Before 1.5 Km run

13.9

10.6

3.3

After 1.5 Km run

17.7

17.7

0

  • A study of 10 experienced rear foot runners were tested with shoes of varying heel flare. This heel flare (figure below) is how much wider the heel is at the bottom than the top, and the flared heels reduced pronation from 12.6 to 11.1 degrees (1.5-degree decrease) when compared with any heel without any flare. In practice, it’s rare for a shoe to be this narrow at its base, and other studies have not shown this effect.

  • A study of 7 people compared pronation when stepping down from a platform in shoes and when barefoot. The shoe was the Adidas Response Cushion and the platform was 4 inches/10 cm high. Pronation with shoes was less (17.9 degrees) than when barefoot (20.5 degrees). However, because the reduction was so small, the study concluded that it was impractical to alter pronation with this type of footwear. 

-4. Running shoes reduce injury:

There is no evidence that running shoes reduce injury rates. Assigning shoes based on arch height does not change injury rate, nor is there any indication that more cushioned shoes have a lower injury rates. There is some evidence that motion control shoes cause greater leg pain and more training days lost, and this applies to all arch types.

-5. Raised heel:

Another common feature of running shoes is a raised heel, which is intended to reduce the strain on the Achilles tendon. However there is little evidence that the raised heel actually reduces the strain on the Achilles tendon, and no evidence that the raised heel actually reduces Achilles tendon injuries.

-6. Barefoot running:

The reduced impact seen with barefoot running led many people to believe that this would in turn result in lower injury rates. However, there is no evidence that barefoot runners have a lower injury rates. More importantly, there is a growing body of evidence to suggest that the transition to barefoot running is associated with a high injury risk.

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Do Running Shoes cause or prevent injury? 

While there’s decent evidence that most runners can go faster in certain types of shoes, there’s much less certainty on the relationship between running shoes and injury. Most experts disagree with runners on the role of shoes in injury. A 2020 review in the Journal of Athletic Training looked at four decades of research on shoes and injury. It concluded that “Footwear does not cause injury but can modify the global training load a runner can tolerate before sustaining an injury.” In other words, think of shoes not as cure-alls or the cause of your injuries, but as part of an overall approach to avoiding injury. But, as two leading running physical therapists wrote in the British Journal of Sports Medicine in 2018, logical fallacies underlie many beliefs about shoes and injury. For example, many runners take for granted that more cushioned shoes are more “protective,” while others assume that running in minimalist shoes will lead to fewer injuries because they allow you to run more “naturally.” Neither idea is supported by evidence.

Consider these articles from peer-reviewed journals:

-1. An extensive literature search found no evidence to support the common practice of matching a shoe’s degree of stability features with a runner’s foot type. For example, the researchers didn’t find support for prescribing conventional motion-control features like firm posts on the inside heel to runners with flat feet.

-2. Studies involving more than 7,000 military recruits found no difference in injury rates when shoe type was randomly assigned compared to when shoes were given based on arch height. That is, the studies argue against basing shoe selection on the so-called “wet test,” which calls for putting people with high arches in flexible shoes, people with average arches in neutral shoes, and people with flat feet in stability shoes.

-3. A five-month study found no significant difference in injury rates in runners wearing shoes with a softer midsole compared to those in shoes with a midsole that was 15 percent firmer.

-4. In a six-month study, overall injury rates were similar among runners assigned to either shoes with a 10-millimeter heel-to-toe drop, a 6-millimeter heel-to-toe drop, or a 0-millimeter heel-to-toe drop. A shoe’s heel-to-toe drop is the difference in the height of the shoe in the heel and the height of the shoe in the forefoot. One theory is that a higher heel-to-toe drop is “protective” against injury, while others claim that low- or zero-drop shoes lower injury rates because they encourage a more “natural” gait.

The evidence for shoes preventing injury is even slimmer than that for shoes causing injury. Shoe companies mostly shy away from making explicit claims about injury prevention.

-1. Nike was careful in how it presented the results of a study it commissioned comparing its Infinity React Run to its Air Zoom Structure 22. The company reported that, during the 12-week study, runners in the Infinity React had 52 percent fewer injuries than those in the Structures. Nike didn’t say “this shoe will cut your injury risk in half.” (Nor, for that matter, did they address whether the Structures increased runners’ risk of injury!)

-2. When shoe companies make broader claims, they can get in trouble. Soon after the minimalist running craze, Vibram paid $3.75 million in a class-action suit filed in 2012 contesting that the company deceived consumers by advertising that its FiveFingers shoes could reduce foot injuries and strengthen foot muscles. The court agreed that the company’s assertions lacked scientific evidence. 

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Running Shoes help running faster and the issue of technological doping:

Long-distance running times are dropping – and the first sub-two hour marathon was completed recently by Kenyan athlete, Eliud Kipchoge. Some are arguing that innovations in shoe design are playing a pivotal role in these improvements. Can running shoes really make such a big difference?  Speed is an object’s rate of change of position with respect to time. An object’s speed is calculated by dividing the distance an object travels by the time it takes for the object to travel that distance. A study found that the type of footwear has some effect the speed of a runner. Running with socks and boots proved to be the slowest, and running in casual and skateboard shoes proved to be the fastest.

A running shoe should protect the foot and the runner from injury. It provides stabilisation of the foot and protects skin from damage. It should also limit potentially harmful impact forces as the foot strikes the ground, while returning energy to the runner.

Running shoes are designed in a way that improves running efficiency. Science suggests that if you can reduce the energy it takes to run, then in theory, you should be able to run faster and for a longer period. To do this, a number of techniques can be adopted.

First, we can reduce the mass of a shoe to make it lighter. This will allow a runner to swing their legs more efficiently.

Another claim is that if there is more cushioning in the midsole, then an athlete can run with straighter legs, again making them more efficient.

Adding stiff plates within the [midsole], may also help an athlete to run better by redistributing positive lower limb joint work from the knee to the joint of your toes above the ball of your foot. These stiff plates may also store and return energy to the runner. In general, when we compress this midsole, and then release it, we want as much energy as possible to be returned. The more energy that is returned, the more efficiently an athlete should be able to run.

It can, of course, be difficult to design tests that systematically explore all these factors, but they are being explored by science.

But every runner is different.

Major sporting brands spend a lot of time and resources designing and tuning running shoes, but the biggest challenge they face is the fact that everyone is different. The design and engineering that goes into a running shoe is quite heavily dependent on the runner, and their requirements. Each person will have his or her own running style and, of course, every foot is unique. There is never going to be a one-size-fits-all in shoe design. Some runners strike the ground right on their heel. These “rear-foot strikers” likely need more cushioning. Others will strike more on their forefoot. They are probably less concerned with cushioning, and could benefit from a more minimalist running shoe, or even running barefoot.

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‘Super shoes’ have revived debate on technological doping at Tokyo Olympics:

At the Tokyo Olympics, athletes have delivered extreme performances that have been partly attributed to these advanced shoes, as well as a high-tech track that they ran on. Since the Rio Olympics of 2016, a slew of world, national and personal athletics records have been broken, thanks to what are described as “super shoes”. While these high-tech shoes have been praised for transforming track and field events, they have also been slammed by purists, who believe the new footwear has ruined athletics. Even at the Tokyo Olympics 2021, athletes have delivered extreme performances that have been partly attributed to these advanced shoes, as well as a high-tech track that they ran on. Critics, however, allege that using the super footwear, first developed by the American multinational Nike and now adopted by several competitors, amounts to ‘technological doping’.

What are ‘super shoes?

In 2017, Kipchoge made his first attempt to break the two-hour barrier but fell short by 26 seconds. Back then, it was believed that the version of the shoe which he wore would have given him an advantage. These shoes were called the Vaporfly Elite. The Vaporfly series of shoes by Nike, lab tests have shown subsequently, helps an athlete save four per cent more energy than a competitor who does not wear them. Two weeks before Kipchoge’s feat in Vienna, Ethiopian great Kenesisa Bekele, another runner who used the Vaporfly, came within two seconds of the former’s world record. A day after the two-hour barrier fell, Kenya’s Brigid Kosgei broke the 16-year-old women’s record at the Chicago marathon. Later, track spikes — shoes that have spikes underneath to give runners a grip — also became more technologically advanced as marathon shoes did before them, as per a report in New Scientist. As per the report, both super shoes and super spikes combine a unique foam with a rigid carbon-fiber plate.

Unlike traditional spikes, which have tried to lessen the amount of midsole foam in order to decrease weight and energy absorption, super spikes have a better foam that is able to return as much as 80 to 90 per cent of energy to the athlete– thus acting like a spring in every step. The carbon-fiber plate in super footwear is believed to allow athletes a more effective push-off.

World Athletics, the governing body for track and field sports, approves “super shoes”, but with regulations on foam thickness, as well as other parameters. The two new research papers, one from World Athletics and another from Cornell University, reinforce prior research indicating that super shoes have improved marathon performances by 1 to 3 minutes.  

Along with “super shoes”, the track specifically engineered for Tokyo that the athletes ran on is also believed to have increased their speed. As per the New Scientist, the track, whose surface required three years to be completed, has been tuned to allow shock absorption and energy return– working like the foam in super spikes.

So, what explains the ‘technological doping’ complaint?

While the technological advancements in shoes have been welcomed by many for the transformative effect they have had on track and field events, there are others who have been less enthusiastic.

Some athletics purists insist that running should only involve human effort, not a combination of human effort and technology. Essentially, they assert that athletes should be rewarded for their endeavor, and not for their choice of footwear.

The debate is especially charged when it comes to elite sports, when even a small difference in technology can be the deciding factor in tight races. Critics ask how it would be possible to accurately assess an athlete’s individual effort in a race by separating it from the boost received from high technology shoes.

There also remain concerns about the high cost of super shoes — which could effectively erase chances of poorer athletes excelling in track and field.  

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Section-10

High heels and flat shoes:    

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High heeled shoes, also known as high heels or simply heels, are a type of shoe in which the heel is tall or raised, resulting in the heel of the wearer’s foot being significantly higher off the ground than the wearer’s toes. High heels make the wearer appear taller, serve to accentuate the muscle tone in the legs as well as make the wearer’s legs appear longer. Wearing heels make women look more stylish, confident and tall.

High-heeled shoes (high heels) are a powerful symbol of modern female sexuality that have been shown to increase women’s attractiveness to men and influence men’s behaviour towards women in experimental studies. It has been suggested that this effect may result from an exaggeration of prototypical feminine gait. Compliance to social norms is a key driver of human behaviour and fashion, and use of high heels is a clear manifestation of this. Being associated more with occasions than non-occasions, use of high heels may be seen as highly desirable and even compulsory at certain workplaces and social events.

The original function of shoes to protect the foot from the rough surface of the ground, weather, and the environment, and to increase the efficiency of walking has now been replaced by the aesthetic effect of high heeled shoes. These days, high heels are preferred for fashion, to increase height, or to follow modern trends. Hence 59% of women wearing high heels wear them for 1 to 8 hours per day. Some women wear them for more than 10 hours continuously per day.

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Advantages of wearing Heels:

A pair of high heeled shoes has been a good friend of women since hundreds of years. Wearing high heels is an evergreen style statement indeed. Have a quick look at the advantages of wearing heels:

Tall Look

Wearing heels help to increase the height by 5-6 inches to the maximum. This is helpful for the women who love tall look. Most of the women like to feel attractive by having a tall look by wearing heels. Women also feel smart and in a proper shape by wearing heels.

Style

High heels give a stylish look to the overall physical appearance of women. Nothing can look sexier with a mini fitting skirt than high heeled boots.

Good Body Posture

After wearing heels women get a feeling of having a good posture. Heels help to bring out and attractive body posture. It also adds to the confidence of the women while carrying her self. The exception to this is the woman who rarely wears heels. Some women may fall in embarrassment if they wear very high heels for the first time. If you buy a pair of high heel sandals do practice walking at home with them. This will help you to avoid possible awkwardness when you actually go out.

Good looking legs

Heels help to enhance the beauty of your legs. Those who like to wear short skirts can make their legs look more gorgeous with the help of stunning heels. Heels make legs look longer and shapelier.

Complementary to Clothes

Heels compliment the attractiveness of the clothes. Box or conical heels go well with the corporate attire. Pencil heels make the minis or tunics look more striking. Wearing platform heels with trousers or wide bottom jeans will give a cool look. If you do not want to show off your heels but look tall wear it with saris or long skirts.

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High heels and your health: 

Concerns regarding the potential impact of high heels on women’s health have been expressed in medical circles for over 50 years and in 2001 podiatrist William Rossi declared footwear to be the primary cause of foot disorders. High heels can often cause ankle sprains and back and lower extremity pain. They also cause shortening of the Achilles tendon, an increase in oxygen consumption, and a decrease in stride length and gait velocity. It is also reported that high heels change the joint mobility of the knees, which can cause degenerative arthritis. Because the contact surface of high heels on the ground is small, instability of the ankle is increased and the position sense is decreased. Therefore, high heels can cause joint problems.

The aesthetic appeal may come at a price – pain in the heel of the foot and posture problems that may cause problems later in life. That’s the conclusion of researchers from the United States who completed a study of foot pain among a group of 1900 women and 1500 men. The team from Boston University School of Public Health found that ill-fitting shoes are the main cause of foot pain – and high heels are the worst offenders. The researchers, who published their findings in the journal Arthritis Care and Research, learned this after asking the men and women about any foot pain they experienced and correlating it with information about the style of shoes they wore both currently and in the past.

For simplicity, shoe types were divided into three categories:

-1. “good” (these shoes had firm non-flexible soles and good support at the back of the shoe, this included athletic shoes and casual sneakers)

-2. “bad” (these shoes lacked support and structure such as high-heeled shoes, sandals, and slippers)

-3. “medium” (shoes with an intermediate level of support including hard- or rubber-soled shoes and work boots).

Overall, foot pain is common, they found; it was reported by about three-quarters of subjects at some time. But it was more common among women, and especially among women who wore “bad” shoes. “Good” shoes however were protective, with women who favoured wearing them 67 per cent less likely to report foot pain than those who favoured wearing medium shoes.

Unnatural posture:

The problem with high-heeled shoes is that they place the foot into an unnatural position, affecting both the foot and posture, the researchers say. Not only can prolonged periods of walking in high heels place stress on the back and neck, it can cause permanent postural changes. The high-heeled shoe also places greater pressure on the forefoot, which can cause a build-up of calluses. And if they have pointed toes, these can cause deformities including bunions, claw toes, corns and thickening of the nails. When you wear high heels, your center of gravity is moved forward about 10 centimeters. Postural muscles in the back became overused and this can cause lower back and sometimes neck pain.

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High heels are source of Multiple Troubles: 

Perhaps the single most visible difference between the shoeless and the shod foot is the elevated heel under the shoe. The numerous influences of the shoe heel on the foot and body column are not fully understood by most medical practitioners. The practitioner commonly speaks of “sensible” heels. Such a heel does not exist. Any elevated heel under a shoe automatically initiates an altered series of foot and body biomechanics.

Standing barefoot, the falling line of body weight normally forms a perpendicular, a 90-degree angle with the 180-degree angle of the foot’s plantar surface. Body weight is distributed 50-50 between heel and fore-foot. (Figure below) The moment any heel elevation, even the most minimal, is applied to the shoe, the normal 90-degree perpendicular of the body column and falling line of body weight is altered

Figure above shows weight distribution on foot in standing, barefoot versus high heels.

The higher the heel the greater the body column change. The heel on a man’s shoe is about one inch in height. On women’s shoes it varies from 1 to five inches—and up to six inches in more extreme footwear styles. If the body column was a single, unjointed column, then even a one-inch heel under the foot could cause the rigid body column to tilt forward or even fall. Like the Leaning Tower of Pisa, only a few inches tilt at the bottom results in a lean of several feet at the top. (Figure below)

Left, normal body column stance barefoot; center, tilt of body column on medium heel if body was a rigid column; to regain erect stance, column makes “adjustments” to create new body profile.

But the body column is a series of adaptable joints and connecting sections: ankle, knee, hip, pelvis, spine, shoulders, neck and head. Unlike the rigid column of Pisa, the body column sections make “adjustments” to maintain an erect stance. With each sectional adjustment there is a shift in the body’s center of gravity (normally about hip height). With the shift of gravity there are corresponding shifts in the line of falling body weight both in standing and walking, resulting in shifts in the path of weight distribution throughout the foot, beginning with the rearfoot. The muscles and ligaments associated with the body column and foot system must also make compensatory changes. Considering that the “simple” act of walking involves half the body’s 650 muscles and 208 bones, the number of automatic “adjustments” is enormous. Inevitably, a toll must be taken, most commonly leg and back aches and, of course, foot aches. High heel shoes lead to unequal weight distribution which may trigger off pain in the lower back, inflammation, and soreness.

A few key changes occur in the body to accommodate the shift in gravity when high heels are worn regularly. We see the muscles and tendons in the legs shorten, the pelvis tilts forward, the curve of the lower back becomes exaggerated, and the upper body leans backward. The long-term effects of high heels contribute to back pain, neck pain, headaches, knee pain, and inflammation in the shortened tendons of legs and buttocks.

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Researchers at Harvard University headed by physiatrist D. Casey Kerrigan, reported in the May, 1998 issue of Lancet, on women walking barefoot and again on 2-inch heels. Barefoot, they found, the weight is shared equally by the lateral and medial surfaces of the knee joint. But on the 2- inch heels the weight was shifted, resulting in a 23 percent increase of weight borne in the center of the knee joint. Kerrigan’s report concluded, “The resulting strain on the knee joints, if frequent or habitual, could well be a contributing cause of degenerative arthritis in the knee joints.” On a medium to higher heel, the increased bowing of the long arch is accomplished in part by a contraction or shortening of the plantar fascia as foot heel and ball are drawn closer together. The plantar fascia now becomes more vulnerable to strain and tearing when lower or flat heels are worn, or with some traumatic foot action that causes an acute pull on the fascia. There certainly appears to be some correlation between elevated heels and plantar fasciitis. If there is a shift in body weight distribution throughout the foot because of the elevated heel, it would seem to follow also that the bursa under the calcaneus would be affected, resulting in heel soreness or pain. It is a dogma of footwear fashion that thin, curvy medium to higher heels are always accompanied by pointed-toe shoe styles. Higher heels and broad or round toes are esthetically incompatible. It is only when the higher heel is chunky or heavy looking that the round or broad toe is acceptable. Thus the classic high heel has a double barreled effect, front and rear.

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Postural effects:

In a 2016 study from the Sahmyook University in Korea, researchers wanted to investigate the effects of high heels on the activation of muscles in the cervical and lumbar portions of the spine which refers to the neck and lower back. Thirteen women were recruited to walk down a walkway in three different testing conditions: barefoot, in 4 cm heels and in 10 cm heels. Surface electrodes were placed on the muscle mass of the women’s spines as well as their feet to measure the electrical activity of muscles at different points of movement. The results of the study indicated an increase in both cervical and lumbar muscle activation as heel height increased. The cervical spine, the neck, assists in maintaining head stability and postural control in the body. The usage of high heels shifts the body’s center of mass which forces the spine to adjust itself in order to maintain balance. The researchers mentioned that over time these results would increase local muscle fatigue that could lead to muscle swelling, decreased muscle movement and even tissue deformation.

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Shortened Achilles Tendon: 

All shoe-wearing people have a shortened Achilles tendon. It begins at about age three or four when tots are wearing footwear with heels three eighths to one-half inches in height. (Figure below) It continues and accelerates into the early puberty years when reaching one inch in height (oxfords, loafers, sneakers, etc.). Few people, including medical practitioners, realize that, relative to body height, a one-half inch heel for a tot or a one-inch heel for a nine-year-old is the equivalent of a two-inch heel for an adult. By the mid or late teen years most girls are into high (two inches or more) heels. By this time the shortening of the heel tendon and calf muscles has become firmly established.

What are the future consequences? In the case of women who become habitual wearers of higher heels, there usually develops the classic aching of calf muscles and heel tendon syndrome, especially when there are shifts to lower heels or, for example, in an aerobics class, resulting in stretch or stress of the calf muscles or the tendon.

Second, the bursa behind the calcaneus serves as a buffer zone between the tendon and the bone. Any change in the length and function of the tendon resulting from the elevated shoe heel is going to affect the bursa itself.

Thirdly, the lower leg, normally on a perpendicular with the 180-degree plane of the bare foot on the ground to form a 90-degree angle, now on a higher heel tilts forward, reducing the leg angle to, say, 70 degrees. Some women in elevated heels learn to maintain the 90-degree angle by keeping the knees “locked” with each step. But most allow the lower leg and knee to angulate. A profile view of the gait quickly reveals this. The result: body weight is no longer falling normally onto the foot, but is moved forward onto the forefoot.

In all ground-linked sports the Achilles tendon plays a vital role, especially where there are quick and violent foot torsions, such as in basketball, football, tennis, etc. Hence a shortened heel tendon would seem to have some influence on athletic performance. We tend to overlook this because most athletes are shoe wearers and have the same heel tendon shortening. But when athletic performance is compared with shoeless athletes, then the difference in tendon length can show itself dramatically. For example, over the eight years l99l-1998, all the winners in the classic Boston marathon were Africans. In 1998, five of the top 10 finishers were Africans. The same pattern appears in other marathons where the Africans have participated over the past decade. Most of these African runners grew up shoeless, and many continue to train shoeless in their native countries. All, consequently, would likely have normal, full-length Achilles tendons and calf muscles. This would seem to have enormous influence on stride and stamina in a marathon run where there are approximately 44,000 Achilles tendon and calf muscle “pulls.” The superiority of the African marathoners has nothing to do with race. African-Americans excel in the short sprints up to 400 meters, but not one has ever won a marathon, and few even compete in distances of one mile or more. Like all of us, African-Americans are habitual wearers of shoes with elevated heels (along with the crooked lasts) and hence, presumably, have the same shortened heel tendon and calf muscles.

Top, contrasting effect of elevated heel on foot, Achilles tendon and calf muscles. Tendon is shortened.

Bottom, changes in leg musculature from barefoot to low heel to high heel.

A study found that women who wore high heels five times a week for two years had calf muscles that were 13 per cent shorter and Achilles tendons that were stiffer and thicker than those who did not wear heels.

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Achillis tendinitis:

Whether they’re sky-high or not, this style can give you a painful knot on the back of the heel. The rigid material presses on a bony area some women have called a “pump bump,” which is permanent. Haglund’s Deformity, also called ‘pump bump’ is identified when there is a bony enlargement on the back of your heel. In fact, the soft tissue next to your Achilles tendon gets irritated when this bony enlargement tends to rub against your high heel shoes. The pressure leads to blisters, swelling, bursitis, and pain in the Achilles tendon. Ice, orthotics, and heel pads may provide pain relief — along with better shoes.

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Unnatural Foot Position:

Ultra-high heels force the feet into a position that puts stress on the ball of the foot. At this joint, the long metatarsal bones meet the pea-shaped sesamoid bones and the toe bones (phalanges). Too much pressure can inflame these bones or the nerves that surround them. Chronic stress to the foot bones can even lead to hairline fractures.

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Ankle Sprains:

All high heels boost the risk of an ankle sprain. The most common, a lateral sprain, happens when you roll onto the outside of the foot. This stretches the ankle ligaments beyond their normal length. A severe sprain may tear those ligaments.

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Vein swelling: 

Further research reveals that another possible consequence of wearing high heels is an increase of pressure in one’s veins. Experiments have proven that the higher the heel, the “higher [the] venous pressure in the leg.” High heels reduce muscle pump function. The continuous use of high heels tends to provoke venous hypertension in the lower limbs and may represent a causal factor of venous disease symptoms. This means that after repeated use of high heels, varicose veins and other undesirable symptoms are much more likely to appear in the legs.

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The annual value of shipments of female non athletic shoes in the United States of America was $263 million in 2002. It has also been shown that 37% of women wear high-heeled shoes for work. Women that are regular wearers of high heels i.e. they wear high heels at least 3 times a week, can expect: shortened gastrocnemius medialis fascicle length,  increased Achilles’s tendon stiffness, reduced ankle active range of motion, increased risk of lateral ankle sprain, reduced medial gastrocnemius muscle efficiency, increased shock wave from heel strike and ‘metatarsal strike’, subchondral bone microfractures (which would lead to articular cartilage degeneration and osteoarthritis) and increased risk of Hallux valgus and plantar calluses. All of these conditions are a result of the altered distribution of plantar pressures or the restricted movement of joints that are the result of with walking in high heeled footwear. Virginia University researchers found that even shoes with heels of about 1.5 inches place 14% more strain on your feet.  It has been demonstrated that when the high pressures produced by wearing high heels are applied to a forefoot that is affected by diabetes there is an increased risk of ulceration. Even in the absence of disease, forefoot pain has been reported as synonymous with increased plantar pressure. Thus, high heeled footwear has been strongly associated with poor foot health.

Wearing high-heeled shoes is strongly associated with injury, including injury requiring hospital care. There is evidence that high-heel-wearers fall more often, especially with heels higher than 2.5 cm, even if they were not wearing high heels at the time of the fall.  Moreover, the potential for high heels to inflict injury both on the wearer and on bystanders should be considered. For example, Williams and Haines identified 240 emergency department (ED) presentations over a 5-year period in the Australian state of Victoria resulting from first-party injury from high heels and a further 65 resulting from second-party injury from high heels. Since pressure is inversely associated with the cross-sectional area through which a force is applied, the potential for high heel shoe wearing to result in injury to both the wearer and on bystanders should be considered.

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Long-term use of high-heeled shoes alters the neuromechanics of human walking, a 2012 study:

Human movement requires an ongoing, finely tuned interaction between muscular and tendinous tissues, so changes in the properties of either tissue could have important functional consequences. One condition that alters the functional demands placed on lower limb muscle-tendon units is the use of high-heeled shoes (HH), which force the foot into a plantarflexed position. Long-term HH use has been found to shorten medial gastrocnemius muscle fascicles and increase Achilles tendon stiffness, but the consequences of these changes for locomotor muscle-tendon function are unknown. This study examined the effects of habitual HH use on the neuromechanical behavior of triceps surae muscles during walking. The study population consisted of 9 habitual high heel wearers who had worn shoes with a minimum heel height of 5 cm at least 40 h/wk for a minimum of 2 yr, and 10 control participants who habitually wore heels for less than 10 h/wk. Participants walked at a self-selected speed over level ground while ground reaction forces, ankle and knee joint kinematics, lower limb muscle activity, and gastrocnemius fascicle length data were acquired. In long-term HH wearers, walking in HH resulted in substantial increases in muscle fascicle strains and muscle activation during the stance phase compared with barefoot walking. The results suggest that long-term high heel use may compromise muscle efficiency in walking and are consistent with reports that HH wearers often experience discomfort and muscle fatigue. Long-term HH use may also increase the risk of strain injuries.

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High-heeled shoes and musculoskeletal injuries: a narrative systematic review 2016:

Objectives

To conduct the first systematic review from an epidemiological perspective regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, osteoarthritis (OA) and both first-party and second-party injury in human participants without prior musculoskeletal conditions.

Results

644 unique records were identified, 56 full-text articles were screened and 18 studies included in the review. Four studies assessed the relationship with hallux valgus and three found a significant association. Two studies assessed the association with OA and neither found a significant association. Five studies assessed the association with musculoskeletal pain and three found a significant association. Eight studies assessed first-party injury and seven found evidence of a significant injury toll associated with high-heeled shoes. One study provided data on second-party injury and the injury toll was low.

Conclusions

High-heeled shoes were shown to be associated with hallux valgus, musculoskeletal pain and first-party injury. No conclusive evidence regarding OA and second-party injury was found. Concern is expressed about the expectation to wear high-heeled shoes in some work and social situations and access by children.

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Health effects And Psychosexual Benefits of wearing high heels: systematic review of reviews, 2017:

Background:

High-heeled shoes (high heels) are frequently worn by many women and form an important part of female gender identity. Issues of explicit and implicit compulsion to wear high heels have been noted. Previous studies and reviews have provided evidence that high heels are detrimental to health. However, the evidence base remains fragmented and no review has covered both the epidemiological and biomechanical literature. In addition, no review has considered the psychosexual benefits that offer essential context in understanding the public health challenge of high heels.

Results

A total of 506 unique records were identified, 27 full-text publications were screened and 20 publications (7 reviews and 13 additional studies) were included in evidence synthesis. The most up-to-date epidemiological review provides clear evidence of an association between high heel wear and hallux valgus, musculoskeletal pain and first-party injury. The body of biomechanical reviews provides clear evidence of changes indicative of increased risk of these outcomes, as well as osteoarthritis, which is not yet evidenced by epidemiological studies. There were no reviews on psychosexual benefits, but all five identified original studies provided evidence of increased attractiveness and/or an impact on men’s behaviour associated with high heel wear. With regard to second-party injury, evidence is limited to one descriptive study and eight case reports.

Conclusions

Authors’ evidence synthesis clearly shows that high heels bring psychosexual benefits to women but are detrimental to their health. In light of this dilemma, it is important that women’s freedom of choice is respected and that any remaining issues of explicit or implicit compulsion are addressed.

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High heel policy:

A high heel policy is a regulation or law about the wearing of high heels, which may be required or forbidden in different places and circumstances. Historically in the West high heels were associated with aristocrats for cosmetic reasons, to emphasize social status among an elite who could afford to wear impractical footwear, to raise their height, or to keep feet and long dresses clean. The style was then subject to sumptuary laws. In more modern times, stiletto heels have been restricted when they might damage the floor surface or cause accidents. Some dress codes, however, require women to wear high heels so that they appear to be taller and more attractive. Such footwear may be painful and damage the feet, and there have been repeated protests by women workers against such policies. In 2016, a British receptionist was dismissed for not wearing high heels and she then started a petition which attracted sufficient support to be considered by the UK Parliament.

High heels have been restricted by law and policy in various places such as schools, museums, and localities such as Mobile, Alabama. In this case, the sign below forbids them on Stearns Wharf in Santa Barbara, California.

In April 2017 the Canadian province of British Columbia amended workplace legislation to prevent employers from requiring women to wear high heels at work. Other Canadian provinces followed suit. The Philippines forbade companies from mandating that female employees wear high heels at work in September 2017. The #KuToo campaign in Japan collected over 150,000 signatures on a petition for a ban on mandatory high heels. The government said that they had no plans to change. Japan’s labor minister commented that high heels are “necessary and appropriate” for women.    

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Zero-drop and Flat shoes: 

Traditional footwear elevates the heel an average of 14-24mm, which throws off the alignment of the spine and forces an unnatural heel strike. In a zero-drop shoe, your heel and toes are level, which mimics your natural barefoot position on a flat surface. Zero-drop shoe can be minimalist, maximalist or even conventional shoes.

A study in 2012 from Harvard Medical Publishing mentions that the high heels users will usually have shorter steps, flexed toes, and also calf muscles shrink so that the feet are more susceptible to injury. Therefore, it is important for you to choose the ideal shoe for maintaining body health, especially muscle. According to information on the Harvard Medical Publishing page, the criteria of an ideal shoe are to have a wide and non-pointed tip, soft material, and flat surfaces.

Wearing flat shoes has its own advantages for your health. Here are the following reasons:

-1. Flat shoes will make the spine remain straight, unlike the high heels that can cause the spine bends.

-2. The flat surface will make the calf muscles become more relaxed.

-3. Flat shoes can help the body weight distributed evenly on the soles of the feet.

-4. Flat shoes are also comfortable; it makes you free to move, does not make you tired, gives you security while walking, and more environmentally friendly.

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Flats is a footwear which is not high-heeled. Flat shoes come in many forms. Ballet flats are women’s shoes for everyday wear which are similar to/inspired by a women’s ballet shoes, with a very thin heel or the appearance of no heel at all. Flat tennis shoes give you a bouncy look and feeling, while flip flops are easy to kick on and off.  Although wearing flat shoes are better than high heels, you still have to rethink about them. Although comfortable, flat shoes without arch support, ankle support and cushioning can harm feet.

Ballet Flats:

Ballet flats are very popular, but they can actually seriously injure your feet over time because they provide no arch or ankle support. You won’t get any arch support from these shoes. That can lead to knee, hip, and back problems. Poor arch support can also cause a painful foot condition called plantar fasciitis.

Solution: Orthotic Inserts:

If you love the look of ballet flats, over-the-counter inserts may help prevent mild foot pain. Heel pads can provide extra cushioning for achy heels. And custom orthotics can ease a whole range of foot pains and problems. Podiatrists prescribe these inserts to provide arch support and reduce pressure on sensitive areas. Prescription orthotics can be pricey, but insurance sometimes covers them.  

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We’ve heard stories about high heels being bad. It’s a proven fact that high heels can cause several ailments related to the knees, back and spine. And when it gets too much to handle, most people simply switch over to flat shoes. But Flat Shoes may cause many problems:

-1. Wearing tight shoes with pointy toes – even with flat heels – puts too much pressure on toenails. This can cause the nails to bend and become ingrown into surrounding tissue. Make sure that flat shoes have plenty of wiggle room for the toes.

-2. Heel pain caused by wearing flat, non-supportive shoes may be plantar fasciitis, or inflammation of the plantar fascia (figure below). This thick tissue runs along the bottom of the foot from the heel bone to the toes. Wearing flat, unsupportive shoes like ballet slippers and flip flops may cause the arches to drop and tendons and ligaments to overstretch or even tear. If you wear flat shoes, make sure they have sturdy soles with adequate arch support.

A band of tissue called the plantar fascia runs along the bottom of the foot. It pulls on the heel when you walk — and it works best with the proper arch in your foot. Walking in flimsy shoes without good arch support can overstretch, tear, or inflame the plantar fascia. This common condition can cause intense heel pain, and resting the feet only provides temporary relief.  According to the Mayo Clinic, plantar fasciitis “is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes.”

-3. Walking with flat shoes that have thin, unsupportive soles causes excessive pressure on your heel bones. This can lead to blisters on your Achilles tendon when the back of the shoe rubs repeatedly against your heel. Surprisingly, this problem often results from a lack of sole support. Choose low-heeled or block-heeled shoes instead of those that are completely flat. Shoes with sturdy, thick heels that are not too high may be better for your foot health than shoes that are completely flat. 

-4. Flat shoes lag in adequate cushioning. This can lead to long-term heel issues. The most vulnerable thing is the misalignment of the pelvis, knees, and spine. So, if you are going to buy a super flat shoe, have a look at this issue. Besides, there are many inserts that can be used in your flip-flops. So, rather than returning your shoe, you can use them with supportive inserts.

-5. Lack of Shock Absorption is the biggest problem with the flip-flops. As they are flat and comes with unsupportive soles, they can make you feel every impact with the ground. This can make your heel bones burnt with every impact and end up with an enormous problem. When this happens, you will notice several painful blisters on your feet. So, it will be better if you select a low heel or block heel shoe instead of the flats.

In a nutshell

The flat shoes with no shock-absorbing capability, arch support, the cushion is really bad for you. If you wear flat shoes constantly, it can lead you to several issues like plantar fasciitis, back pain, and more. According to some foot experts, cheap flat shoes are equally harmful, like high heels.

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Flip-Flops Foot Problems:

Your feet will get very little protection, so cuts, splinters, and other foot injuries are a risk. Plus, many flip-flops provide no arch support. Like ballet flats, they can worsen plantar fasciitis and cause problems with the knees, hips, or back.

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Flip-flops, also known as shoe thongs in some areas, don’t offer any arch support for your foot. Because the sole of flip-flops is thin rubber or another material, your foot is as flat as possible — which, for most people, is not ideal. You can suffer from arch and heel soreness, as well as foot pains and excessive pressure. The footwear also doesn’t provide any protection for your feet and has no heel cushioning. Instead, a thin rubber material acts as the sole of the shoe. Because your heel often has less than one inch of protection from the ground, flip-flops don’t offer shock absorption. When you’re walking, your feet endure extreme amounts of force. When you wear a shoe thong with no arch, ankle or heel support, protection or shock absorption, you can suffer from foot pain, sprained ankles or tendinitis. If you wear flip-flops for extended periods, you increase the risk of foot injuries, discomfort and other bodily sorenesses. Several adverse effects of wearing flip-flops include blisters, foot fungus, balance issues, strained or overextended tendons, shooting pains, plantar fasciitis, foot swelling and more.

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Flip-flops can cause problems with arches and heels. Their lack of protection means toes can be badly injured if someone steps on them, or drops something on your foot.

Falling Objects:

When you wear flip-flops, your toes and feet are exposed, making them susceptible to falling objects or people stepping on your toes. Doctors are seeing more nail injuries and broken or bruised toes, which wouldn’t happen if you covered the front of your feet.

Thin Soles:

Flip-flops don’t offer much in the way of support: no arch support, no heel cushioning, and no shock absorption. That can cause foot pain, tendonitis, and even sprained ankles if you trip.

Thong Effect:

The Auburn study indicates that the thongs in the middle mean you have to grip the shoe to keep it on. The thong can actually rub against the skin and causes ulcerations and sores. Also, when you have a toe thong, you tend to grip the shoe with your toes to try and keep it on. That alters your gait and puts strain on muscles you don’t normally use when you walk in regular shoes.

Also, a recent study found that men and women who wear flip-flops actually strike the ground with less force than when they wear sneakers, again altering the way you walk and causing you to take shorter steps, which may account for why people who wear them for extended periods experience lower leg pain and have more heel problems, such as heel spurs (little bony growths on the heel) and plantar strain (inflammation of the sheet of tissue covering the bottoms of the feet).

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At best, moderation will help you avoid these discomforts. Wear flip-flops only when you find it most necessary. For example, wearing shoe thongs to the beach, pool, spa or public shower is often practical. However, they are not ideal for extensive walking or hiking activities. Try to avoid walking long distances, and wear them for shorter periods of movement like running errands. Continuously wearing flip-flops can affect various parts of your body, such as your posture, toes, skin, heels and arches.

While the U.S. has very few statistics related to flip-flip footwear, the Journal of the American Podiatric Medical Association found that footwear affects your stride length. Wearing flip-flops causes you to take shorter strides compared to sneakers. They also found that flip-flops increase peak plantar pressures, putting your feet at risk for plantar fasciitis and other abnormalities.

Flip-flops offer very little protection. The risk of getting splinters or other foot injuries is higher when the feet are so exposed. People with diabetes should not wear flip-flops, because simple cuts and scrapes can lead to serious complications.

Better: ‘Fitted’ Flops:

The thick sole keeps your foot off the ground and away from things that could cause cuts. And this type of shoe can have really good arch support. Some have a seal of approval from the American Podiatric Medical Association.

Instead of flip-flops, wear fitted flops as seen in the figure above. 

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Moderate Heel Height:

According to Pauline Fu, DPM, a doctor of podiatric medicine and an assistant clinical professor of orthopedics at Mount Sinai hospital in NYC, shoes with a slight heel are best. The fact that your heels are slightly elevated allows your ankle to turn a little bit and rotate differently. A heel that’s the same height as or lower than the toe of the shoe, on the other hand, affects the way your leg — and, in turn, your pelvis — turns. That, then, will affect your spine and lower back and cause back pain, Dr. Fu says.

What qualifies as a “slight” heel? Bryon Butts, DPM, a doctor of podiatric medicine at Performance Footcare in New York City, points out that the recommendation from the American Podiatric Medical Association is something under 2 inches and never anything higher than that. Fu notes that 2-inch heels have been shown to alleviate the pressure on your feet while walking. The ideal range, she says, is between 1 and 2 inches. Anything over that will not be kind to your back. While heel height is more typically a concern when it comes to women’s shoes, the concept of heel height as a positive applies to men as well, Fu says. That said, she also points out that most men’s shoes are neutral in heel height, so the heel and toe are on the same level — and that men have a lower incidence of back pain than women.

Muscular and occupational therapist Dr Preeti Jadhav says, “Modest heels of about one or one and a half inch can improve alignment of the lower back reducing the risk of lower back pain. It also helps people with straight backs as it restores a healthy curve and eases tension in the muscle. For total comfort while walking, one must stick to the one to one and a half inch heel rather than wearing the absolute extremes.”

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Section-11    

Corrective and Prescription Shoes: Therapeutic footwear (Orthopedic shoes):    

In a new study, scientists from Staffordshire University’s Centre for Biomechanics and Rehabilitation Technologies have established recognized terms, definitions, design characteristics and prescription criteria for off-the-shelf stability footwear for the first time. Specialist footwear is often prescribed to help children with a range of conditions including cerebral palsy, pes planus, toe walking, Duchenne muscular dystrophy, spina bifida, Down’s syndrome and intoeing. However, despite its widespread use there is a lack of common understanding of how to define and characterize this intervention. Numerous terms have been used in the literature concerning clinical footwear interventions, including orthopedic shoes, rehabilitative boots, modified shoes, supportive shoes and special shoes.  A group of multinational professionals, from clinicians to those involved in the footwear industry, were recruited to take part in an online survey and to provide further insights through a series of open-ended questions. “Therapeutic footwear” was the agreed term to represent children’s footwear interventions, with grouping and subgrouping of therapeutic footwear being dependent on their intended clinical outcomes: accommodative, corrective or functional. Design characteristics of off-the-shelf footwear were also grouped under three themes: stability, ergonomics and esthetics.

This is believed to have many benefits including: 

-A common understanding of therapeutic footwear terminology to facilitate communication between clinicians, researchers and manufacturers.

-Research-informed evidence for selection of appropriate off-the-shelf stability therapeutic footwear based on identified design characteristics.

-Research-informed evidence for dispensing off-the-shelf stability therapeutic footwear to patients.

-Standardized outcome measures for clinical assessment of the effectiveness of off-the-shelf stability therapeutic footwear interventions.

The development of recognized terms, definitions and characteristics afford an understanding of how therapeutic footwear should work, the value it should provide, who should benefit, how to measure its success, what risks are present and what is and is not included within the intervention. This study has achieved an expert consensus where none previously existed, which is important from both a manufacturing and clinical perspective. This is a huge step forward which will lead to quicker, more personalized and more effective treatment for children with mobility issues.

The term therapeutic footwear can also be used for any medical footwear interventions for adults. There is evidence to indicate that therapeutic footwear can help prevent lower extremity amputation in patients with diabetes.

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The therapeutic shoes and inserts must be prescribed by a podiatrist or orthopedist, or another qualified professional described below:  

-An orthotist is a healthcare professional who specializes in the provision of orthoses.

-A prosthetist is a healthcare professional who makes and fits artificial limbs (prostheses) for people with disabilities.

-A pedorthist is a professional who has specialized training to modify footwear and employ supportive devices to address conditions which affect the feet and lower limbs.

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Orthotics and orthoses:

Orthotics is a medical specialty that focuses on the design and application of orthoses. An orthosis (plural: orthoses) is “an externally applied device used to influence the structural and functional characteristics of the neuromuscular and skeletal system”.  Orthoses are grouped according to their function. There are paralysis orthoses, relief orthoses and soft braces.

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Foot orthoses: (commonly called “orthotics” or inserts):

Foot orthoses (orthotics) are devices inserted into shoes to provide support for the foot by redistributing ground reaction forces acting on the foot joints while standing, walking or running. Orthotics, also known as orthoses, refers to any device inserted into a shoe, ranging from felt pads to custom-made shoe inserts that correct an abnormal or irregular, walking pattern. Sometimes called arch supports, orthotics allow people to stand, walk, and run more efficiently and comfortably. Orthotics is a “catch-all” term that refers to just about any device that can be worn inside a shoe. They can be bought at retail stores, online or made to measure. The custom molded varieties are fit by specialists who can design a device that will provide the precise characteristics to provide relief from pain, make walking easier, treat fallen arches and reduce the risk of injury to patients. Orthotic devices come in many shapes, sizes, and materials and fall into three main categories: those designed to change foot function, those that are primarily protective in nature, and those that combine functional control and protection. A great body of information exists within the orthotic literature describing their medical use for people with foot problems as well as the impact “orthotics” can have on foot, knee, hip, and spine deformities. They are used by everyone from athletes to the elderly to accommodate biomechanical deformities and a variety of soft tissue conditions.

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Inserts vs. orthotics:

Inserts that you can buy in stores without a prescription can provide cushioning and support. They may be made of materials like gel, plastic, or foam. Inserts fit into your shoes. But they’re not custom-made for your feet. They can provide arch support or extra cushioning on the heel, around the toes, or for your entire foot. Inserts might make your shoes more comfortable but aren’t designed to correct foot problems.

Orthotics are prescription medical devices that you wear inside your shoes to correct biomechanical foot issues such as problems with how you walk, stand, or run. They can also help with foot pain caused by medical conditions such as diabetes, plantar fasciitis, bursitis, and arthritis. Orthotics might even help you avoid surgery to fix flat feet.

Both over-the-counter inserts and custom orthotics should fit the contours of your shoe and feel comfortable. A packaged insert that rubs your foot in the store won’t get better at home. Prescription orthotics made from molds of your feet should fit quite well. If they don’t, tell your podiatrist.

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Types of orthotics:

Rigid Orthotics:

Rigid orthotic devices are designed to control function and are used primarily for walking or dress shoes. They are often composed of a firm material, such as plastic or carbon fiber. Rigid orthotics are made from a mold after a podiatrist takes a plaster cast or other kind of image of the foot. Rigid orthotics control motion in the two major foot joints that lie directly below the ankle joint and may improve or eliminate strains, aches, and pains in the legs, thighs, and lower back.

Soft Orthotics:

Soft orthotics are generally used to absorb shock, increase balance, and take pressure off uncomfortable or sore spots. They are usually effective for diabetic, arthritic, and deformed feet. Soft orthotics are typically made up of soft, cushioned materials so that they can be worn against the sole of the foot, extending from the heel past the ball of the foot, including the toes. Like rigid orthotics, soft orthotics are also made from a mold after a podiatrist takes a plaster cast or other kind of image of the foot.

Semi-Rigid Orthotics:

Semi-rigid orthotics provide foot balance for walking or participating in sports. The typical semi-rigid orthotic is made up of layers of soft material, reinforced with more rigid materials. Semi-rigid orthotics are often prescribed for children to treat flatfoot and in-toeing or out-toeing disorders. These orthotics are also used to help athletes mitigate pain while they train and compete.

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Doctors may prescribe orthotics to treat a number of medical conditions. Examples include:

-Arthritis. Rheumatoid arthritis and osteoarthritis can cause discomfort in the feet and poor positioning that orthotics may help to correct.

-Back pain. Sometimes poor positioning of the feet, such as arches that roll inward, or lack of cushioning can cause pain that orthotics can lessen.

-Bunions. Bunions are painful bumps that can develop at the base of the big toe and cause foot deformities. Orthotics with a wide toe box can help to reduce pressure on the big toe.

-Bursitis. Inflammation of fluid-filled sacs in the heels and toes can cause bursitis pain and discomfort. Orthotics with heel and arch support can help to reduce bursitis discomfort.

-Diabetes. Sometimes, a person with diabetes can lose sensation in their feet, a condition known as diabetic neuropathy. When this occurs, orthotics can help to reduce excess stress and pressure that can lead to foot ulcers.

-Flat feet. Flat feet can cause foot, ankle, and back pain. Orthotics can help to support the feet and promote proper foot positioning.

-Hammer toes. Hammer toes often occur as a side effect of bunions on the big toe. They cause second-toe pain and deformities on the ball of the foot. Orthotics can provide additional support to the feet and reduce the likelihood that hammer toes will worsen.

-Heel spurs. Heel spurs are conditions where excess bone grows on the back or bottom of the heel. Orthotics can support the foot and reduce inflammation.

-High arches. Very high arches can stress muscles in the feet and lead to a number of conditions, such as shin splints, knee pain, and plantar fasciitis. Orthotics can help prevent a person’s feet from rolling excessively inward or outward.

-Injuries. People who’ve experienced trauma to their feet and ankles may require extra support during the healing process with orthotics.

-Plantar fasciitis. Plantar fasciitis is a common cause of heel pain. Doctors may sometimes recommend orthotics to support the heel and foot.

Doctors may also prescribe custom orthotics for people who have positional concerns with their feet or legs. This can include those with underdeveloped leg and foot muscles.

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Things to keep in mind when buying Insoles/Inserts & Orthotics: 

There are two primary considerations when choosing any type of insert or orthotic.

The first consideration is the type of footwear you will wear. Many shoes do not accommodate a full-size insert. To accommodate a full-size insert, that shoe must have a removable insole. Many casual and dress shoes do not have removable inserts. Sandals, heels, and clogs generally will not accommodate any type of insert. Although most athletic shoes have removable inserts, many of those inserts are very thin, and replacing them with a full-size insert will cause the shoes not to fit anymore. This is why the first consideration should always be the type of footwear you plan to wear before selecting any insert or orthotic.

The second main consideration should be the overall use of the insert. If the insert or orthotic is to address a specific ailment, you should strongly consider only wearing footwear that supports the type of orthotic. Some orthotics that will be the best for you, will only work in certain shoes. This is why both must footwear and use must be considered before buying any insole, inserts, or orthotics. Another use of an orthotic could be for improved support. If your primary goal is to add support to your existing footwear, you should consider the footwear over the use in this situation.

Sizing –

Since there is a wide variance in sizing with footwear, the best option is to make sure you have orthotics when you are trying on the shoes you are looking to purchase. For example, if you wear a size 9.5, a size 9 or size 10 might fit best depending on the actual shoe. Another consideration with sizing is the overall width of the shoes. Many shoes have a narrow arch fit which makes orthotics difficult to fit. When the shoe is too narrow in the middle, that shoe is trying to support the arch with the upper of the shoe. Adding an arch support to this shoe will generally cause that shoe to be too tight and make the heel slip. You want to make sure the heel cup of the orthotics sits flat into the heel cup of the shoe, the arch fits nicely into the middle, and the toe extension fits into the forefoot of the shoes without folding up or pinching.

Placement –

You always want to place orthotics at the rear of the shoe with the heel cup seated flat on the inside heel of the shoe. The arch placement should start at the forward portion of your heel and should end just before the joint at your big toe. If the arch support also has metatarsal support, you want the metatarsal pad to sit just behind the bones in the ball of your foot. Correctly placed met pads will usually feel like a small ball in the middle of your foot. If the met pad is placed correctly and appropriately for your foot, that feeling will diminish over time.

Your Arch Type –

All feet fall within a range of three arch types. Those are the low arch, normal arch, and high arch foot. The low arch type is commonly referred to as a flat foot. The high arch type is also referred to as a cavus foot. An easy way to identify your arch type is to take a look at your bare footprint either in soft sand/dirt or on a dry surface after your foot is wet. The lower your arch, the more of your foot will make contact with the ground leaving a fuller imprint. A high arch foot will generally only show the heel and the ball of the foot with no part of the middle of the foot making an imprint. While the flat foot and the cavus foot are the types of feet that usually feel the most immediate relief from arch supports, the normal foot benefits as well. As we age, our tendons and ligaments begin to wear out and the arches of our feet have to work harder and harder. By wearing good arch support you can keep your feet and body supported which helps prevent many issues.

Materials –

Arch supports are made in a wide variety of materials. Most are made with a variety of types of plastics ranging from a hard molded support to a soft foam. There are hundreds of types of varieties used in the manufacture of arch supports. Two of the most popular used materials are EVA and Polyurethane. These are the same types of materials you will find in many running shoe midsoles. The reason why they are commonly used is that they have really good shock absorption and rebound properties. Both of these make for an instant comfort factor. Orthotics made from firmer plastic materials are usually used in the manufacturing of custom-molded orthotics. These orthotics are usually made to correct a foot condition and have maximum support. This is why the firm plastics need to be custom-molded for the individual by a specialist.

Footbed Type –

There are two main types of arch support footbeds. They are full length and ¾ length. A full length is designed to replace an existing insole in a pair of shoes. A ¾ length is designed to go on top of or under an existing footbed.

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Insoles and Orthotics for running shoes: 

Runners want to wear comfortable running shoes that help prevent injuries; however, because running shoes are not custom-made, there will always be a bit of a compromise when it comes to fit. Because each runner’s foot is unique and not even symmetrical with the other foot, it becomes apparent that accommodations may be needed in order to enhance a running shoe’s fit and its function. To customize the fit and function of their shoes, runners turn to insoles and orthotics.

Each pair of running shoes comes with an insole. It is made of EVA or a material combined with EVA to add comfort (shock absorption) and to aid the fit of the shoe. It costs less than 50 cents to manufacture, and it is mostly useless. It is removable, and for a good reason. Most runners remove the inexpensive insole and replace it with a more cushioned or more stable insole that actually has some resemblance to the shape of the human foot. In the past decade, over-the-counter replacement insoles have become a serious revenue generator for running specialty stores. The proliferation of these stores has led to more retail outlets for the sales of insoles, and the insole manufacturers have responded by producing good-quality products for less than $30.

It seems a bit redundant to spend $90 on a pair of shoes and $30 on a pair of insoles when you could just buy a $120 pair of running shoes. The true value of the insole is that it customizes the shoe to the runner’s foot. Thus, the $90 shoe feels closer to a perfect fit than the $120 shoe because it more closely resembles a shoe made from a mold of the runner’s own foot. Not only does the insole aid fit, but current insoles also help correct for poor biomechanics. They can be posted to compensate for pronation factors or high-arched to help prevent plantar fasciitis. They do work well, but they are not for every runner. Many runners can do without insoles because they do not have major biomechanical problems that their training will exacerbate. For those runners who have run a lot of miles in their lives, are training at a high volume, or have chronic injuries, insoles are a viable option. For those runners who do not find relief with an over-the-counter insole, the next step is to visit an expert (certified pedorthist or podiatrist) to obtain custom-made orthotics.

An orthotic device is meant to correct an anatomical or biomechanical abnormality. In theory, an orthotic device realigns the foot strike, which, in turn, alleviates any imbalances or weaknesses through the kinetic chain of events initiated by running. Do orthotics work? Sometimes.

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Shoe supports for problem feet:

If you have foot or ankle problems, you may need to change shoes, make some changes to your existing shoes or use various shoe supports (inserts/orthotics).

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-1. Arch Supports: 

As civilization has evolved, the human race has moved from walking barefoot in soft natural terrain to wearing footwear walking on hard flat surfaces. The natural shape and design of the foot are to step softly into soft terrain. This is why the foot has arches. For most of us, we now wear footwear and walk on hard flat surfaces, so the need for arch support has never been greater!

An arch support is a term used for a large variety of shoe inserts that help support the arches of the foot. This can have a very broad range of devices from a basic pad to a hard graphite custom-molded support. For most purposes, an arch support is an insert that goes into your shoes which helps support the arches of your feet.

Importance of Arch Supports:

Arch supports are becoming more and more important. The foot is not designed to walk on hard flat surfaces. Most footwear has little to no support simply offering protection from debris and the elements. Additionally, footwear choices are now primarily made based on style preferences over functionality. Finding footwear with good support built-in is actually more of a specialty or rarity with the large majority of footwear manufacturers. This is why it has become more important than ever to select the proper supports for the footwear you choose to wear.

One of the most common mistakes someone makes when choosing an arch support is assuming that one arch support will work in any type of shoe. This is a fallacy. Footwear varies widely from high-heeled pumps to ballet flats, to running shoes, to boots, and so on. The type of footwear you plan to wear is the first and most important consideration when choosing an arch support. Certain types of footwear don’t accommodate arch supports. Sandals and backless shoes generally need to have a built-in arch support rather than what is generally considered an arch support as pictured above.

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When properly fitted and used, arch supports can be the best non-invasive treatment for many foot, knee, hip, and back issues.

Plantar Fasciitis – This is one of the most common foot issues people deal with. Plantar Fasciitis is an inflammation of the Plantar Fascia of the foot. This can be caused by wearing poorly fitted shoes, shoes that are too worn, overuse, flattening feet, trauma, and numerous other reasons. The most common symptom of plantar fasciitis is heel pain when you first wake up in the morning or after being seated for a long period then standing up. While the pain is most common in the morning or after being seated, the inflammation is usually irritated because you are not supporting the arch of the foot. This is why arch supports are one of the best possible options for plantar fasciitis sufferers. By supporting the foot all day, you can help the inflammation heal. This is why so many sufferers of Plantar Fasciitis find relief by using orthotics.

Arch Pain – If you are experiencing arch pain, it may be time to start wearing arch supports. Arch pain can be due to underlying problems, or from excessive activity. Arch supports will benefit your feet and whole body, in the long run.

Over-Pronation – Overpronation is when your ankles tend to roll inward while walking. If you notice this or have been diagnosed with overpronation, an insert orthotic will help to keep your ankle and body aligned properly.

Supination – Supination is the motion of your foot rolling outward when you walk. If you supinate when walking, orthotics will help to keep your feet and body aligned.

Standing For Long Periods – If you have an occupation where you are on your feet all the time, you should consider wearing orthotics in your shoes at all times. Wearing insoles will help prevent the occurrence of a more serious foot problem later on.

Heel Spurs – A heel spur feels like a hard rock in your heel. If you suffer or are at risk of getting a heel spur an orthotic will help to alleviate the pain that comes with a heel spur. Orthotics help to evenly distribute pressure and doing this will also help to lower your risk of the heel spur getting larger and more painful.

Morton’s Neuroma – Orthotics are especially beneficial to someone with Morton’s Neuroma because an orthotic with a met pad helps to alleviate the pressure and pain between and around the toe area.

Other Reasons [Diabetes/Arthritis/Running/Metatarsalgia]

-The effects of Diabetes on the feet is another reason one might need orthotics/arch supports. Diabetes may cause pain and swelling, arch supports/orthotics will help keep the feet and body aligned and evenly distribute that pressure.

-The effect Arthritis can have on the body and the feet can vary widely from person to person. Some people with Arthritis have no problems with pain in their feet, knees, hips, or back while others have extreme issues which require a high level of care. Arch supports/orthotics will help keep the feet and body aligned and evenly distribute that pressure associated with Arthritis

-Running causes extreme wear on the knee, foot, and hips. Wearing an arch support and/or an orthotic will alleviate the pressure on the impacted areas and will also redistribute the pressure because the body is better aligned with an arch support.

-Metatarsalgia is a condition in which the ball of your foot becomes painful and inflamed. It is commonly associated with sports and active activities that involve running and jumping. There are other causes as well, including foot deformities and shoes that are too tight or too loose. Wearing an arch support and/or an orthotic will alleviate the pressure on the impacted areas and will also redistribute the pressure because the body is better aligned with an arch support. Arch supports can be modified with a met-pad that will help to even further reduce the pressure. Some arch supports come with a built-in met-pad, for those who prefer the option to remove as needed, a modification might be the best solution.

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-2. Heel cup:

A heel cup may alleviate pain beneath the heel. Made of plastic, foam or rubber, the cup may provide support around the heel while relieving pressure beneath the tender spot.

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-3. Metatarsal pad:

A metatarsal pad can be used to relieve pressure or pain beneath the ball of the big toe (sesamoiditis) or other toes. Made from a range of materials, the pad affixes to the insole behind the tender area. In this way, the pad helps distribute pressure that would otherwise be placed on the ball of the foot.

Talk with a healthcare professional (such as a podiatrist or physiotherapist) about any problems with your feet or footwear. They may be able to recommend a treatment to help your symptoms, or a specialist shop that has shoes suitable for you.

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Orthopedic shoes (prescription shoes):  

Orthopedic shoes are specially-designed footwear to relieve discomfort associated with many foot and ankle disorders, such as blisters, bunions, calluses and corns, hammer toes, plantar fasciitis, or heel spurs. They may also be worn by individuals with diabetes or people with unequal leg length. These shoes typically have a low heel, tend to be wide with a particularly wide toe box, and have a firm heel to provide extra support. Some may also have a removable insole, or orthotic, to provide extra arch support.

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Custom-made orthopedic shoes (OS) are used for a large variety of serious foot and/or ankle problems: for example, to prevent recurrence of foot ulcers, reduce plantar pressure, diminish pain in the feet or ankles during standing and walking, support foot deformities, enhance mobility, or provide stability. OS are prescribed for patients with a wide range of disorders, such as diabetes, rheumatoid arthritis, degenerative foot disorders, spasticity, and muscular diseases. These patients do not fit standard off-the-shelf footwear. OS, including the insole, are completely individually designed and fabricated from a positive model cast from the patient’s foot.

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When varying degrees of structural foot problems are evident, the right footwear is essential to accommodate the forefoot joints and toes, support the rearfoot and protect the foot from trauma. However, footwear is much more than a protective wrapping for the feet and an aid to function. Although shoes have been described as ‘the principal intersection between the body and physical space’ that allow us to move around in our environments and experience the world in which we live, they also have a powerful influence on social and emotional aspects of our lives. In this respect, footwear acquires different roles and has different meanings dependent on a person’s taste, identity, social status, and gender. Here lies the challenge: for people with feet that may be painful, swollen, wider and deeper than the average foot, finding footwear that is both comfortable and suitable for all occasions, including social events can be a difficult task. In order to be effective, orthopedic shoes must be used by those for whom they are prescribed. However, it has been frequently reported that patients do not use their OS. Varying rates of nonuse have been reported, ranging from 20 to 25 percent for first-time users and from 4 to 19 percent for experienced users. 

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The general rule is that shoes should be long enough to have ½ inch or 1cm space between the longest toe and the end of the shoe. However, if you have a bunion and/or clawing of the toes you need to have shoes that are the length that your foot would be if all your toes are straight – this is so the widest part of your foot fits into the widest part of the shoe.

The foot on the left is affected by RA, and the one on the right is a normal foot. These feet are the same length overall, but the one on the left has a short ‘toe to ball’ measurement due to the lesser toes being retracted and the big toe drifting over. If shoes are purchased to fit the overall length of the left foot, then the widest part of the foot will not be at the widest part of the shoe. Therefore, it is important for people with toes such as these to buy shoes to the length of the foot as it would be if the toes were straight. 

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Orthopedic shoes characteristics:

There are certain characteristics and design features of orthopedic shoes which set them apart from regular shoes. Below listed a few of the main differences:

-1. Extra widths and more sizing options

Because people’s feet are all so unique, most orthopedic brands are available in three main widths (narrow, regular and wide) and almost limitless sizes.

-2. Taller upper-soles (uppers)

People who experience forefoot issues like ‘clawed’ or ‘crossed-over toes’ require more vertical space for their feet.

-3. Easier to fasten

Most orthopedic shoes favour a hook-and-loop closure system which is easier to tighten for persons living with restricted mobility or functions.

-4. Seamless upper-soles (uppers)

Removes areas that might cause rubbing or abrasion.

-5. A firm and supportive heel

To support the rear of the foot.

-6. A well cushioned and strong outer-sole and mid-sole

The outer-sole typically has defined ‘impact points’ to absorb the impact of walking.

-7. A firm sole

Ideally made of Ethylene-vinyl acetate (EVA) which allows you to add ‘wedging’ which lifts the heal of the foot and/or ‘rocker soles’ which are used to reduce pressure on the bottom of the foot.

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Although each patient’s needs are different and prescription footwear must be individualized to meet those needs, there are certain basic objectives that can be accomplished with prescription footwear.

-1. Relieve Excessive Pressure from Sensitive or Painful Areas

Many patients have some area of the foot that is particularly sensitive or painful, such as prominent metatarsal heads, nodules, or bony prominences. Prescription footwear can minimize this pain or sensitivity by relieving pressure from these areas of the foot.

-2. Reduce Shock and Shear

In addition to relieving specific high-pressure areas, prescription footwear can be helpful in decreasing the overall amount of vertical pressure, or shock, on the foot. A reduction in the horizontal movement of the foot within the shoe, or shear, also can be achieved. Shock and shear reduction are particularly important for patients with arthritis because they often have sensitive skin and a loss of fatty tissue. Also, their joints can be inflamed, painful, and lack mobility, making them more sensitive to shock and shear forces.

-3. Accommodate, Correct, and Support Deformities

Fixed or rigid deformities can be accommodated with the use of soft materials in shoes and orthoses, and certain shoe modifications can help replace lost joint motion. Prescription footwear also can be helpful in providing needed support, correction, and pain relief for more flexible deformities.

-4. Control or Limit Painful Motion of Joints

Limiting the motion of certain foot and ankle joints through the use of prescription footwear often can decrease inflammation, relieve pain, and result in a more stable and functional foot.

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Healthy foot benefits of orthopedic shoes:

-1. Orthopedic shoes provide great support.

Not only are they designed to cater to your arches, but orthopedic shoes cushion your heels and can help realign your foot. Without this support and proper alignment, painful and frustrating issues such as flat foot and plantar fasciitis can occur.

-2. Foot pain can be diminished by wearing orthopedic shoes.

5,000 to 10,000 footsteps. That’s how much the average person walks per day. If you are wearing poor-fitting shoes, imagine the damage you are doing to your foot by walking that many steps in them per day. Orthopedic shoes give your toes the room needed to move around comfortably, and they often come in sizes and widths not available in regular shoes. They prevent your feet from rubbing against the inside of the shoes, and don’t have heels that will push your feet forward into unnatural and uncomfortable positions.

-3. Wearing orthopedic shoes can help diabetic.

If you suffer from diabetic nerve pain, orthopedic shoes can be your best friends. It’s so important for those suffering from diabetic neuropathy to wear shoes that are comfortable and have great arch support. As diabetic neuropathy lessens a diabetic’s ability to feel much in the foot area, injuries to the foot may go unnoticed. Neuropathy also lessens the circulation in the feet. Wearing orthopedic shoes will allow the foot room to move and function in a healthy environment. They can actually save diabetics from losing a foot.

-4. Orthopedic shoes cost less than having foot surgery!

Not taking good care of your feet will most likely catch up with you, even if it’s in old age. Wearing orthopedic shoes when you have foot pain or other foot issues can prevent the need for costly surgery down the road.

-5. Foot problems can be corrected with orthopedic shoes.

Because they can help realign feet and preserve arches, orthopedic shoes can be a solution to the foot problems you’ve been having. Far too often, major foot issues occur simply from wearing the wrong shoes.

-6. Orthopedic shoes equal mobility for some people.

Chronic foot pain and issues such as flat feet, plantar fasciitis, bunions, hammertoe and heel spurs can not only slow someone down – but they can stop someone from being able to walk all together. Cushioned, roomy orthopedic shoes can give someone back his or her mobility.

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Selecting a prescription shoe:

When being presented with a patient requiring prescription footwear, there are some initial concerns that should be taken into account before proceeding on to the shoe prescription, since they may alter the type of shoe selected.

-1) Immediacy of need—When does the patient require the shoe and how soon can one be obtained? The use of the “ideal” shoe may have to be postponed in order to get the patient into footwear now.

-2) Cost—The perfect shoe has no value if it cannot be provided to the patient. An affordable shoe that meets the patient’s most critical needs will do the most good.

-3) Style—A prescription shoe is of no benefit if the patient refuses to wear it because of the way it looks. This aspect of using prescription footwear should always be discussed with all patients, both men and women. The need for the prescription footwear and its importance to the foot health, even foot survival, must be stressed. A compromise on style, if appropriate, should also be presented. If possible, both spouses should be included in this consultation session. The patient’s spouse may serve as an advocate or an antagonist to the patient wearing the “orthopedic” shoes. It is not uncommon to have a wife complain that a prescribed shoe makes her husband look an old man, even if the husband is over 80 years old!

-4) Patient’s ability to put on and remove shoes—If the patient cannot perform this task due to a medical condition or mental status, it must be determined whether or not there is someone else available to take on this responsibility before a custom prescription shoe is ordered.

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Basic Types of Prescription Shoes:

There are three basic types of prescription shoes used for patients with various forms of foot pathology:

-1) post-operative shoes;

-2) depth inlay shoes (in-depth shoes); and

-3) custom-made molded shoes.

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Post-Operative Shoe:

Post-operative shoes were initially designed to be used following surgery in order to accommodate extreme swelling and bulky dressings. They are constructed with a wide forefoot and are available as either open or closed toe models (Figure above). The uppers are made of canvas or more commonly nylon mesh with either Velcro straps or lace closures. Most come with a rigid rocker sole to allow the patient to walk while limiting joint motion. One of the major advantages of this type of shoe is its very low cost, making it possible for the clinician to keep them on hand in the office, providing immediate availability to the patient. In addition to being used in accommodating for swelling, edema, or dressings, the post-operative shoe can be used to relieve both dorsal and plantar foot pressure on bony prominences from rigid foot deformities.

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Depth-Inlay Shoe:

Figure above shows Depth inlay shoe with removable insole to accommodate a foot orthosis.

The depth-inlay shoe, often referred to as an added-depth or in-depth shoe, is the most common type of prescription footwear utilized in the management of numerous foot pathologies. The depth-inlay shoe is a roomy shoe with a removable insole measuring 1/4 inch to 3/8 inch in thickness. Commercially available or custom-made orthoses and other foot appliances can be easily inserted into this kind of shoe after removing the original insole. As a rule, a depth-inlay shoe is usually one size longer (1/3 inch longer) and two sizes wider (1/2 inch wider in circumference at the level of the metatarsophalangeal joints) than the corresponding regular shoe. The depth inlay shoe usually comes in a basic oxford style, but is more recently available as both an athletic and dress shoe. They are available in a wide range of shapes and sizes for both men and women and can be used for all but the most severely deformed feet.

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Custom-Made Molded Shoes:

A custom-made shoe is a shoe constructed from a model made from a cast of the patient’s foot. This type of footwear is needed only in cases where a depth-inlay shoe cannot be modified to meet the patient’s needs.

Indications for custom-made molded shoes include:

-1) Severe foot deformities such as talipes equinovarus, equinovalgus, extreme hallux valgus, rigid hammertoes, and Charcot foot.

-2) Marked leg-length discrepancy (Figure below)

-3) Marked foot size discrepancy, congenital absence of various parts of the foot, or foot amputations often require the combination of molded shoes and various foot fillers so that these patients can wear matching shoes.

-4) Feet with peripheral neuropathies resulting in loss of protective sensation may require a molded shoe for protection from repeated trauma that can produce skin necrosis. 

-5) Feet with severe peripheral vascular disease that heal very slowly from even minor injuries.

-6) Feet with severe arthritis, such as rheumatoid arthritis, which involves numerous joints producing synovitis, deformities, exostoses, instability, subluxations, and dislocations that make them prone to injuries.

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Shoe Modifications:

The various parts of the shoe upper can be enlarged or made roomier to accommodate for bony prominences, ulcers, or pre-trophic areas. One of the advantages of using leather for shoe construction is that leather not only conforms to the foot through the course of normal wear, but can also be forced-conformed by stretching. Spot stretching can be accomplished with the use of a Hoke ball-and-ring stretcher or a shoemaker’s swan. These devices are used in conjunction with the application of a stretching fluid, which is a fifty-fifty mix of rubbing alcohol and water. Another type of stretching is used to increase the width, and to a lesser degree, the length of a patient’s footwear. There are two types of devices used for this purpose. One is the traditional shoe stretcher, which is available in various configurations and can easily be used in the office. The other, the Eupidus device, is used for general stretching and is found in shoe repair, pedorthic, and orthotic facilities. This device has the advantage of greater leverage in stretching the shoe and is needed for shoes that are constructed of thick leather. Splitting or making cruciate cuts through the shoe leather and its underlining, or by simply cutting out the impinging portion of the shoe upper, can offer immediate reduction in pressure. A more permanent method of accommodating for an isolated bony prominence is applying a balloon patch to the shoe. A balloon patch involves the cutting of the upper of the shoe away from the area of the affected toes or joints. Once the leather has been removed, a patch of deerskin or other soft material is applied loosely over the cut-out and dyed to match the shoe. Shoe closures can also be customized and should be selected to match each patient’s needs. Common closures include eyelets and shoe laces, elastic bands, Velcro straps, and zippers. Elastic bands allow for easy insertion of the foot into the shoe while keeping the shoe on the foot. Velcro and zipper closures are beneficial for patients who have difficulty in tying laces, such as those with severe arthritis or paralysis of their hands. A surgical lace-to-toe closure has lace stays or Velcro straps that extend all the way to the toe. This closure is useful for patients who have difficulty getting their foot into a shoe. It is commonly used with ankle orthoses, for an edematous foot and ankle, for a flaccid or obese foot, or for feet affected by neurological disorders, such as cerebral palsy and myelomeningocele.

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Stabilization:

Stabilization is a type of external shoe modification that involves the addition of material to the medial or lateral portion of the shoe to stabilize some part of the foot. A flare is an extension to the heel or heel and sole of the shoe. Flares can be medial or lateral, and their purpose is to stabilize a hindfoot, midfoot, or forefoot instability. For example, a medial heel flare may be used to support a valgus heel deformity. A stabilizer is an extension added to the side of the shoe, including the sole and upper. Made from rigid foam or crepe, a stabilizer provides more extensive stabilization than a flare and is used for more severe medial or lateral instability of the hindfoot or midfoot.

Solid Ankle Cushion Heel:

A solid ankle cushion heel, or SACH heel, consists of a wedge of shock absorbing material that is added at the heel of the shoe. Its purpose is to provide a maximum amount of shock absorption under the heel, for example, in the case of a loss of fatty tissue in the heel area.

Wedge:

A wedge of sole material sometimes is added medially or laterally to the heel of the shoe or to the heel and sole (Figure below). It can be inserted between the upper and the sole, or added directly to the bottom of the shoe, to redirect the weightbearing position of the foot. A wedge also is useful in stabilizing a flexible deformity in a corrected position, or in accommodating a fixed deformity (by essentially bringing the ground to the foot). A medial wedge may be indicated in cases of extreme pronation, whereas a lateral wedge may be used for ankle instability or a varus heel deformity.

Figure above shows Lateral wedge.

Studies have shown that lateral-wedge orthotics can result in lower peak knee loads in subjects with medial compartment knee OA. The lateral wedge essentially alters the mechanical axis of the lower extremity by pronating the foot and thereby decreasing the lever arm and rotational torque on the knee joint.

Extension: 

An extension consists of material added to the sole of a shoe to increase the height or thickness of the sole. Extensions may be added to the heel area only or to the entire sole and heel. When an extension is added only to the heel area of the sole, its purpose usually is to accommodate a fixed equinus deformity. A complete heel and sole extension is used to compensate for a leg length discrepancy. Depending on its height, the extension generally is made of crepe, leather, or rigid foam, and the larger extensions generally are used in conjunction with a rocker sole. Extensions can be used with various shoes, including athletic footwear and dress shoes, and can be covered with matching upper material to achieve cosmetically pleasing results.

Metatarsal Bars:

Metatarsal bars are often placed on shoes to provide pressure relief for symptomatic metatarsal heads and their adjacent structures. A typical metatarsal bar is approximately 1/8-inch to 3/8-inch high, made of leather or soling rubber, and is fixed transversely across the bottom of the outsole with its apex immediately proximal to the metatarsal heads (Figure above). It is often used for the treatment of sesimoiditis, hallux rigidus, plantar callosities, and fractures of the metatarsals. 

Rocker-Soles:

As its name suggests, the basic function of a rocker sole is to literally rock the foot from heel strike to toe off without bending the shoe. The actual shape of a rocker sole varies according to the desired effect or purpose of the rocker sole and the patient’s specific foot problems. In general, the biomechanical effects of a rocker sole are to restore lost motion in the foot or ankle related to pain, deformity, or stiffness, resulting in an overall improvement in gait, and to relieve pressure on some area of the plantar surface. Many athletic shoes, usually labeled as running or walking shoes, are made with a mild rocker sole. This generic rocker sole, which provides some metatarsal relief and gait assistance, often is adequate for many patients. However, a rocker sole also can be custom made to relieve more specific or more severe problem areas.  

A rocker sole modification is used for any type of pathologic or pathomechanical condition that either limits normal movement of the ankle, tarsal, or metatarsophalangial joints or in situations where it is desirable to limit such motion. The rocker-sole provides a smooth rocking motion from heel to toe to imitate the heel rise and push-off sequence of normal gait. It allows for very little motion to occur at the metatasophalangial joints with a significant reduction of motion at the ankle, subtalar, talonavicular, calcaneocuboid, and tarsometatarsal joints.

The rocker-sole can be used in the treatment of metatarsalgia; fractures of the metatarsals and phalanges; insensitive feet; arthritis, fusions, and subluxations of the ankle and joints of the rearfoot; and after partial foot amputations. The rocker sole commonly extends from the midshank area to just proximal to the anterior tip of the shoe, with its highest point at the ball of the shoe (Figure above). When used for partial foot amputations, placement of the rocker is governed by the level of amputation. As the foot becomes shorter, the apex of the rocker must be placed more proximal. Footwear with rocker soles are best known for helping to redistribute plantar pressures during gait in patients with diabetes, but some studies suggest rocker soles can negatively affect wearers’ balance and in some may even increase the risk for falls and injury.  

Extended Steel Shank:

An extended steel shank is a strip of spring steel that is inserted between the layers of the sole, extending from the heel to the toe of the shoe. It is used most commonly with a rocker sole and often will make the rocker sole more effective. An extended steel shank also can prevent the shoe from bending, limit toe and midfoot motion, aid propulsion on toe off, and strengthen the entire shoe and sole. It is often used after transmetatarsal amputations and in the treatment of painful hallux limitus.

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New biomechanical footwear relieves knee OA pain: Apos (All Phases of Step) Therapy:

A new biomechanical footwear system was effective in relieving pain and improving physical function among patients with knee osteoarthritis, according to results of a randomized controlled trial presented at the ACR/ARHP 2018 Annual Meeting.

The experimental biomechanical footwear system (AposTherapy) is a regular shoe with two adjustable convex pods that are screwed into the soles as seen in the figure above.  The pods have different degrees of convexity and diameters that are designed to retrain neuromuscular control, improve functional alignment while walking and unload pressure from the affected areas, thereby reducing pain. Certified physical therapists individually calibrate the footwear system based on patients’ symptoms and observed gait pattern. Apos Therapy is a clinically proven drug-free and non-surgical treatment for knee osteoarthritis, torn meniscus, knee ligament damage & lower back pain.

A 30% reduction in pain was reported by 92% of patients assigned to the experimental footwear system vs. 58% assigned to the sham device (adjusted risk difference of 34%; 95% CI, 23%-45%). Similarly, a 50% reduction was reported by 82% of patients in the experimental footwear group vs. 42% in the sham device group (adjusted risk difference of 41%; 95% CI, 28%-52%). The clinical trial suggests that the new biomechanical footwear system is both efficacious and safe in relieving knee pain and disability with knee OA. 

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Diabetic shoe:

Diabetic shoes are sometimes referred to as extra depth, therapeutic shoes or Sugar Shoes. They are specially designed shoes, or shoe inserts, intended to reduce the risk of skin breakdown in diabetics with existing foot disease. The primary goal of therapeutic footwear is to prevent complications, which can include strain, ulcers, calluses, or even amputations for patients with diabetes and poor circulation. Neuropathy can also change the shape of a person’s feet, which limits the range of shoes that can be worn comfortably. In addition to meeting strict guidelines, diabetic shoes must be prescribed by a physician and fit by a certified individual, such as an orthotist, podiatrist, therapeutic shoe fitter, or pedorthist. The shoes must also be equipped with a removable orthosis. Foot orthoses are devices such as shoe inserts, arch supports, or shoe fillers such as lifts, wedges and heels. The diabetic shoes and custom-molded inserts work together as a preventive system to help diabetics avoid foot injuries and improve mobility.

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 Many diabetics need special prescription footwear. The various types include:

-1. Custom-made shoes. When extremely severe deformities are present, a custom-made shoe can be constructed from a cast or model of the patient’s foot. With extensive modifications of in-depth shoes, even the most severe deformities can usually be accommodated.

-2. External shoe modifications. In these cases, the outside of the shoe is modified in some way, such as adjusting the shape of the sole or adding shock-absorbing or stabilizing materials.

-3. Healing shoes. Immediately following surgery or ulcer treatment, special shoes may be necessary before a regular shoe can be worn. These include custom sandals (open toe), heat-moldable healing shoes (closed toe), and post-operative shoes.

-4. In-depth shoes. An in-depth shoe is the basis for most footwear prescriptions. It is generally an oxford-type or athletic shoe with an additional 1/4-inch to 1/2-inch of depth throughout the shoe. This extra volume accommodates inserts, or orthotics, as well as deformities commonly associated with a diabetic foot. In-depth shoes are usually designed to be light in weight, have shock-absorbing soles, and come in a wide range of shapes and sizes to accommodate virtually any foot.

-5. Orthoses or shoe inserts. Also known as orthotics, an orthosis is a removable insole which provides pressure relief and shock absorption. Both pre-made and custom-made orthotics or shoe inserts are commonly recommended for patients with diabetes, including a special total contact orthosis, which is made from a model of the patient’s foot and offers a high level of comfort and pressure relief.

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Advantages of wearing Therapeutic Shoes in diabetes:

Therapeutic shoes are the recommended footwear for people with diabetes. Diabetics have an increased risk of foot problems due to poor circulation and nerve damage that occurs in the feet. Diabetics are unlikely to feel an injury in that area because of the nerve damage, which leaves them at risk of getting infections and foot ulcers. Specially made therapeutic shoes are a necessary investment for diabetics. They are designed to reduce the risk of many different complications. Here are some of the advantages of wearing therapeutic shoes:

-1. Skin Protection

Ill-fitting shoes tend to cause blisters, calluses, and other minor injuries. When someone without diabetes gets any skin related injury in the foot area, pain alerts them of the injury, but diabetics do not have this advantage. Therapeutic shoes are designed to be comfortable. They hold the feet steadily to prevent the soles from sliding around and they do not pinch the skin, thus reducing the risk of skin related injuries.

-2. Lower Risk of Foot Ulcers

Foot ulcers are formed when the top layer of skin on a foot breaks. The breakage leads to an infection which causes the condition. Diabetics are more prone to foot ulcers because of poor circulation which slows the healing process. The most common cause of foot ulcers are poor fitting shoes which can cause pressure and cuts on the foot. Therapeutic shoes shelter the feet and lower the risk of skin breakage.

-3. Reduced Pressure

Humans put a lot of pressure in the feet due to constant walking and the risk of pain in this area is very high. Diabetics are even more sensitive to pain in the foot region because of their condition. Pressure that causes pain on the plantar surfaces of the feet normally occurs because of limited ankle mobility. While non-diabetics can tolerate the pain that accompanies the pressure, diabetics have a higher risk of getting chronic foot complications. Good therapeutic shoes can help to lessen the pain. They are crafted with extra cushioning that provide support and reduce pressure. Walking becomes less painful and damaging.

-4. Increase Blood Flow

Therapeutic shoes encourage blood flow in the feet. Poor circulation, which is a common problem for diabetics, can lead to swelling of the feet. The shoes are designed to stimulate the flow of blood by keeping the feet comfortable without any restrictions, and they therefore reduce swelling.

-5. Increased Comfort

Diabetics with foot ulcers and other conditions can experience a lot of discomfort and pain when walking. Therapeutic shoes are adequately cushioned to increase comfort and reduce pain, making them ideal for diabetics who already have foot ailments.

-6. Reduced Sweating

Ordinary shoes tend to be made with inexpensive materials that do not allow the feet to breathe. This increases the temperature inside the shoe which in turn causes sweating. Sweaty feet are prone to blistering and other foot injuries that normally occur in diabetics. Therapeutic shoes are specially designed with materials that allow the feet to breathe. This greatly reduces the risk of skin problems.

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Effectiveness of Different Types of Footwear Insoles for the Diabetic Neuropathic Foot, a 2004 study:

Diabetic foot infection is a common cause for hospital admission among diabetic patients in India. This could be attributed to several sociocultural practices, such as walking barefoot, inadequate facilities for diabetes care, poor education, and poor socioeconomic conditions. It was reported earlier that recurrence of foot infection was common among South Indian type 2 diabetic subjects and was related to the presence of peripheral vascular disease and neuropathy. A diabetic patient with a history of previous ulceration or amputation is at an increased risk for further ulceration, infection, and subsequent amputation. Alterations in foot dynamics due to ulceration, joint deformity, or amputation can cause abnormal distribution of plantar pressures and result in the formation of a new ulcer. In earlier study, it was reported that limited joint mobility and increased plantar pressure appear to be important determinants of foot ulceration irrespective of the duration of diabetes. The reduction of pressure peaks by providing special shoes turns out to be an effective tool for managing the neuropathic foot. Data from randomized trials on the usefulness of therapeutic footwear in preventing foot ulcers varies, with some studies showing benefits and a few others not showing any beneficial effects. The aim of this study was to determine the efficacy of therapeutic footwear in preventing foot ulcers and reducing plantar pressures in diabetic patients.

This study found that patients who were using therapeutic footwear showed lower foot pressure (group 1, 6.9 ± 3.6; group 2, 6.2 ± 3.9; and group 3, 6.8 ± 6.1 kPa; P = 0.0001), while those who used the nontherapeutic footwear showed an increased foot pressure (group 4, 40.7 ± 20.5 kPa; P = 0.008).  Nontherapeutic footwear does not reduce foot pressures significantly, and thus foot ulcers are still subject to load, which hampers the healing process. The higher recurrence rate of ulceration in the nontherapeutic footwear group underscores the need to use specially designed footwear and include it as part of the overall diabetes care regimen for these patients.

A reduction of plantar pressures with the therapeutic footwear in a 9-month period clearly highlights the benefit of using soft, shock-absorbing insole materials and correctly designed footwear in diabetic patients, particularly those with high-risk feet. The materials and styling of footwear are clearly able to reduce the pressure on high-pressure regions.

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The effectiveness of footwear as an intervention to prevent or to reduce biomechanical risk factors associated with diabetic foot ulceration: A systematic review 2013:

Aim

Footwear interventions are used within clinical practice in an effort to reduce ulcerations however the effectiveness of these interventions is unclear. The aim of this paper was to conduct a systematic review which examined the effectiveness of footwear as an intervention for prevention of diabetic foot ulcers or the reduction of biomechanical risk factors for ulceration and to discuss the quality and interpret the findings of research to date.

Methods

The CINAHL, Medline and Cochrane Register of Controlled Trials databases were searched with 12 articles identified for review.

Conclusions

No research to date has examined the effectiveness of footwear in preventing ulceration. Conflicting findings are reported on the effective of footwear interventions to prevent reulceration. While the use of rocker sole footwear and custom orthoses in plantar pressure reduction are supported in cross sectional studies, longitudinal studies are required to confirm their benefit.

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Flat feet:

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As bipeds, humans have evolved dramatically different feet from other primates. One of the most distinctive features of the human foot is the longitudinal arch (LA), whose anatomical scaffold is created by the conformation of the tarsal and metatarsal bones, and which is reinforced by numerous soft tissue structures that span the plantar surface of the foot. The LA stiffens the foot under loading, enabling it to function as a propulsive lever during walking and running. LA stiffness partly derives from ligamentous structures, including the long and short plantar ligaments, the spring ligament and the plantar aponeurosis, that traverse the plantar surface of the foot longitudinally and act as trusses to resist compressive forces on the LA. The intrinsic foot muscles also contribute to LA stiffness by contracting to help control LA deformation during walking and running, thereby relieving an unknown proportion of the stress borne by the plantar ligaments. 

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The standing height of the LA on the medial side of the foot is the most commonly used indicator of relative arch height. Individuals with exceptionally low LAs while standing are characterized as having flat foot (pes planus). All humans are born with a low arch, and most develop a fully adult configuration of the LA by 10–12 years of life. However, roughly 20–25% of adults in the United States and Canada are diagnosed as having flat feet, either because they fail to develop a normal height arch or because the arch collapses. Most individuals diagnosed with flat foot possess a so-called ‘flexible’ flat foot, characterized by substantial eversion of the rear foot during weight-bearing, resulting in a marked drop in LA height, and reduced LA stiffness during walking. Although this condition is often asymptomatic, in some individuals it causes foot pain and fatigue after long durations standing and/or walking. Reduced LA stiffness is also a risk factor for numerous lower extremity musculoskeletal disorders including plantar fasciitis, knee osteoarthritis, tibialis posterior tendinopathy, and metatarsal stress fracture. Thus, developing strategies to prevent and treat this condition is an important health objective.

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Flat feet, also called pes planus, is a deformity that occurs when the arch of the foot collapses and comes into complete or near-complete contact with the ground. The condition may be congenital (occurring at the time of birth) or acquired (developing over time, most often as a result of age or injury). Flat foot is common in both children and adults. An arch usually develops during the first 10 years of life. However, a certain percentage of people don’t develop arches in their feet. The exact cause of flat feet is not clear, but there is evidence that shoes may be a contributing factor. Research published in the Journal of Bone and Joint Surgery looked at the influence footwear had on the development of arches in children. The study found that kids who wore shoes were three times more likely to have flat feet than those who went shoe-less. The researchers noted that shoe-wearing in early childhood is detrimental to the development of a normal or a high medial longitudinal arch. Other studies have found this condition is rare in people who are habitually barefoot or wear minimal shoes compared to people who wear conventional modern shoes. In one of the largest of these studies, which included 1,846 adults from southern India, Sachithanandam and Joseph found that individuals who never wore shoes before age 16 had roughly half the rate of flat foot of those who grew up wearing shoes. More recently, in a study of 810 school children between 6 and 18 years old, Hollander et al. found significantly higher LAs in children who were habitually barefoot compared to those who were habitually shod. These findings are potentially significant given that, until relatively recently, all humans were either barefoot or wore minimal footwear lacking the cushioning, arch supports, restrictive toe boxes and other features of conventional shoes. It has also been shown that the use of minimal shoes by adults who grew up in conventional modern shoes is associated with increases in intrinsic foot muscle size, as well as LA height and stiffness. It is therefore reasonable to hypothesize that the reduction in LA stiffness that characterizes flat foot is a mismatch condition caused by the human foot being inadequately adapted to the novel environmental condition of wearing shoes that provide comfort and protection at the expense of weaker foot muscles.

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Diagnosis of flat feet typically involves a visual examination of the foot, supported by imaging tests. Treatments may involve over-the-counter pain medications, orthotic arch supports, foot exercises and, less commonly, surgery. Flat feet can cause back pain, bunions, or tendon damage. However, wearing shoes that support the arches can make walking more comfortable and reduce the risk of complications. If you are bothered by symptoms of flat feet, the first course of action is to find shoes that compensate for the abnormal structure of your foot. While there are companies that can custom-make corrective shoes, it is usually a costly process. A somewhat less costly option is to have custom-made insoles, which you can slip in and out of your pairs of shoes as needed. Flat feet need insoles with structured support made with a low or medium arch height and a deep heel cup to aid in heel stabilization. Some online retailers will send you a plasticine slab to create the foot mold, which they can use to create different types of insoles for running, walking, or work. The cost is usually between $100 to $150 per pair. But in many cases, custom-made shoes or orthotics are not necessary. All you may really need is the appropriate shoe fitted properly. Surprisingly, many foot problems stem from wearing poorly fitted and sized shoes.

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Most people with flat feet need a wide fit shoe. In general, they should try to avoid shoes with a pointed or narrow front. The front of the shoe should be high enough not to squash the toes. Shoes that are wide at the toes allow them to spread out. This reduces pressure on the front half of the foot, which can help prevent pain and bunions. A firm sole and heel support can prevent the foot from rolling inward. The medical term for this is overpronation, which is common in people with flat feet. Overpronation can cause pain and may damage the tendons in the foot. The most common injury is to the tendon that connects the bones on the inside of the foot to the calf muscle. This tendon supports the foot when walking. People with flat feet should choose shoes with a reinforced heel. A firm heel counter in the shoe provides support for the foot. This can protect the heel, the tendon that attaches the bones of the foot to the calf muscle, and the Achilles tendon. This tendon attaches the heel bone to the calf muscle. Wearing high heeled shoes puts a lot of pressure on the front half of the foot. It can cause pain and damage the tendons. If possible, choose a low heel with cushioning and heel support.

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Section-12 

Safety Shoes:

A pair of safety shoes (also known as safety boots) is personal protective equipment (PPE) for foot protection at workplaces. It prevents from getting foot injuries due to slippery surface, heavy falling or rolling objects, sharp piercing edges, pinch points, rotary machinery, hot objects, loops of ropes under tension, splinters, electricity, chemicals or even bad weather etc. Safety shoes come in many styles both formal or informal. However, workers require reliable and durable work shoes for their safety. Traditional safety shoes are steel toed, but it can also be made of composite materials such as thermoplastics and aluminum. Following considerations are to be made for selecting right type of safety shoes for the workers:

-Work environment and associated hazards

-Material used in safety shoes and their effectiveness to resistant hazards

-Water, heat and cold resistance

-Electric resistance

-Puncture and cut resistance

Following are the examples of work environments where the safety shoes are mandatory:

-Handling heavy objects or tools that might be dropped (impact resistant)

-Handling pipes, tree trunks, stones, rolls, wheels or round shaped items that might roll over on feet

-Handling hazardous materials

-Works involving sharp tools such as knife, axes, nails, scrap metals and glasses etc.

-Working with live or dead electric cables

-Working on a floor which might produce static electricity

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Different types of safety shoes for different work environment:

Wearing safety shoes is important to ensure safety at your workplace but the correct safety footwear is necessary because wearing the right pair of safety shoes will ensure complete protection at your workplace, protecting your feet from falling, pointed and heavy objects and hot molten materials. This is the reason that different types of safety shoes are available to meet the needs of different job roles. Let’s have a closer look at some of the important types:

-Safety-toed shoes

Do you work in an environment where your toes are at risk? If yes, then these safety-toed shoes are ideal for your workplace. These shoes are made of steel, alloy or non-metallic toe caps that cover your toe area and prevent it from getting hurt or damage.

-Steel insole shoes

These shoes are another important type, designed to protect you from joint problems that might arise from driving heavy trucks, riding bikes or pushing pedals. These comfortable shoes help in keeping your foot stabilized, preventing bone and joint problems.

-Metal instep footwear

This type of safety footwear keeps your feet protected from accidents or injuries at your workplace. It is best for those who work in industrial factories as it is designed mainly to protect your feet from pointed and sharp objects such as glasses, nails etc.

-Metatarsal shoes

Designed and created mainly to protect the upper part of your bones and feet, these shoes prevent you from any injuries or mishaps while working. These shoes are right for you if you work at the construction sites and your job demands lifting of heavy objects. The best thing about these shoes is that they protect your feet and toe both externally and internally.

-Electric hazard shoes

This kind of footwear is specially designed for those who work with high voltage machines, circuits, electricity, wiring etc. These shoes ensure your safety even when you’re exposed to electricity and high voltage circuits by reducing your potential to receive an electric shock.

-Chemical resistant shoes

Chemical-resistant footwear should be worn in areas with potential chemical or corrosive splashes. Unfortunately, there are more chemical compounds than types of shoes, and matching footwear material to a chemical hazard can be a challenge. Generally, there are three types of chemical-resistant footwear material: rubber, neoprene or PVC. The best way to make sure a particular material will work in a specific chemical environment, is to have the footwear tested.

-Cold Weather shoes

When working in conditions colder than minus 10, workers should wear arctic footwear, not typical steel-toe safety shoes. Generally, such cold temperatures present more of a risk to feet than a potential crushing hazard. When choosing the appropriate footwear for cold-environment applications, a boot’s warmth factor should be considered. Because insulation can make cold-weather footwear heavy, seek a lighter boot. All-rubber bottoms are heavy, so footwear that combines rubber with a lighter material, such as polyurethane, will reduce the boot’s weight. Workers wear them for eight hours or more a day so weight is very critical.

There are many other types of safety shoes that you can choose from, depending on your work environment and all possible hazards.

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Essential benefits of safety shoes at workplaces:

-1. Prevention from Slips and Falls

Unforeseen slips, tripping or falls are untoward incidents that can happen in any workplace resulting in a great deal of accidents annually. Many businesses can resort to taking steps like formulating stringent housekeeping measures and installing anti-slip floor tapes to drastically reduce any risks posed by these mishaps. However, there is no alternative to proper safety footwear that provides additional protection against trips, falls, and slips. Shoes with a good amount of traction can reduce friction and help prevent falls in slippery environments.

They also help prevent falls from ladders, which are commonplace especially when people don’t wear shoes with proper treads on them.

-2. Protection against burns

Dangerous burns from industrial fires can take place at almost any workplace, so can burns from chemicals and materials like cement, etc. Safety footwear made from sturdy, durable materials can prevent nasty burns from chemical splashes, metal splashes and other dangerous substances that could injure the skin on the feet/hands or any other part of the body.

-3. Keeping feet warm in extreme weather

In some places, harsh cold weather can pave the way to injuries such as frost bites and hypothermia, and these dangers shouldn’t be overlooked. Employees working outside during the harsh rough winters are at risk, along with employees who work in a refrigerated environment. Keeping the feet warm and comfortable in conjunction with a slew of other measures is thus, very pertinent in the workplace.

-4. Resist Fatigue

Fatigue can be a major nagging problem for workers who stand all day, especially on hard surfaces like concrete. Muscles in the feet, the legs, back and other important parts of the body can grow tired, especially when the employees don’t wear appropriate footwear. Reflective safety shoes provide a comfortable cushioning for the ankles and balanced arch support that can make people more comfortable alleviating any unnecessary strain on muscles resulting in less fatigued employees. This aspect helps them to be more alert on their job and allows them to do their jobs safely and more efficiently.

-5. Savior against electrical hazards

As we all know, electricity poses a plethora of risks in the workplace. Workers are prone to potential electric shocks from short-circuits, etc. To reduce the possibility of an electrical accident, footwear made from leather, rubber or other materials that are bad conductors of electricity can be worn. These precautions significantly reduce the threat posed by naked wires, coils, good conductors of electricity, etc.

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Professional footwear and its importance to stop contamination in a hospital environment:

It is very important to choose a shoe designed for the specific requirements and needs of hospital environments. Leather or fabric shoes enhance the retention and spread of bacteria and the consequent contamination of the environment. Injected polymers prevent the proliferation of bacteria. In a medical-hospital environment there are two realities, the operating room in which the risks of infection are recognized and the use of sterilizable shoes is mandatory and outside the operating room where different practices are allowed according to the institution. Several studies have pointed out that footwear is one of the biggest reasons for contamination of users in the hospital context, emphasizing the importance of using appropriate and preventive footwear with regard to the proliferation of infections, while reinforcing all other good practices implemented. Professional footwear used in the workplace is considered to be PPE – Personal Protective Equipment. PPE is specially designed to protect users from potential injuries and contamination in a professional context with the aim of reducing the risks to which users are exposed. 

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Benefits of metal-free footwear for men and women:

We know that steel toe and midsole safety footwear has been regarded as the favoured choice for foot protection across most industries. More recently, without compromising on safety, metal-free footwear (also known as composite) is replacing traditional steel toe and midsole safety footwear at scale, which is not surprising given the many benefits of choosing to go metal-free.

-1. Working in a security conscious environment

Metal-Free footwear is non-negotiable in high security environments, such as airports, military bases and government buildings, as workers are routinely scanned, preventing theft or prevention of weapons being bought in. In these environments if footwear is not metal-free, it must be removed beforehand, compromising on safety.

-2. Better protection without the unnecessary weight

Composite footwear (metal-free) features a toe or midsole that is made from incredibly tough, yet lightweight material, such as fiberglass, Kevlar or carbon fiber. Offering superior strength and support, as well as a thermoneutral temperature, and not to mention increased agility. In no way is the protection of the wearer’s feet compromised, to be sure look for metal-free composite footwear that meet or exceed the stringent ISO 20345 – S1 or SIP standards.

-3. Prevents post impact trapping

Composite footwear, in particular a composite toecap is made from material that lets the footwear recover its shape following significant impact. A steel toecap on the other hand, bends into a fixed position and can trap parts of the feet after a serious accident, making it extremely difficult and in some instances very painful to try and remove the foot, in extreme cases the footwear may need to be cut apart or dismantled. When buying or supplying safety footwear please ensure you take into consideration the impact rating and compression rating of the footwear. The impact rating will tell you the number of pounds or joules the shoe will protect you against, whilst the compression rating lets you know the amount of resistance the shoe could cope with before breaking.

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Section-13

Shoes in Women Fashion:  

Fashion is a means of communication. Footwear, as all fashion, sends powerful messages about social status, gender, and ideals of beauty. Fashion is also a highly personal expression of the wearer’s identity. A certain style, material, accessory, or pair of shoes says ‘this is part of who I am’; in this way fashion establishes relationships between one person and another. The political, social, and economic events influence fashion styles and individual clothing choices throughout history. Materials, shapes, and height of heel are all expressions of society and culture at large. Throughout its history in Western fashion, the high heel has been used to enhance stature, status, and sex appeal; and the high heel of today bears the imprint of its complex 500-year evolution. From the extravagant chopines of the 16th century to the elegant stilettos of the 20th century, influences as varied as politics to pavement have contributed to the enduring success of elevating shoes.

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Shoes are a key part of nearly any outfit, whether you realize it or not. While most people can overlook poorly-coordinated accessories, undershirts, and socks, shoes are often one of the things they will pick up on first, and there are very few situations where you can salvage your appearance if you turn up in a combination that looks ridiculous to other people. Even the most conventionally attractive people would struggle to look formal in exercise shoes or sandals, and the wrong shoes for the job can really put the brakes on an otherwise perfect outfit.

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When it comes to women fashion, one of the most important accessories is shoes. For a lot of women, there’s nothing more crucial to their entire look than a good pair of shoes, whether we talk about women’s gothic boots, heels, flats, or any other. It is their footwear only that keeps the whole outfit together. As you might already know that fashion is limitless, different people have a different take on style and that is the reason new trends keep coming in. But the only constant that the fashion industry has seen over the years is the need to have perfect shoes. In case, you are someone who admires the fashion trends and wants to keep up with them, you must understand how significant shoes are.

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What makes shoes so important to women fashion?

-1. It is the major focus of your outfit

The first point that proves the importance of shoes is that no matter how stylish your outfit is, people will always notice your shoes first. This means every day you walk out of your door, it is your shoes that will catch more eyes. Sometimes we think that we can wear a good outfit without caring too much about the shoes and it might go unnoticed, but your shoes are the center of attraction, it stands out from your outfit or any other accessory you wear, and therefore never goes unnoticed.

-2. They help you get ready for Different Occasions

For those women who don’t like to spend too much time dressing up, shoes are a great escape. For example, if you have a party to attend, you can simply put on the first dress you find in your wardrobe and complement it with a nice pair of heels and you are good to go. Besides, you can easily find numerous options for women’s heels online. So if you have a list of events coming up, just focus on having a suitable pair for each function, the rest will take care of itself.

-3. Shoes keep your fashion Game strong

A pair of quality shoes when worn with anything, like a casual dress, jeans and t-shirt, etc. will enhance your overall look. When you have a good collection of footwear, you can keep your fashion game strong without having to do too much. Your shoes can define how you perceive and carry out your admiration for fashion.

-4. Time of day matters

While it might seem strange if you’re not that keen on fashion trends, a lot of people prefer to have separate shoes for daytime and night-time events, even if they’re essentially the same as another pair with a slightly different design or visual style. There can be various reasons for this, but it usually comes down to the presentation: a party in the morning is likely to be very different to one taking place near midnight, so an outfit that blends in at one might look really out-of-place at another, even if they involve the same group of friends.

Some shoes are also simply better-suited to certain times in the day. Sandals, for example, are often seen as something you’d wear when it’s sunny and warm, so it might look a little strange if you’re wearing them after the sun goes down. That’s not to say that you can’t wear them, but they might not fit in with the current situation and can make you look slightly lazy if they’re clearly taken from another outfit that you wore earlier in the day.

-5. Mismatched Shoes attract attention

First impressions are always important, and clothes make a huge difference in how happy, and approachable you might look, even if you don’t know it. You might find yourself gravitating towards clothes that suit your current mood, but shoes are often overlooked, which can result in you getting the wrong kind of attention from people you’re trying to talk to or avoid. Even the most considerate person will be a little bit confused if you dressed in all black except for your lime-green trainers, or you are wearing casual clothes with bulky hiking boots underneath. Even if you’re not looking to get people to talk with you, it can still result in stares or people pointing it out to you, which could ruin your mood if you’re already not feeling up to having long conversations with people. If you’re unlucky, it might even result in new friends getting certain misconceptions about how you dress – presentation has a significant impact on the way people interpret you as a person.

-6. Shoes let You express yourself

Shoes are one of the few areas where the majority of major brands hide their logos in relatively inconspicuous places or incorporate it into the design so that it’s not immediately obvious to a casual observer. While this isn’t always true, and there are certain offenders that paste their logos on wherever they can, shoes give you a lot more room to express yourself with different colors, styles, and patterns.

-7. Vanity sometimes Pays Off

We’re all taught that money doesn’t buy happiness, but it sometimes buys things that you can be proud of, and footwear is no different. There’s nothing wrong with being proud of some stylish shoes that complete your look, especially if they’re from a really prestigious brand or a style that’s fashionable at the moment: some people are simply more receptive to branding and status than others, and you might find that wearing high-quality and desirable brands or styles might give you a boost to your self-confidence, especially if you wear them to parties or other social gatherings.  It can also help you earn the respect and attention of people who are into similar brands, especially if they’re the kind of people who are very into current fashions and popular clothing. Not everybody’s looking for these kinds of people as friends, but it can still be a useful conversation starter or a way to introduce yourself to groups of people that you normally wouldn’t.

-8. You create fashion

Sometimes breaking away from established fashions can be a fashion in and of itself, so you should also keep an eye out for shoes that break with the norm without being too extreme or out-of-place with your clothing. Just because something doesn’t fit in with popular styles doesn’t mean that it won’t look great on you, and you don’t need to follow a popular trend to look your best. If you find an outfit that works, shoes included, you can always stick to it as your personal style. 

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Footwear: Fashion versus Function:

When it comes to footwear, podiatrist Andrew Saunderson has this to say, “Treat fashionable shoes like chocolate and functional footwear like a regular healthy meal.”

Footwear can be a significant causative factor for your pain and discomfort with your feet. Shoes that are too narrow or short around your forefoot are bound to increase your chances of foot problems. All too often, we try to squeeze our forefoot – the widest part of our foot – into the narrowest part of the shoe (the toe box) just because these shoes look trendy.

What are Functional Shoes?

Generally, any shoe that is wide/ wider through the forefoot or at the toes. These shoes fit the natural shape of your foot. These shoes mimic the ‘fan-shape’ of a healthy foot. The weight–bearing area of the sole should be flat to the floor to provide maximum surface area. They can’t be folded up and put in your pocket. They are designed to give your toes freedom to move and flex.

It is worth bearing in mind that your foot has more nerve endings than your hand. It has evolved to be incredibly sensitive to inform your body of what you are walking on, enabling you to balance. Each step you take initiates a cascade of muscular contractions that start at your foot, works up and across your body and ends in your opposite arm. You need your foot to be able to be receptive and to move naturally to enable this to occur. Just like any part of the body, the foot muscles and nervous system will get deconditioned if not allowed to function properly by wearing improper shoes. 

What are Fashion Shoes?

Fashion shoes tend to be narrower through the forefoot or at the toes. They are narrow, have high heels, unstable and/or floppy. What’s more, they come with a high price tag! They may look good but can be a significant cause or trigger for your sore feet and lower limb aches and pains. Long-term use can cause changes in foot structure like bunions, claw toes, muscular tightness and irritation of tendons, nerves and fascia. If you wear these kinds of shoes, you may experience numbness, tingling, burning or sharp, shooting pains or a dull pain in your feet, ankles and lower limbs.

What’s the solution?

Treat fashion shoes like chocolate. It’s a “sometimes” food; enjoy them in moderation. Don’t wear them all day, every day. Try commuting to the office or to a party in functional footwear. Think of fashion shoes as something you would wear at while you’re with clients, in meetings or when you need to make an impression. When your back at your desk or commuting, switch to something more comfortable that isn’t narrow/ or too small for your foot.  Buy shoes that are that are wider around the forefoot/toe area with more support and your feet will thank you for them. 

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Section-14

Smart shoes:

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Smart shoes is a smart footwear technology. It adopts smartphone applications to support tasks that cannot be done with standard footwear. A smart shoe has a tracker in it which helps you to evaluate how many steps you have taken, which one is the most touched-down area in your feet, how many calories did you burn, how much more you should burn in a day. Also, a smart shoe has features like changing its color with LED strip lights, auto-tightening the shoelaces and more. A smart shoe is pretty much capable of providing you all the needful health metrics so that you can keep a tab and improve your health. 

Smart Shoes has loads of sensors inbuilt, including gyroscope, accelerometer, magnetometer, ambient environmental sensors, atmospheric pressure sensors, and much more.

All these sensors together provide you a detailed evaluation of:

-How many steps you are taking

-At how many intervals

-For how long

-How much calories you have burnt

-And how much is left

-What is the temperature in the shoes

-What are your pressure points in feet

-What is the status of your fatigue

-What is your location on the map

-What is your pace

-What about the stride

-Are you following your correct posture?

-What is your weight?

The list is pretty huge. And so are the benefits. A smart shoe works with all the sensors, its storage, and transmitting system so that you can see a detailed analysis on your smartphone.

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Smart shoes require a reliable system for data acquisition, data transmission, storage, and data analysis. A wide variety of sensors are used to acquire data for smart shoes:

-1. Inertial-magnetic measurement units made up of an accelerometer, a gyroscope, and a magnetometer are used for gait analysis.

-2. Satellite navigation systems such as GPS, GLONASS, and GALILEO are used to provide information for the real-time location.

-3. Pressure sensors are used to provide information on the distribution of body weight mid-gait.

-4. Ambient environmental sensors, including atmospheric pressure, light, and sound sensors, are used for acquiring data from altitude-dependent activities and the surrounding environment.

-5. Internal status sensors are used to provide information on battery and memory capacity.

Besides sensor recording, data acquisition systems often have cloud-based transmission abilities. Raw sensor data is processed to get relevant information using filters, drift correction, or gradient descent-based algorithms. The data is further segmented using sequential model-based approaches, template-based approaches, multidimensional subsequencing, and a dynamic time warping approach. And gait or activity patterns can be extracted and analyzed for personalized feedback, visualization, and various health applications.

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From measuring athletic performance to tracking fitness and evaluating health metrics, smart shoes are here to provide personalized feedback to users. Efforts are on to engineer traditional shoes with integrated technology to boost comfort, convenience, and good health. Smart shoes feature insoles that can act as a Bluetooth-connected accessory and can link activity or position to a smartphone app. They can function as a high-tech brain.

Smart Shoes available in 2020:

-1. Nike Hyper-adapt 1.0

Nike is very well known for its superb shoes, and even in the ‘smart shoes’ section, they have embarked on the journey. Nike Hyperactive 1.0 is a self-lacing shoe, which makes it cooler immediately. It serves the purpose of auto-lacing up by using algorithmic pressure equation tech. And that is all it is capable of.

-2. HOVR Phantom

HOVR has a proper smart shoe that helps you to figure out your pace, step tracker, and other essentials that are required to monitor your fitness, unlike Nike. The app which it runs on is named Map My Run is compatible with both iOS and Android.

-3. Digitsole

This shoe also has auto-lacing and temperature control along with all the other features a current smart shoe should possess. It is a much better buy than Nike. It runs on Bluetooth 4.0 and it is capable of sending precise data to your smartphone.

-4. Altra Torin IQ

This one serves uniquely. While all the other shoes in the list depend on either left foot or right, this one sends you precise data of both the feet, separately. So this one provides with many accurate data, you can say. It runs on the iFit app on smartphones.

-5. Xiaomi MiJia Smart Shoes

Xiaomi smart shoes are very popular, because they are way more convenient than the others, and priced very much aggressively. Xiaomi MiJia smart shoe comes with a box packing where the shoes and the tracker come separately. You need to open one sole and slide the tracker in after connecting it with the app. This will tell you about your steps, pace, and much more.

Smart Shoes Cost:

Well, Nike costs you around $350 just to provide you with an auto-lacing and LED light strip on the shoe, whereas a Xiaomi MiJia cost you less than 3K. So it really depends on which one you would like to pick.

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Why are smart shoes not used widely?

Shoe companies need tremendous investment and technical know-how to make smart shoes. It requires expertise, innovative engineering, and a lot of resources. Then there are some social hurdles to jump, as well. Many consumers do not see smart shoes as a part of their life yet. However, as technology is advancing, these issues can be resolved.

A new industry insiders’ report suggests that the market for smart shoes will continue to grow steadily through 2022, at a CAGR of about 23% over the next four years. Already, companies like Adidas and Salomon are in the process of testing shoes that can be customized with foot biomechanics. In collaboration with Puma, MIT Design Lab is developing biologically active smart shoes capable of sensing how we feel, which can therefore adapt to the wearer. Apple is designing smart shoes that could prevent damage to feet, helping users to avoid an injury. More companies like Sensoria, Garmin, Vivobarefoot, E-Traces, E-vone, and others are shaping the future of athletic wear with their innovations. The era of smart shoes has just begun. Let’s wait and watch for the next best pair of smart shoes.

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Section-15

Footwear and children:

The foot is a complex structure of 26 bones and 35 joints, held together and supported by the ligaments. A baby’s foot is padded with fat and is highly flexible. Most children begin to walk anywhere between 8 and 18 months of age. Most toddlers are flat-footed when they first start walking, or tend to turn their feet inwards, because muscle strength and ligament stiffness needs to catch up to other development. The flat-footedness nearly always improves as the bones develop and as the feet strengthen. As child masters walking, the ligaments and muscles will strengthen and the fat pads in the arch area won’t be so noticeable. By around six years of age, child should have normal arches in both feet.

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A child learning to walk receives important sensory information from the soles of their feet touching the ground. Footwear helps to protect their feet from injury and from the heat and the cold. When toddlers are learning to walk, they should be in bare feet or a soft soled shoe as much as possible so they can feel what they touch with their feet and develop muscle strength. When toddlers have been walking on their own confidently for a period of time, they can progress to a firmer soled shoe. Have your child’s shoes professionally fitted, which should include measuring each foot for length and width. Children’s feet grow very quickly and their shoe size may need updating every few months. Expensive shoes are not always better. Children outgrow their shoes very quickly.

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Right Shoe for Children:

For infants:

Until an infant learns to walk, all they need are soft, warm booties or socks. Introducing your baby early to tight crib shoes may only hinder their feet to stretch, breathe and feel different kinds of surfaces vital for sensory development.

For toddlers:

When indoors, it is ideal for toddlers to go barefoot to strengthen the muscles around their ankles and develop arches. Just make sure the ground is always free from hazardous objects that a child may accidentally step upon. Young children toddling outdoors may wear lightweight child shoes that have flexible and soft soles to encourage natural foot movement.

For children 4 years old and above:

Opt to shop for shoes at the end of the day. Various morning activities make your child’s feet expand by afternoon. This enables you to choose a shoe size that will fit the feet in its largest possible state.

Choose natural shoe materials:

Leather, suede and canvas are examples of breathable shoe materials. When these are combined with mesh, it permits air circulation allowing your child’s foot to stay cool and dry.

Carefully assess the overall shoe fit:

While your child is trying the shoes on, check the length, width, height and room for the toes, if everything fits comfortably. A good shoe fit should be snug in the midfoot and heel part. On the other hand, the toes must have plenty of room. Children should be able to wiggle their toes. Hence, it is important to consider a wide toe box in choosing the right type of kids’ shoes. As a general rule, always ensure a half-inch clearance between the front end of the shoe and the outermost tip of your child’s toes. Check your child’s foot length every 3-6 months

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Things to check in shoes for school going children are:

-Cushioned heel for shock absorption

-Raised arch to support the mid-foot structure

-Widened toe box to prevent compression and trauma.

-Straps or Laces (slip-on shoes or trainers are often popular but it should be remembered that the foot must work harder to keep the shoe in place)

As young, fit, and healthy children run around the school ground, it is a shoe with all of the above qualities that best provides the movement and support to do so. Most shops will offer a style of shoe with the above desires already mentioned.

Then, there is the actual fitting of a shoe. Does professional fitting really matter? Clinical investigations would say yes! A study of 858 children found that around 60% of the children’s footwear in a school was too small leading to lateral deviation of the big toe. This is a predisposing factor to something commonly known as a bunion!  Recent studies also highlight the issue, claiming that a large proportion of children had footwear too narrow in nature, causing foot deformities, furthermore, stressing the importance of correct shoe fitting.

Some tips for shoe purchasing in children include:

-Have feet measured

-Buy slightly larger to allow room from growth

-Make sure footwear is wide enough not solely focusing on the length

-Buy footwear in the afternoon allowing for expansion of the foot from morning activities

-Focus on materials such as. water-resistance and breathable qualities

Once you have found the perfect shoe and fit remember to check the shoes regularly for any signs of wear and tear, hopefully before there are signs on the feet!

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Children’s Foot Problems:

According to a study, 65% of children wear ill-fitting shoes. Unknowingly, your kid could be one of them. Indeed, there are potentially serious effects of ill-fitting shoes in children; not only to their feet but also to their physiological and mental growth. Several factors such as age, gender, body mass index (BMI) and physical activity influence a child’s foot development. Merely wearing the wrong type of shoes or shoe size may likely cause short term as well as long term health risks for your kids. As a word of wisdom says, good shoes take you to good places. True enough, a good pair of shoes will not only get kids to wonderful places but protect children’s feet from getting injuries against different ground textures and temperatures.

Experts estimate that 70% of adults suffer from foot health problems and that the majority of these problems are the result of wearing ill-fitting shoes in childhood. This is because when child is very young the bones in their feet are made of soft spongy cartilage which can easily be pushed out of alignment by shoes (and even sleepsuits and socks) which don’t fit properly.

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Adverse Effects of Ill-fitting Shoes in Children:

-1. Minor Foot Ailments

Wearing shoes too tight for long periods of time may give your child foot problems such as reddened skin, blisters, cuts and sore spots.

-2. Ingrown Toenails

Footwear that puts too much pressure on the corners of the toes makes the toenails grow into the soft flesh. This, in turn, may result in pain, swelling and infection.

-3. Foot Deformities

If a child wears ill-fitting shoes and frequently rubs feet against neither breathable nor bendable footwear materials, it may progressively cause hammertoes, calluses, corns and bunions.

-4. Falls

Poorly-fitting shoes that are either too loose, too snug and without secure closure may affect children to trip often and fall down.

-5. Arthritis

Prolonged use of ill-fitting shoes that don’t provide proper support may increase the risk of developing arthritis or joint pain in hips, knees, ankles and feet later in life.

-6. Nerve Damage

Ill-fitting shoes may stress the foot repetitively and put extra pressure on the nerves resulting in nerve damage. Signs of nerve damage involve sensations such as numbness, tingling, muscle weakness and unusual pain.

-7. Anxiety

Suffering from foot malformation, discomfort, pain and frequent fall in wearing ill-fitting shoes may cause an individual to become anxious. This may lead to poor self-esteem and affects your child’s quality of life.

The side effects of ill-fitting shoes in children may have short to long term physical as well as mental implications. As a parent, it is your responsibility to properly choose the type and size of footwear fit for your child.

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The long-term effect of flexible shoes on children’s foot strength and functional performance, a 2021 study:

Barefoot childhood results in better foot strength and performance outcomes than shod childhood (Hollander et al., 2017; Zech et al., 2018). Laboratory studies have established standard school shoes restrict foot motion and alter foot kinematics (Wegener et al., 2015). No long-term studies into the effect of different children’s shoe design on foot and low limb strength development exist to date. The aim of this prospective, longitudinal, randomised controlled trial was to establish whether a child’s foot strength and low limb functional performance improves with flexible shoe use.

Seventy 9–12-year-old healthy children were recruited from a Sydney School and randomly assigned control or experimental shoes. Exclusion criteria were: <3-month-old foot/ankle injury, orthotic use, general ligament laxity, >4 hours/week of gymnastics/dance, BMI >95th percentile.

The control group wore standard school shoes. The experimental group wore shoes previously established in pilot laboratory studies to have minimal foot motion restriction. The shoes were worn for non-sports days, during school hours (±18hrs/wk) for 9 months. Pre- and post-intervention measures were taken.

Primary outcome measures were cross-sectional areas (CSA) of Abductor Hallucis (AH) and Flexor Digitorum Brevis (FDB) muscles, and toe flexor strength (TFS) of hallux and lesser toes separately. Single leg balance (SLB), Y-balance test (YBT) and standing long jump (SLJ) were secondary outcome measures.

This was the first study to establish long-term effects of different shoe designs on children’s foot development and low limb functional performance. There is strong potential for flexible shoes to positively influence the growth and development of children’s feet, with added performance benefits to balance and lower limb power. Children would benefit from a growing awareness of the impact of shoe design amongst parents, health professionals and children’s shoe manufacturers.

Conclusions:

Wearing flexible shoes long-term improves balance in children. Toe flexor strength in children is correlated with better balance and standing long jump performance.

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Section-16  

Footwear and elderly:  

The world is ageing rapidly. By 2050, the world’s population aged ≥60 is expected to total 2 billion, up from 900 million in 2015, and the population aged ≥80 is projected to triple from 137 million in 2017 to 425 million in 2050.

Morphological changes in foot with aging:

Changes in foot morphology occur with ageing, and might differ between men and women. Older adults have a lower medial foot arch but an increased circumference of the forefoot, ankle and instep. For the same foot length, older men have larger foot parameters than women, including foot width, ball girth, upper arch, and toe depth. Flat feet are more common in older women and the first and fifth metatarsophalangeal angles are increased, which might be due to the higher prevalence of hallux valgus in women. For older women, ball width, high instep circumference, and heel instep circumference also increase with age.

Pain:

Many older adults are confronted with foot pain when wearing shoes. This may be due to an increased prevalence of foot deformities, such as hallux valgus, mallet toes, hammer toes and claw toes. Hallux valgus is related to the wearing of shoes with small toe boxes at age 20–39 years.

Doffing and donning, i.e., getting in and out of shoes:

Ageing frequently leads to problems with doffing and donning, i.e., getting in and out of shoes. Therefore, easy and effective closing mechanisms are usually preferred.

Ill-fitting shoes and safety aspects:

As a consequence of the afore-mentioned changes, older people often wear ill-fitting shoes or resort to comfort shoes or slippers, especially in and around the home. Unsafe or unsuitable shoes affect balance and gait, and might play an important role in increasing fall risk with ageing.

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Around one in three older people falls each year with one-third of over 65s and half of over 80s falling each year. Postural and walking instabilities have been recognized as major risk factors for frequent falls in older adults. Furthermore, it is well accepted that plantar sensation from the cutaneous receptors, is a critical element to stability during standing and walking. Although the causes of falls are complex and multifactorial, shoes alter gait and impair control of stability via diminished perception of walking surfaces which may result in an increased risk of falling. Some authors have suggested that poorly fitting footwear and slippers or shoes with inadequate fixation may increase the risk of trip-related falls. The slip resistance of shoes has not been extensively evaluated although it has been suggested that older people at risk of falls should wear textured slip-resistant soles and some laboratory mechanical tests to simulate heel contact suggest that a bevelled heel may increase slip resistance.

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Problems with shoe wear have long been recognized as an endemic issue among the geriatric population with a prevalence rate of nearly 80%. Women in particular are more susceptible to these problems than men. Individuals having foot pathology are often severely physically impaired, making it increasingly difficult to perform activities of daily living. Consequentially, this leads to physical inactivity, which is cited as one of the first signs of deterioration and the overall decrease in quality of life. Moreover, some studies have linked physical inactivity to suicide, depression, and increased risk of cardiovascular-related problems. Individuals with diabetes, chronic disease, nondiabetic neuropathy, and inflammatory conditions are at a severe disadvantage.  Further complications of foot pathology, which include cellulitis, ulcerations, and difficulty in maintaining balance, have increased the risk of serious injuries and fractures from falls. Studies have shown that adults older than 65 years fall at least once per year on average, some of which are attributed to generalized thinning of skin and fat pad atrophy. The increased risk of falls may highlight the need to promote preventative measures to combat this issue. One of these measures may include wearing appropriate footwear.

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Wearing inappropriate footwear may also impair balance and alter gait patterns in the elderly. The shoe features which have been shown to influence balance performance include heel height, heel collar height and sole thickness and hardness.

Heel height and width influence a shoe’s tendency to tip sideways on an uneven surface, as well as influencing gait and posture. Lord and Bashford evaluated balance in 30 older women when barefoot, wearing low-heeled walking shoes, wearing high-heeled shoes and wearing their own shoes. The worst balance performance was seen when subjects wore high heels.

High-heel counters have been associated with improved balance. The authors postulated that the heel collar height may be associated with improving proprioceptive feedback of ankle position and movement thereby providing an additional tactile cue and contributing to greater ankle stability.

Robbins found that older men performed better with thin hard-soled shoes rather than running shoes with soft soles and hypothesized that soft midsoles induce a more unstable foot position; the deformable material alters plantar feedback and may induce a greater maximum supination angle that is underestimated by the wearer which may limit postural adaptations to maintain stability. Contrary to the findings of Robbins et al., Lord et al. found no relationship between sole hardness and balance in 42 older women. However, the results are not directly comparable as the authors used different balance tests (beam walking test versus swaymeter) and different methods to evaluate footwear midsole density.

The sole material and shoe tread design can affect the coefficient of friction on the walking surface, which may influence the risk of slipping. Most of the studies to date have been carried out in community dwelling older subjects. The effects of footwear on older subjects at high risk of falls have been less studied.

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In a study done by Munro et al it was found that older people typically wear slippers because they are comfortable and can be worn without increasing discomfort from foot deformities. However, in a sample of 312 older persons, those who wore slippers had more foot pain and significantly greater fall risks compared to those who wore fastened shoes or no shoes at all (Mickle et al). In fact, numerous studies report that walking barefoot or wearing socks or slippers increased fall risk by up to 11 percent as compared to wearing athletic or canvas shoes (Koepsell et al). Most falls occurred in peoples’ homes (48%), where slippers are the most commonly worn footwear (Sherrington et al). Keegan et al found that slip on shoes, sandals, medium to high heel height and narrow shoes were also contributing factors to increased foot fracture from falls in people over 45 years of age (Keegan et al).

Since wearing slippers or socks can lead to increased fall risk, it is recommended that elderly wear shoes even when inside your home. You may want to keep a specific pair of comfortable shoes for indoor use only if you are concerned about bringing dirt in from the outside. For people who must or prefer to wear slippers in the home, it is best to choose slippers that are well-fitting and have a closed back and non-skid sole.

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Foot Orthoses for elderly: 

Foot orthoses are widely used for a range of musculoskeletal conditions in general (Chapman et al 2018, Nester et al 2017, 2018), but have a pivotal role in the management foot and lower limb problems in the older adult (de Morais Barbosa et al 2013, Mulford et al 2008, Kruizinga et al 2003, Whitney 2003). Each year, in the National Health Service, 75% of the appliance budget is spent on foot orthoses (Fox & Winson 1994). Foot orthoses can range from a simple flatbed insole with adhesive pads, to prefabricated, off-the-shelf devices that can be modified to more complex custom-made devices manufactured from plaster casts, or three-dimensional scans of the foot which are becoming more popular within clinical practice.

The use of foot orthoses in older individuals has been shown to reduce plantar pressures from various symptomatic areas of the foot such as the toes, forefoot and heel (Bonanno et al 2011, Johnson et al 2012, Lee et al 2014, Menz 2016). Other studies have explored the use of foot orthoses in older individuals with osteoarthritis at the first metatarsophalangeal joint and the midfoot, and have demonstrated that pain and symptoms are reduced (Halstead et al 2016, Menz et al 2016, 2017). Evidence also suggests that the use of foot orthoses for older individuals improves balance and stability through the stimulation of the mechanoreceptors of the plantar aspect of the foot (De Morais Barbosa et al 2018). Using a series of standing and functional gait measures, Gross et al (2012) showed that foot orthoses improved the balance in adults over the age of 65 years with a history of a fall within the previous 12 month period. In a study of healthy over 65-year-olds, Aboutorabi et al (2015) showed that balance and postural stability were improved through the use of foot orthoses, through a biomechanical or somatosensory influence.

Although there is evidence to indicate the benefits for the use of foot orthoses in the older individual, there are a number of considerations which need to be considered prior to prescribing. These include the need to ensure that the patient has adequate body flexibility and dexterity (of the hands) to adjust and remove the foot orthoses if required, that they have appropriate accommodative footwear and that they can tolerate a contoured arch support in terms of comfort and skin integrity.

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Is it beneficial to walk Barefoot for elderly?

Footwear has been implicated as a factor in falls, which again is a crucial issue affecting health and quality of life in older adults. In relation to this, older adults are often advised to wear shoes with low heels and firm slip-resistant soles. McKeon et al. noted that permanent support to the foot might result in degenerative efficiency in foot muscles and sensitivity, and therefore carry a potential of adverse effects on the gait pattern. Accordingly, suggest that walking barefoot is less restricting for motion control, which increases the sensitivity of the sensory mechanisms and activates the foot and lower leg muscles. Both sensory feedback sensitivity and increased foot strength showed to improve balance in older adults, and are therefore significant predictors in the prevention of falls. Thus, barefoot walking might result in beneficial effects on sensorimotor control.

Many people assume that walking without shoes would decrease their fall risk because it improves their ability to feel the ground. However, studies show this may not be the case, especially for older people who have worn shoes since childhood. Robbins et al noted that joint position sense was 162% lower in older individuals as compared to their younger counterparts, possibly due to an age related decline in proprioception (i.e. the ability to sense stimuli arising within the body regarding position, motion, and equilibrium). In addition, community dwelling older individuals tasked with walking on a 7.8 cm wide beam fell more frequently when barefoot than while wearing shoes (Robbins et al). This study demonstrates that when a persons’ balance is challenged, they perform better wearing shoes than when they were barefoot. So wearing shoes improves stability and reduces the risk of slipping. Recent studies have shown that some insoles can improve proprioception and reduce falls. One product, called BalancePro, are shoe inserts with raised edges. These raised edges provide additional feedback to your body about your balance. In one study, users of the BalancePro insoles had 40% less falls than the control group.

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Evaluating Problems with Footwear in the Geriatric Population, a 2015 study: 

Foot pathologies are common in nearly 80% of all elderly patients, and studies have indicated inappropriate footwear as one of the major underlying cause. It has been postulated that ill-fitting shoe wear affects plantar pressure, thus exacerbating weak balance. Complications arising from foot pathologies, which include difficulty in maintaining balance, have increased the risk of falls that can result in fractures and other serious injuries. The link between footwear and the onset or progression of certain foot pathologies has emphasized the need to explore and promote preventative measures to combat the issue. Wider and higher toe boxed shoes, along with sneakers, are examples of footwear documented to evenly distribute plantar pressure, increase comfort, and facilitate appropriate balance and gait. Ultimately, the use of appropriate footwear can help to better stabilize the foot, thus reducing the risk of sustaining debilitating physical injuries known to drastically decrease the quality of life among the geriatric population.   

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Shoe design for older adults: Evidence from a systematic review on the elements of optimal footwear, a 2019 study:

Highlights:

  • Foot morphology changes with ageing.
  • Older people frequently wear ill-fitting shoes.
  • Anthropometric data should be translated into shoe lasts specific to older people.
  • There is sufficient evidence to design safe, well-fitting and comfortable footwear for older adults.
  • The shoe market should pay attention to older people’s specific requirements in relation to shoes.

Due to changes in foot morphology and the occurrence of foot deformities and foot pain with ageing, older people frequently wear ill-fitting shoes. This can lead to discomfort and reduced mobility. Based on the evidence collected in this review authors are able to make design recommendations for the shoe elements required for a comfortable and safe shoe for older adults as seen in the figure below:

An optimal shoe for older adults should include the following elements: a proper anatomical fit, a well-fitting toe box, a limited heel height, a broad enough heel, a firm insole and midsole, an outsole with sufficient tread and width, a bevelled heel, a bevelled shoe nose, a firm heel counter with snug fit, and an easy and effective closing mechanism.

Authors conclude that there is a need for shoe design specifically aimed at the foot morphology and demands of older people. The shoe market should increase the availability of well-fitting shoes designed for the older foot and person. 

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Section-17

Culture and footwear: 

As an integral part of human culture and civilization, shoes have found their way into our culture, folklore, and art. A popular 18th-century nursery rhyme is There was an Old Woman Who Lived in a Shoe. This story tells about an old woman living in a shoe with a lot of children. In 1948, Mahlon Haines, a shoe salesman in Hallam, Pennsylvania, built an actual house shaped like a work boot as a form of advertisement. The Haines Shoe House was rented to newlyweds and the elderly until his death in 1962. Since then, it has served as an ice cream parlor, a bed and breakfast, and a museum. It still stands today and is a popular roadside attraction.

Shoes also play an important role in the fairy tales Cinderella and The Red Shoes. In the movie adaption of the children’s book The Wonderful Wizard of Oz, a pair of red ruby slippers play a key role in the plot. The 1985 comedy The Man with One Red Shoe features an eccentric man wearing one normal business shoe and one red shoe that becomes central to the plot.

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In the Bible’s Old Testament, the shoe is used to symbolize something that is worthless or of little value. In the New Testament, the act of removing one’s shoes symbolizes servitude. Ancient Semitic-speaking peoples regarded the act of removing their shoes as a mark of reverence when approaching a sacred person or place. In the Book of Exodus, Moses was instructed to remove his shoes before approaching the burning bush:

Put off thy shoes from off thy feet, for the place whereon thou standest [is] holy ground (Exodus 3:5).

The removal of the shoe also symbolizes the act of giving up a legal right. In Hebrew custom, the widow removed the shoe of her late husband’s brother to symbolize that he had abandoned his duty. In Arab custom, the removal of one’s shoe also symbolized the dissolution of marriage.

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In Arab culture, showing the sole of one’s shoe is considered an insult, and to throw a shoe and hit someone with it is considered an even greater insult. Shoes are considered to be dirty as they frequently touch the ground, and are associated with the lowest part of the body—the foot. As such, shoes are forbidden in mosques, and it is also considered unmannerly to cross the legs and display the soles of one’s shoes during conversation. This insult was demonstrated in Iraq, first when Saddam Hussein’s statue was toppled in 2003, Iraqis gathered around it and struck the statue with their shoes. In 2008, United States President George W. Bush had a shoe thrown at him by a journalist as a statement against the war in Iraq. More generally, shoe-throwing or shoeing, showing the sole of one’s shoe or using shoes to insult are forms of protest in many parts of the world. Incidents where shoes were thrown at political figures have taken place in Australia, India, Ireland, Taiwan, Hong Kong, Pakistan, the United Kingdom, the United States, and most notably the Arab world.

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Empty shoes may also symbolize death. In Greek culture, empty shoes are the equivalent of the American funeral wreath. For example, empty shoes placed outside of a Greek home would tell others that the family’s son has died in battle.  At an observation memorializing the 10th anniversary of the September 11 attacks, 3,000 pairs of empty shoes were used to recognize those killed. The Shoes on the Danube Bank is a memorial in Budapest, Hungary. Conceived by film director Can Togay, he created it on the east bank of the Danube River with sculptor Gyula Pauer to honor the Jews who were killed by fascist Arrow Cross militiamen in Budapest during World War II. They were ordered to take off their shoes, and were shot at the edge of the water so that their bodies fell into the river and were carried away. The memorial represents their shoes left behind on the bank.

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Pueblo farmers and nomadic hunters and warriors inhabited the American Southwest for approximately 10,000 years. Their material culture, lifestyles, belief systems and world views reflect their relationship with their diverse environments and natural resources. By closely examining the traditional footwear of these peoples, a variety of topics can be explored: spiritual beliefs, social organization, the influence of environment and climate on the economies, social structure, and culture of a traditional society.

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Chinese Foot Binding in the Name of Culture:

In the aristocratic circles of China old women used to break little girls’ toes, fold them under and bind them to prepare them for a “privileged” life at the palace, as one of the Emperor’s wives. Crippled for life, hardly walking, and certainly not being able to run away from the Emperor, these young girls were assured a future life of wealthy slavery.

Like Chinese foot binding, narrow shoes cause permanent damage to the feet.

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Shoes and wedding:

Shoe-throwing at weddings has been observed in several cultures.  In Charles Dickens’ novel David Copperfield (1850), the custom is recorded by the narrator following his marriage to Dora Spenlow:

“When we were all in a bustle outside the door, I found that Mr. Peggotty was prepared with an old shoe, which was to be thrown after us for luck, and which he offered to Mrs. Gummidge for that purpose.”

In 1887, an article in The New York Times observed that: “[The] custom of throwing one or more old shoes after the bride and groom either when they go to church to be married or when they start on their wedding journey, is so old that the memory of man stretches not back to its beginning.” Peter Ditchfield, writing in Old English Customs Extant at the Present Time (1896), expands: “We also throw old shoes after young married folk in order to express our wishes for their good fortune. Probably this was not the original meaning of the custom. The throwing of a shoe after a bride was a symbol of renunciation of dominion and authority over her by her father or guardian, and this receipt of the shoe by the bridegroom was an omen that the authority was transferred to him. In Kent the shoe is thrown by the principal bridesmaid, and the others run after it. It is supposed that she who gets it will be married first. It is then thrown amongst the men, and he who is hit will be first wedded.”

Some odd traditions surrounding weddings and shoes include:

-In Hungary the groom drinks a toast to the bride out of her wedding shoe.

-In China, one of the bride’s shoes is tossed from the roof. The shoe must be red and this gives the couple good luck in the marriage.

-In the Middle Ages, the father and the groom-to-be would have a shoe ceremony. The father would then give the man authority over his daughter. At the wedding, the bride would put the shoe on to show she was now the groom’s possession.  

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Shoe tossing:

Shoe-tossing, also known as shoefiti, is the act of using footwear as a projectile as part of a number of folk sports and cultural practices. Shoe-throwing is often associated with tossing a pair of shoes with the laces tied together onto raised wires such as telephone wires and power lines, as well as trees. Shoe-tossing occurs throughout North America, Latin America, Europe, Australia, and New Zealand, South Africa, in both rural and urban areas. Often, the shoes are sneakers; other times, they are leather shoes and boots. Many cultural variations exist; differences abound between socioeconomic areas and age groups. In some cultures, shoes are flung as part of a rite of passage, like to commemorate the end of a school year or a forthcoming marriage.  Shoe throwing may be a form of bullying, where a bully steals a pair of shoes and tosses them where they are unlikely to be retrieved.  Shoe tossing has also been explained as a practical joke played on drunks, who wake up to find their shoes missing. Shoes on a telephone wire are popularly said to be linked to organised crime, signifying the location of gang turf or commemorating the death of a gang member. The shoes are also rumored to mark a spot for drug deals, although a 2015 study of shoe-tossing data in Chicago rejected this explanation.

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Section-18 

Choosing the footwear: the fit and the size:    

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Use the rule of thumb:

There should be about 3/8-1/2 inch between the front of your big toe and the end of the shoe — about a thumb’s width. The heel should fit relatively tightly; your heel should not slip out when you walk. The upper part of the shoe — which goes over the top of your foot — should be snug and secure, and not too tight anywhere. When fitting in to shoe you should be able to freely wiggly all of your toes when the shoe is on. 

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Footwear has been used by humans for approximately 30,000 years. Although originally worn as a protective covering for the foot, modern footwear is designed to fulfil a range of purposes, the accomplishment of which is judged by three criteria: form, function and fit. Form relates to the aesthetic appeal of footwear, while function relates to the ability of footwear to accomplish its intended purpose, e.g., to protect the feet of individuals who undertake activities that may present a risk of injury. Finally, fit pertains to how footwear can accommodate the morphology of the foot.

Footwear fitting is acknowledged as being vitally important as in most cases fit governs function. This means that footwear cannot fulfil its intended purpose if it does not fit the foot correctly. Furthermore, it has been suggested that incorrectly fitted footwear is a major contributor to the development of structural foot disorders, such as hallux valgus and lesser toe deformity, as well as skin lesions, such as corns and calluses.

Correct footwear fitting is an inherently complex undertaking for two main reasons. Firstly, the footwear industry is currently unable to design and manufacture footwear that can conform to the three-dimensional morphology of all feet in the population. This is because foot morphology is highly variable between individuals, and there is limited variety in the shape of lasts used to construct footwear. Secondly, footwear selection is not purely based on quantitative measurements of footwear shape and size, but may be influenced by qualitative factors. It is therefore probable that a substantial proportion of the population are wearing incorrectly fitted footwear.

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While most of the population is tempted to just put their feet in a pair of shoes they find aesthetically pleasing, great-looking footwear is often not the best choice for either proper foot function or overall health. More importantly, the consequences of wearing poorly fitting shoes can be painful and debilitating, leading to a variety of foot disorders like blisters, callouses, bunions, hammer toes, circulation problems. It can also lead to changes in the skeletal system and the muscular structure that it supports and even change a person’s posture and the way they walk. Aching feet can zap a person’s energy and cause pain in the ankles, hips, knees and lower back. What works best for one person won’t necessarily work the same for others. For some people, for example, significant limb length differences can lead to problems that are exacerbated by wearing the wrong shoes. But for many people, simply identifying shoes that fit well, are adequately cushioned, and provide the right kind of support is a step in the right direction. 

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Consider the shape of your feet:

Feet come in many shapes and sizes. To avoid painful problems, consider the shape and size of your feet when buying a pair of walking shoes. Remember, your shoes should conform to the shape of your feet. Your feet should never be forced to conform to the shape of a pair of shoes.

Width and length:

Shoes that are too narrow or too wide can lead to painful blisters and calluses. And a toe box that’s not high enough — and doesn’t provide enough room for your toes — can cause pain in disorders such as bunions and hammertoes.

Arch type:

The intricate alignment of bones, muscles, ligaments and tendons in your feet forms side-to-side (metatarsal) and lengthwise (longitudinal) arches. As you walk, these springy, flexible arches help distribute your body weight evenly across your feet. Your arches play an important role in how you adapt to various surfaces as you walk.

Choose walking shoes that accommodate your arch type. Generally, feet fall into one of three categories:

  • Neutral-arched feet. Feet with neutral arches aren’t overly arched nor are they overly flat. If you have neutral arches, look for shoes with firm midsoles, straight to semicurved lasts — last refers to the shape of the sole and the footprint around which the shoe is built — and moderate rear-foot stability.
  • Low-arched or flat feet. Low arches or flat feet may contribute to muscle stress and joint problems in some individuals, though there is not a direct correlation. If you have significantly flat feet, you may benefit from a walking shoe with a straight last and motion control to help stabilize your feet.
  • High-arched feet. High arches may contribute to excessive strain on joints and muscles, as your feet may not absorb shock as well, especially if you perform a lot of impact or jumping activities. Look for shoes with cushioning to help with shock absorption. A curved last also may help in some cases.

Most important of all, however, is comfort. There is no one “best shoe” for a particular foot type, and comfort and proper fit should be the main criteria you use.

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Some shoe choices are bad for our ankles and toes. They include fashionable heels, pointy-toed shoes and sandals that provide no support. So, you might be wondering what makes footwear “healthier” than the choices mentioned above. You should look for the following while shoe shopping:

  • Low or flat heels with cushioning
  • Rounded toes
  • Arch support
  • Soft inside
  • Good fit

You can decide on any design, but first, you should have a pair that meets the above aspects to ensure comfort and safety. When it comes to comfort, the shoes should bend where your toes bend and have room for your toes to sit comfortably. The shoes should also not push the toes or curl them.

Some other features to look for include:

  • Heel collars for ankle cushioning
  • Insoles for feet support
  • Outsoles for maintaining traction
  • Tendon protectors for Achilles tendon stress reduction

Before going to buy footwear for yourself, consider the shape of your feet. You should know your size and the best type of arch support that doesn’t cause any foot pain. If you look at podiatrist recommended shoes, you will see that they prescribe different shoes for different activities. It is especially true for activities that require a lot of footwork, like running. Some of the most commonly prescribed shoes that help you maintain an active lifestyle include:

  • Athletic shoes: There are various types of athletic running shoes: motion control, stability, cushioning, minimalistic etc. When choosing an athletic shoe, some of the most important aspects are the arch type and how you move your body. Look for shock-absorber shoes or ones that have good torque, meaning you can twist them a little from edge to edge.
  • Specific sports shoes: There are different shoes based on various sports. For instance, you have distinctive running shoes for soccer, and you would have different shoes for playing basketball. These posture corrective shoes provide additional side-to-side support.
  • Walking footwear: Athletic walking shoes are best for walking. Sandals with arch support are also good for casual walking. You can also choose boots that fit loosely but provide the necessary foot support. You should invest in boots with sturdy arch supports to get maximum comfort against the balls of the feet.
  • Dress shoes: Since these shoes are for special occasions, it is better to slip into low-heel footwear if you have to walk. It is best to avoid moving around with pointed heels as they directly affect your bones and joints.

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Look for shoes that:

-1. Have a stiff back. Grasp the heel in one hand and the shoe above the heel in the other hand. You should not be able to move the shoe side-to-side around the heel.

-2. Have a small amount of torque. Hold the shoe at both ends. You should be able to twist it slightly.

-3. Bend where your toes bend.

-4. Provide arch support. If the shoe does not have arch support, add an extra arch support. Check that the arch support can fit in the shoe without squeezing the toes or causing the shoes to slip off the heel.

-5. Are wide enough and long enough at the toes. It should not push the toes in or make them curl. The widest part of your foot should sit in the widest part of the shoe.

-6. Feel comfortable right away.

Once your feet are measured, make sure to put your shoes on with a shoe horn. This way, you won’t damage the back of the shoe.

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If you shop at a quality running store, the employees often have extensive knowledge about shoes and can help you select a pair that supports your foot type. When you try on shoes, remember these tips:

-1. Wait until the afternoon to shop for shoes — your feet naturally expand with use during the day and may swell in hot weather.

-2. Wear the socks, orthotics, and braces that you would typically wear when running.

-3. Stand up to check the length and width of the shoe.

-4. Perform a heel raise, walk, and a jog with the shoe to make sure it is comfortable and offers the support you need.

-5. How the shoe feels in the store is how it will feel when you are running, so take your time and choose carefully.

-6. Your left and right foot are most likely not the same size and may change in size from year to year.  Always fit the larger foot. Adjustments can be made to your footwear to help fit the smaller foot.

-7. Shoes, sneakers, and other footwear should feel comfortable and not pinch or irritate any part of your foot even when new. When you try on shoes, spend some time walking around in them and paying attention to how they feel. No matter how good they look, don’t buy shoes that are too tight, too loose, unsupportive, or in any way uncomfortable.

Replace your running shoes every 300 to 500 miles, because the shock absorption depletes with every passing mile. You shouldn’t be able to see the white midsole material peeking through the outsole and the sole under your heel should not appear crushed.

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Characteristics of Good Shoes: 

It is estimated that in an average lifetime, we use our feet to walk the equivalent of three times the circumference of the earth. Yet we rarely give our feet — and our footwear — much attention beyond aesthetics. Shoes may be in fact the most important part of an individual’s attire, as no other article of clothing must fit so precisely and perform critical mechanical functions such as transferring body weight. Aside from immediate foot discomfort, inadequate or incorrect footwear may lead to problems with the lower legs, knees, hips and lower back. In addition, falls – which can have dire consequences in the elderly – are most frequent among those with poorly fitting footwear.

There are many characteristics to a good shoe. Typically, price isn’t a factor as a good shoe may be cheaper than an inappropriate shoe, and famous brands are not a guarantee of a quality shoe. You should check if the shoe has the following features.

-1. Adjustable

There should be an adjustable strap such as laces or Velcro which allows for adjustment depending on an individual’s needs.

-2. Stable

The shoes’ heel support / heel cup should be soft and stable, preventing vertical or horizontal heel movement.

-3. Roomy enough

There should be sufficient room (both width and depth) at the front of the shoe for your toes. During normal walking your foot both spreads out and lengthens up to one centimeter in each direction. Therefore, you should pick a shoe that is longer than your longest toe by about the width of your thumb.

-4. Max 2.5cm (1 inch) heel

The shoe’s heel must not exceed 2.5cm in height. Otherwise, the heel and ankle become more unstable and thus prone to sprains and forefoot pain.

-5. In good condition

Monitor your footwear and discard shoes that are too worn-down, as these have often lost some of their basic functions. Continuing to run in worn-out running shoes increases the stress and impact on your legs and joints, which can lead to overuse injuries. It is suggested that a pair of running shoes should be changed every 300 to 500 miles. 

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Tips for Better Shoes for foot health:

-Make sure the shoe bends at the toe box but is not too flexible.

-Make sure there is enough arch support.

-When choosing heels, look for chunky ones that are less than 1 inches high.

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We’re all susceptible to foot and ankle injuries, but we can reduce our risk for them by wearing properly fitting shoes that conform to the natural shape of our feet. In selecting shoes, keep this basic principle of good fit in mind: Your feet should never be forced to conform to the shape of a pair of shoes.

Recommendations for Footwear:

The American Academy of Orthopedic Surgeons has developed the tips below to help people reduce their risk of foot problems:

-1. Have both feet measured every time you purchase shoes. It’s a myth that foot size doesn’t change in adults. It does change as we get older, so have your feet measured twice a year. Sizes also vary between brands, so go by what fits, not by what size the shoe is.

-2. Women should not wear a shoe with a heel higher than 2-1/4 inches.  If you do need to wear a high-heeled shoe for work or a social event one day, it is best to wear a low-heeled shoe the next day.

-3. Try on new shoes at the end of the day. Your feet normally swell and become larger after standing or sitting during the day.

-4. Shoes should be fitted carefully to your heel as well as your toes.

-5. Try on both shoes.

-6. There should be 1/2-inch of space from the end of your longest toe to the end of the shoe.

-7. Fit new shoes to your largest foot. Most people have one foot larger than the other.

-8. When you’re in the store, walk around in the shoes to make sure they fit well and feel comfortable. Try to walk on different surfaces, if possible (carpet, marble and wood, for example).

-9. Sizes vary among shoe brands and styles. Judge a shoe by how it fits your foot — not by the marked size.

-10. When the shoe is on your foot, you should be able to freely wiggle all of your toes.

-11. If the shoes feel too tight, don’t buy them. There is no such thing as a “break-in period.”

-12. Most high heeled-shoes have a pointed. narrow toe box that crowds the toes and forces them into an unnatural triangular shape. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.

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Choose footwear with straps or laces:

Slip-on shoes may be easier to put on and take off, but when it comes to comfort and injury prevention, it is not the best option. Make sure your shoes are firmly attached to your feet: sandals with adjustable straps and lace-up shoes are the best. Unfortunately, ballet flats look great but will cause you all sorts of problems. However, if you do choose to wear them make sure they have straps to hold the foot in place and have a thicker sole. As for your flip-flops, this type of footwear should not be worn for an extended period of walking or standing time. Flip-flops afford little to no structure or stability. Most are not able to provide adequate protection for longer mileage or rockier terrain. Some sandals like Birkenstock, Teva, or Naot are better constructed, but for a lot of walking, a good, stable, breathable sneaker would be best.    

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Measures and sizes of shoes:

A shoe size is an indication of the fitting size of a shoe for a person.  The measure of a foot for a shoe is from the heel to the longest toe. Shoe size is an alphanumerical indication of the fitting size of a shoe for a person. Often it just consists of a number indicating the length because many shoemakers only provide a standard width for economic reasons. There are several different shoe-size systems that are used worldwide. These systems differ in what they measure, what unit of measurement they use, and where the size 0 (or 1) is positioned. Only a few systems also take the width of the feet into account. Some regions use different shoe-size systems for different types of shoes (e.g., men’s, women’s, children’s, sport, or safety shoes).

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Proper fit is important for most types of footwear. Shoes are available in multiple sizes and widths to accommodate the anatomic variation of human feet. Several footwear sizing systems are being used to indicate the size and width of footwear: UK, US, EU, and mondopoint. A length increment of 4.23 mm for half sizes and a width increment of 4.76 mm for widths are used for the US sizing system (Luximon & Luximon, 2013). Shoe sizes are supposed to help retail customers buy well-fitting shoes. Ideally, all shoes labelled with the same size and width should provide the same fit. However, physical measurements (Jastifer et al., 2017; Wannop et al., 2019) and X-ray images (Jurca & Dzeroski, 2013) of shoes of the same size have shown inconsistent internal lengths and widths.

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Units for shoe sizes vary widely around the world. European sizes are measured in Paris Points, which are worth two-thirds of a centimeter. The UK and American units result in whole-number sizes spaced at one barleycorn (1⁄3 inch), with UK adult sizes starting at size 1 = 8+2⁄3 in (22.0 cm). In the US, this is size 2. Men’s and women’s shoe sizes often have different scales. Shoe size is often measured using a Brannock Device, which can determine both the width and length size values of the foot. A metric standard for shoe sizing, the Mondopoint system, was introduced in the 1970s by International Standard ISO 2816:1973 “Fundamental characteristics of a system of shoe sizing to be known as Mondopoint” and ISO 3355:1975 “Shoe sizes – System of length grading (for use in the Mondopoint system)”. the current version of the standard is ISO 9407:2019, “Shoe sizes—Mondopoint system of sizing and marking”. The Mondopoint system includes measurements of both length and width of the foot.

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Shoe Size is crucial for Foot Care:

Before buying new shoes, have a professional measure the length and width of your feet at the end of the day, while you’re standing. For unusually flat feet or high arches, you may want to see a podiatrist. These conditions can make you more likely to get osteoarthritis. Early treatment and wearing the right kinds of shoes will go a long way to help your feet stay well. 

Shoes are not only crucial to your style, but also for foot care. Wearing the wrong size shoe can actually bring you a lot of health problems. Not only will your feet suffer, so will your ankles, knees, and back. Diabetic people should be especially careful as ill-fitting shoes can become a critical health problem. Also, wearing the wrong size of shoes will end up damaging your footwear, which decreases the longevity of the shoe and requires consumers to make large purchases more often. For example, leather shoes should adapt to your feet in the long run, but if the shoe doesn’t fit well, they create cracks and creases.

When you wear a shoe that fits your foot properly, not tight and not loose, it provides a good platform for your foot to support your body, given that it is a good shoe to begin with. As we all know, if you wear a shoe that is too tight it will hurt your feet and lead to foot ailments, such as blisters, bunions and calluses. But wearing a shoe that is too big will cause us to walk in an unnatural and dysfunctional way. This can lead to serious foot problems.

When buying new shoes, one should buy shoes that fit comfortably. Also, do not assume that a size in one brand equates to the same size in another. When you buy new shoes measure your foot’s length and width with a Brannock Device. A Brannock Device is the standard foot measuring tool used by footwear designers and manufacturers. Use these measurements to find a proper fitting shoe and always try on and walk around wearing the shoe.

The only time that you could wear a shoe in a bigger size is when purchasing a sneaker but you should only go up about half a size. The reason for this is that our feet tend to swell because fluid accumulates due to gravity with prolonged standing and weight baring activities. Buying a sneaker that is slightly larger than your foot allows for better circulation which minimizes swelling. If one foot is slightly larger than the other go for the bigger size and always consider the kind of socks you plan to wear with your shoes. Your feet will thank you at the end of the day when they are comfortable, supported, and unrestricted.

Although feet are usually the last part of your body to pick up body fat, once fat wraps around parts of your feet, the length and width may be the same as before but your foot can become too large to fit into footwear designed for that length and width. So if you are overweight, you should not order footwear online. 

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Measuring your feet at Home:  

If you don’t have access to the Brannock Device, you can also measure your feet at home. It merely takes a simple sheet of paper, a pen and a measurement device (ruler or a measuring tape.) But there’s a setback with this method: You won’t be able to measure your arch. It is definitely more accurate to use the Brannock Device.

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Measuring your feet: The Brannock Device®

The Brannock Device is the best way to measure your feet. It gives you three important measurements:

Length

Width

Depth (arch measuring)

Having these three measures will provide you with an accurate and current size of your shoe. The device is usually present in shoe stores and department stores, allowing you to get the measurements before purchasing a shoe. The only setback with the Brannock Device is that it won’t measure your instep. The Brannock Device pictured above is commonly used to measure sizes in the USA. The size system is linear. Men’s size 1 is 7 ⅔ Inches long and each additional size is ⅓ Inch longer.

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Mondopoint:

Figure above shows measurement of foot length, width and perimeter (circumference) as defined in the Mondopoint standard.

The Mondopoint shoe length system is widely used in sports industry to size athletic shoes, ski boots, skates, and pointe ballet shoes; it was also adopted as the primary shoe sizing system in the Soviet Union, Russia, East Germany, China, Japan, Taiwan, and South Korea, and as an optional system in United Kingdom, India, Mexico, and European countries. The Mondopoint system is also used by NATO and other military services. 

The Mondopoint system was introduced in the 1970s by International Standard ISO 2816:1973 “Fundamental characteristics of a system of shoe sizing to be known as Mondopoint” and ISO 3355:1975 “Shoe sizes – System of length grading (for use in the Mondopoint system)”. ISO 9407:2019, “Shoe sizes—Mondopoint system of sizing and marking”, is the current version of the standard.

The Mondopoint system is based on average foot length and foot width for which the shoe is suitable, measured in millimeters. The length of the foot is measured as horizontal distance between the perpendiculars in contact with the end of the most prominent toe and the most prominent part of the heel. The width of the foot is measured as horizontal distance between vertical lines in contact with the first and fifth metatarsophalangeal joints. The perimeter of the foot is the length of foot circumference, measured with a flexible tape at the same points as foot width. The origin of the grade is zero.

The labeling typically includes foot length, followed by an optional foot width: a shoe size of 280/110 indicates a foot length of 280 millimeters (11.0 in) and width of 110 millimeters (4.3 in). Other customary markings, such as EU, UK and US sizes, may also be used.

Because Mondopoint takes the foot width into account, it allows for better fitting than most other systems. A given shoe size shall fit every foot with indicated average measurements, and those differing by no more than a half-step of the corresponding interval grid. Standard foot lengths are defined with interval steps of 5 mm for casual footwear and steps of 7.5 mm for specialty (protective) footwear. The standard is maintained by ISO Technical Committee 137 “Footwear sizing designations and marking systems.”

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How to choose the correct shoe size: 

Measuring the insole (shoe insole) is the best known and easiest method when buying new shoes. However, it also has its pitfalls, so take it as a guide only. Why? The insole sometimes bends at the toe or heel of the shoe, therefore reducing the foot’s inner space. The inner space of the shoes can also be reduced by a thicker insole. On the contrary, thanks to a thicker insole, longer and wider shoes can suit people with shorter and narrower feet, as this results in the shoe fitting better.

Ideally measure the insole in your favourite shoes and orient yourself according to its length when choosing the size of new shoes.

INSOLE LENGTH = FOOT LENGTH + A 12 MM EXCESS

When choosing the size of the shoe, pay attention to the 12 mm minimum excess. (Note: The excess is the free space in front of the toes and behind the heel that’s necessary for the free foot movement.) With a smaller excess, the shoe will squeeze you when you walk and there’s a risk of unpleasant blisters / deformations of toes or feet when worn over a long period.

For example: For size 36, the insole is 230 mm. After deducting the excess 12 mm, the maximum length of the foot is 218 mm. If you have a longer foot, you should consider size 37.

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International shoe size conversion:

This converter chart which will help you find your US shoe size (both, US men’s and US women’s), UK sizes and Euro shoe sizes. Either convert from one shoe size to another or measure your foot and convert to the preferred size. Remember this chart of shoe size denotes shoe size in foot length only.

Shoe Size Conversion Chart:  

US Men’s Shoe

US Women’s Shoe

UK Size

EU Size

Foot Length in Inches

Foot Length in CM

3

4,5

2,5

34,5

8 1⁄2

21,6 cm

3,5

5

3

35

8 2⁄3

22,0 cm

4

5,5

3,5

35,5

8 5⁄6

22,4 cm

4,5

6

4

36,5

9

22,9 cm

5

6,5

4,5

37

9 1⁄6

23,3 cm

5,5

7

5

37,5

9 1⁄3

23,7 cm

6

7,5

5,5

38

9 1⁄2

24,1 cm

6,5

8

6

39

9 2⁄3

24,6 cm

7

8,5

6,5

39,5

9 5⁄6

25,0 cm

7,5

9

7

40

10

25,4 cm

8

9,5

7,5

40,5

10 1⁄6

25,8 cm

8,5

10

8

41,5

10 1⁄3

26,2 cm

9

10,5

8,5

41,5

10 1⁄2

26,7 cm

9,5

11

9

42,5

10 2⁄3

27,1 cm

10

11,5

9,5

43,5

10 5⁄6

27,5 cm

10,5

12

10

44

11

27,9 cm

11

12,5

10,5

44,5

11 1⁄6

28,4 cm

11,5

13

11

45,5

11 1⁄3

28,8 cm

12

13,5

11,5

46

11 1⁄2

29,2 cm

12,5

14

12

46,5

11 2⁄3

29,6 cm

13

14,5

12,5

47

11 5⁄6

30,1 cm

13,5

15

13

47,5

12

30,5 cm

14

15,5

13,5

48,5

12 1⁄6

30,9 cm

14,5

16

14

49

12 1⁄3

31,3 cm

15

16,5

14,5

49,5

12 1⁄2

31,8 cm

15,5

17

15

50

12 2⁄3

32,2 cm

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Shoe size with foot width system:

There are 9 widths in the US system. From narrowest to widest, they are: AAA, AA, A, B, C, D, E, EE, EEE. The D width is considered to be “medium”. The widths are linear and are separated by 3/16 of an inch. Just to keep things interesting, the actual width measurement which yields a D width size varies with the length size. 

When you use one of these at a shoe store, make sure it’s marked for men’s sizes and also that it isn’t the special red version made for athletic footwear. Sneakers don’t use the US men’s measuring system… they are about a size smaller than footwear which uses the standard US men’s measuring system.

Even with these systems, shoes vary in size because the lasts on which footwear is built tend to vary from the standard. It is very likely that you have shoes and boots in your closet which fit just fine but are labeled with a number of different sizes. Athletic shoes are notorious in this regard. It’s not unusual to see someone with a size 10 foot wearing athletic shoes in size 11 or 12. On the other hand, they may wear a size 9 or 9½ combat boot.

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Shoe Size Changes:

Many often think of foot size as being static; once you reach age 18, or at least when you stop growing, your feet no longer change in size. But your feet change in many ways over the course of a lifetime:

-As you age, tendons relax and your feet can naturally widen.

-Certain medical conditions and medications cause water retention, which can cause foot swelling (and, therefore, size difference).

-During pregnancy, feet are affected by hormones that often result in an increase in shoe size.

-Even in younger people, feet swell slightly by the end of the day. They also swell when engaging in an upright activity such as walking, running, or playing sports.

While your shoes may fit right in the morning or before your workout, they may be too tight later in the day. Even people who wear “sensible” shoes can experience problems with fit.

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Importance of wearing the Right Shoe Size: 

If you’ve experienced foot pain, corns or callouses, foot deformities, or you aren’t feeling as steady on your feet as usual, you may want to get your shoe size measured. According to a 2018 study, only about 28 to 37% of people are actually wearing shoes of the right length and width. Other studies have found that only about a quarter of people are wearing shoes of the right length and width. This is especially alarming when the studies were looking at elderly patients who may be at risk from falls when their shoes have a sloppy fit.

Several studies have now demonstrated how ill-fitting shoes can have a negative effect on health and why well-fitting shoes are so important.

Peripheral neuropathy is a painful and usually irreversible condition with symptoms of pins and needles in the feet and a decreased ability to feel where the feet are in space. A 2017 study found that, among older adults with a history of foot lesions, such as corns and calluses, only 14% were wearing the right size shoes. Thirty seven percent of the population reported evidence of neuropathy; tight-fitting shoes can worsen the symptoms of neuropathy by putting pressure on the nerves. Other conditions that are more common in older adults, such as diabetic neuropathy, can work together with poorly fitting shoes to worsen both the symptoms and prognosis.

A 2018 scientific review of 18 studies looking at shoes and foot problems found that poorly-fitting shoes were associated with foot pain and foot conditions, such as lesser toe deformity (hammer toe), corns, and calluses. Notably, people with diabetes tended to wear shoes that were too narrow.

It’s not just shoes that are too tight that can lead to pain and deformity. In some cases, the shape of the shoe may not be a good fit to contour to the shape of your foot. If you already have a foot deformity of some kind, for example, shoes with a smooth shape that causes pressure on the irregularly-shaped bony areas of your foot can make it worse.

If your shoes are too narrow or short, the extra pressure placed on your toe can lead to the edge of a toenail growing into your skin. Ingrown toenails can cause the skin around your nail to become red or infected. Ingrown toenails are most common on the big toe, but can also occur on other toes. To avoid this issue, ensure that you have properly fitting shoes and are not cutting your nails too short or rounded at the edges.

In addition, foot pain and foot conditions related to poor-fitting shoes can lead to falls, reduced mobility, and related loss of independence in older adults.

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How to tell if shoes are too big or too small:

The simplest way to tell if a shoe is too big or too small is to look at how much room there is in the toe of the shoe. There should be about one finger’s width of space between your longest toe and the end of the shoe. Another way to check this is to slip a finger between the heel of your foot and the heel of your shoe. There should be just enough space for your finger to fit snugly. If your finger slides in easily with space to spare, you should probably go down a half size, while if it’s a tight squeeze, go up half a size.

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Nike to fix the wrong size shoe:

Nike has launched an app setting that provides “hyper-accurate” sizing recommendations for each of its shoes by scanning your feet with a smartphone camera. Called Nike Fit, the tool – available as both in-store and at-home options – aims to address the problem of customers ordering and wearing the wrong-fit shoe. The tool – which is a part of the existing Nike app – uses augmented-reality technology to scan your feet with a smartphone camera, mapping each foot’s dimensions using a 13-point measuring system. The sizing predictions are programmed using artificial intelligence, meaning that the more people use it, the more accurate it will become. Nike hopes the tool will reduce the number of size-related returns and increase customer satisfaction. To gauge the correct shoe size, users are asked to stand with their feet facing against a wall with socks that contrast with the colour of the floor. The frame is then calibrated by moving a line to mark the base of the wall. A photo is then taken of the feet using the phone camera. The information collected is used to suggest the best fit for every shoe in Nike’s catalogue, in UK, US and European size conversions. A scan can take less than 15 seconds. And then Nike Fit will recommend a size for that particular shoe being considered. That information — such as the width of the shoppers’ foot, down to the millimeter — will be saved for later purchases, too, because the size may vary with the style. Nike’s Air Jordan shoe, for example, fits differently than other sneakers. In stores, Nike will have a similar experience, but a sales associate will do the scanning.

Data shows how many people are either squeezing into a shoe too small or have one falling off the foot. At any given time, 3 in 5 people are wearing the wrong shoe size, based on industry research. And the biggest reason for shoes being returned — whether they were purchased in store or online — is because of size. Nike receives more than 500,000 calls each year to its customer-service line related to sizing. Return deliveries of all products will cost retailers $550 billion by 2020, according to estimates.

And, worse news for consumers, wearing the wrong size shoes can lead to injuries that can sideline them from playing a sport or from going to the gym. Foot injuries can also keep you from going to work. At least 60,000 foot injuries are responsible for keeping Americans out of the office each year, according to data from the Bureau of Labor Statistics.

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Shoe rotation:

Shoe rotation involves alternating the pair of shoes you wear day to day, rather than wearing the same pair day in, day out. Shoe rotation is of upmost importance for both your health and the health of your footwear. Many podiatrists recommend shoe rotation to their clients for various reasons. Recent evidence based literature has also concluded that shoe rotation reduces the chance of suffering from painful conditions of the foot such as plantar fasciitis (heel pain) (Werner R 2010).

The old idea of rotating shoes is very sound, as is participating in other forms of exercising. Rotating your shoes can make them last longer, and it might also be better for your feet, experts say. Take shoes that have cushioning, such as running sneakers, for instance. Try not to go for the same pair of shoes every day. A lot of shoes have cushioning built into them, usually some sort of open-cell compression material. But when you run, the cushioning flattens out, and it takes some time for the cushion to get back to its pre-squished state. Buy two pair of the same shoes, if you can, and alternate them. Another reason you might want to rotate your shoes is Sweat. Our feet sweat throughout the day, and shoes soak it up.  That means shoes need time to dry before you wear them again. Rotating shoes can also decrease injury risk by up to 39% and mixing up training was even better.

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In first-of-its-kind research published in 2013, runners who split their mileage among multiple shoe models had 39 percent fewer injuries during the 22-week study than runners who always or almost always wore the same shoes. Of the 264 runners in the study, 116 were classified as single-shoe wearers; runners in this group did 91 percent of their mileage in the same shoe and ran in an average of 1.3 pairs of shoes during the study. The other 148 were classified as multiple-shoe wearers; runners in this group tended to have a main shoe, which they wore for an average of 58 percent of their mileage, but they rotated among an average of 3.6 pairs of shoes for their training during the study. The researchers wrote that this could be because different shoes distribute the impact forces of running differently, thereby lessening the strain on any given muscle tissue. “Multiple shoe use and participation in other sporting activities are strategies leading to a variation of external and internal loads applied to the musculoskeletal system that could have a beneficial effect on running injuries,” the researchers wrote.

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Section-19

Shoe care:

Regardless of the style, clean and well-kept shoes are the biggest tell about how invested the person is in coming across as well-put-together in front of others; which is why it’s important to clean your shoes properly.

Leather Shoes:

During the make and tanning process of leather shoes, the natural oils present in the leather are extracted and later reapplied to give the leather its sheen. As the leather gradually loses its external layer due to wear, it loses the shine and elasticity with it. To prevent this from happening, leather shoes need to be cleaned regularly. It’s recommended to clean them after every wear by taking a brush and gently removing the dust from the surface. Shoe polish and sprays help in keeping the shine and elasticity of the shoes. Once the shoe has been thoroughly sprayed, work it into the leather by gently rubbing the polish all over. For better results, polish the shoes with a quality fabric.

Suede Shoes:

Just like leather, dust and dirt can be removed easily by a cleaning brush made for suede shoes.

Fabric Shoes:

Textile shoes often absorb dirt and stains so a superficial clean with a damp piece of cloth isn’t enough to maintain its quality. Fortunately, shoes made out of fabric can be soaked in water and a universal solvent to remove stubborn grime. It’s best to use a mild detergent and hand-wash it to maintain its integrity.

Certain seasons and weather conditions aren’t suited for most shoes. In such cases, caring for a soaked pair of wet boots or muddied sneakers can not only prove to be tiring but may also damage the shoes. It’s best to leave such an arduous task to professionals and experts who can handle the shoe repair and shine using the right substances and cleaning kit.

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Shoe care tips:

-1. Keep shoes away from heat or direct sunlight. Don’t leave them in a hot car. This dries up, shrinks, and hardens the midsole, which reduces the durability and cushioning.

-2. Shoes can break down when you’re not running. Don’t stack them under your boots or other heavy shoes. The uppers are pliable, and crushing them wears them down.

-3. If you get caught in the rain and your shoes get soaked, take out the insoles. If you have orthotics, remove them as well, and let your shoes completely dry. If you don’t want to spend extra money on water-resistant footwear, opt for a waterproofing spray and let your shoes dry for at least 24 hours before you wear them. Dry wet shoes by stuffing them with newspaper after removing the insoles. Wet shoes that air-dry on their own tend to stink. In addition to helping dry your shoes quickly, stuffing newspaper tight into the toebox helps retain the shape of the shoe. After the first 10 minutes the paper will have soaked up as much water as it can, so switch it out with another batch, and leave it.

-4. Unlace your shoes to take them off, rather than using your foot to kick them off. And retie them when you put them on. This prevents the heel cup from getting crushed and losing support.

-5. Thin, lightweight uppers can wear out before the sole does. Reinforce weak spots in the upper with blister patches.

-6. Give your shoes a 48-hour break between runs by training with a second pair. It takes about that long for the foam to de-compress. And that can extend the life of a pair by up to 100 miles. Footwear rotation is important for everyone. Shoes need to air out in order to stop the breeding of bacteria and fungus to protect the health of your feet and also the durability of the shoes.

-7. Some shoes don’t show when they’re past their prime, especially if you use them indoors. If you don’t log every mile, write the date you start using your shoes on their sides to estimate total mileage.

-8. Never put shoes in the washing machine or dryer. The textiles and performance materials are not meant to go through an intense wash and dry cycle. Buy some baby wipes to clean them, or use a little soap on a dish brush and scrub off whatever part you’re bummed got dirty.

-9. Don’t stockpile a lifetime supply of shoes in your closet. Typically, within two years, any shoe’s midsole will start to break down even without use.

-10. To put shoes on or to remove them use always a shoehorn. It makes it a lot easier to slip in the shoe and spares the shoe from damage. Most shoehorns are made of plastic, but there are also great one made of wood or metal. For boots there are special longer shoehorns.

-11. Use disinfectant spray. If you exercise a lot, one concern you probably have is athlete’s foot, which you can help prevent with proper shoe hygiene. Spraying Lysol into your sneakers help kill any microbes that may cross contaminate the outside environment to the inside of the shoe. 

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Shoe storage:

Shoes should be stored somewhere the leather can breathe and they’re not affected by sun or heat. A shoe rack in the corridor should do it. If you’re not wearing a pair very often, a clear shoe box may be a stylish alternative. Your shoes are safe and you can easily look at them. The most important thing about storage is the shoetree. Every time you get home put a shoetree in your shoes. A shoe tree is a device approximating the shape of a foot that is placed inside a shoe to preserve its shape, stop it from developing creases and thereby extend the life of the shoe. Perhaps more important than maintaining the shape, shoe trees also play a crucial part in wicking away moisture caused by sweat – a major cause of lining rot and leather degradation. This is especially important when shoes are worn without socks. Higher quality shoe trees are made from softwood, usually cedar, which helps control odor and absorb moisture. A shoe tree holds a shoe in its proper shape so it dries out correctly, and keeps the leather from cracking by wicking away moisture. The absorbent wood also helps dry out the lining of shoes so that they don’t rot from the inside out.

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Shelf Life of running shoes:

Your running shoes are like your car’s tires. They provide traction and support while getting you where you want to go. Just like tires, your running shoes should be replaced after a certain number of miles. But what about shoes that you haven’t worn yet? Some runners buy multiple pairs of their favorite shoes or stock up when they’re on sale. But even if you’re not wearing them, your running shoes will eventually begin to break down while sitting inside your closet.

Most shoes are made with a rubber outsole, which grips pavement and adds durability, and a foam midsole to absorb shock and provide a springy feel. Sadly, neither component lasts forever; both will eventually break down, even on unworn shoes. If the soles feel noticeably less cushioned than when you first bought them, it’s time to get a fresh pair. Once shoes have been sitting around for a while, the impact absorption rate will go down, because the rubber and foam age. The foam can also start to splinter on the inside. The decreased shock absorption may also cause injuries to some runners. Instead of the shoe absorbing the impact, the legs and body are now taking on a greater amount of force than they were when the shoes were new. Experiencing new aches and pains without any increase in training volume is another clue that your shoes have worn down.

The rubber and foam aren’t the only materials that begin to deteriorate. The upper can malfunction as well. That’s because the upper piece is usually all one stitch and is typically attached to the midsole with glue. It’s usually the glue that degrades first, even just sitting on a shelf. Noticing loose threading on the upper, specifically around the edges, is another clue that your shoes have aged.

While shoes won’t start to deteriorate immediately after buying them, you should begin using them six to 12 months after your purchase. This is when they start to break down little by little. It may not mean they’re completely unusable. It just means that if you were to compare them with a new pair of the same exact shoe, they won’t feel as cushioned. Not only will the shoes begin to feel stiffer, but they won’t last as long as a fresh pair. Most manufacturers recommend using their shoes for about 300-500 miles. You’ll sometimes only be able to get 200 miles out of older unworn shoes without increasing your risk of injury.

Heat and humidity really hurt the shoes because the glue can start breaking down faster and the foam will become softer and worn down. If they’re stored in cold weather, the foam will become stiff, making it unable to decompress and absorb shock the way it should. A good rule of thumb is to keep your running shoes indoors, whether they’re new or old. If you are going to buy an older model of shoes on sale, do so within two to three months from when the newer model is released. If it’s one of the last colors made by the manufacturer, they’re likely from the last batch and haven’t been sitting around for too long. Any longer than that, you won’t know how long they’ve been sitting around. Your local running store can likely tell you how long they’ve had a pair of shoes in stock, but there’s no telling how long the manufacturer has had them. Even though we all love a great discount, it may not be cost effective to buy sale shoes if they’ve been sitting around in a warehouse for six months. They probably won’t last you the full 300 to 500 miles that a new shoe will.

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Section-20

Worn-out footwear:

The shoe sole consists of an outer sole, midsole and insole from the bottom to the interior. The midsole is mainly required to perform two functions: shock absorption and stability during human locomotion. Shock absorption plays a role in protecting the body from impact forces at heel strike, which reduces the strain of the muscles and the soft-tissue vibration in the lower limbs (Clarke et al., 1983; Light et al., 1980; Lafortune and Hennig, 1992). Stability plays a role in bracing the ankle to limit excessive movement of the lower limbs and stabilize locomotion (Lafortune et al., 1994; Milani et al., 1995; Nigg et al., 1998). These two functions prevent various injuries of the joints, muscles, ligaments, and cartilage in the lower limbs. However, wear of the shoe sole is unavoidable with long term use of the shoe. One study using young men showed that most of the shoe sole used for at least one year was worn out around the outer lateral portion of the heel, and this local wear reached up to the midsole. Furthermore, the worn-out shoes that simulated long term use increased supination of the subtalar joint and extortion of the lower leg during walking, compared to that of a shoe without wear. These findings indicated that a worn-out sole affects the stability of the shoe.

While walking, the human body requires optimal movements in order to minimize the energy cost. Conversely, deviation from these optimal movements increase the energy cost (Cavanagh and Williams, 1982; Michael et al., 1996). In another study, worn-out shoes increased movement of the lower limb, as previously described, and shifted the center of foot pressure (COP) further toward the side at mid stance. The lateral shift of the COP indicates increased displacement of the body from side to side during walking (Nigg et al., 2003; Yuancheng et al., 1993). Thus, these biomechanical responses to worn-out shoes produce additional energy cost, which is reflected in an elevation in oxygen uptake during walking.

Prolonged physical activity leads to muscle fatigue in active muscles and a decline in muscle tension (Sargeant and Dolan, 1987; Newham et al., 1983). Prolonged walking with worn-out shoes might cause fatigue of the muscles to compensate for the inadequacy of the shoe in preventing excessive movement of the lower limbs. This phenomenon would make it difficult to stabilize the movement of the lower limbs, and consequently, require an additional energy cost. In addition, prolonged walking might increase impact acceleration in the lower limbs, because some muscles adapt to heel strike-induced impact forces and shock waves (Wakeling et al., 2001; Wakeling et al., 2003; Lafortune et al., 1996).

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Over time, the wear and tear on your shoes can wear them out. When that happens, it’s time to replace them. Otherwise, your worn out shoes can lead to foot problems and pain. Your feet use a combination of muscles, bones, and joints that work together to help you walk, run, or jump. Whereas, your shoes help to provide your feet with support while you’re completing these actions. Additionally, your shoes protect your feet when you’re walking on rough terrain or on hot or cold surfaces. And they shield your feet from harm, like cuts and bruises, to some extent. Periodically, you need to do a footwear checkup on all your shoes – especially if you have shoes that you’ve worn for over 8 months to a year. Sometimes, shoes can even wear out after 6 months of use, especially if they’re your favorite, go-to shoes, work boots, or running shoes. It all depends on how much you wear them.

Worn out shoes can contribute to a variety of foot problems, such as:

Blisters

Corns

Calluses

Plantar fasciitis

Achilles tendinitis

Shin splints

Twisted ankles

Knee pain

Back pain

If you have any existing foot conditions or pain, your worn footwear can actually make these conditions worse. Therefore, you should complete a shoe quality inspection every so often to ensure your shoes are still functional and in good condition.

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Signs of worn-out Shoes:

Most people realize their shoes are worn when they get a hole in them. But not all signs of shoe wear are glaringly obvious! Just because your dress shoes, casual shoes, and/or athletic shoes may still look good, their condition can deceive you. Shoes can lose their functionality long before they lose their looks. You should make a note each time you buy a pair of shoes, so you don’t forget how long you’ve actually had them.

ATHLETIC SHOES:

The cushioning on these wears down fastest because they suffer from fast starts, stops and changes in direction, plus more pressure than walking shoes. When you run, the pressure you put on the shoe is two or three times your body weight. When you land from jumps in sports such as basketball or volleyball, the pressure is 7 to 8 times your body weight.

As a general rule, the life of a running shoe is 300 to 500 miles, though it varies with your body weight, gait and surface on which you run. Following that rule, someone who runs 4 miles, four times a week should consider replacing shoes after about 6 months, while a more casual athlete could wait a year. Running shoes typically can’t be repaired.

One way to check if running shoes need to be replaced is to look at the midsole, which is the foam part of the shoe between the outer sole (the bottom of the shoe, where the treads are) and the upper (the top of the shoe, where the laces are). When it starts to wrinkle deeply, the shoe is losing its cushioning and getting worn out. The midsole warps with heat, sun exposure and moisture, so if you run somewhere damp, it breaks down faster.

CASUAL WORK OR WALKING SHOES:

As a rule of thumb if you wear a pair of shoes to work three to four times a week, after a year or so they’ll either need fixing or trashing. You know it’s time to repair or replace when you have scuffed heels or flat spots on the outer sole, or when the back edge of the heel gets so worn that it’s angling sharply. Another sign is when inside pieces of the shoe poke through, like a nails showing in the heel. One test is to set the shoes on a flat surface and look at them from behind. If they tilt to the side, it’s time to fix or toss.

LEATHER DRESS SHOES: 

If you buy good-quality shoes and take good care of them, resoling and re-heeling when necessary, they could last five to 15 years. Whether repairing is worth the cost depends on how much you paid for the shoes in the first place, as high-quality leather resoling runs $35 to $45. If they’re inexpensive shoes, it’s probably smarter to just buy new ones. (The leather sole needs replacing if when you put your thumb in the center of the outer sole at the ball of the foot, the leather feels soft instead of firm.) A component to keep an eye on is the leather on the upper part of the shoe, which can get stiff if not regularly cleaned, polished and conditioned. Once it hardens, the leather can crack where the shoe bends, and there’s nothing you can do about that. In addition, these shoes can suffer damage to the toe box, the cardboard frame at the toe of the shoe, such as indentations from kicking or being stepped on. That’s too costly to fix, so it’s time to toss.

HIGH HEELS: 

Because the heels are narrower and the soles are usually thinner, high heels wear down faster than flatter shoes. The most wear happens near the toe on the bottom of the shoe, because that’s the area that bears the most weight. If the thickness of the sole has worn down by half, it’s time to resole or replace. The heel also wears down quickly, so as soon as you start to see the nail poke through, get new heel lifts. High-quality heel lifts can last twice as long as the originals from the manufacturer.

SANDALS, FLIP-FLOPS:

The upper part of a sandal bears a lot of stress to keep the foot in place, making for a shorter life than enclosed shoes. Stretched or broken straps mean it’s time to replace or, if they’re very expensive shoes, repair. The same heel and sole issues apply to sandals as other shoes. So if those Crocs are starting to look like lopsided pancakes, time for a new pair. 

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According to the American Academy of Podiatric Sports Medicine, check your athletic shoes after a total of 300 to 500 miles of running or walking, or 45 to 60 hours of sports, such as basketball, dance, or tennis. After that time, your shoes will have endured approximately one million steps and may have lost their cushioning and support. A worn shoe can exaggerate the biomechanical faults you already have. Shoe wear patterns can help you decide whether you need to correct any issues, if your feet are being adequately supported, or if it’s time to go shopping for a replacement pair. And keep in mind that even a shoe that appears relatively new could be hiding a worn-out sole.

-1. Heels

The shoe on the left shows a normal shoe wear pattern after 350 miles. The shoe on the right is the same model and the same user. But the shoe on the right has only been worn for 100 miles. This depicts a normal shoe wear pattern for a person with a neutral gait, who neither overpronates nor supinates. It rolls through the step from heel strike to push off with the big toe in a straight line. You can see the wear at the toe and at the heel.

-2. Soles

Worn soles signify that you should replace your sneakers.  Shoes are often designed to show this wear on the sole with a change of color, which can help persuade you that it is time to replace the shoes. The shoe pictured on the left has logged about 350 miles and is showing wear on the sole near the big toe.

-3. Sole Cushioning

Wrinkles are developing in the indented area in the heel of the shoe on the left, a sign that the shoe isn’t springing back from the compression it uses to cushion each step. The shoe pictured on the left has endured about 350 miles of walking, which equates to about 770,000 steps. It’s clear there’s already a significant loss of cushioning. Though this is a bit more difficult to assess than other wear patterns, inspect your shoes for different patterns of wrinkles. Compression lines signify that the shoe is aging and losing its ability to cushion and support. (If you were switching back and forth from wearing the older shoe to wearing a fresh pair of shoes, you could probably feel the difference in cushioning.) 

-4. Shoe Exterior

Constant pressure and rubbing from your big toe or your little toe may cause small holes to appear on the tops of your shoes. Worn-out uppers (the fabric covering the toe box) are a sure signifier that it’s time to replace your sneakers. Other holes may appear around the ankle cuff of the shoe due to ankle friction while walking. When you see a hole, it’s time to replace your shoes.

-5. Shoe Interior

The shoe pictured is breaking down from the inside out. Not only do the outside of shoes reflect wear and tear, but you also may be creating holes in the interior of your shoe. This walker has worn through the first layer of fabric at the bottom of his ankle as the bone rubs against the side of the shoe. A hole may occur in a spot where you developed a blister or hot spot. The rubbing of your foot against the shoe creates friction that can damage your skin as well as the shoe fabric.  Interior holes are also a sign that your shoes may be too tight and you need bigger shoes, as feet naturally swell while walking. This is also why when buying shoes, it’s better to shop in the afternoon when your feet increase in size to ensure a better fit. 

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Painful consequences of running in worn-out shoes:

The ramifications of running in worn-out shoes are pretty serious, and likely to result in overuse injuries like plantar fasciitis, patellofemoral syndrome, shin splints and IT band soreness.

Plantar fasciitis:

Plantar fasciitis is one of the most common injuries that occur when running in worn-out shoes. As one may predict plantar fasciitis has to do with inflammation of the plantar fascia, which spreads from the medial side of the calcaneus (heel bone) to the ball of the foot. Commonly, the pain experienced with plantar fasciitis is localized to the medial aspect of the heel bone, as well as the medial arch of the foot. This is because when the fascia is stretched during the landing phase of running, stress is placed at the heel. Thus, when inefficiencies in gait, foot or shoes are present, plantar fasciitis can develop.

Patellofemoral Syndrome (aka Runner’s Knee):

Runner’s knee is commonly characterized by pain behind or around the kneecap (patella), that most often occurs when climbing or descending stairs, squatting, or during activities such as running or cycling. The injury is thought to result from increased pressure on the patellofemoral joint which may result from a combination of increased activity, quadriceps imbalance and tight stabilizing structures such as the iliotibial band.

Shin Splints:

Shin splints, also known as Medial Tibial Stress Syndrome, is the most common overuse injury among avid runners and multisport athletes. The pain usually occurs gradually and is often the cause of biomechanical irregularities, changes in training, chronic overuse and/or the sudden change in footwear. Thus making it crucial to be aware of your training load and running shoe condition.

IT Band Syndrome:

Sharp, stabbing pain on the outside of the knee is the most common symptom. It tends to be most noticeable five to ten minutes into a run and usually forces a runner to walk or stop running altogether. A common cause for IT band soreness in runners, is running in worn-out shoes. This can be also influenced by a lack of strength in the gluteus medius muscle. A muscle used for single leg stance stabilization. 

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Second hand shoes: 

When it comes to secondhand shopping, there’s undoubtedly a market for shoes. Here are some tips:

-1. Pre-owned shoes are often priced significantly lower than brand new styles, even with little to no wear. People often buy a pair, only to discover they don’t fit quite right or are uncomfortable. So, when they clean out their closets and put the shoes up for sale, you have the opportunity to get the shoe that’s still in great condition for a reasonable price. 

-2. It’s good for the Environment.  While many brands have worked to eliminate toxic chemicals and incorporate eco-friendly materials in the production process, recycling and reusing shoes is still one of the most effective ways to limit harmful carbon emissions in the air and waste in landfills. 

-3. The thought of slipping into another person’s shoes may seem gross to some, but most shoppers have little reason to be concerned about their health being affected in doing so. The safety of wearing used shoes should be considered carefully in high-risk patients who are immunocompromised. However, gently used shoes that have been properly cleaned and deodorized should not negatively impact the foot health of a new owner. It’s important to note that if there is a break in the skin or toenail, the transferring of fungus, molds or yeasts can occur — which can lead to infections like Athlete’s foot. These types of infections are treatable with over-the-counter anti-fungal medications, but can easily be prevented by washing your feet daily, wearing clean socks and properly cleaning and drying shoes if they get wet or soiled.

-4. Depending on the material that a shoe upper is made out of, the fit of the shoe can change based on the shape or structure of the foot that occupied the shoe before. Leather, for example, has a lot of stretch and can be broken in by the first owner in a way that may not correspond to the foot shape of the new shoe owner. Styles like pumps and heels that feature the material can become stretched to the point where they no longer hold the foot in place when walking. This can cause the tendons and muscles to compensate, resulting in overuse injuries such as tendinitis. Shoe width is also another important consideration, especially if there are areas of rubbing that are causing calluses or pressure points. In order to avoid these results, doing a few laps around the store in the shoes to see if your foot is properly supported. In some cases, pre-wear can actually help with the normal break in process. This happens when the leather is stretched and worn in areas that typically cause pressure — particularly on the sides of the toes.

-5. While pre-wear can work to your advantage, you should still avoid styles with dramatic wear on the sole. Thinning on the bottom of flat styles like sneakers or uneven heel patterns in dress shoes can result in greater pressure on the ball of the foot — and thus more pain — for a new owner.

-6. If you fall in love with a pair of shoes, all hope is not lost. Arch support products or heat-molding insoles can be used to help add structure to shoes. And as far as smell is concerned, there are some handy sprays and cleaners available to decrease odor.

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Section-21

Socks:

A sock is a piece of clothing worn on the feet and often covering the ankle or some part of the calf. Some type of shoe or boot is typically worn over socks. The word sock comes from the Old English word socc, which translates to light shoe or slipper, but the concept of using foot coverings for protection dates all the way back to ancient Egypt between A.D. 250 and A.D. 420. Early knit socks were made individually through a time-consuming process, making the garment strictly reserved for members of high society. As time passed, however, innovations throughout the Industrial Age and an increasing demand for textiles led to greater accessibility of socks. Nowadays, socks come in so many silhouettes, prints, materials and price points. From comfort, to health concerns, to personal style, there are many different reasons we wear them. Socks can be created from a wide variety of materials, such as cotton, wool, nylon, acrylic, polyester, olefins (such as polypropylene). To get an increased level of softness other materials that might be used during the process can be silk, bamboo, linen, cashmere, or mohair.  

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With the rise of boat shoes and the ever-popular flip flop, spring and summer are the seasons a lot of people go sock-free. While we often make sacrifices for the sake of fashion, there are few words of warning for those skipping the sock drawer altogether.

-1. Socks are important for the overall health of your feet. Not only do socks absorb moisture, but they are also used to help prevent rubbing of shoes on the bare foot. Socks can also provide cushioning to pad the feet and help keep them warm. As we are going into the fall and winter months, socks can help prevent cold feet and even frostbite. Specialty socks, such as compression stockings, can improve circulation and prevent leg fatigue as well.

-2. Wearing socks keeps the feet dry and prevents conditions such as athlete’s foot. Going sockless can result in conditions such as blisters or sores on the foot. Also, odor can develop if you don’t wear socks, since your feet have a lot of sweat glands.

-3. The best time to go without socks is at night. This gives your feet a chance to air out. Other times to go without socks would be when wearing water shoes or showering. 

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Diabetic sock:  

People with diabetes wear diabetic socks because they have help with diabetic foot problems. Common issues include damaged blood vessels, foot ulcers, and diabetic neuropathy. Diabetic socks offer extra support, increases blow flow, comfort, and protection over regular socks. This special support is often required because people with diabetes tend to have poor circulation from nerve damage, which is caused by high blood sugar levels. Minor injuries can go unnoticed by people with diabetes simply because there is no sensation in the feet. As a result, small injuries often turn into serious foot infections. Wearing socks for diabetics can be beneficial to diabetics in numerous ways.  A large percentage of diabetic patients undergo nontraumatic amputation after diabetic neuropathy renders them unable to feel festering foot injuries. What’s more, within 3 years of a first amputation, up to half of these patients have a second either new same side or contralateral amputation. Diabetic socks has the same look as normal socks, but provide more cushion and does not constrict the legs. Quite often, diabetic socks are designed without seams in order to reduce the chance of blistering. In addition, diabetic socks may also be designed to control moisture in order to reduce risk of fungal infection or with cushioning to prevent foot ulcers.

The Research:

A few studies have looked at what happens to feet wearing socks of differing fabrics and constructions in diabetes. Also, the textile industry has conducted research into fiber composition and characteristics. In 1989, Veves et al. used Thorlo socks to show that cushioning decreased vertical pressure to the diabetic foot. They concluded that in conjunction with wearing proper orthoses, cushioning can help to prevent ulcer formation. In 1990, the same authors looked at the duration of cushioning effects. In this study, they found that a cushioned sock, while losing some of its effects, provided more pressure relief than being barefoot, even after 6 months. They concluded that a high-density sock is probably the best choice for the insensitive foot. Murray et al. also used Thorlo socks to look at the acceptability of cushioned socks for people with diabetes who have insensitive feet. They found a high acceptance of these socks over time.

Herring and Richie conducted two studies comparing the degree of moisture on feet and socks, foot temperature, and blister formation resulting from wearing acrylic and cotton socks. In the first study, they used socks with thickly padded cushioning in the soles. In the second study, the socks had no extra padding. Interestingly, in the study using padded socks, they found a significant advantage to using acrylic, whereas in the study of generic cushioned socks, they found no demonstrable difference in moisture. Herring and Richie’s results agreed with textile industry claims that natural cotton and wool fibers absorb moisture from the skin. However, socks are like towels. If a cotton towel is used to dry the skin after a bath, the cotton does well at absorbing the water from the skin, but the towel is then damp because it retains the moisture. A characteristic of acrylic is that it does not absorb moisture well. However, it is able to wick moisture from the skin. Herring and Richie concluded that people whose feet are exposed to increased moisture because of exercise should wear socks that are not only made of acrylic fabric, but also densely padded.

Clearly, diabetes educators and other health care professionals often base advice on tradition rather than on scientific evidence. The available evidence suggests that people with diabetes who have “normal” feet should be able to wear whatever socks they find to be comfortable. Socks should fit well, without constricting cuffs, lumps, or uncomfortable seams. Therefore, fitted socks are preferable to tube socks. Lighter-colored socks may alert wearers with compromised sensation to a draining wound. Patients can judge for themselves which type of fabric feels the most comfortable.

Patients who are at risk for ulcer development because of decreased pressure sensation should be advised to wear densely padded socks. In the studies cited here, the padded socks used were the Thorlo brand, which are made of 100% acrylic fiber with nylon and spandex for elasticity. Because cotton was not used, it is difficult to say whether a 100% cotton padded sock would also produce less vertical pressure.

Herring and Richie found that padded acrylic socks produce less moisture at the skin surface and less blistering in runners than do cotton socks. Therefore, educators should recommend that their patients wear padded acrylic socks when engaging in vigorous exercise.

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Socks care:

Even with good diabetic socks, you will eventually need to replace them. However, taking care of them properly will help to extend its useful life. Here are some general tips to get the most from your socks:

-Flip socks inside out before washing

-Wash socks in cold water

-Use a mild detergent to avoid damaging the sock fibers

-Low tumble dry or hang dry is the best way to preserve the stretch of the socks

-Trim your toenails to avoid putting holes in socks

-Avoid using bleach on white socks and wash darker socks with like colors

-Do not use an iron or excess heat, as the socks may become damaged

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Section-22

Footwear evidence: 

Figure above shows Shoeprints left on a dusty surface.

Because footwear impressions are found at virtually every crime scene, footwear impression evidence often provides an important link between the suspect and the crime scene. As a significant form of physical evidence, impressions left behind at the crime scene may provide valuable information on where the crime occurred and the direction the suspect traveled while committing the crime. This information may place the suspect at the crime scene or eliminate the suspect as having been there. Although interest in footwear evidence has increased over the years, many crime scene investigators and crime scene technicians still fail to recognize the importance and value of footwear impressions as physical evidence. Often, impressions are overlooked, improperly collected, or not collected at all. However, with the increased awareness of footwear impression evidence, accompanied by continued research and additional training now being offered on the proper detection, recovery, and collection of footwear evidence, the analysis of this valuable form of physical evidence will continue to be an integral part of criminal investigations.

Forensic footwear evidence can be used in legal proceedings to help prove that a shoe was at a crime scene. Footwear evidence is often the most abundant form of evidence at a crime scene and in some cases can prove to be as specific as a fingerprint. Initially investigators will look to identify the make and model of the shoe or trainer which made an impression. This can be done visually or by comparison with evidence in a database; both methods focus heavily on pattern recognition and brand or logo marks. Information about the footwear can be gained from the analysis of wear patterns which are dependent on angle of footfall and weight distribution. Detailed examination of footwear impressions can help to link a specific piece of footwear to a footwear imprint as each shoe will have unique characteristics.

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Types of footwear evidence

Footwear evidence can come in at least three forms, footwear outsole impressions, footwear insole impressions and footwear trace evidence.

-1. Footwear outsole impressions

Footwear outsole impressions are impressions left on an object that was caused by contact with a piece of footwear. These can be left on the ground or raised surface by persons treading over it, left on doors or walls by persons attempting to kick or climb over a wall or even left on other persons after being kicked or stomped on.

There can also be latent impressions not easily visible to the naked eye, on many different surfaces such as floor tiles, concrete or even carpet. Detection may require the use of additional specialized light sources such as portable ultraviolet lighting. Recovery typically includes photography as well as lifting with “gel” or “electrostatic” dust lifters.

-2. Footwear insole imprints

Imprints of a person’s foot can be left on the insole (inside) of footwear. Due to the sweat and dirt from the foot the insole impression can be left regardless of the wearers foot being in a sock or other covering. The size and arrangement of foot and toe imprints can be used to determine whether a person has worn a piece of footwear. The analysis and comparisons of foot imprints is part of the discipline of forensic podiatry. The insole will show a virtual image of the bare foot print of the wearers foot. This can be compared to the actual barefoot print of the shoe owner to gain a match. A 3D optical surface scan can then be used to build up a model of the foot itself, useful in forensic evidence casting and identification.

-3. Footwear trace evidence

Footwear trace evidence is trace evidence that is recovered from footwear. Types of trace evidence that could be recovered include skin, glass fragments, body hair, fibers from clothing or carpets, soil particles, dust and bodily fluids. The study of this trace evidence could be used to link a piece of footwear to a location or owner. DNA can be one of the contributing factors in forensic footwear evidence.

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Footwear imprints are a type of pattern evidence that can be valuable in a criminal investigation. Much like fingerprints, shoes leave behind unique imprints or impressions that can be examined by investigators. They can be found on a variety of surfaces including glass, wood, concrete, tile, mud, sand, and snow. Footwear imprints can be collected for analysis and compared to an exemplar shoe to determine if the shoe is the source of the imprint.

A footwear analyst considers three types of characteristics.

-1. The first is class, in which a characteristic is shared by two or more shoes. This includes brand, model, and size that will have corresponding tread designs and dimensions. Examiners can identify the type of shoe that left an imprint by searching tread patterns in databases created by manufacturers, the FBI, and other agencies. Class characteristics reduce the possible number of shoes that could have made an imprint, but alone they are not a basis for an individualization. Nonetheless, it is still powerful for eliminating shoes as the source. 

-2. Individual characteristics are the second type and include features on footwear outsoles that are not shared by any other shoe, commonly referred by experts as Randomly Acquired Characteristics (RACs). These characteristics on the outsoles are unique, accidental, and include random damage such as tears, nicks, holes, and cuts that are the result of its use. The changes to an outsole are evident on the footwear and sometimes the footwear imprint. More importantly, these characteristics accumulate over time, making footwear outsoles increasingly distinguishable. 

-3. Wear is the third characteristic examiners use to analyze footwear evidence. Wear is the result from the natural erosion of a shoe’s sole resulting from its use. The position, condition, amount, location, and pattern are specific characteristics that are considered while examining wear damage. Wear, like RACs, is commonly reflected in footwear imprints and is helpful for comparisons to include or exclude a potential source of an imprint. 

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Raven technology:

Modern forensic policing recognizes the value of footwear evidence gathered at scene and recovered from suspects. The unique National Reference Collection and National Footwear Database delivered by Raven Technology allows practitioners to access a huge repository of patterns defined using standard notation that is designed to promote collaboration. The system was developed in the United Kingdom and is used thousands of times a day by footwear examiners to guide investigations and make “cold”hits. A specific version has been established for the USA which allows new patterns to be added real-time by the users of the application. Furthermore, the system comes with the UK NFRC as an embedded component, allowing access to close to 30,000 patterns that have been subject to rigorous quality control by their police forces. A wealth of additional information including wear variations, commonality, reference samples (for specific sizes) and linked items is available on the reference collection. The NFRC exists in the “cloud” so you can take the collection anywhere you like. You can use it at a crime scene on a mobile device, in the lab to match evidence, or on a detective’s computer. It’s web-based and shared among all users. So, when a colleague across the country enters a new shoe into the system, you’ll see it in your searches right after quality control is complete. It will even tell you how often you or your colleagues have seen the shoe before.

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Shoeprint matcher:

Currently the process of figuring out the model and type of a shoeprint found at a crime scene can be very labor intensive. A shoeprint expert has to perform a manual search through his own archives or start a search on internet. If no match is found often the help of colleagues is requested which is still no guarantee for a satisfactory answer.  Overall this process is very time consuming, while it is important for the investigation to get the results as fast possible. To overcome these issues HOBBIT has developed PRIDE which is an automatic shoeprint matcher. This system is built in conjunction with shoeprint experts and forensic intelligence departments from the Netherlands.  The comparison of the shoeprints is fully automated and is based on the comparison of pictures, so no manual feature marking is required unlike other comparable systems on the market. Another unique feature of PRIDE is the possibility to create a central database with shoe references and traces. This database can be shared throughout all your departments and locations, no need to create local files which are prone to duplication of information. Maintenance of the database can be centrally controlled by the built-in authorization options.

PRIDE offers the following four functionalities:

-1. Compare shoeprints with the reference database with outsoles

-2. Compare reference outsoles with shoeprints found at crime scenes

-3. Create nationwide reference database for the storage of pictures of outsoles

-4. Create nationwide database for the storage of crime scene shoeprints.

In the latest release of PRIDE it is also possible to collect shoeprints from crime scenes in a separate database. The functionality is comparable to that of the ‘normal’ reference database with outsoles. At this moment reference databases are available for shoes and car tires. PRIDE is constructed in such a way that it is possible to create reference files for other products as well, for instance firearms and tattoos. 

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The Accumulation of Wear on Footwear Pattern Analysis, a 2019 study:

Wear is defined as the erosion of a shoe’s outsole or the loss of tread pattern, and it happens gradually over time with use. After a shoeprint is collected from a crime scene, it is questioned whether an individualization can be made if an exemplar is created after additional use of the shoe. The shoes of ten volunteers at San Jose State University were analyzed over a period of 40-45 days. Wear and Randomly Acquired Characteristics (RACs) were analyzed over time to determine if there were any observable changes or additions to the already present wear. It was hypothesized that initial wear and RACs would persist over time. The present wear retained over time throughout the study. Sixty-five percent of the shoes showed no additional wear or RACs. The remaining 35% showed at most 1 cm of additional loss of tread pattern. Therefore, it is possible for an individualization after 40-45 days between evidence collections. This study was limited by the time allotted. Future studies will need to investigate wear over many months of use.

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Section-23

Global footwear market: 

The global footwear market size was valued at $365.5 billion in 2020, and is estimated to reach $530.3 billion by 2027 with a CAGR of 5.5% from 2020 to 2027. Footwear is used for covering and protecting the foot from ground textures, temperatures, and from gravel roads. Footwear is made up of different materials such as leather, plastic, rubber, and fabric. Among these, leather is one of the prominent materials used for fabricating footwear. Major players, such as Nike, use eco-friendly raw materials, including recycled car tires, recycled carpet padding, organic cotton, and vegetable-dyed leathers for producing footwear.

India is the second largest global producer of footwear after China, accounting for 13% of global footwear production of 16 billion pairs in 2017. India produces 2065 million pairs of different categories of footwear (leather footwear – 909 million pairs, leather shoe uppers – 100 million pairs and non-leather footwear – 1056 million pairs). India exports about 115 million pairs. Thus, nearly 95% of its production goes to meet its own domestic demand.  

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Athletic footwear market:

The global Athletic Footwear market size is projected to reach USD 66,310 Million by 2027, from USD 52,830 Million in 2020, at a CAGR of 3.3% during 2021-2027.

Major factors driving the growth of the athletic footwear market are:

-1. Growing enthusiasm and awareness regarding the health benefits of sports & fitness activities

-2. Easy accessibility and multiple option availability due to the flourishing retail e-commerce sector is expected to further impact the athletic footwear market

-3. Urbanization along with rising levels of disposable income is expected to further fuel the athletic footwear market

The increasing awareness about leading a healthy lifestyle especially among the younger population is expected to drive the growth of the athletic footwear market. The younger generation is becoming more interested in leading a healthy lifestyle and is participating in sports and other related activities. People are also becoming more aware of the importance of wearing the proper athletic shoes to avoid muscular injuries, leg injuries, knee pain, hip discomfort, and back pain while participating in sports. As a result, sports shoe demand is expected to skyrocket in the coming years.

The COVID-19 has had a strong impact on the athletic footwear market during its onset; however, with the presence of online shopping and doorstep delivery, the category witnessed a pace in demand over the mid-months of 2020. Consumers joined the fitness bandwagon after the lockdown measures were lifted in many of the countries. Owing to this, the demand for athletic footwear surged, keeping the market afloat during the year-long pandemic period.

Furthermore, innovations in sports footwear such as smart footwear that calculates the calories burnt are expected to have a lucrative impact on the athletic footwear market.

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Future Trends in the Global Footwear Market: 

The evolution of footwear has required major shoe companies to focus on strategies such as faster delivery processes, mass customization, and personalization. Mass customization and personalization have slowly been gaining importance in the footwear and apparel industry. These factors are driven by technology, supply chain transformation, and organizational restructuring. Major advances on the technological front such as tracking the measurements of consumers to final product development and delivery have facilitated this trend. Adidas Group and Nike are two of the pioneers and are among the largest shoe companies in the establishment and adoption of customization techniques. Such mass customization and personalization of sports footwear is enabling footwear companies to further attract consumers and help them build strong brand loyalty.

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Top Shoe Companies in the World in 2020: 

-1. Nike

As one of the world’s largest shoe brands, Nike has always been at the leading edge of innovation, technology development, and cutting-edge marketing campaigns that help it surpass other brands in terms of popularity and sales. Nike’s ‘Just do It’ marketing campaign featuring Colin Kaepernick has proven to be beneficial for the company as it helped grow their online sales of footwear products across the world. Nike, the world’s largest sports footwear brand, is reinventing itself for the digital era. The company is taking several steps toward its goal of becoming a retail tech company and some of these tactics already appear to be working.  Nike is also getting its flagship products right with shoes like Nike Air Max 270, ZoomX, React, and VaporMax.

-2. Adidas

With its roots in Germany, adidas has become one of the top shoe brands in the world. The company produces more than 900 million sports and lifestyle products with independent manufacturing partners around the world. It generated sales of approximately $25 billion in 2019, and these staggering numbers are a testament to what a large and multifaceted company adidas has become. With more than 1000 stores across the world, the shoe brand has risen to extreme heights of success. Adidas has not only become a symbol of sports fashion but has also presented a collective image of street, pop-culture, music, sports, and other fashion statements, defining its existence through its remarkable communication strategies.

-3. New Balance

Unlike many of its rivals, the Boston-based multinational corporation New Balance shuns celebrity endorsement. The company claims to emphasize substance over style by highlighting lesser-known athletes. Besides manufacturing men’s and women’s shoes for basketball, tennis, golf, hiking, running, and cross training, New Balance offers fitness apparel and shoes for kids and owns shoemaker Dunham. The company’s product portfolio also includes Aravon shoes for comfort performance, Warrior hockey gear, PF Flyers footwear, and Brine, a leader in field hockey, lacrosse, soccer, and volleyball. The company is striving to expand beyond the US and it recently opened its first UK store on London’s Oxford Street.

-4. ASICS

ASICS is one of Japan’s top shoe companies and purveyor of other equipment. Since its foundation in 1949, ASICS has been a global footwear brand committed to nurturing youth around the world through sports. Over more than six decades, the company has provided its own products while creating changes in the social environment. ASICS recently announced the launch of its new product ‘Solution Speed’ tennis footwear, which is designed to enhance agility and speed during the game. The Solution Speed shoe features three of company’s advanced technologies: Court Specific FlyteFoam, TWISTRUSS, and FLEXION FIT.

-5. Kering (PUMA)

Kering is a world leader in apparel and accessories. It develops an ensemble of powerful luxury, lifestyle, and sports brands, including Gucci, Bottega Veneta, Volcom, and Puma. Its Puma brand provides an impressive and versatile collection of footwear, apparel, and accessories. Over the past few decades, Puma has consistently evolved to introduce a diversified product portfolio that includes Puma Suede, Basket, Roma, Easy Rider, and many more. Puma’s motorsports collection includes co-branded sneakers with leaders such as Ducati and Ferrari. The brand’s technologically advanced sneaker, Faas, is endorsed by the fastest man in the world, Usain Bolt.

-6. Skechers

Founded in 1992, Skechers is one of the fastest growing shoe companies in the US, focusing on trendy and casual styles for men and women between the ages of 19 and 40. The billion-dollar, award-winning company’s success stems from its high-quality product offerings, cutting-edge print and television advertising, and diversified domestic and global distribution channels. Skechers’ products include boots, sneakers, training shoes, oxfords, sandals, and semi-dressy shoes. The company offers street-focused and fashion footwear under the Zoo York, Marc Ecko, and Mark Nason brands. Skechers shoes are sold in more than 160 countries through specialty stores and some 390 company-owned outlet stores.

-7. Fila

Beginning as a textile firm in Biella, Italy more than nine decades ago, Fila (Fabbrica Italiana Lapis ed Affin) has since grown into one of the top shoe companies in the categories of tennis, soccer, and running in Asia, Europe, and the Americas. Today, Fila is a leading designer and marketer of footwear, apparel, and accessories for sport and leisure with product categories including casual and athletic footwear, casual wear, activewear, and sportswear. The company offers its wide range of products under a number of brands, including Tratto, Das, Giotto, Pongo, Lyra, and others.

-8. Bata

For more than 130 years, Bata has been the most recognized footwear brand in the world. Today, the company is led by the third generation of the Bata family and continues to dedicate itself to finding new shoe materials, developing innovative technologies, and manufacturing new products that blend fashion with comfort. The company today has a presence in over 60 countries with more than 5000 retail stores, 24 fully-owned factories, and dedicated e-commerce operations. Bata combines the best of local and global, effectively catering to the needs of consumers across the world, making it one of the world’s fastest growing shoe companies.

-9. Burberry

Burberry is a well-established manufacturer of luxury clothing, readymade fashion outerwear, fragrances, cosmetics, sunglasses, shoes and other accessories for men, women, and children. It is one of the most recognized brands in the EU, Australia, US, and various parts of Asia. The British designer company is planning to expand its shoe business rapidly and is set to make a strategic investment in its leather goods supply chain. Burberry recently acquired a leather-good facility from its Italian partner CF&P.

-10. VF Corporation

Founded in 1899, VF is one of the world’s leading apparel, footwear, and accessories companies with socially responsible operations spanning several regions, distribution channels, and product categories. It serves consumers across the world with its wide-ranging portfolio of lifestyle apparel and shoe brands that include The North Face, Wrangler, Lee, Timberland, and Vans. These brands’ popularity earned the company many consumers, which prompted it to open outlet stores across the globe. The company launched its e-commerce portal in 2013.

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Buying Shoes Online:

You need to buy a new pair of shoes. But you’re really busy at work or taking care of your kids, and you’re just not sure when you’re going to have time to get to the store. A couple decades ago, that might have been a problem since you would have had to make time in your schedule to go shoe shopping. But nowadays, more people are choosing to shop for and buy their shoes online. While shopping for your shoes online is really convenient and more people are turning to the Internet to buy shoes, you need to know and understand the pros and cons of online shoe shopping before you hit the “buy” button. 

Pros of Online Shoe Shopping:

Some of the benefits of shopping online for your shoes include:

-1. 24/7 shopping availability. You can shop online anytime of the day or night from the comfort of your own home.

-2. Accessibility to a variety of brands and designers. If you’re really wanting to buy a certain designer’s shoes, you don’t have search out a physical store that carries that designer’s shoes. Online platform has a massive involvement with the brands. A brand lover will prefer online shops because it provides every brand in one shop like Nike, Puma, Bata, Fila etc.

-3. Wide selection of styles and colors. If you’re trying to match your shoes to a certain outfit, online stores carry more styles and color options than traditional shoe stores.

-4. More size options. If you wear a women’s size 14 or an extra narrow width shoe, you’ll have more luck finding them online.

-5. Price comparison shop. You don’t have to drive around town to comparison shop for the shoes you want.

-6. Free online shipping at some stores. Many online shoe stores offer free shipping. As the customer is price conscious, so the online platform provide bundle of offers and discount to the customer which is more than the outside shops. They provide some extra discount to those who purchased the items most frequently.

-7. Actual new shoes. Contrary to shopping at a department or shoe store, where shoes can be tried on by multiple people, when you shop online, you are actually getting a pair of brand-new shoes that haven’t been broken in by someone else.

-8. Free return shipping at some stores. Some of the bigger online shoe retailers offer free shipping on returns. So you can buy shoes in multiple sizes and then return the ones you don’t want.

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Cons of Online Shoe Shopping:

Some of the disadvantages of shopping for your shoes online include:

-1. Disreputable online shoe discounters. Make sure you shop from well-known online shoe stores. If the price is too good to believe, you’re likely going to end up with a shoddily made shoe. Also, check reviews to make sure the store offers good customer service, otherwise you may get the run-around when trying to make returns.

-2. Shoes don’t fit properly. If you’re not sure about your shoe size or width, have your feet measured by a qualified professional before you order online. Also, understand what styles of shoes fit your particular foot shape. Slender, tapered feet can wear shoes with a tapered, narrow toe box more comfortably than wider feet. If you have wider feet, look for shoes with a square toe box that will give your feet more ample room. Shoes that don’t fit correctly can cause painful foot conditions.

-3. Special footwear needs. If you require special footwear needs due to foot deformities, poor circulation or other physical conditions affecting your feet, you likely need to discuss these issues with a footwear expert before buying your shoes. Customer service reps at online stores may not be knowledgeable concerning your particular needs.

-4. Not knowing the brand. Shoe sizes can vary between manufacturers, so you really need to know the brand. Because a size 7 in one brand may be bigger or smaller than a size 7 in another brand. And even by knowing the brand, there are still no guarantees that the shoes will fit once you get them.

-5. Shipping charges. Check the online company’s shipping charges before you place the order. What may seem like a great price on a pair of shoes may not be if you have to pay a shipping charge, too.

-6. Need your shoes in a hurry. If you must have your shoes by a certain date, like a wedding, you need to make sure you understand the shipping policies of the online company. Some companies may charge more for rush shipping. And if the shoes aren’t delivered on time, you may be out of luck.

-7. Backorders. When you buy your shoes online, make sure the item you’re ordering is actually in stock. Otherwise you may have to wait several weeks before your shoes are delivered.

-8. Exchanges or returns. Before you buy shoes online, read the company’s exchange and return policies. Some stores may require the shoes to be repackaged in the original packaging and with special return paperwork. Some stores may offer free returns and exchanges while others may charge you a return shipping fee. And some stores may charge a restock fee once the item is returned.

-9. Online shopping safety. If you’re uncomfortable buying shoes online, then you probably shouldn’t, especially if you have concerns about the safety of your credit card information. Make sure you purchase from trustworthy companies with secure websites.

-10. Product confirmation. If we choose offline mode of the buying then we can try that shoe and can also check the quality of the product, color and suitability of the shoe and the size also. But in online product we are unable to see the product in hand. Product may be differing in color, size, quality etc. so the person will prefer offline shopping where they can get in hand experience.

-11. Copied product. Many times, we see that in online shopping product is not just same as the image and in online mode we will not able to identify that the product is branded or just a copied one. There are many sites where they sold the product by using the brand name but the product is false. Nowadays it is very common and after getting the product they will only take that product back when the product is defaulted or damaged.

-12. Lack of face-to-face interaction. This is the biggest flaw of online shopping because until and unless the customer does not know the person they will not trust them. When we purchase anything from the outside shop or local market it works as evidence because anything will happen with the product at least the customer can go and find the shop so easily. Physical evidence is better than the imaginary place where we don’t know the person where the product belongs to.

Buying your shoes online can be a great way to save time and money, but just make sure you understand the pros and cons before you buy. And to save yourself from future pain, you really need to know your correct shoe size and style to ensure a proper shoe fit. 

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Section-24

Barefoot, minimalist and maximalist shoes: 

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Barefoot: 

Barefoot is the most common term for the state of not wearing any footwear. Wearing footwear is an exclusively human characteristic, however some animals held by humans are also issued with footwear, such as horses and, more rarely, dogs and cats. A growing body of both biomechanical and anthropological evidence supports a hypothesis that humans were evolved to run, and specifically, to run barefoot. Many skeletal features define us as runners; leg length in particular appears to have evolved early in the Homo lineage. There are health benefits and some risks associated with going barefoot. Footwear provides protection from cuts, abrasions, bruises, and impacts from objects on the ground or the ground texture itself, as well as from frost or heat burns, and parasites like hookworm in extreme situations. However, shoes can limit the flexibility, strength, and mobility of the foot and can lead to higher incidences of flexible flat foot, bunions, hammer toe, and Morton’s neuroma. Walking and running barefoot results in a more natural gait, allowing for a more rocking motion of the foot, eliminating the hard heel strike and therefore generating less collision force in the foot and lower leg.

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Subjective reports that walking barefoot on the Earth enhances health and provides feelings of well-being can be found in the literature and practices of diverse cultures from around the world. One hypothesis is that connecting the body to the Earth (barefoot) enables free electrons from the Earth’s surface to spread over and into the body, where they can have antioxidant effects. Specifically, mobile electrons create an antioxidant microenvironment around the injury repair field, slowing or preventing reactive oxygen species (ROS) delivered by the oxidative burst from causing “collateral damage” to healthy tissue, and preventing or reducing the formation of the so-called “inflammatory barricade”.  It is hypothesized that electrons from the Earth can prevent or resolve so-called “silent” or “smoldering” inflammation.  

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Dr. Rossi, a consultant for the footwear industry, believes that “Natural gait and shoes are biomechanically incompatible because all shoes automatically convert the normal to the abnormal, the natural to the unnatural. And no therapy or mechanical device, no matter how precisely designed or expertly applied, can fully reverse the gait from wrong to right.”  In a study looking at how habitual shoe wear changes the shape and biomechanics of the foot, people who spent most of their lives barefoot had wider feet and distributed pressure on their feet more evenly than those who habitually wore shoes. This suggests that frequent barefoot walking enables the foot to achieve its biologically normal shape and function. A study was conducted by the University of the Witwatersrand in Johannesburg called “Shod Versus Unshod: The Emergence of Forefoot Pathology in Modern Humans?” In this study they examined 180 modern humans from three different population groups (Sotho, Zulu, and European), comparing their feet to one another’s, as well as to the feet of 2,000-year-old skeletons. The researchers concluded that, prior to the invention of shoes, people had healthier feet. Among the modern subjects, the Zulu population, which often goes barefoot, had the healthiest feet while the Europeans—i.e., the habitual shoe-wearers—had the unhealthiest.

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Effects of Traditional Footwear on shape and functions of feet:

Flat Surface

The foot is a flexible structure. This flexibility allows the foot to conform to uneven surfaces when walking barefoot. Shoes can act as a rigid, unchanging platform for the foot. This has the potential to weaken muscles on the underside of the foot and the stabilizing muscles in the lower leg.

Compressed Toebox

Many shoes are designed with bullet-shaped toeboxes, or a tapering of the width of the shoe towards the toes. This shape can prevent the toes from spreading.

Arch Support

Built-in arch supports are designed to control the motion of the foot or hold the foot in a fixed position. This can potentially alter the activity of the foot’s own arch supporting muscles.

Elevated Heel

Most traditional shoes, including athletic and dress shoes, have a raised heel. This places the foot in a plantarflexed (pointed down) position. Over time this can cause a loss of flexibility in the calf muscles. The collapse of the arch is one way the body can compensate for a lack of ankle flexibility.

Toe Spring

Almost all shoes have a toe spring or a curving up of the front of the shoes. This is necessary, in part, because shoes with rigid soles cannot bend in the same way as the foot. The toe spring allows for a rocking motion of the shoe to make up for this. The toe spring can hold the toes in an extended position. Walking in a shoe with your toes held elevated off the ground is very different from how toes would function when walking barefoot. While toe spring, can make walking easier and more comfortable, it may also weaken feet and potentially open them up to some common (and painful) foot-related problems.  

Heel Counter

Many shoes are reinforced at the back to control the motion of the heel inside the shoe. Again, holding a part of the foot in a fixed position is a change from the way the foot would function barefoot.

Decreased Sensation

Like the palm of the hand, the bottom of the foot has many sensory nerve endings that function to provide information to the brain about the position of the body and pressure under the foot. This sensory input allows the foot to adapt to the ground. The sole of a shoe, while offering cushioning and protection, can also decrease the need for this feedback loop and muscle activity.

Effect on Arch Strength

Because the research in this area is somewhat limited, the role shoes play in flat feet and overpronation is not entirely clear. It’s evident that shoes can alter the functioning of the foot and arch. Still, many people have normal or high arches despite regularly wear shoes.

In a nutshell:

The structure of the foot make it well adapted to walking without support on a variety of surfaces. Modern life tends to limit the amount of time most of us spend going barefoot. Footwear serves a purpose in protecting our feet. But there are also potential benefits from spending time barefoot — allowing the foot to function the way it is adapted to work. For situations when barefoot is not an option, you can use shoes that are as minimal and “barefoot-like” as possible.

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Since the latter half of the 20th century, there has been scientific and medical interest in the benefits and harm involved in barefoot running. The 1970s, in particular, saw a resurgent interest in jogging in western countries and modern running shoes were developed and marketed. Since then, running shoes have been blamed for the increased incidence of running injuries and this has prompted some runners to go barefoot.  However, the American Podiatric Medical Association has stated that there is not enough evidence to support such claims and has urged would-be barefoot runners to consult a podiatrist before doing so. The American Diabetes Association has urged diabetics and other people with reduced sensation in their feet not to run barefoot, citing an increased likelihood of foot injury.  One study showed a link to early bone damage in new barefoot runners.

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The structure of the human foot and lower leg is very efficient at absorbing the shock of landing and turning the energy of the fall into forward motion, through the springing action of the foot’s natural arch. Scientists studying runners’ foot motions have observed striking differences between habitually shod runners (wearing shoes) and barefoot runners. The foot of habitually shod runners typically lands with an initial heel strike, while the foot of a barefoot runner lands with a more springy step on the middle, or on the ball of the foot.  In addition, the strike is shorter in duration and the step rate is higher. When looking at the muscle activity (electromyography), studies have shown a higher pre-activation of the plantar flexor muscles when running barefoot.  Indeed, since muscles’ role is to prepare the locomotor system for the contact with the ground, muscle activity before the strike depends on the expected impact. Forefoot strike, shorter step duration, higher rate and higher muscle pre-activation are techniques to reduce stress of repetitive high shocks. This avoids a very painful and heavy impact, equivalent to two to three times the body weight.  “People who don’t wear shoes when they run have an astonishingly different strike”, said Daniel E. Lieberman, professor of human evolutionary biology at Harvard University and co-author of a paper appearing in the journal Nature. “By landing on the middle or front of the foot, barefoot runners have almost no impact collision, much less than most shod runners generate when they heel-strike.”

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Shoes designed specifically for running were developed in response to the running movement in the 1970’s. Over time, the running shoe industry has responded to the specific needs by developing specialized shoes for cushioning, motion control, stability etc. Recently, a barefoot/minimalist shoe running movement began based on an evolutionary perspective that promoted a more ‘natural’ method of running (Lieberman, 2012). Running in minimalist shoes has been promoted as a method to decrease impact forces through a forefoot striking pattern and increased stride frequency (De Wit, De Clercq, & Aerts, 2000; Lieberman et al., 2010; Squadrone & Gallozzi, 2009; Willy & Davis, 2014 ). Other reported benefits of minimalist running are improved performance, decreased risk of certain injuries (Jenkins & Cauthon, 2011) and improved economy for habitual barefoot runners (Perl, Daoud, & Lieberman, 2012).

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However, when comparing different populations of habitually barefoot runners, not all of them favor the forefoot strike. A 2012 study by Hatala et al. focusing on 38 runners of the Daasanach tribe in Kenya found that a majority of runners favored a heel strike instead of a forefoot strike. Hatala and Lieberman are comparing their data, but Lieberman did note that his study, which focused on the Kalenjin people, also found some barefoot runners favoring a heel strike as well. He also said that the Daasanach people were primarily, “tall, lanky goat-herders who don’t run nearly as much as the Kalenjin, who own many of the world’s distance running records.”

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The longitudinal (medial) arch of the foot also may undergo physiological changes upon habitually training barefoot. The longitudinal arch has been observed to decrease in length by an average of 4.7 mm, suggesting activation of foot musculature when barefoot that is usually inactive when shod. These muscles allow the foot to dampen impact and may remove stress from the plantar fascia. In addition to muscle changes, barefoot running also reduces energy use – oxygen consumption was found to be approximately 4% higher in shod versus barefoot runners. Better running economy observed when running barefoot compared to running with shoes can be explained by a better use of the muscle elasticity. In fact, reduction of contact time and higher pre-stretch level can enhance the stretch shortening cycle behavior of the plantar flexor muscles and thus possibly allow a better storage and restitution of elastic energy compared to shod running.

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Running shoes also appears to increase the risk of ankle sprains, plantar fasciitis, as well as other chronic injuries of the lower limb. However, running shoes also provide several advantages, including protection of the runner from puncture wounds, bruising, thermal injuries from extreme weather conditions, and overuse injuries. Transitioning to a barefoot running style also takes time to develop, due to the use of different muscles involved. Doctors in the United States have reported an increase in such injuries as pulled calf muscles, Achilles tendinitis, and metatarsal stress fractures, which they attribute to barefoot runners attempting to transition too fast.

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Lower extremity injuries have consistently been problematic for runners regardless of footwear. Taunton and colleagues reported that over a 13-week training period, 30% of runners incurred a running-related injury, most commonly patellofemoral pain, iliotibial band friction syndrome, and plantar fasciitis. Since the inception of the cushioned running shoe, its fundamental purpose has been to protect the foot in an effort to reduce running-related injuries. Despite significant advances in shoe technology over the past 50 years, the rate of sustaining a running related injury has remained relatively stable.

Numerous variations of running shoes have been developed to accommodate different types of runners, running styles, and running conditions. Footwear manufacturers have modified the basic components of their running shoe models to accommodate these differences, including midsole cushioning and heel-toe drop. For several years, traditional running shoes tended to have a heel-toe drop, which refers to the difference between the heel elevation and forefoot elevation of the midsole, of greater than 10 mm.

In 2009, the minimalist shoe, defined by very little cushioning and heel drop, became popular among runners. Popularity of these shoes spiked largely because their benefits were espoused by shoe manufacturers and authors of popular-press books, who claimed that a lack of cushioning would reduce injuries by promoting a more natural forefoot-strike pattern. However, popularity of minimal shoes has declined, largely due to research suggesting that adopting a forefoot-strike pattern does not decrease injury risk, improve running economy, or reduce the impact peak or loading rate of the vertical ground-reaction force.  A recent randomized controlled trial (RCT) suggested that heavier runners might be at an increased risk for injury in minimalist shoes (designed to mimic barefoot running) as compared to conventional footwear. Research continues to examine how transitioning from a traditional shoe to a minimal shoe influences running style, lower extremity biomechanics, and risk for injury.

At about the same time that minimal shoe popularity was rising, a company called Hoka One One introduced a highly cushioned “maximal” running shoe, a stark contrast to the minimal shoe. Currently, there is no academic definition of a maximal shoe, but in industry, the defining feature is increased cushioning of the midsole. Since 2010, maximal shoes have slowly gained popularity, with more than 20 variations of maximal running shoes now on the market. Conceptually, this increase in cushioning is thought to improve shock attenuation and reduce the risk of injury. Anecdotally, runners have expressed in the popular press that maximal running shoes reduce or eliminate running elated pains that often appear several miles into their run.

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Figure below shows a) conventional, b) maximalist, c) minimalist shoes:

-a. The conventional footwear had an average mass of 285 g and a heel drop of 14 mm (New Balance 1260 v2).

-b. The maximalist footwear had an average mass of 318 g and a heel drop of 6 mm (Hoka One-One).

-c. The minimalist footwear had an average mass of 167 g and a heel drop of 0 mm (Vibram five-fingers). 

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A recently developed consensus definition for minimalist shoes describes them as having high flexibility, low weight and stack height, absence of heel to toe drop and motion control technology (Esculier, Dubois, Dionne, Leblond, & Roy, 2015). These shoes are designed to promote barefoot-like biomechanics by allowing natural movements of the foot (Esculier et al., 2015; Rixe, Gallo, & Silvis, 2012). Numerous authors have compared the biomechanics of running in standard shoes to running in minimalist and/or barefoot running. Several findings suggest that running in minimalist shoes changes the initial contact approach from a rearfoot to a midfoot to forefoot strike, which reduces stride length and increases step cadence and ankle plantarflexion angle at the foot contact (Altman & Davis, 2012; Bergstra et al., 2015a; Lieberman et al., 2010).

Conversely, highly cushioned shoes or ‘maximalist’ shoes are designed with a high stack height, with the intent to reduce impact upon landing (Ruder, Atimetin, Futrell, & Davis, 2015). While a consensus definition has not yet been published, maximalist shoes have a lower heel to toe drop (8–10mm) than a standard running shoe, which claims to dissipate up to 80% of heel shock for rearfoot strike runners (McCartan, 2013). These shoes are designed to increase shock absorption upon impact, in theory reducing the injury risks associated with vertical impact loading and loading rate (Ruder et al., 2015).

The study of footwear cushioning began in 1983 with Clarke, Frederick, and Cooper (1983) reporting that impact forces took longer to reach the peak with a more cushioned/soft shoe. However, since this time the concept of ‘soft’ vs. ‘cushion’ and the materials used for absorbing running forces have changed drastically, with little research evaluating these recently developed maximalist shoes. With several authors noting that shoe cushioning properties may alter natural running biomechanics and increase both oxygen consumption and energy expenditure (Franz, Wierzbinski, & Kram, 2012; Lieberman, 2012; Perl et al., 2012), evaluating how maximalist footwear affects runners may be significant for injury prevention or running performance.

Research comparing the biomechanical properties of maximalist running shoes with those of standard or minimalist shoes is emerging. Musculoskeletal modeling has demonstrated an increase in patellofemoral forces (Sinclair, Richards, Selfe, Fau-Goodwin, & Shore, 2016) and an increase in leg stiffness (Kulmala, Kosonen, Nurminen, & Avela, 2018) in maximalist shoes compared to a minimalist shoe and a conventional shoe, respectively. Agresta et al. (2018) reported increased shank and lower heel accelerations in minimalist shoes during running as compared to running in a maximalist shoe. These same authors also noted an increased injury rate when transitioning from running in a standard shoe to a minimalist shoe.

With the broad spectrum of specialized shoes that are available to runners, it is imperative that consumers and rehabilitation specialists are knowledgeable regarding the properties and benefits of the many running footwear choices. One parameter of biomechanics that remains unknown for maximalist and minimalist shoes relates to plantar forces and pressure distributions.

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Minimalist shoe:

Minimalist shoes are shoes intended to closely approximate barefoot running or walking conditions in comparison to traditional shoes.  They have reduced cushioning, thin soles, a wide toe box, and are of lighter weight than other running shoes, allowing for more sensory contact for the foot on the ground while simultaneously providing the feet with some protection from ground hazards and conditions (such as pebbles and dirt).  Research shows that wearing a minimalist shoe can help improve foot strength and arch function.

Types:  

Generally, there are two types of minimalist shoes:

-1. Barefoot Running Shoes are characterized by their zero drop from heel to toe, no arch support, minimal cushioning at the heel, and a very thin sole of around 3-10mm. Also, the toe box is considerably wider to provide more space to the toes, whereby they slightly resemble the shape of ducks’ feet, when viewed from above and compared to traditional shoes. Barefoot shoes are considered any form of closed toed footwear that has minimal structure and allows the feet and legs to behave with a degree of approximation to no shoes being worn at all. They allow the body the freedom to function as nature intended. Few product lines fall into this category. Examples include the Vibram FiveFingers and Merrell Glove, which use an outsole produced by Vibram, or the Xero Prio.

-2. Minimalist Running Shoes are in between traditional running shoes and barefoot running shoes. They have a reduced heel-to-toe drop of about 4–8 mm, reduced cushioning and reduced or no arch support. The toe box is usually in-between barefoot and traditional running shoes.

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Figure below shows Barefoot Running shoe & sandal:

Barefoot running:

The meaning of this term has become somewhat muddy as of late. Before the book Born to Run came out, barefoot running used to mean engaging in the act of running while barefoot. These days it can still mean running barefoot, but it also is a synonym for running while wearing footwear that allows the foot to react to the ground and to behave as if it were barefoot, such as barefoot shoes or barefoot running sandals. 

Barefoot running sandals are similar to barefoot shoes in that they provide minimal support while still offering various options for different uses. Barefoot running sandals differ from barefoot shoes in that they can provide the least amount of structure and support possible, allowing the foot to effectively grip the earth’s diverse terrain via the complex mechanics of the metatarsals and toes as if barefoot. For example, the nominal upper of a running sandal (just a strap) and the extreme flexibility of the minimal sole forces the foot to grip the sandal with the arch and toes which affects running form positively by encouraging a higher cadence and lighter steps.

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Advantages and Disadvantages of Minimalist Running Shoes:   

The main idea of minimalism is for a runner’s footwear to help mimic barefoot running as best as possible, providing a wide toe box and low heel to toe drop. These shoes are often lightweight and highly responsive. But, are they truly better than traditional running shoes? Listed below are the advantages and disadvantages of the most popular running shoe trend.

Advantages:

Proponents of minimalist running shoes argue that the advantages of barefoot mimicking shoes far outweigh any potential disadvantages. From improved form, muscle strengthening, and body awareness, the advantages make these shoes appear very tempting.

-Strengthens feet, Achilles, and calves

When a foot is placed in a traditional running shoe with a lot of support, cushioning, and a high heel to toe drop, the foot is not able to move as naturally as when barefoot, which can cause atrophy of certain muscle groups. Minimalist running shoes promote a midfoot strike which helps to strengthen feet, Achilles tendon, and calves. Flexibility among the ankle and foot also improves.

-Provides greater awareness of feet

When your foot moves more naturally you are better aware of how you use your feet when running. The absence of motion control helps you understand exactly how your body functions, which can lead to a better awareness of your body for improved performance.

-Improves Posture

A low heel to toe drop is most natural because it mimics the way humans stand when barefoot. Traditional running shoes place the heel above the foot which can lead to problems with lower back or hip alignment.

-May reduce injury risk

When runners improve their posture and also strengthen weak areas such as feet, calves, and Achilles they are theoretically less likely to become injured.

-Improves uphill running

When running uphill a runner should be leaning slightly forward and landing on his or her toes. Minimalist running shoes naturally place the body in this position which can improve hill running performance. Additionally, minimalism helps strengthen the muscles that are required for effective hill running, which improves power and stability.

-Expend less energy

Minimalism running shoes weigh less and promote a more natural foot strike which ultimately leads to better efficiency due to the decreased expenditure of unnecessary energy.

Disadvantages:

Despite the numerous proposed advantages of the minimalism movement there are also plenty of potential disadvantages for their wear which should be considered as well.

Requires time to adjust:

While running barefoot is arguably how humans were born to the run the reality is that not everyone will naturally be able to fit the mold of the barefoot runner. People who are trying minimalist running shoes for the first time may find they feel unnatural and will need a period of adjustment before being able to wear these shoes exclusively. While minimalist shoes do strengthen numerous muscle groups, runners who are seeking to switch to minimalist footwear should be aware that feet, calves, and Achilles will be sore during the adjustment period and a reduced running load is recommended.

-May increase injury risk

For runners with certain biomechanical issues or muscle imbalances, switching to minimalist running shoes may actually increase the risk of injury, especially if the runner does not respect the amount of time that is required for adjusting to the new shoes. The risk of developing metatarsal stress fractures and tendonitis increases among first time minimalist wearers, especially if foot and calf muscles are already weak. Although few studies have been performed, recent research has suggested that the minimalism shoe trend also has led to an increased risk of developing bone marrow edema in the feet, which is similar to a bruise.

-May not be good for beginners

With all the stresses that a beginning runner places on his or her body when starting a new running regime, the additional stress to lower leg muscles should be avoided. Although there are experts that will argue or defend this point passionately, the truth of the matter is that minimalist shoes require a degree of strength, flexibility, and body awareness that a beginning runner may not possess. The best option for a newbie who is interested in minimalism is to purchase a minimalist running shoe and traditional shoe model and gradually increase the amount of running done in the minimalist running shoe.

-Not likely to be a miracle cure

Runners should be aware that while the minimalism movement has been touted to help runners overcome injuries, run faster times, and improve their running efficiency, these claims are not proven. While these statements may hold true for some individual runners, no one should expect that a simple change in footwear will drastically improve running ability. In fact, a recent class action lawsuit resulted in Vibram USA having to pay out millions of dollars for their unsupported claims.

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Counterpoint:

Are Maximalist Running Shoes better than Minimalist Running Shoes?

Maximalist shoes are characterized by big, cushiony and wide midsoles. You can look at an athletic shoe and if the midsole looks too big for the shoe, it is probably a maximalist version. Almost every shoe company has maximalist shoes in its shoe line and some shoe companies, like Hoka One One or Altra, only have this type of shoe.

Maximalist shoes arrived on the scene around 10 years ago and did not get much press. The barefoot running controversy had started and shoes with little soles were getting most of the publicity and fanfare. However, where maximalist shoes have survived the test of time, minimalist shoes are fading in popularity. 

The maximalist shoes of today are more stable than their predecessor Masai Barefoot Technology (MBT) shoes. These shoes were cushioned but very unstable. The modern day maximalist shoe is more stable with similar eversion as neutral shoes and has so many options. These shoes are all more cushioned than the typical Brooks or New Balance athletic shoe. This protects runners from developing problems related to poor shock absorption.

The classic maximalist shoe is the Hoka One One shoe line. The thicker midsole with a 4 mm heel drop on average allows for a rocker effect across the ball of the foot. This is so helpful for many metatarsal problems since it eliminates the bend across the metatarsophalangeal joints. Runners just roll through the ball of the foot, decreasing the force to bend these joints at push-off. Running in maximalist shoes can help alleviate the pain with conditions and injuries like metatarsalgia, capsulitis, neuromas, sesamoid injuries and hallux limitus/rigidus symptoms.

One of the positives that came out of the barefoot running controversy was that running shoes had evolved with too high of a heel to forefoot drop. Thus, the heel was too elevated, causing instability issues and forcing the knees and hips to take more stress at impact. Minimalist shoes solved that by lowering the heel to forefoot ratio to zero. In other words, there was no heel drop. Maximalist shoes have also used that philosophy with 0- to 8 mm drops, especially in the whole line of shoes produced by Altra, which have zero heel drop.

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Maximalist or Minimalist or Traditional running shoes?

A good rule of thumb is if you supinate, you want a nicely cushioned shoe to mitigate excessive outwards rolling. If you pronate, then you need a hard wedge (or maybe nothing at all) on the inside of your foot to stop your ankle rolling in. Translating this, a supinator may do better with a maximal shoe, and a pronator may do better with a minimal shoe. But this doesn’t always run true. So, if your pronation or supination is bad enough, go and see the podiatrist. If you’ve had it all your life and it’s not been much of an issue, your body has most likely adapted, and you’ll be okay with either type of shoe. There’s a middle ground and that’s traditional. Traditional running shoes tend to take aspects from both maximal and minimal shoes and roll them all into one. If you’ve been running most of your life in these traditional types of shoes and you’ve had a little to no issues, then just keep doing it. Running is mostly about enjoying the experience as injury-free as possible.  

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The Risks and Benefits of Running Barefoot or in Minimalist Shoes: A Systematic Review 2014:

Context:

The popularity of running barefoot or in minimalist shoes has recently increased because of claims of injury prevention, enhanced running efficiency, and improved performance compared with running in shoes. Potential risks and benefits of running barefoot or in minimalist shoes have yet to be clearly defined.

Objective:

To determine the methodological quality and level of evidence pertaining to the risks and benefits of running barefoot or in minimalist shoes.

Data Sources:

In September 2013, a comprehensive search of the Ovid MEDLINE, SPORTDiscus, and CINAHL databases was performed by 2 independent reviewers.

Study Selection:

Included articles were obtained from peer-reviewed journals in the English language with no limit for year of publication. Final inclusion criteria required at least 1 of the following outcome variables: pain, injury rate, running economy, joint forces, running velocity, electromyography, muscle performance, or edema.

Results:

Twenty-three articles met the criteria for this review. Of 27 possible points on the Downs and Black checklist, articles scored between 13 and 19 points, indicating a range of evidence from very limited to moderate. Moderate evidence supports the following biomechanical differences when running barefoot versus in shoes: overall less maximum vertical ground reaction forces, less extension moment and power absorption at the knee, less foot and ankle dorsiflexion at ground contact, less ground contact time, shorter stride length, increased stride frequency, and increased knee flexion at ground contact.

Conclusion:

Because of lack of high-quality evidence, no definitive conclusions can be drawn regarding specific risks or benefits to running barefoot, shod, or in minimalist shoes.

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Barefoot vs common footwear: A systematic review of the kinematic, kinetic and muscle activity differences during walking, a 2015 study: 

Habitual footwear use has been reported to influence foot structure with an acute exposure being shown to alter foot position and mechanics. The foot is highly specialised thus these changes in structure/position could influence functionality. This review aims to investigate the effect of footwear on gait, specifically focusing on studies that have assessed kinematics, kinetics and muscle activity between walking barefoot and in common footwear. In line with PRISMA and published guidelines, a literature search was completed across six databases comprising Medline, EMBASE, Scopus, AMED, Cochrane Library and Web of Science. Fifteen of 466 articles met the predetermined inclusion criteria and were included in the review. All articles were assessed for methodological quality using a modified assessment tool based on the STROBE statement for reporting observational studies and the CASP appraisal tool. Walking barefoot enables increased forefoot spreading under load and habitual barefoot walkers have anatomically wider feet. Spatial-temporal differences including, reduced step/stride length and increased cadence, are observed when barefoot. Flatter foot placement, increased knee flexion and a reduced peak vertical ground reaction force at initial contact are also reported. Habitual barefoot walkers exhibit lower peak plantar pressures and pressure impulses, whereas peak plantar pressures are increased in the habitually shod wearer walking barefoot. Footwear particularly affects the kinematics and kinetics of gait acutely and chronically. Little research has been completed in older age populations (50+ years) and thus further research is required to better understand the effect of footwear on walking across the lifespan.

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The influence of minimalist, maximalist and conventional footwear on impact shock attenuation during running, a 2016 study:

The current investigation examined the effects of minimalist, maximalist and conventional footwear on skeletal accelerations and shock attenuation during running. Ten male runners ran at 4.0 m.s−1 in minimalist, maximalist and conventional footwear. Axial accelerations were measured using accelerometers positioned at the tibia and sacrum. Peak tibial and sacral accelerations were obtained and used to calculate the extent of shock attenuation. The results showed that peak tibial acceleration and shock attenuation were significantly lower in the minimalist in comparison to the conventional and maximalist footwear. Running in conventional and maximalist footwear may place increased demands on the musculoskeletal structures in order to attenuate impact transients, which may be detrimental to passive tissues.

It is proposed that this finding is caused by the change in footstrike pattern associated with running in minimalist footwear (Lieberman, et al., 2010; Sinclair, et al., 2013a, c). Running with minimalist footwear causes runners who habitually strike the ground with the anterior aspect of their foot to adopt a mid/forefoot strike pattern (Lieberman, et al., 2010; Sinclair, et al., 2013a, c), which decreases the vertical velocity of the center of mass and thus effectively attenuates the magnitude of impact transient generated by the footstrike itself. This observation may have clinical significance, given the association between impact accelerations and the aetiology of chronic injuries (Robbins, & Hanna, 1987; Whittle, 1999; Murphy, et al., 2003; Burne, et al., 2004; Warden, et al., 2006). The current investigation indicates that minimalist footwear may reduce runners’ risk from impact related injuries compared to maximalist running shoes.

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Running Injury Risk Using Minimalist Shoes is Influenced by Training Distance and Body Mass, a 2017 study:

This randomized clinical trial performed in Australia investigated running injury risk in 61 male runners with a mean age of 27 years old. All participants had a rearfoot strike at the beginning of the trial and met minimum training and performance requirements. Participants were randomized to a minimalist shoe or conventional shoe group for the remainder of the study. The minimalist shoe runners were then transitioned from their conventional shoes to minimalist shoes gradually over a 26 week period. Ultimately, 31 runners were allocated to the minimalist shoe group and 30 runners were allocated to the conventional shoe group. Runners completed a visual analog scale (VAS) weekly to assess their pain levels.

Key findings of minimalist vs. conventional shoes include:

-For runners using minimalist shoes, the risk of injury increased with increasing body mass and with increasing training distance

-Runners over 187 lbs were more than 3x as likely to sustain a running injury

The study authors concluded that heavier runners should avoid running in minimalist shoes.

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Comparison of in-shoe plantar loading forces between minimalist and maximalist cushion running shoes, a 2019 study:

While several published studies have evaluated the biomechanical responses to minimalist (MIN) footwear, little has been reported on maximalist (MAX) shoes. The purpose of this study was to compare in-shoe plantar loading parameters between MIN and MAX running footwear. Researchers recruited 15 recreational runners who ran in a minimalist (New Balance Minimus Hi-Rez) and maximalist (Hoka One One) footwear conditions. Data were collected through PEDARVR insoles. A paired t-test was conducted comparing plantar loading variables during stance: contact time (CT), maximum mean pressure (MMP), peak pressure (PP), pressure time integral (PTI) and force time integral (FTI) with further evaluation of the total foot, forefoot, midfoot and rearfoot. Statistically significant decreases were seen in all plantar loading variables under the total foot and forefoot in the maximalist shoe when compared to the minimalist shoe (p < .003). On average, the following decreases were seen in the maximalist shoe in the total foot when compared to the minimalist shoe: MPP 11.6%, PP 30.6%, PTI 29.8%. Larger differences were seen in the forefoot and less so in the rearfoot when the plantar surface was evaluated in thirds. The findings suggest that maximalist cushion footwear decreases plantar loading under the total foot and forefoot during running. Maximalist shoes may be considered when the aim is to reduce forces and pressures under the foot during running activities.

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Walking barefoot vs. with minimalist footwear – influence on gait in younger and older adults, a 2020 study:

Background

In recent years, minimalist footwear has been increasingly promoted for its use in sportive and recreational activities. These shoes are considered to function naturally like barefoot walking while providing a protective surface. Despite a growing popularity of these shoes in the older population, little is known about the influence of minimalist footwear on gait patterns. This study investigated whether overground walking with minimalist shoes is comparable to barefoot walking regarding gait stability and variability parameters.

Methods

In a randomized within-subject study design, 31 healthy younger (29 ± 4 years) and 33 healthy community-dwelling older adults (71 ± 4 years) volunteered. Participants walked on flat ground, once barefoot and once with minimalist shoes. Gait variability of minimum toe clearance (MTC), stride length, stride time, and local dynamic gait stability were analysed.

Results

The results for both age groups showed significant condition effects (minimalist shoes vs. barefoot walking) for the outcomes of local dynamic stability (p = .013), MTC variability (p = .018), and stride length variability (p  < .001) indicating increased local dynamic stability and decreased gait variability during the minimalist shoe condition. Group effects (young vs. older adults) were detected in all gait outcomes.

Conclusion

Walking with minimalist shoes appeared to be associated with better gait performance than walking barefoot in both age groups. Thus, walking with minimalist shoes is not similar to barefoot walking. With respect to reducing the risk of falling, authors suggest that minimalist shoes could be an alternative to barefoot walking or a transition option between shoes to barefoot for older adults.

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Section-25

The Wrong (Bad) Shoes:

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The Link between Your Feet and the rest of Your Body:

According to the American College of Foot and Ankle Surgeons, your entire body is like a long chain, with each link (or bone) connected to the next. Naturally, if one bone is damaged, it will initiate a chain reaction causing radiating pain throughout the rest of your body. This is how a mere foot injury can cause long-term leg, back, and neck problems. Dr. James Ioli from Harvard Medical School verifies this analogy. He observes that long-term heel wearers are more vulnerable to muscle and joint deformities. The most common of these is the permanent shortening of the Achilles tendon, the fibrous tissue that supports your ankle muscles. This stunts your calf muscles and restricts your strides.  But that’s not all. Alarmingly, ill-fitting shoes can also permanently damage the nerves in your feet. This condition, known as peripheral neuropathy, occurs when nerves are under constant pressure from tight or misshapen footwear. Vocal experts have also suggested a link between bad shoes and your vocal cords. Apparently, wearing uncomfortable shoes leads to shallow, rapid breathing. This, in turn, causes permanent damage to your respiratory system and vocal cords. As you can see, shoes affect more than just your feet; they affect your whole body. Therefore, investing in a well-fitting pair of shoes means investing in your overall health.

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The trouble with the wrong shoes:

If your shoes are too tight, too loose or insufficiently supportive, you could be placing stress on your feet, ankles, lower legs and other joints during normal activity. Athletic activity can amplify this stress, which contributes to pain and injuries like shin splints, Achilles tendon pain, corns and bunions, ingrown nails, postural issues and lower back pain. Wearing the wrong shoe can exacerbate existing problems such as pain or arthritis in your hips, knees, ankles, back or feet.

At a more basic level, shoes affect how you walk. The movement of your feet during each step determines how the rest of your body responds and stepping incorrectly can cause problems up the line – e.g., in your hips and back. Some people’s arches roll inward too much, or not enough. If the shoe is not compensating for this defect, the feet will not absorb shock effectively. This can contribute to additional stress on other joints.

Dr. Richard Hayes of Great Basin Orthopedics has seen the consequences of poor shoe selection during his 25-year career. “Rarely does a patient with back or knee pain consider that their choice of footwear is contributing to their problem,” Dr. Hayes explains. “It’s not always a fall or an accident. A job that requires you to be on your feet while wearing unsupportive shoes can be enough to cause a problem.”

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Are you wearing the wrong shoes?

If you are, you could be significantly reducing your quality of life without even realizing it.  According to the National Centre for Biotechnology Information data, approximately 72% people wear inappropriate sized footwear. This is associated with all kind of foot problems like foot pain, poorer overall foot health, corns and calluses in older people and foot ulceration in older people with diabetes.

All footwear alters the shape of our feet, but studies have shown that poor footwear can affect us in ways that actually start a vicious health cycle. Even in relatively healthy people, bad shoes cause foot pain, which in turn is a key predictor of reduced physical activity. Lack of exercise in turn raises the risk of a wide number of chronic ailments, including diabetes, which then can cause even more damage to your feet, such as neuropathy. For people in poorer health, footwear can directly result in foot impairment and disability.

The wrong choice of winter boots can have even worse outcomes. In 2016, the Toronto Rehabilitation Institute at the University Health Network tested 98 pairs of winter boots, including both safety and casual footwear. Only eight per cent of the 98 types of footwear met the minimum slip resistance standards set out by the test.

Slips and falls can be brutal at any age, but for seniors they can be downright deadly. According to Health Canada, falls cause 85% of seniors’ injury-related hospitalizations, and deaths due to falls rose 65% between 2003 and 2008. Just wearing the wrong footwear has been shown to increase levels of apathy, anxiety, and loss of balance in those over the age of seventy. Considering that the shape and size of our feet changes with age and life events such as pregnancy, altogether too many people are walking around wearing the wrong shoes.

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Shoe bite:

A shoe bite is a painful area on your foot that’s the result of friction from rubbing against your shoe. The simplest way to prevent shoe bites is to purchase shoes that fit properly. If you have shoes that are causing shoe bites, consider not wearing them. The simplest answer to your problem is to buy shoes that fit properly or to wear socks. However, if you love the shoes that caused the bite, you can try other alternatives, such as stretching or softening the material to better conform to your foot. Preventing and treating shoe bites usually involves putting some sort of protection on your foot, such as toe protectors or toe caps, or in your shoes, such as insoles, to protect your skin from friction. If you have recurring sores or blisters on your feet that don’t respond to at-home treatment and preventive measures, talk with a doctor or a podiatrist. They can diagnose the issue and recommend treatment options

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Effects of wearing wrong shoes: 

The direct consequences of wearing bad, tight or ill-fitted shoes are described below:

-1. Blisters: Blisters are the most typically symptomatic of ill-fitting shoes. These fluid-filled vesicles of dead skin are your skin’s immediate reaction to constant friction. Blisters are extremely painful and take weeks to heal, leaving behind permanent scars and discolored, damaged skin.

-2. Corns: Most people start getting corns after the age of 30. Corns are hard layers of skin which start occurring over a pressure point in your soles. They usually develop over a bony area such as a joint and can be very painful when pressure is applied on it.

Corns are developed due to repetitive pressure and friction over that particular part of skin. This friction and pressure is often caused by ill-fitting shoes, tight shoes or high heels which compress your soles. It can be very difficult to get rid of corns. If not treated properly, corns can turn into minor complications and then serious feet problems over a period of time. Calluses are similar to a corn, these are hard, rough areas of skin that are often yellowish in colour. 

-3. Athlete’s foot: This is a condition very often triggered by wearing tight fitting shoes for long periods of time. It is caused by a fungal species living on the skin and causes itching, inflammation and flaking of the skin.

If it reaches in to severe stage it can limit your mobility. The fungal species act on the sweaty and wet areas of the foot, mainly in between the toes. Poor ventilation and moist shoes increase the risk of athlete’s foot. Too tight shoes tend to squash the toes in to each other causing sweat and dampness to accumulate in between the toes for long period to time.

-4. Hammertoes: This painful deformity causes your toes to bend out of shape. Often, your toes have to adapt to the small space of a tight shoe. Eventually, they will just readjust and bend like a hammer.

-5. Bunions: To put it into simple terms this is a condition in which the big toe turns towards the smaller toes, meaning the two bones which comprise the big toe form an angle that may stick out. In a lot of cases, a bunion will distort the shape of footwear and carefully selected and fitted shoes are essential for comfortable day to day wear. Bunions can be hereditary or linked to arthritis however the most common cause is generally accepted to be ill-fitting footwear. Your bones and joints can react negatively to tight shoes. In this case, a bone-like bump forms at the base of the big toe, causing the toe to turn inwards. 

-6. Ankle pain: Uncomfortable shoes cause you to adjust your walk. Oftentimes, you’ll end up walking in a way that is very unnatural for your bones. As a result, you’ll have extremely sore ankles.

-7. Ingrown toenails: This occurs when the sides of your toenails curve inwards and grow into the surrounding skin. Ingrown toenails are a result of shoes that are too tight, narrow, or flat for your feet. If you’re athletic, you’re extremely likely to develop ingrown toenails, especially if you have bad shoes.

Ingrown toenail is a condition in which the side of the nails bruise the surrounding skin and cause intense pain and often infection if it turns into a fungal toenail. The main reason for developing ingrown toenail or fungal toenail is wearing very tight socks and tight footwear. 

-8. Nail fungus: Your toenails are purely made of keratin, and certain species of fungi feed off this keratin. If your toenails are already weak from ill-fitting shoes, then they are more susceptible to fungus. Nail fungus is extremely difficult to treat, and sometimes the damage can be permanent.

-9. Metatarsalgia: Metatarsalgia is a common foot condition that involves inflammation and pain in the balls of the feet. The pain could be achy, sharp, or even a burning sensation. Poorly fitting or worn out shoes are one of the underlying causes of metatarsalgia.

-10. Foot Ulcers for Diabetics: Tight footwear is the leading cause of foot ulcers in patients who have diseases such as diabetes. Ulcers are open sores or wounds that can form when the shoes are constantly rubbing up against the feet. According to the American Podiatric Medical Association, 85% of diabetes-related amputations are preceded by foot ulcers. These ulcers are preventable when wearing the right type of footwear.

-11. Soreness in Other Areas:  If you are feeling pain or soreness in your legs, hips or lower back, this could be caused by tight shoes. When you have to adjust your gait and posture due to poorly fitting shoes, high heels, or their associated foot problems, your body’s alignment is thrown out of whack. Incorrect posture can lead to soreness and pain spreading to those other areas of your body.

-12. Joint disorders: Constant pressure on the joints can lead to arthritis. Additionally, if your shoes don’t have adequate cushioning or other shock-absorbing mechanisms, your body has to compensate for it. If you develop pain in your knees, it’s probably because your knees are acting as shock absorbers instead of your shoes.

-13. Back Injuries: Your shoes support more than just your feet; they support your back too.

-14. Nerve damage: Numbness or excessive tingling in your feet is symptomatic of serious nerve damage. Tight or narrow shoes can often lead to permanent nerve damage.

-15. Flat feet: Most flat shoes without arch support tend to give flat feet or fallen arches in the long run.  It causes stiffness in Achilles’ tendons and affects the entire leg and its muscles. This can further cause strain and more serious problems with spring ligament and plantar fascia.

Other Risks:

According to the Bureau of Labor Statistics, 43% of work-related injuries in the private sector are actually sprains, strains, or falls. The culprit? Uncomfortable and slippery shoes that could not withstand long, laborious work hours. But it’s not just the private sector. Your entire lifestyle is heavily dependent on footwear. Whether you’re a professional athlete or an office worker, your shoes will greatly affect your overall productivity.

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Loose shoes:

There are two potential errors when selecting what size shoes to wear. Either the shoe will be too small for the foot or too large for the foot. It is easy to recognize a shoe is too small as it is immediately uncomfortable. It takes time to recognize the shoe is too large. An explanation for choosing shoes those are too large for a foot is failing to recognize or act on the fact that the width of the foot may not be average. The statistical average shoe width size for men is a D width, and a lady is a B width. A statistical average or median shoe width size means some individuals foot size are greater than a standard deviation wider or narrower than the average shoe width size. Some individuals have skinny long feet; some individuals have short wide feet. If you happen to have less than average foot size particularly width, than you are not going to fit in the average shoe.

Individuals with short wide feet who try to fit in an average width shoe are likely going to select a shoe that is too long for the foot in order to accommodate for the wide foot.  This shoe is too large for the relatively short foot. The flex point of the shoe will be in the wrong spot.

Individuals with a long narrow foot who accept an average width shoe are then in a shoe which is too wide for the narrow foot.

Recognize the width of the foot can be an important consideration when selecting the size of shoe. To check the fit of the width of a shoe grasp the upper of the shoe at the ball of the foot and squeeze the upper material.

-If there is excessive bunching of the material of the shoe upper the shoe is too wide

-If you are unable to grasp upper material the shoe is too narrow

-If there is a slight amount of bunching of the upper material the width of the shoe is appropriate

-With the shoe laces tided comfortably slide a finger down the inside of the ankle. If the finger can touch the bottom of the inner sole of the shoe the heel cup of the shoe is too wide.

There is a relatively easy solution. Ask for a shoe of the appropriate width of your foot size. Unfortunately, not all manufactures will produce shoes of varying widths.  Also retail stores often do not stock shoes that are narrow or wide.

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Problems wearing shoes that are too large for foot:

Shoes which are too large for foot size can lead to problems.

Blisters:

Blisters occur because of shearing force.  Sliding shearing movement can occur if the shoe is too large for the foot.  The same is true for “blood blisters” under the toe nails. The tip of the shoe flexes upward catching the end of the toe nail lifting it away from the toe nail bed.

Achillis tendon problem:

Shoes longer than the appropriate size result in increased in activity of the calf muscles and there is less propulsive force forward.

Metatarsalgia:

Wearing shoes that are too big or too wide contribute to excessive shearing (side to side movement of foot in shoe). This can also contribute to interdigital neuritis (Moten’s toe syndrome).

Injury:

Without debate, by far the riskiest part of wearing shoes that are too loose is increasing your risk of various foot and ankle injuries. Whether it is jamming your toe or spraining an ankle, loose shoes aren’t worth it. If you feel like any of these happen to you often, loose-fitting shoes might be part of the problem.

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What can you do if your shoes are Too Big?

If you’ve already bought shoes that are too big, you may be able to fix it. Of course, this depends on the type as well as how big it is. Here are some simple tips:

-1. Try to wear thicker socks or even multiple pairs—this works best with athletic footwear. It could add half an inch of bulk, which may be enough. However, this might not be the best idea in the summer when it’s hot out.

-2. For a quick solution, use a type of stuffing to fill out the excess space. You can use cotton balls, tissue paper and even toilet paper. This is a fantastic trick for closed-toe heels, flats and dress shoes, but not so much athletic wear.

-3. Insoles are a great solution that works with most shoes. They usually consist of foam or gel and work as a soft pad providing cushioning and support. They’re generally utilized to help posture problems and feet discomforts.

-4. For flats or heels, you can try pads, like ball-of-foot types. These are small cushioning devices that you attach to your feet, which will then provide friction and support.

-5. Heels strips are another alternative to insoles, sometimes called heel grips. These are adhesive pads that help tight shoes feel more comfortable. But you can also use them to add bulk in a needed spot. 

-6. If none of the above work, consult a shoe repair professional. Such a person will evaluate your shoes and assess what can be done. If you have expensive or heirloom shoes, you go directly to a professional for help.

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Shoes to avoid:

Fashion shoes may look attractive, but they aren’t doing your body any favors. The worst types of shoes for your feet include:

-1. High heels. Three- to four-inch heels change the alignment of your body, which puts extra stress on your legs, hips and back. Wearing high heels regularly causes the Achilles tendon to tighten and shorten, which can actually make it painful to wear flat shoes. High heels also create more pressure on the ball of your foot, which causes the foot’s natural padding to thin and provide less cushion where you need it most. All of this extra pressure can also lead to calluses.

-2. Pointed-toe shoes, particularly high heels, that scrunch your toes together. These can aggravate an existing bunion, which is a hard lump on the joint of your big toe. The awkward positioning of your toes can also cause them to contract and eventually curl under permanently, a condition known as hammertoe. Hammertoe requires medical intervention to correct. 

-3. Flip flops. Flat flip flops provide no support. Lack of proper foot support is a leading cause of plantar fasciitis and Achilles tendinitis. Plantar fasciitis is caused by the excessive pull of the plantar fascia, an arch-supporting ligament, causing pain and inflammation at the heel. Achilles tendinitis is caused by poor mechanics of the foot, leading to overstretching of the tendon. This sometimes leads to bone spurs. The thong flip flop can also cause hammertoe as the toes constantly struggle to hold the foot in the shoe.

-4. Ballet flats. Ballet flats are equally as bad for your feet as flip flops because they, too, provide little support. There is no arch system to help absorb the brunt of the pressure the feet endure every day.

-5. Flexible shoes. If you can bend and twist a pair of shoes with ease, they are not going to be supportive enough. Shoes with good arch support will be difficult to manipulate. Avoid buying any shoes that can bend in half.

-6. Wrong size. Nine out of 10 women are wearing shoes that are too small (figure below). The consequences aren’t pretty — calluses, blisters, bunions, corns, and other problems. The constant rubbing can irritate the joints in the foot and lead to arthritis.

-7. Barefoot shoes. These aim to mimic the natural feel and mechanics of walking barefoot. There’s no support or shock absorption built in. And in some brands, the shoes separate the toes, hampering your feet’s natural walking position.  

 

-8. Platform shoes. Platform shoes (figure below) and wedges tend to have rigid foot bed that throws off the biomechanics of walking. Your foot is trying to bend a certain way, but the shoe is fighting you because it’s so rigid.

-9. Slip-on shoes. Slip-on shoes may be easier to put on and take off, but when it comes to comfort and injury prevention, it is not the best option. It causes your foot slipping sideways or forwards in your shoe.

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Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature, 2018 study: 

Background

Correct footwear fitting is acknowledged as being vitally important, as incorrectly fitted footwear has been linked to foot pathology. The aim of this narrative review was to determine the prevalence of incorrectly fitted footwear and to examine the association between incorrectly fitted footwear, foot pain and foot disorders.

Methods

A database search of Ovid MEDLINE and CINAHL yielded 1,681 citations for title and abstract review. Eighteen articles were included. Findings were summarized under the categories of children, adults, older people, people with diabetes and occupation- or activity-specific footwear. Differences in footwear fitting between sexes were also explored.

Results

Between 63 and 72% of participants were wearing shoes that did not accommodate either width or length dimensions of their feet. There was also evidence that incorrect footwear fitting was associated with foot pain and foot disorders such as lesser toe deformity, corns and calluses. Specific participant groups, such as children with Down syndrome and older people and people with diabetes were more likely to wear shoes that were too narrow (between 46 and 81%).

Conclusion

A large proportion of the population wear incorrectly sized footwear, which is associated with foot pain and foot disorders. The high prevalence of incorrectly fitted footwear suggests that greater emphasis should be placed on footwear fitting education so people are more aware of their foot dimensions and appropriate foot size. Furthermore, footwear manufacturers should provide an appropriately large selection of shoes that can accommodate the variations in foot morphology among the population. In particular, a greater range of widths for each length sizing option should be made available in order to accommodate feet with wider dimensions.

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Section-26

Home footwear:

Working from home during COVID-19 has certainly changed things, especially when it comes to our wardrobes. Most of us have traded our office attire for something a little more casual. This includes a change in footwear. Now that we’re social distancing and limiting the amount of time we spend outside of our homes, we’re passing on shoes all together. But while being barefoot is incredibly comfortable, is it actually good for you? Are there benefits to wearing shoes, aside from protecting us against the elements?

Walking barefoot on hard surfaces at home for an extended amount of time is bad for your feet because it allows our foot to collapse which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. Our feet naturally pronate during the gait cycle, however when we walk barefoot on hard surfaces we pronate for a longer period of time which then alters the biomechanics and distribution of pressure and weight across the foot. This imbalance may increase the progression of underlying foot deformities such as bunions and hammertoes and lead to painful conditions associated with excessive pronation such as arch/ heel pain, shin splints/ posterior tibial tendonitis, and Achilles tendonitis. This imbalance can then translate upward affecting other parts of the body such as our knees and back.

Walking barefoot may help improve the strength and flexibility of the muscles and ligaments of the foot, improving the function of the feet and improving posture and balance of the body, but avoid hard surfaces for long periods of time.

It is good to wear slippers for most of the time at home but shoes do provide ample health benefits, including arch support, protection against bacteria and fungus, and shock absorption for sensitive bones and joints. Needless to say, podiatrists recommend wearing something while working from home to protect your feet. Try a comfy, sturdy slipper that softens the impact from hard surfaces, or a lightweight walking shoe that offers additional arch support. Avoid flip flops or backless sandals since they don’t offer much support and require your feet to work extra hard at keeping them on.

It’s also important to alternate footwear throughout the day and week. The repetitive stress of walking and wearing the same shoes everyday, all day, can inflame ligaments, tendons, fascia and even cause pain, injury and stress fractures. Wearing your slippers in the mornings and evenings but opting for sneakers or walking shoes in the afternoon will do the job just fine.

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Should you be wearing slippers around the house?

Many people prefer to wear slippers in the house rather than shoes as they are often soft and comfortable for clawed toes and prominent joints. However, there are some negative aspects to wearing slippers which you need to consider before choosing them as your ‘house footwear’:

-1. Slippers aren’t a good idea for those who have to wear special insoles or foot orthoses. They do not provide the additional support needed to ensure the maximum benefits can be achieved from the insoles/foot orthoses.

-2. Slippers also sometimes contribute to falls in older people.

-3. The soles can lack adequate cushioning, and they can be generally unsupportive.

-4. Backless slippers and slippers with a high heel should not be worn as they are both unsafe and do not provide stability.

Therefore, slippers should be reserved for foot protection and warmth whilst resting or for low levels of activity. The features of the ideal slipper are generally the same as for the ideal shoe. If you are doing tasks within the home such as ironing or cooking which require standing for long periods, then it is advisable that you wear your shoes rather than slippers particularly if you have been provided with special insoles or foot orthoses. Slippers should be replaced as soon as the uppers, linings or soles start to wear out as in this state they can increase the risk of trips and falls and additionally can cause sore areas on the skin of the feet.

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I strongly advise against wearing outdoor shoes indoors to avoid the unnecessary and non-hygienic transfer of soil, bacteria, viruses, and pollen from the environment into our homes. A study by Charles Gerba, a microbiologist and professor at the University of Arizona, and The Rockport Company found large numbers of bacteria both on the bottom and inside of shoes. Although some scientists suggest this concern is overblown, some of the bacteria found on the shoes such as E. Coli can cause intestinal and urinary tract infections, meningitis and diarrhea while other bacteria such as Klebsiella Pneumonia, can cause pneumonia as well as wound and bloodstream infections. A convenient new shoe that recently entered the market are Muvez shoes.  Muvez shoes are indoor slippers with a detachable outdoor sneaker sole. These shoes would be a nice compromise for those that do not currently remove their outdoor shoes when at home. The outdoor sneaker sole easily comes off when you arrive at home turning into an indoor slipper and then quickly attaches when you leave to become an appropriate outdoor shoe.

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Section-27

Footwear for driving:   

There are all sorts of things you shouldn’t be doing while driving. But when talking about the dangers of eating, wearing headphones, using smartphones or doing makeup in your car, it can be easy to forget what a crucial role your feet play in operating a car. An often-overlooked safety preparation that drivers can take to reduce the chances of getting into a deadly car crash is simple: Wear the right shoes. And to do that, you need to know what the wrong shoes are. These are types of shoes you should avoid wearing while driving.

-1. Sandals/mules

Flip-flops hit several different hazardous marks when it comes to driving. Most importantly, flip-flops, more than any other shoe, have the potential to just come right off. The concern with these types of footwear is the chance of the sole getting caught or stuck under the pedal or even sliding off the person’s foot while driving. This is highly unsafe and dangerous, especially if…one needs to apply either the brakes or gas pedal at a moment’s notice. Flip-flops also completely lack any ankle support. And it’s not just flip-flops; you should probably avoid driving while wearing any type of sandals or shoes with no back. Flip-flops might be the most likely to fully come off, but the less secure fronts of any type of sandal have the potential to get stuck under a pedal.

-2. Slippers

Slippers hold the same potential dangers as sandals: They’re not secured around your ankle and could (as their names suggest) slip right off your feet at any time.

-3. High wedges/platform shoes

While shoes with tiny, thin heels present problems, so, too, do particularly large, chunky shoes. Thin shoe soles keep your feet as close to the pedals as possible, making them better suited to helping your feet gauge the proper amount of force needed to work the pedals. Therefore, driving with very thick-soled shoes, like wedges, platform shoes, or even heavy boots, could cause you to miss a pedal, press two pedals at the same time, or use the wrong amount of pressure.

-4. High heels

Considering how cumbersome high heels are to walk in, it shouldn’t come as a surprise that they’re not ideal driving shoes. To maintain control of pedals, the heel of your foot must rest on the floor of your vehicle. When you’re wearing thin heels, your heel instead hovers over the floor of your vehicle, only making contact with the floor at a point with a tiny surface area. There are a few other drawbacks as well, including heels positioning your feet in an uncomfortable, unfamiliar position than what you’re used to and skinny heels’ potential to snag on your car’s floor mat. In addition, if the shoes have pointy toes, as many high heels do, the shape and front of the shoe can make it difficult to apply the necessary pressure needed due to the limited surface area of the shoe.

-5. Brand-new shoes

To prevent nasty surprises while driving, you should make sure you know exactly how any shoes you wear feel on your feet before driving in them. And certain types of new shoes may have a slippery sole until they’re worn in. The last thing you want is for your shoe to slip off the pedal while you’re driving.

-6. Work Boots

Large boots may cause an obstruction to your driving. In addition, the larger the boots, the trickier it can be to drive in them, because it’s harder to accurately feel where the pedals are.

-7. Cowboy Boots

They have an adequate sole, but the raised heel may cause interference between the pedals when driving.

-8. No shoes

When you’re used to driving in shoes, driving without them can feel foreign, and that’s not what you want when operating a motor vehicle. It requires you to put more pressure on the pedals than you usually do when wearing shoes. That could affect your braking time, putting you at risk.

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Suitable footwear for driving:

There are a few things you want to have in any shoe that you wear while driving. You want your foot to be fully enclosed and secure in the shoe, and your heel should be firmly touching the ground to provide enough leverage and pressure. You also want good ankle support and relatively thin soles, factors that ensure that you can apply the right amount of pressure on pedals. A wide toe box also provides safer pedal operation than a narrow one. Some good options for driving shoes are sneakers, (comfortable) flats, and loafers; some shoes like these are even specifically designed for driving.

Driving Shoes:

Originally designed for sportscar enthusiasts, the driving shoe is a slip-on moccasin-type with rubber soles and grommets that wrap around on the back of the heel. These shoes allow for better grip and pedal traction and provide a pivot point to move your foot back and forth from the brake to the accelerator.

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Drivers could be fined up to £5,000 if they get behind the wheel in flip flops or sandals:

The RAC in U.K. has compiled a list of what footwear you should and should not use when driving – and sandals, flip flops and bare feet do not make the list. Also unlikely to be deemed safe are large walking boots and high heels. According to the RAC: “While light, flimsy and impractical footwear can be dangerous, so can sturdy, robust shoes, such as walking or snow boots. It’s important to have a good base and grip to apply pressure to the pedals, but you need a certain degree of finesse to manipulate the controls. If not, you could strike the brake and accelerator together, producing a heart-in-mouth incident.”

The RAC produced guidelines on what footwear to drive in.

Your shoes should:

-Have a sole no thicker than 10mm

-The sole should not be too thin or soft

-Provide enough grip to stop your foot slipping off the pedals

-Not be too heavy

-Not limit ankle movement

-Be narrow enough to avoid accidentally depressing two pedals at once 

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Section-28

Environmental impact of shoes:  

If you bought a pair of shoes made out of recycled soda bottles that falls apart in a couple months, that’s probably less eco-friendly than just buying a pair of standard sneakers and wearing them for years.

Pete Lankford, footwear industry consultant

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While that might be a plus for some, the sneaker market carries a significant negative, as well: Sneakers carry a large environmental footprint. Conventional sneakers are generally made from leather, plastic or rubber. The sneaker manufacturing practice is extremely energy-intensive, producing a large amount of greenhouse gases. The average sneaker contains many parts and is difficult to make — and most sneakers contain plastics that are not biodegradable. On top of that, typical pair of running shoes generates 30 pounds of carbon dioxide emissions, equivalent to keeping a 100-watt light bulb on for one week, according to a new MIT-led lifecycle assessment. This is all compounded by the fact that many sneakers are trend-driven, meaning they are often purchased and then discarded relatively quickly. Additionally, an estimated 80 percent of sneakers go to landfills. The fact that shoes are made of so many different materials is what makes them so hard to recycle. They break down very slowly, and when they do, they release toxins, chemicals and fossil fuels into the surrounding environment.

Shoes are a product of everyday use that everyone in the world owns; there are more than 20 billion pairs of shoes manufactured each year. However, too much of anything isn’t good as there are many environmental impacts of shoe industry that cannot be ignored much longer. Shoe manufacturing and shoes in general poses many threats to the wellbeing of our planet as many toxins, chemicals and fossil fuels are produced and leaked into the environment during the first and last steps in the shoe life cycle. These chemicals are harming both the wildlife and humans that come in contact with them, which, in turn, causes many health problems. Also, shoe manufacturing produces large amounts of carbon dioxide which contributes to the already serious effects of climate change and global warming.

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One of the largest environmental impacts of shoes come from the manufacturing stages of the shoe life cycle; and surprisingly, out of the people surveyed a majority of them believe that shoes only an environmental impact after they are thrown out. In the stage of manufacturing, large amounts of machinery and chemicals are required to produce shoes. To power these machines, a great amount of fossil fuels are needed and these fossil fuels produce greenhouse gases when burned. Coal is one of the sources of energy that used very often to power these factories as it quite cheap compared to oil or other sources of energy. Burning coal produces carbon dioxide which eventually ends up in our atmosphere, contributing the greenhouse effect, which is not a positive effect for the environment. On average, the production of one shoe produces 30 pounds of carbon dioxide and there are more than 20 billion shoes produced each year! Another aspect that is regularly overlooked and also contributes to the carbon dioxide emissions from shoes is the transportation. This is because transportation is fundamental to the marketing aspect of the shoe industry as most footwear manufacturing companies choose to build factories in third world companies for cheap labor. Since these factories are situated far away, transportation such as ships, airplanes and trucks are needed in order to deliver the goods to the retailers. Next, chemicals used in the manufacturing process also contribute to the negative impact that shoes have on the environment. Many chemical adhesives and tanning chemicals are used to process different parts of the shoe. An example of some of these chemicals include Chlorinated phenols , tribromphenol, chlorinated paraffins, dimethylfumarate etc., which are used to preserve the materials, such as leather, in shoes. These chemicals are easily leaked into the environment and water through the discharge from the factories. These chemicals can harm the wild life who may consume infected water or plants. To sum up, the manufacturing process of shoes poses many threats to the environment as there are large amounts of carbon dioxide produced and many chemicals are used to manufacture them.

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The last step in the shoe life cycle, which is disposal, also contributes greatly to the environmental impacts of the shoe industry. According to statistics, 38% of students in Fletcher’s Meadow secondary school throw out their old shoes and 42% donate them. For the 38% who throw out their shoes, these shoes end up in landfills and can eventually end up contaminating the soil and even drinking water, much like many other materials that are thrown out, as the chemicals used in the manufacturing slowly start to leak into soil as the shoe slowly starts decomposing. This has a huge effect on both wildlife and humans. This is because biomagnification and bioaccumulation can occur as wildlife that humans consume may have drunk the contaminated water or consumed contaminated plants. This can lead to many health defects including cancer. Ultimately, the disposal of shoes has a large impact on the environment much like the manufacturing as harmful chemicals start to leak into and contaminate the soil and water.

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To help prevent these environmental impacts the best thing to do is to recycle or donate your used shoes so that they do not end up in the landfills. There are many programs that have been set up to help reduce the impacts of the disposal of shoes on the environment and one of the major ones that is actually created by one of the largest shoe companies (Nike) is called Reuse-a-shoe. In this program, Nike takes old used shoes and recycle the old materials and grinds them to be used as sports grounding for tennis courts, tracks etc. Another way you can help is by educating yourself and other about the negative impacts that shoes have on the environment so that you can help raise awareness of the issue.

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Manufacturing-focused emissions reductions in footwear production, a 2013 study:

What is the burden upon your feet? With sales of running and jogging shoes in the world averaging a nontrivial 25 billion shoes per year, or 34 million per day, the impact of the footwear industry represents a significant portion of the apparel sector’s environmental burden. A single shoe can contain 65 discrete parts that require 360 processing steps for assembly. While brand name companies dictate product design and material specifications, the actual manufacturing of footwear is typically contracted to manufacturers based in emerging economies. Using life cycle assessment methodology in accordance with the ISO 14040/14044 standards, this effort quantifies the life cycle greenhouse gas emissions, often referred to as a carbon footprint, of a pair of running shoes. Furthermore, mitigation strategies are proposed focusing on high leverage aspects of the life cycle.

Using this approach, it is estimated that the carbon footprint of a typical pair of running shoes made of synthetic materials is 14 ± 2.7 kg CO2-equivalent. The vast majority of this impact is incurred during the materials processing and manufacturing stages, which make up around 29% and 68% of the total impact, respectively. Other similar studies in the apparel industry have reported carbon footprints of running shoes ranging between 18 and 41 kg CO2-equivalent/pair (PUMA, 2008; Timberland, 2009).

For consumer products not requiring electricity during use, the intensity of emissions in the manufacturing phase is atypical; most commonly, materials make up the biggest percentage of impact. This distinction highlights the importance of identifying mitigation strategies within the manufacturing process, and the need to evaluate the emissions reduction efficacy of each potential strategy. By suggesting a few of the causes of manufacturing dominance in the global warming potential assessment of this product, this study hypothesizes the characteristics of a product that could lead to high manufacturing impact. Some of these characteristics include the source of energy in manufacturing and the form of manufacturing, in other words the complexity of processes used and the area over which these process are performed (particularly when a product involves numerous parts and light materials). Thereby, the work provides an example when relying solely on the bill of materials information for product greenhouse gas emissions assessment may underestimate life cycle burden and ignore potentially high impact mitigation strategies.

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Biodegradable Shoes?? 

An average pair of shoes made today is estimated to last around 1,000 years before it breaks down in a landfill. Not so the new BIO-D line from Simple Shoes. According to the company, the midsoles and outsoles of the shoes (as well as shoe bags) are impregnated with EcoPure, a pellet containing millions of tiny microbes. When in contact with the moisture and warmth of a landfill or compost bin (but not during daily use or storage) the microbes break down the shoes. The process takes about 20 years, and works in both anaerobic and aerobic conditions.

Another sneaker specifically designed to biodegrade, the Orba Ghost launched recently, is made almost entirely of natural materials. It is a 94 per cent plant-based, bespoke, durable shoe with a bio-rubber sole made of natural rubber, rice husk ash, coconut oil, and insoles of cork, coconut husk and natural rubber. The formula is not only a global first combining aesthetics, technical excellence, and ethics, but is also designed to eliminate the number of disposed shoes entering landfills. While the shoes are built with natural products and built to biodegrade, this does not compromise the design or quality of Orba shoes. If you put a cotton T-shirt on it won’t biodegrade while you’re walking around town, but if you put it in a nutrient-rich environment it won’t be there for long. To complete the cycle of consumption, Orba wants you to send the shoes back to them when you’re finished with them. They will biodegrade in a really specific environment so company want people to send them back to us so they can dispose of them in the right environment. 

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Eco-friendly sneakers?

Eco—friendly shoes are made of materials that have been recycled or materials that are renewable, meaning it’s more environmentally-friendly to produce than a conventional material. There’s no concrete definition on what makes a sneaker eco-friendly or sustainable, but most of the leading models boast a build using recycled materials, like plastic and rubber, or renewable materials, like cotton or cork. While it’s nearly impossible to create a completely recycled shoe, due to the sheer amount of materials used, most eco-friendly models are a step in the right direction. There’s also typically no difference in performance between sustainable and standard sneakers. Having said that, there is a calculation to be made when buying sneakers. For example, a pair of sustainable Allbirds sneakers are not as strong as a pair of Air Jordans. 

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Major footwear brands such as Clarks, Crocs, Nike and Adidas have all announced initiatives to reduce their impact on the environment with new eco-friendly products. Clarks Originals launched vegan versions of its iconic Desert Boot and Wallabee silhouettes. Adidas said it would look to create more eco-friendly sneakers using Mylo, a substance found in the underground roots of mushrooms. Crocs began introducing a new bio-based Croslite material into its product lines to help it reach a 50% reduction in its carbon footprint per pair of Crocs shoes by 2030.

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Moral of the story: 

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-1. The science of footwear is neither perfect nor complete. Various studies narrated in this article show fundamental flaws including sample size too small to draw solid conclusions; plenty of confounding variables unaccounted for; varying definitions & varying population in different studies, and the bias. The bias existed due to shoe industry’s conflict of interest, selective outcome reporting, incomplete data etc. All these shortcomings caused conflicting conclusions and recommendations. Here are some examples:

-1. There are proponents of flexible shoes and there are proponents of not so flexible shoes, each quoting science to justify shoe recommendation. 

-2. The commonly held beliefs follow this logic: Runners get injured due to impact and excessive pronation, running shoes reduce impact and pronation, and therefore running shoes reduce injury. Unfortunately, every part of this rationale seems to be flawed.  

-3. It has been proposed that a change in footwear may have an impact in the reduction of running injury. Two possible solutions in footwear alterations include decreasing the cushioning in the shoe to better mimic barefoot running or increasing the cushioning to help absorb impact forces on the runner. Over the past 50 years, running shoes have experienced tremendous changes. That is, from very minimal to highly supportive and cushioned shoes, and then to very minimal and finally back to highly cushioned shoes. While different shoe constructions showed the remarkable changes in running biomechanical and performance-related variables, no consistent findings on running biomechanics can be found for most shoe constructions. Various biomechanical variables such as strike pattern, ground impact forces, foot posture or foot pronation have all been proposed as injury risk factors. Various footwear features such as cushioning, stability provided, and motion control systems have been designed to lessen these risk factors. Yet, despite significant advances in shoe technology over the past 50 years, the rate of sustaining a running related injury has remained relatively stable.

-4. The change in biomechanics that shoes cause may be a leading factor in impact force injuries according to 2014 study. However, a 2016 study found significant reduction in the risk of pain or injuries accomplished by wearing running shoes.

-5. A 2015 study reviewed the data regarding the relationship between impact characteristics and ankle pronation to the risk of developing a running-related injury. Based on the lack of conclusive evidence for these two variables, which were once thought to be the prime predictors of running injuries, two new paradigms are suggested to elucidate the association between footwear and injury. Two new paradigms, ‘the preferred movement path’ and ‘the comfort filter’, suggest that a runner intuitively selects a comfortable product using their own comfort filter that allows them to remain in the preferred movement path. This may automatically reduce the injury risk and may explain why there does not seem to be a secular trend in running injury rates.

-6. A study finds that shod running required 3-4% less metabolic energy than running barefoot. Another study finds that barefoot running reduces energy use – oxygen consumption was found to be approximately 4% higher in shod versus barefoot runners. 

-7. Many runners take for granted that more cushioned shoes are more “protective,” while others assume that running in minimalist shoes will lead to fewer injuries because they allow you to run more “naturally.” Neither idea is supported by evidence. 

The conundrum is unending. We need better science. However, most of us don’t think much about the science of the shoe – we think more about the style.   

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-2. The foot and ankle form a complex system which consists of 28 bones, 33 joints, 112 ligaments, controlled by 13 extrinsic and 21 intrinsic muscles. A study of 2,000 adults found they each typically stroll 6,839 steps a day – amounting to 2,496,235 a year. The structure of the foot make it well adapted to walking without support on a variety of surfaces. The foot endures 3 times body weight during running. Foot functions as a rigid structure for weight bearing and it also function as a flexible structure to conform to uneven terrain. The foot arches shape is designed in a similar manner to spring; bears the weight of the body and absorbs the shock that is produced with locomotion. The structure of the human foot and lower leg is very efficient at absorbing the shock of landing and turning the energy of the fall into forward motion, through the springing action of the foot’s natural arch. The foot’s flexibility conferred by the arches is what facilitates everyday loco-motor functions such as walking and running. The metabolic energy saved by the arch is largely explained by the passive-elastic work it supplies that would otherwise be done by active muscle. This elegant arrangement allows the mechanical characteristics of the foot to be rapidly adapted to loading or task demands and is thought to improve the efficiency of human running, returning between 8% and 17% of the mechanical energy required for one stride, via passive mechanisms alone. 

The human feet provide the body with support, balance, and mobility. Your feet use a combination of muscles, bones, and joints that work together to help you walk, run, or jump. Whereas, your shoes help to provide your feet with support while you’re completing these actions. Additionally, your shoes protect your feet when you’re walking on rough terrain or on hot or cold surfaces, and shield your feet from harm, like cuts and bruises, to some extent. 

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-3. Running is one of the most intense physical activities, constantly involving impact between foot and ground. In the long run, the impact can cause injuries and pain. The impact force depends on the type of the collision, which can occur in 3 ways: a rear-foot strike (RFS) with the heel landing first (shock absorption by heel); a mid-foot strike (MFS) with the heel and ball of the foot landing simultaneously (shock absorption by arch); and a forefoot strike (FFS) with the ball of the foot landing before the heel (shock absorption by calf muscles and Achilles). Most runners have rearfoot foot strike during running. Most runner bring their foot down first on their heel and roll forward to the ball of their foot. Some runners may also land on the ball of their foot first and then push off. Shoes with cushioned heels promote a heel-strike running pattern, whereas barefoot runners often have a forefoot or mid-foot strike pattern; although a study found that majority of barefoot runners also favoured a heel strike instead of a forefoot strike. Running is a higher impact exercise and each time your foot comes down, your body absorbs force approximately three times your body weight. When you land from jumps in sports such as basketball or volleyball, the force is 7 to 8 times your body weight.   

Conversely, walkers all walk much the same way, with the heel of the foot making contact with the ground first before the foot, and thus the body’s weight, rolls forward to the ball and then the toes. It’s a less impactful exercise, with your body absorbing force about one and a half times your body weight. Walking also distributes the weight more evenly for your feet and your legs.    

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-4. We push on the ground, the ground pushes back allowing us to move. It is a basic law of physics. Each time your foot hits the ground while walking, standing or running, a ground reaction force (GRF) is produced. When a person stands motionless, they exert a contact force on the ground which is equal to their bodyweight. In the same manner, an equal but opposing ground force, is exerted back. This acts like a mirror of the force the person exerts on the ground. During heel-toe running aka rear-foot strike (the most prominent footfall pattern), there is an initial peak (often referred to as the ‘impact or passive peak’) and a second peak (often referred to as the ‘push-off or active peak) of GRF. Initial small spike that corresponds to your foot and lower leg smacking into the ground and almost immediately jarring to a halt; and a bigger, slower spike that corresponds to the rest of your body reaching the lowest point of its up-and-down motion. The overall force is simply the sum of those two spikes. Impact peak is the force seen during the initial landing. The impact peak ranged from 2 to 3 times body weight during running and this shock travelled through the skeletal system to the head. This meant that the body had to attenuate the shock using either passive structures (i.e., bones, cartilage, etc.) or via altering the body geometry (i.e., altering lower extremity joint angles). Greater the GRF, greater running speeds are achieved. But along with increased speed, there are the increased injury risk. The high impact peak occurs with heel-strike and likely causes increased loads on the tibia, calcaneus, and plantar fascia thus increasing the injury risk. On the other hand, midfoot striking runners do not have the high impact peak but only have the lower push-off peak in their GRF versus time curves due to landing on the arch. Actually the little spike is still there; it’s just obscured by the bigger one.  

It was thought that footwear should have some cushioning ability to aid in attenuating the foot-ground collision. Therefore, cushioning materials such as ethyl vinyl acetate (EVA) and polyurethane (PU) were used in the midsole as cushioning materials. The “common sense” would predict that smaller impact force peaks would occur while running on softer midsoles. However, a study found that subjects reacted differently than expected to variations in midsole hardness. Each runner, by using his/her central nervous system (CNS) control, modified their landing strategy during running, depending on the midsole hardness to keep the external impact force peaks constant. Runners were less inclined to use a landing strategy that would reduce impact force if they had been told that cushioning would be provided by the surface material. Therefore, midsole softness does not always reduce impact forces during running. A 2020 systematic review did find that softer midsoles can reduce impact forces and loading rates. Midsole cushioning increases the time of impact and absorbs part of the impact by getting compressed during landing and returns energy by getting decompressed during push-off. Thicker midsoles could provide better cushioning effects and attenuate shock during impacts but might also decrease plantar sensations of a foot at the touchdown. It is worth bearing in mind that your foot has more nerve endings than your hand. It has evolved to be incredibly sensitive to inform your body of what you are walking on, enabling you to balance. Each step you take initiates a cascade of muscular contractions that start at your foot, works up and across your body and ends in your opposite arm. You need your foot to be able to be receptive and to move naturally to enable this to occur. The foot muscles and nervous system will get deconditioned if not allowed to function properly by wearing very thick midsole shoes.          

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-5. Foot plantar pressure is the pressure field that acts between the foot and the support surface during everyday locomotor activities. The analysis of foot plantar pressure distributions between the foot plantar surface and the shoe sole has multiple applications including footwear design, sports performance analysis and injury prevention, improvement in balance control, and diagnosing disease. 

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-6. Pronation refers to the way your foot rolls inward for impact distribution upon landing. Pronation is the natural movement of your foot as you walk or run, with your foot rolling in slightly with each step.

In Overpronation: the foot rolls more inward with each step and continues that motion when the toes should start to push off. Common in those with flat feet, overpronation creates a twisting motion with the big and first toes doing most of the work.

In Underpronation: Also called supination, this gait causes your foot to roll outward with each step, putting more pressure on the outside edge of your foot and small toes. It’s most common in people with high, rigid arches.

Understanding your pronation type can help you find a comfortable running shoe.

Stability shoes are best for runners with normal arches and only mild control problems. Motion control shoes are great for flat-footed and heavy runners who tend to overpronate. Cushioning shoes support people with high arches and rigid feet who tend to underpronate. There is good evidence to support the widely held belief that injury rates among runners are quite high, with estimates of injury rates varying between 75% and 80% of runners. It is widely assumed that impact forces and excessive pronation cause running injuries, and that running shoes are designed to alleviate these problems.  However, evidence indicates that even motion control shoes can only reduce pronation by around 1.5%, which is unlikely to be enough to make any real-world difference. The causality between pronation and running injuries has been shown in neither cross-sectional nor longitudinal study designs with sufficient sample sizes.    

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-7. Until the beginning of 19th century, there was no distinction between shoes made for left or right feet and no distinction between shoes made for men or women. 

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-8. Although shoes have been described as the main intersection between the body and physical space that allow us to move around in our environments and experience the world in which we live, they also have a powerful influence on social and emotional aspects of our lives. In this respect, footwear acquires different roles and has different meanings dependent on a person’s taste, identity, social status, and gender.  

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-9.  All footwear, due to its characteristic position between the human foot and the environment, acts as an Artificial Interface. The foot with its anatomical and physiological structures, and the footwear with its construction characteristics exhibit a mutual interplay and form a common system, which determines the functional benefit of a footwear for its wearer during its interaction with the environment. It is assumed that the comfort, performance and injury prevention of athletes can be improved by optimization of the interaction of the shoe to the foot, and the interaction of the shoe to the environment.    

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-10. Footwear is a term that covers all things worn on feet. Shoes implies footwear that encapsules/covers all parts of the feet till the ankle at least. Boots are footwear that covers not only the feet but also the ankles and sometimes even the lower leg. Shoes cover and protect the feet but generally stay below the ankles. Boots are commonly used for work wear, industry, mining, military, riding, walking in snow, skiing, snowboarding, and ice skating. Shoes are commonly used for jogging, running, walking, golf, bowling, dancing, and for formal occasions like weddings and at work.

Although shoes imply full covering of feet not above ankle, partial covering of feet like slippers, sandals etc. are also classifies as shoes by most authors. Shoe has become generic term for all footwear worn by men and women. There are many different types of shoes that exist, such as running, walking, loafers, high heels, sandals, slippers, work boots, dress shoes, and many more. So, anything worn on feet is shoes except socks, bandages and orthotics.  

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-11. Footwear in the manner of shoes primarily serves the purpose to ease locomotion and prevent injuries. Footwear can also be used for fashion and adornment as well as to indicate the status or rank of the person within a social structure. Outdoor footwear requires features that protect the foot from the external environment, but has further requirements to promote lower limb health and mobility. Such requirements include: adequate width, depth and length to accommodate the foot; a soft, flexible and protective upper; low heel height; stable heel counter and limited available torsion for overall shoe stability; adequate outsole grip to prevent slipping; and being fit for purpose.     

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-12. One of the major reasons why we have foot pain or discomfort is the kind of footwear one wears. There is footwear which are pain-causing as also footwear which provide pain relief and it is important to know the difference between both of them. While shoes are helpful, wearing the wrong kind and not giving your feet enough time with your shoes off, will likely cause problems. 

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-13. Footwear is worn to the office or workplace for a long duration. It is usually worn between 4 to 14 hours. Always remember to take off your shoes if working from desk for a long time so that you allow the feet to breathe and the muscles to relax. 

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-14. Anatomy of shoe:

As the name suggests, the upper is the combination of materials that wrap around the top of the foot. The upper holds the foot in place and prevents excessive movement from side to side or up and down. The upper covers your foot to ensure a snug, secure fit, while providing stability. The upper helps hold the shoe onto the foot.

The outsole is the bottom of the shoe. The outsole provides traction and contributes to how soft or firm the shoe “rides” as well as its torsional rigidity and flexibility. The outsole is the layer in direct contact with the ground. Grooves and treads can help maintain traction. 

The midsole, which is sandwiched between the insole and outsole is the most important part of the shoe. The midsole is the core of the shoe and provides cushioning and energy return. Virtually all modern running shoes have midsoles made from various foam materials that, to varying degrees, cushion impact, store and return mechanical energy.  Midsole composition dictates the durability or longevity of the shoe, as well as the quality of the ride. Midsole material has been combined with other proprietary cushioning materials such as air and gel as well as engineering designs like wave plates, footbridges, cantilevers, and truss systems to minimize impact shock generated during the foot strike and to guide the foot through its normal path. The midsole is mainly required to perform two functions: shock absorption and stability during human locomotion. Shock absorption plays a role in protecting the body from impact forces at heel strike, which reduces the strain of the muscles and the soft-tissue vibration in the lower limbs. Each time an average runner’s foot strikes the ground, the vertical component of its momentum reduces to zero. To reduce the stress of this load on the leg and foot of the runner, the time of impact has to be increased. Midsole cushions the foot increasing the time of impact and absorbs part of the force on the runner’s body. Stability plays a role in bracing the ankle to limit excessive movement of the lower limbs and stabilize locomotion. These two functions purportedly prevent various injuries of the joints, muscles, ligaments, and cartilage in the lower limbs.

The insole is the interior bottom of a shoe, which sits directly beneath the foot under the footbed (also known as sock liner). Insole cushions and supports your foot and arch. Removable insoles can be laundered or taken out to dry between walking sessions.

The shoe heel is used to improve the balance of the shoe, increase the height of the wearer, alter posture or other decorative purposes.

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-15. The drop of a shoe is the difference in height between the heel and the forefoot. The greater the drop, the steeper the angle between your heel and your forefoot. For example, when barefoot, the heel and forefoot touch the ground at the same level: the drop is 0. Human tissues can be sensitive to sudden changes in the way they are loaded, and that differing shoe drops may load certain tissues differently. Zero-drop shoes help people walk and run more naturally and efficiently. Many people claim that it helps with the prevention of injuries. It helps people naturally land on the midfoot where the arch is located and it may help prevent some knee injuries. However, if you are currently uninjured there is no justification for changing the drop of your shoe. Historically most running shoes were manufactured with a 10mm drop, but present day you will find running shoes can range from zero drop up to 12mm. 

It is worth noting that the drop refers only to the difference in thickness between the front and back of the shoe, and is not a narrative on the magnitude of the thickness — do not assume if a shoe has a very thick and very cushioned midsole that it will have a high drop. 

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-16. The most crucial feature in shoe design is not the pattern used for the shape and look of the shoe but the fundamental material from which the shoe is made. Knowing the various materials most prevalent in shoes helps immensely in choosing the right shoes to match your needs at the time. The five materials most commonly used in shoe production are leather, textiles, synthetics, rubber and foam. Leather is expensive and heavy compared to other shoe materials. Running shoes nowadays are mostly made of lightweight foams and polyester fabrics for breathability, comfort, and weight reduction. Non-breathable materials trap sweat, bacteria/fungi as well as heat inside the shoe.    

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-17. Socks made from soft material (wool, cotton, etc.) are typically worn between feet and footwear for comfort and relief. Socks make your shoes more comfortable to wear. Socks are important for the overall health of your feet. Not only do socks absorb moisture, but they are also used to help prevent rubbing of shoes on the bare foot. Socks can also provide cushioning to pad the feet and help keep them warm. Going sockless can result in conditions such as athlete’s foot and blisters or sores on the foot.

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-18. If you’re looking for a pair of shoes that’s easy to slip on, both slippers and sandals may come to mind. Aside from being easy to slip into, they both often lack adequate arch support. By definition, slippers are soft shoes that are meant to be worn in the home. Please note that such footwear should be with open heel and without functional laces, buckles or fasteners. Sandals are a type of footwear that leaves the front of your feet exposed. The sole is usually thin and adheres to your foot through the use of one or several straps. Because sandals keep the majority of your feet exposed, most people prefer to wear them in hotter weather. Doing so provides two benefits: it circulates cool air around your feet, plus moisture is allowed to dissipate. Unlike slippers, sandals are meant to be worn outside. Flip flops are a type of sandal that is characterized by the toe post that slips between the first and second toes of the foot and the open-backed, flexible sole that, when you walk, makes the characteristic ‘flippy’ sound that gives them their name.

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-19. The reason why sneakers shoes got their name was because they made very little noise while walking due to their rubber soles. You could sneak up to someone else while wearing these shoes and hence the name. Sneakers are a type of athletic (sports) shoes. Sneakers are generally made from canvas or synthetic fabric with rubber soles. Sneakers are meant for comfort and physical activities and also as casual shoes. 

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-20. Remember, walking shoes are not the same as running shoes. Running shoes work for running because they are designed and manufactured for the biomechanics of running to meet the demands of bearing three to four times the body’s weight on impact. Running shoes tend to be lighter in weight, breathable but heavier in cushioning, especially for the heel and the toe. Walking shoes don’t need to be as light, breathable and heavily cushioned but they do need to provide good arch support. Walking shoes are built more for stability while running shoes are built for speed, faster movements and shock absorption. That said, running shoes can be suitable for walking, although this may wear out your running shoes quicker. If you walk a lot and continue to use the same pair of shoes to run, the shoes may break down faster.   

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-21. The general purpose of wearing athletic footwear (sports shoes) is to improve comfort, performance and injury prevention during sport specific movements. These three major purposes of athletic footwear do not always complement each other but may impose mutual conflicts.    

-22.  Running has become very popular in the last 30-40 years. Thousands of people around the world run on a regular basis, for recreation, pleasure, or competition. Beside physical exercise, the ability to run fast is crucial in many sports for passing a defender, catching a ball, or developing enough take off velocity for a jump. Research and surveys show that nearly 75%-80% of the runners suffer from recurring injuries. The only equipment a runner has to protect against overuse injuries sustained during running is a pair of shoes.

Running shoes are designated to improve shoe comfort, enhance running-related performance and reduce the injury potential. Running shoe cushioning has become a standard method for managing impact loading and consequent injuries due to running. However, despite decades of shoe technology developments and the fact that shoes have become increasingly cushioned, aimed to ease the impact on runners’ legs, running injuries have not decreased. Despite the huge financial investment in the development of running shoes, running injury rates remain relatively unchanged over the last 40 years, leading some to question the efficacy of modern running shoes in preventing injury.  

However, running shoes are not the whole story. Your gait and biomechanics are also important. If you have poor biomechanics and running form, you may be injured despite wearing running shoes because you have not worn well fitted corrective running shoes. Proper running shoes are only part of the solution: strengthening and conditioning our muscles in our legs and feet is also essential for healthy biomechanics and injury prevention. Many injuries traditionally thought to be solely running-related (like “runner’s knee”) are not so much related to running in-and-of itself, but rather to poor biomechanics and underlying health conditions (i.e.: pre-existing arthritis). In fact, people who do not run and are inactive tend to experience more injuries than runners.   

Remember, not all feet are perfect, so for people with poor biomechanics in feet and lower extremities, shoes can help align their feet, ankles, knees, hips and back to correct their gait and improve posture. In such people, without supportive shoes, the biomechanics of the body are off causing unnecessary impact and stress on parts of feet and knees that aren’t meant for shock absorption or pressure. This can eventually lead to back, knee and foot pain.       

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-23. Each individual is unique; differences in structure, movement, and gait pattern require footwear to vary from person to person. Efforts to meet this concern are further multiplied by the critical factors to be considered in the design of each shoe: shock absorption, flexibility, fit, traction, sole wear, breathability, weight, etc. Due to the diversity of the human form, it is impossible to provide for the needs of every runner on the planet.  

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-24. For distance runners, the goal would presumably be to minimize impact forces. But it’s worth noting that the opposite is true for sprinting. The primary way people run faster is by striking the ground harder: the more force you can plow into the ground, the faster you’ll go. In this regard, minimizing impact and loading rate is directly in conflict with increasing speed. That’s one reason training shoes and racing shoes are so different. Classic training shoes are made to last up to 500 miles and their burly outsole rubber resists abrasion and protects the softer midsole, while the foam withstands thousands of compressions without losing (much) spring. Racing shoes are designed to be lighter and faster than your everyday training shoe. Racing shoes historically featured less cushioning than a training shoe, and some used less outsole rubber to cut down on weight. But advances in technology mean that many racing shoes now boast the same amount of cushioning as some training shoes (or more) with a lighter weight. Take the Nike ZoomX Vaporfly NEXT% and the New Balance FuelCell 5280 for example. These new shoes employ the lightest materials, bounciest foams and most propulsive carbon fiber plates to give you an edge on race day.    

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-25. Running shoes are designed in a way that improves running efficiency. Science suggests that if you can reduce the energy it takes to run or increase energy return, then in theory, you should be able to run faster and for a longer period. Benno Nigg summarizes six main parameters which have shown to influence running economy, and at what magnitude. They are: shoe weight, midsole material, heel thickness, longitudinal bending stiffness (flat sole shape), longitudinal bending stiffness (curved sole shape) and muscle mechanics. Studies have consistently shown that heavier shoes reduce running economy. Each 100g/3.5oz added to the weight of each shoe reduces running economy by about 1%.  A well cushioned running shoe can improve running economy by an estimated 2-3.5% compared with a weight matched un-cushioned shoe due to increased energy return. The air-soled shoes, with midsoles containing an inflated air bladder under pressure, required 2.8% less metabolic energy than conventional EVA midsole running shoes. A meta-analysis found significant small beneficial effects on running economy for light shoes and barefoot compared with heavy shoes and for minimalist shoes compared with conventional shoes. The CNS-controlled mechanism of lower extremity stiffness optimization of runners in response to the type of surface on which they are running is also responsible for the changes in the metabolic cost when running on surfaces and/or shoes of varied stiffness.

Advanced footwear technology (AFT) is defined as distance running shoes with high stack height, high energy return midsole material and an often curved, stiff plate embedded within the midsole along the length of the shoe.  The goal of using carbon fiber curved plates in midsoles of athletic shoes is rooted in the idea of improving energy return, particularly at the “toe-off,” i.e., where an athlete’s toe pushes off the ground. The carbon fiber plate is shaped with a curve at the arch that bends slightly downward under the ball of the foot. The intent is to store energy when the heel strikes the ground and release the athlete’s own energy back to them at the toe-off, giving a boost, improving running efficiency and performance.   

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-26. Shoe upper influence the fit and comfort of the shoe which changes the kinematic and kinetic strategies of runners. It was demonstrated in many research studies that firmer foot contact within a shoe would result in lower loading rates due to a better coupling of foot and the footwear. The design of the upper of the shoe determines the fit of the shoe, not the length of the shoe but how the shoe envelops the foot. This is important because if the shoe fit is improper, the biomechanical needs of the runner may not be met. Only when the fit of the shoe is spot-on can the function (be it stability, motion control, or cushioning) work as designed. For example, if the fit of the upper is too baggy in the midfoot, excessive pronation can occur despite the presence of a medial support. The lack of a proper fit renders the stability device ineffective in combating the pronation it was designed to limit. Injuries can occur—in this case, tibial pain—even if a runner wears a shoe that is the correct category for his or her foot type. If the shoe doesn’t fit your foot well, it isn’t the best shoe for you, regardless of whether its biomechanics are matched to your foot type. For example, it could be argued that for a mild overpronator, a cushioned shoe that fits perfectly is more stable than a mild stability shoe that is too roomy.

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-27. When it comes to women fashion, one of the most important accessories is shoes. For a lot of women, there’s nothing more crucial to their entire look than a good pair of shoes. High heels make the wearer appear taller, serve to accentuate the muscle tone in the legs as well as make the wearer’s legs appear longer. Wearing heels make women look more stylish, confident, tall and attractive. High-heeled shoes are a powerful symbol of modern female sexuality that have been shown to increase women’s attractiveness to men and influence men’s behaviour towards women, thus high heels bring psychosexual benefits to women. 

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-28. Standing barefoot, the falling line of body weight normally forms a perpendicular, a 90-degree angle with the 180-degree angle of the foot’s plantar surface. Body weight is distributed 50-50 between heel and fore-foot.  The moment any heel elevation, even the most minimal, is applied to the shoe, the normal 90-degree perpendicular of the body column and falling line of body weight is altered. The body column is a series of adaptable joints and connecting sections: ankle, knee, hip, pelvis, spine, shoulders, neck and head. The body column sections make “adjustments” to maintain an erect stance. With each sectional adjustment there is a shift in the body’s center of gravity (normally about hip height). With the shift of gravity there are corresponding shifts in the line of falling body weight both in standing and walking, resulting in shifts in the path of weight distribution throughout the foot, beginning with the rearfoot. The muscles and ligaments associated with the body column and foot system must also make compensatory changes. Considering that the “simple” act of walking involves half the body’s 650 muscles and 208 bones, the number of automatic “adjustments” is enormous. We see the muscles and tendons in the legs shorten, the pelvis tilts forward, the curve of the lower back becomes exaggerated, and the upper body leans backward. The long-term effects of high heels contribute to back pain, neck pain, headaches, knee pain, and inflammation in the shortened tendons of legs and buttocks.

During gait, high heeled shoes are shown to affect the ankle joint, causing significantly increased plantarflexion. This, in turn, increases the metabolic costs of walking and leads to faster muscle fatigue. Accelerated muscle fatigue may then increase the likelihood of ankle sprains and or falls due to impaired foot and ankle stability. Wearing high heels can also lead to shorter stride lengths, greater stance time, unstable posture and gait, and a decrease in lumbar flexion angles.

Wearing high heels have been shown to have the following effects (among others): changing the posture & putting weight on the toes; increasing the pelvic tilt; changing the gait; increased activity of lower spine muscles & lower back pain; muscle fatigue and pain; corns & bunions; deformation of the toes; and increased risk of ankle sprains. Wearing high heels is associated with greater risk of falls in the elderly, musculoskeletal pain, developing foot deformities and developing varicose veins.

A study found that women who wore high heels five times a week for two years had calf muscles that were 13 per cent shorter and Achilles tendons that were stiffer and thicker than those who did not wear heels. Another study found that high heels place 23% more pressure on your knees than that of your natural barefoot state. Even shoes with heels of about 1.5 inches place 14% more strain on your feet. The most up-to-date epidemiological review provides clear evidence of an association between high heel wear and hallux valgus, musculoskeletal pain and first-party injury. The body of biomechanical reviews provides clear evidence of changes indicative of increased risk of these outcomes, as well as osteoarthritis of knee.

If any government or company forces their employees to wear high heels (>1.5-inch heels), they are jeopardizing health of their employees.   

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-29. Traditional footwear elevates the heel an average of 14-24mm, which throws off the alignment of the spine and forces an unnatural heel strike. In Zero-drop shoes, your heel and toes are level, which mimics your natural barefoot position on a flat surface. Zero-drop shoes can be minimalist, maximalist or even conventional shoes.

Wearing zero-drop shoes has its own advantages for your health.

-1. Zero-drop shoes will make the spine remain straight, unlike the high heels that can cause the spine bends.

-2. Zero-drop shoes will make the calf muscles become more relaxed.

-3. Zero-drop shoes can help the body weight distributed evenly on the soles of the feet.

-4. Zero-drop shoes are also comfortable; it makes you free to move and does not make you tired.

However, wearing flat shoes with NO shock-absorbing capability, arch support, ankle/heel support and heel cushioning can harm feet. If you wear such flat shoes constantly, it can lead you to several issues like plantar fasciitis, back pain, and more. Cheap flat shoes are equally harmful, like high heels.    

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-30. Wearing flip-flops causes you to take shorter strides compared to sneakers. Fip-flops increase peak plantar pressures, putting your feet at risk for plantar fasciitis and other abnormalities. Flip-flops offer very little protection. When you wear a shoe thong with no arch, ankle or heel support, protection or shock absorption, you can suffer from foot pain, sprained ankles or tendinitis. If you wear flip-flops for extended periods, you increase the risk of foot injuries.  People with diabetes should not wear flip-flops, because simple cuts and scrapes can lead to serious complications.

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-31. Slip-on shoes may be easier to put on and take off, but when it comes to comfort and injury prevention, it is not the best option. Avoid using slip-on shoes as fastenings such as Velcro straps or laces stop your foot slipping sideways or forwards in your shoe. Make sure your shoes are firmly attached to your feet. The firm foot-to-shoe coupling with higher lacing leads to a more effective use of running shoe features and is likely to reduce the risk of lower limb injury. Take time to tie and untie your shoes. Your shoe will work best when it fits snugly and acts as an extension of your foot, without sliding around. Pulling off your shoe without untying it will cause the support in the shoe to break down much faster.

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-32. Rule of thumb for choosing well-fitting shoes.

-1. During normal walking your foot both spreads out and lengthens up to one centimeter in each direction. Therefore, you should wear a shoe that is one centimeter longer than your foot length. Remember width of the shoe is also an important part of fit.

-2. The heel should fit relatively tightly; your heel should not slip out when you walk.

-3. The upper part of the shoe — which goes over the top of your foot — should be snug and secure, and not too tight anywhere.

-4. When fitting in to shoe you should be able to freely wiggle all of your toes when the shoe is on.     

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-33. The measure of a foot for a shoe is from the heel to the longest toe.  A shoe size is an indication of the fitting size of a shoe for a person. Shoe size often consists of a number indicating the length because many shoemakers only provide a standard width for economic reasons. There are several different shoe-size systems that are used worldwide but only a few systems also take the width of the feet into account. It’s a myth that foot size doesn’t change in adults. It does change as we get older, so have your feet measured twice a year. Shoe sizes are supposed to help retail customers buy well-fitting shoes. Ideally, all shoes labelled with the same size and width should provide the same fit. However, physical measurements and X-ray images of shoes of the same size have shown inconsistent internal lengths and widths. So do not assume that a size in one brand equates to the same size in another. Shoe sizes can vary between manufacturers, so you really need to know the brand. Because a size 7 in one brand may be bigger or smaller than a size 7 in another brand. And even by knowing the brand, there are still no guarantees that the shoes will fit once you get them. Athletic shoes are notorious in this regard.

If you choose offline mode of the buying then you can try that shoe and can also check the quality of the product, color and suitability of the shoe and the size also. But in online product you are unable to see the product in hand. Product may be differing in color, size, quality etc. The biggest reason for shoes being returned — whether they were purchased in store or online — is because of size.

Although feet are usually the last part of your body to pick up body fat, once fat wraps around parts of your feet, the length and width may be the same as before but your foot can become too large to fit into footwear designed for that length and width. So, if you are overweight, you should not order footwear online.

According to a study, 65% of children wear ill-fitting shoes. Unknowingly, your kid could be one of them. Indeed, there are potentially serious effects of ill-fitting shoes in children; not only to their feet but also to their physiological and mental growth. Experts estimate that 70% of adults suffer from foot health problems and that the majority of these problems are the result of wearing ill-fitting shoes in childhood. This stresses the importance of correct shoe fitting in children.

According to the National Centre for Biotechnology Information data, approximately 72% people wear inappropriate sized footwear and long-term use is associated with all kind of foot problems like foot pain, poorer overall foot health, blisters, bunions, fungal infections, corns and calluses in older people and foot ulceration in older people with diabetes. It can also lead to changes in the skeletal system and the muscular structure that it supports and even change a person’s posture and the way they walk.  In addition, falls – which can have dire consequences in the elderly – are most frequent among those with poorly fitting footwear. Diabetic people should be especially careful as ill-fitting shoes can become a critical health problem. Foot injuries can also keep you from going to work. Also, wearing the wrong size of shoes will end up damaging your footwear, which decreases the longevity of the shoe and requires consumers to make shoe purchases more often.  

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-34. The high prevalence of incorrectly fitted footwear suggests that greater emphasis should be placed on footwear fitting education so people are more aware of their foot dimensions and appropriate foot size. Furthermore, footwear manufacturers should provide an appropriately large selection of shoes that can accommodate the variations in foot morphology among the population. In particular, a greater range of widths for each length sizing option should be made available in order to accommodate feet with wider dimensions.

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-35. Your feet should never be forced to conform to the shape of shoes but your shoes should conform to the shape of your feet.  Wear properly fitting shoes that conform to the natural shape of your feet. If the shoes feel too tight, don’t buy them. There is no such thing as a “break-in period.”  Footwear should feel comfortable and not pinch or irritate any part of your foot even when new. When you try on shoes, spend some time walking around in them and paying attention to how they feel. No matter how good they look, don’t buy shoes that are too tight, too loose, unsupportive, or in any way uncomfortable.  Footwear fitting is acknowledged as being vitally important as in most cases fit governs function. This means that footwear cannot fulfil its intended purpose if it does not fit the foot correctly. Furthermore, incorrectly fitted footwear is a major contributor to the development of structural foot disorders and deformities, as well as skin lesions, such as corns and calluses.

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-36. Tips for Right Shoes for foot health:

-Make sure that shoes are well fitted.

-Make sure the shoe bends at the toe box but is not too flexible.

-Make sure there is enough arch support.

-When choosing heels, look for chunky ones that are less than 1 inches high.

For simplicity, shoe types are divided into three categories:

-1. “good” (these shoes had firm non-flexible soles and good support at the back of the shoe, this included athletic shoes and casual sneakers)

-2. “bad” (these shoes lacked support and structure such as high-heeled shoes, sandals, and slippers)

-3. “medium” (shoes with an intermediate level of support including hard- or rubber-soled shoes and work boots).

The best shoes are well-fitted, have a firm sole, are well-cushioned with a stiff heel counter that is strong and supportive (but not too stiff). The front of the shoe should be flexible. 

-37. Wearing proper footwear is one aspect of daily life that people tend to pay very little attention to. Most of the pain that people have throughout the day such as back pain and shin splints may start at the feet. The wrong shoes mean your shoes are too tight, too loose or insufficiently supportive or high heeled or highly flexible. Well fitted shoes can also be wrong shoes if they are unsupportive, high heeled or highly flexible. Far too often, major foot issues occur simply from wearing the wrong shoes. Long-term use of wrong shoes can cause changes in foot structure like bunions, claw toes, muscular tightness and irritation of tendons, nerves and fascia. Wearing the wrong shoe can exacerbate existing problems such as pain or arthritis in your hips, knees, ankles, back or feet. Just wearing the wrong footwear has been shown to increase levels of apathy, anxiety, and loss of balance and falls in those over the age of seventy. About 43% of work-related injuries in the private sector are actually sprains, strains, or falls due to uncomfortable and slippery shoes that could not withstand long, laborious work hours. Even in relatively healthy people, bad shoes cause foot pain, which in turn is a key predictor of reduced physical activity. Lack of exercise in turn raises the risk of a wide number of chronic ailments, including diabetes, which then can cause even more damage to your feet, such as neuropathy. 

Remember all the harms of wrong shoes occur when you wear them for extended period of walking or standing time. Wearing high heels or flip-flops for short time occasionally is okay if occasion demands.      

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-38. A shoe bite is a painful area on your foot that’s the result of friction from rubbing against your shoe. The simplest way to prevent shoe bites is to purchase shoes that fit properly. In other words, mere presence of shoe bite means you have chosen poorly fitted footwear. 

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-39. Most toddlers are flat-footed when they first start walking, because the bones, muscles and ligaments of their feet are underdeveloped. Toddlers should go barefoot as often as possible to encourage balance, posture and coordination. As child masters walking, the ligaments and muscles will strengthen and the fat pads in the arch area won’t be so noticeable. By around six years of age, child should have normal arches in both feet.

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-40. Around one in three older people falls each year with one-third of over 65s and half of over 80s falling each year. Postural and walking instabilities have been recognized as major risk factors for frequent falls in older adults. One of the most pervasive effects of aging is the loss of cutaneous and pressure sensation, which has been correlated with impaired balance control and increased risk of falling. The increased risk of falls may highlight the need to promote preventative measures to combat this issue. One of these measures may include wearing appropriate footwear.  Due to changes in foot morphology and the occurrence of foot deformities and foot pain with ageing, older people frequently wear ill-fitting shoes or resort to comfort shoes or slippers, especially in and around the home. Ill-fitting or unsuitable shoes affect balance and gait, and might play an important role in increasing fall risk with ageing. In fact, numerous studies report that walking barefoot or wearing socks or slippers increased fall risk by up to 11 percent as compared to wearing athletic or canvas shoes. Since wearing slippers or socks can lead to increased fall risk, it is recommended that elderly wear sports shoes (sneakers) even when inside their home.       

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-41. If you have foot or ankle problems, you may need to change shoes (prescription shoes), make some changes to your existing shoes (shoe modifications) or use various shoe supports (inserts/orthotics).

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-42. Inserts and orthotics refer to devices that can be worn inside a shoe. They are used by everyone from athletes to the elderly to accommodate biomechanical deformities and a variety of soft tissue conditions. Inserts are devices that you can buy in stores without a prescription that can provide cushioning and support. Orthotics are prescription medical devices that you wear inside your shoes to correct biomechanical foot issues.

Runners want to wear comfortable running shoes that help prevent injuries; however, because running shoes are not custom-made, there will always be a bit of a compromise when it comes to fit. Because each runner’s foot is unique and not even symmetrical with the other foot, it becomes apparent that accommodations may be needed in order to enhance a running shoe’s fit and its function. To customize the fit and function of their shoes, runners turn to insoles (full size inserts) and orthotics. 

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-43. The natural shape and design of the foot is to step softly into soft terrain. This is why the foot has arches. The foot is not designed to walk on hard flat surfaces. For most of us, we now wear footwear and walk on hard flat surfaces, so the need for arch support has never been greater!  Arch support is a term used for a large variety of shoe inserts that help support the arches of the foot. Most footwear has little to no support simply offering protection from debris and the elements. Additionally, footwear choices are now primarily made based on style preferences over functionality. Finding footwear with good support built-in is actually more of a specialty or rarity with the large majority of footwear manufacturers. This is why it has become more important than ever to select the proper supports for the footwear you choose to wear. When properly fitted and used, arch supports can be the best non-invasive treatment for many feet, knee, hip, and back issues.

One of the most common mistakes someone makes when choosing an arch support is assuming that one arch support will work in any type of shoe. Footwear varies widely from high-heeled pumps to ballet flats, to running shoes, to boots, and so on. The type of footwear you plan to wear is the first and most important consideration when choosing an arch support. Certain types of footwear don’t accommodate arch supports. Sandals and backless shoes generally need to have a built-in arch support rather than what is generally considered an arch support insert.

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-44. Prescription (Orthopedic) shoes are specially-designed footwear to relieve discomfort associated with many foot and ankle disorders, such as blisters, bunions, calluses and corns, hammer toes, plantar fasciitis, or heel spurs. They may also be worn by individuals with diabetes or people with unequal leg length.  

A prescription shoe is of no benefit if the patient refuses to wear it because of the way it looks. The need for the prescription footwear and its importance to the foot health, even foot survival, must be stressed. Therapeutic shoes can actually save diabetics from losing a foot. Therapeutic footwear is effective in preventing foot ulcers and reducing plantar pressures in diabetic patients. In conjunction with wearing therapeutic footwear, diabetic socks with cushioning can help to prevent ulcer formation. 

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-45. Safety shoes (safety boots) are personal protective equipment (PPE) for foot protection at workplaces. It prevents users from getting foot injuries due to slippery surface, heavy falling or rolling objects, sharp piercing edges, pinch points, rotary machinery, hot objects, loops of ropes under tension, splinters, electricity, chemicals, bacteria/fungi or even bad weather etc. Different types of safety shoes are available to meet the needs of different job roles. 

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-46. A number of surface scanning systems with the ability to quickly and easily obtain 3D digital representations of the foot are now commercially available. Modern 3D surface scanning systems can obtain accurate and repeatable digital representations of the foot shape and have been successfully used in medical, ergonomic and footwear development applications. The 3D scans produced by these systems are accurate representations of the foot and that the measurements taken from them are in general comparable to those that would be taken manually. And their role in orthosis and customized shoe design and manufacture has been established.  

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-47. Customized last production usually requires a few weeks of lead time before custom manufacture of the individual footwear can begin. This massive lead time can be significantly reduced if the shoe lasts are created using additive manufacturing i.e., 3D printing.  3D models of these lasts can be obtained via computer-aided design (CAD) or 3D scan. Apart from orthopedic shoe technology, this method also provides numerous benefits for classic made-to-measure shoe production or for prototype construction in series production of shoe lasts. 

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-48. Most of the world uses footwear of some kind. It protects their feet, provides some comfort, and adds fashion for many. On the other hand, going barefoot can have some health benefits and some risks. But it is not practical or acceptable for most people to go barefoot around town or work.

Footwear provides protection from cuts, abrasions, bruises, and impacts from objects on the ground or the ground texture itself, as well as from frost or heat burns, and parasites like hookworm in extreme situations. However, shoes can limit the flexibility, strength, and mobility of the foot and can lead to higher incidences of flexible flat foot, bunions, hammer toe, and Morton’s neuroma. Shoes control the position of your foot and natural walking positions are not available in most shoes. Shoes control a foot’s angle, cushioning, pressure points, and arch support. Normally your foot would take on these jobs and help you develop strength and support in your feet and legs. In a study looking at how habitual shoe wear changes the shape and biomechanics of the foot, people who spent most of their lives barefoot had wider feet and distributed pressure on their feet more evenly than those who habitually wore shoes. This suggests that frequent barefoot walking enables the foot to achieve its biologically normal shape and function.  

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-49. The longitudinal (medial) arch of the foot may undergo physiological changes upon habitually training barefoot. The longitudinal arch has been observed to decrease in length by an average of 4.7 mm, suggesting activation of foot musculature when barefoot that is usually inactive when shod. These muscles allow the foot to dampen impact and may remove stress from the plantar fascia. In addition to muscle changes, barefoot running also reduces energy use – oxygen consumption was found to be approximately 4% higher in shod versus barefoot runners. Better running economy observed when running barefoot compared to running with shoes can be explained by a better use of the muscle elasticity. It has been suggested that unshod runners are better able to take advantage of elastic energy storage in the Achilles tendon and arch of the foot.

The biomechanical differences between running barefoot versus in shoes include: Flatter foot placement, overall less maximum vertical ground reaction forces, lower peak plantar pressures and pressure impulses, less extension moment and power absorption at the knee, less foot and ankle dorsiflexion at ground contact, less ground contact time, shorter stride length, increased stride frequency, and increased knee flexion at ground contact. Runners who normally run in shoes will have higher impact when initially running barefoot, but after adaptation the impact forces are actually lower without shoes.

The long-term and actual health benefits of unshod running are still not well understood and remain an area of active research. The reduced impact seen with barefoot running led many people to believe that this would in turn result in lower injury rates. However, there is no evidence that barefoot runners have a lower injury rates.   More importantly, there is a growing body of evidence to suggest that the transition to barefoot running is associated with a high injury risk.        

-50. A typical running shoe has a 10-12 mm heel to toe drop due to extra cushion in the heel. This cushion reduces the compressive load at heel strike.

Barefoot Running Shoes are characterized by their zero drop from heel to toe, ultra-lightweight, ultra-flexible from heel to toe, no arch support, minimal cushioning at the heel, and a very thin sole of around 3-10mm. Also, the toe box is considerably wider to provide more space to the toes, whereby they slightly resemble the shape of ducks’ feet, when viewed from above and compared to traditional shoes. The runners rely solely on the body’s natural shock absorbing mechanisms.

Minimalist Running Shoes are in between traditional running shoes and barefoot running shoes. They have a reduced heel-to-toe drop of about 4–8 mm, reduced cushioning, high flexibility, low weight and stack height, and reduced or no arch support. The toe box is usually in-between barefoot and traditional running shoes. The minimalist shoe index is the combined scores of shoe quality, sole height, heel-toe drop, motion control, and stabilization techniques, and flexibility (longitudinal flexibility and torsional flexibility). 

Maximalist shoes have a lower heel to toe drop (8–10mm) than a standard running shoe, highly cushioned with high stack height, with the intent to reduce impact upon landing. Some maximalist shoes have 4mm drop or even zero drop.   

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-51. Recently, a barefoot/minimalist shoe running movement began based on an evolutionary perspective that promoted a more ‘natural’ method of running. Conventional thinking suggests that a good running shoe should have ample cushioning to absorb shock, but there are advocates for minimalist running shoes that have almost no cushioning. Minimalist shoes change the initial contact approach from a rearfoot to a midfoot or forefoot strike, which reduces stride length and increases step cadence and ankle plantarflexion angle at the foot contact. Running in minimalist shoes has been promoted as a method to decrease impact forces through a midfoot or forefoot striking pattern and increased stride frequency. Other purported benefits of minimalist running are improved performance, decreased risk of certain injuries and improved running economy. However, popularity of minimal shoes has declined, largely due to research suggesting that adopting a midfoot or forefoot-strike pattern does not decrease injury risk, improve running economy, or reduce the impact peak or loading rate of the vertical ground-reaction force. Minimalist shoes increase the metatarsophalangeal and ankle joint loading compared to the conventional shoes. A recent randomized controlled trial (RCT) suggested that heavier runners might be at an increased risk for injury in minimalist shoes (designed to mimic barefoot running) as compared to conventional footwear. Runners should be aware that while the minimalism movement has been touted to help runners overcome injuries, run faster times, and improve their running efficiency, these claims are not proven. On the other hand, maximalist cushion footwear decreases plantar loading under the total foot and forefoot during running. Running in maximalist shoes can help alleviate the pain with conditions and injuries like metatarsalgia, capsulitis, neuromas, sesamoid injuries and hallux limitus/rigidus symptoms.   

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-52. An often-overlooked safety preparation that drivers can take to reduce the chances of getting into a deadly car crash is simple: Wear the right shoes. The wrong shoes for driving include sandals (flip-flops), sleepers, high heels, work boots, barefoot etc. Good options for driving are sneakers, (comfortable) flats, and loafers. 

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-53. Just because your dress shoes, casual shoes, and/or athletic shoes may still look good, their condition can deceive you. Shoes can lose their functionality long before they lose their looks. Even a shoe that appears relatively new could be hiding a worn-out sole. Worn-out running shoes affect the stability of the shoe, produce additional energy cost, cause fatigue of the muscles of foot & lower limbs and result in overuse injuries like plantar fasciitis, patellofemoral syndrome, shin splints and IT band soreness. Worn-out shoes can also contribute to a variety of foot problems, such as blisters, corns, and twisted ankles. If you have any existing foot conditions or pain, your worn-out footwear can actually make these conditions worse.

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-54. Because the outsole of the shoe lasts much longer than the midsole cushioning, using outsole wear as a guide for when to replace your running shoes is erroneous. The best method of measuring the life of a running shoe requires little work. Pay attention to the mileage on your shoes by keeping a log or quick estimation of miles per week multiplied by weeks of training, and after approximately 300 to 500 miles replace shoes. As a general rule, the life of a running shoe is 300 to 500 miles or 300 hours of exercise, though it varies with your body weight, gait and surface on which you run. Running shoes typically can’t be repaired.

As a rule of thumb if you wear a pair of shoes to work three to four times a week, after a year replace it. 

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-55. Normally, if a shoe model is not correct for a runner’s biomechanics, weight, flexibility, or foot shape (all factors that determine the best shoe), discomfort or injury will occur within the first 100 miles of running. Thus, the wrong shoe should rarely be confused with an old shoe.  

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-56. Shoe rotation involves alternating the pair of shoes you wear day to day, rather than wearing the same pair day in, day out. Shoe rotation is of upmost importance for both your health and the health of your footwear.

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-57. Dry wet shoes by stuffing them with newspaper after removing the insoles. In addition to helping dry your shoes quickly, stuffing newspaper tight into the toebox helps retain the shape of the shoe. After the first 10 minutes the paper will have soaked up as much water as it can, so switch it out with another batch, and leave it.

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-58. Our homes have hard surface to walk. Walking barefoot on hard surfaces for an extended amount of time is bad for your foot because it allows your foot arches to collapse which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. So sturdy slippers with built-in arch support or lightweight walking shoe is recommended for wearing at home. Also, outdoor shoes should never be worn indoor as they may bring in pathogenic microorganisms and also damage the floor surface.      

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-59. Don’t stockpile a lifetime supply of shoes in your closet. Typically, within two years, any shoe’s midsole will start to break down even without use. If you are going to buy an older model of shoes on sale, do so within two to three months from when the newer model is released. Even though we all love a great discount, it may not be cost effective to buy sale shoes if they’ve been sitting around in a warehouse for six months. They probably won’t last you the full 300 to 500 miles that a new shoe will.  

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-60. Because footwear impressions are found at virtually every crime scene, footwear impression evidence often provides an important link between the suspect and the crime scene. Footwear imprints are a type of pattern evidence that can be valuable in a criminal investigation. Much like fingerprints, shoes leave behind unique imprints or impressions that can be examined by investigators.

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-61. Typical pair of running shoes generates 30 pounds of carbon dioxide emissions, equivalent to keeping a 100-watt light bulb on for one week and there are more than 20 billion pairs of shoes manufactured each year. This is compounded by the fact that many sneakers are trend-driven, meaning they are often purchased and then discarded relatively quickly. Additionally, an estimated 80 percent of sneakers go to landfills. Most mass-produced shoes require 1000 years to degrade in a landfill. To reduce these environmental impacts, the best thing to do is to recycle shoes or use renewable materials or donate your used shoes so that they do not end up in the landfills. Major footwear brands such as Clarks, Crocs, Nike and Adidas have all announced initiatives to reduce their impact on the environment with new eco-friendly products.    

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-62. Shoe Industry Misinformation: Shoes will hurt until you “break them in.” 

Sorry, you are not “breaking in” a shoe. If a shoe hurts when you first try it on, it is the shoe that is breaking your foot with severe long-term damage in the form of bunions, hammertoes and poor stability. Don’t buy the shoe that needs ‘break in’.    

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-63. It is estimated that in an average lifetime, we use our feet to walk the equivalent of three times the circumference of the earth. Yet we rarely give our feet — and our footwear — much attention beyond aesthetics. Shoes may be in fact the most important part of an individual’s attire, as no other article of clothing must fit so precisely and perform critical mechanical functions such as transferring body weight. So be feet conscious and shoe conscious.

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Dr. Rajiv Desai. MD.

October 9, 2021 

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Postscript:

I have learnt a lot while doing research for this article. Most of my shoe habits are wrong like wearing same shoes daily rather than rotating with another pair; buying shoes without knowing meaning of shoe drop and arch support; using the same size for decades not knowing foot measurement changes even in adulthood; storing brand new shoes in cupboard for year or more; and so on. It is better to know that you don’t know rather than not know that you don’t know.      

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