Shoe Design Flaws

Ch. 1   Ch. 2   Ch. 3   Ch. 4   Ch. 5   Ch. 6   Ch. 7   Ch. 8

Chapter 7: Shoe Design Flaws and Shoe Myths

  • heel elevation: Mistakenly, almost every shoe available today has some sort of heel height; this is especially harmful in athletic shoes.
  • toe spring: (sole curvature upwards) From the ball of the foot to the toes, shoes curve upwards, incorrectly lifting the toes off the ground.
  • tapered toebox: (narrow toe area) Nearly every shoe narrows from the ball of the foot to the toes (symmetrically), however, the shape of the foot is widest at the toes and off center from the big toe.
  • curved last: (i.e. "crooked" last) The midfoot area of the sole is cutout, denying use of the 5th metatarsal ray which is naturally a weight-bearing bone.
*other design flaws that you need to be aware of include: motion control, arch support, plush cushioning, thick soles, shank stiffeners, and medial posting devices 

    Articles of Evidence

    Footwear: The Primary Cause of Foot Disorders- A MUST READ
    to read article. click here
    Dr. Rossi, a podiatrist with over 400 published articles, explains the details of how footwear design affects the health of our feet. Main points:
    • Elevated heels create a "domino effect" of bones
    • Shortened achilles tendons in shoe-wearing countries
    • Nearly all shoes neglect the weight-bearing function of the midfoot & toes
    • Lacing shoes is nothing more than "foot corseting"
    • "The less a shoe does TO a foot, the better FOR the foot"
    And for informative fun here are 3 articles:
    The Painful Truth about Trainers
    Rising Heels, Raising Economy..and Pain (Washington Post)
    You Walk Wrong (NY Times)

    Children's Footwear: Launching Site for Adult Foot Ills
    to read article click here
    Dr. Rossi explains how shoes both "deform and handicap" our feet from early development. And comes up with a solution calling for podiatrists to lead the way by encouraging healthy foot development in childhood which will force shoe manufacturers, for the first time in history, to introduce shoes that "do not deform and defunctionalize feet." Interesting points:
    • The Myth of Support
    • The Myth of Pronation
    • The Myth of Ankle Support
    Dr. Ray McClanahan
    Takes a rare approach in podiatry. He helps clients to a more self-sustainable foot instead of setting out to make immediate and often short-lived corrections. His entire site is incredibly knowledgeable. Click here.

    This video explains a lot in a few minutes.

    "Many people know that high heels are more about fashion than being orthopedically-sound for walking.  But what is wrong with athletic shoes? Even athletic shoes elevate the heel, extend the toes, and pinch to the toes together. Instead of enhancing performance, this actually compromises the natural gait, leading to chronically tight extensor muscles and toes that structurally change so that they are crunched toward the midline. The foot functions best as a barefoot, that is, when the heel and forefoot are completely level, and the toes are allowed to flex, extend, and spread."

    "...the reality, the shoe market is driven by what "looks good" on the shelf and will therefore sell. This is as true of athletic shoes as it is of fashion shoes...Indeed, even when shoe designers are presented with findings that flat, wide shoes are optimal for foot function and health, they do not utilize this information, because such a style is not congruous with the fashionable look.  Additionally, considerably more money can be charged for a shoe that boasts "arch support" or "motion control" than for a simple flat shoe. So ultimately, the very shoes that are supposed to enhance performance actually hinder it by altering natural foot shape and gait."
    quoted by Dr. Ray McClanahan
    Shoe Myths
    Cushioning in a shoe absorbs shock.
    Myth Busted: 
    Cushioning underneath the foot increases the force that you step down with. Every time the foot steps down the body tries to find its stability and so with softer material under the foot you subconsciously attempt to step through the shoe to get to a harder my stable surface. Also, cushioning blocks feeling of the type of surface beneath your feet. With cushioning the 200,000 nerve endings on the sole of the foot send false information to the brain because of the confusion for what's actually under the foot, "is it hard or soft?", "flat or uneven?". The other thing about cushioning is that it's typically combined with arch support and a snug fitting shoe, which together rob the body of its natural suspension system.

    In the past they didn't have the hard surfaces of today, so we need soft cushioning and support.
    Myth Busted: 
    First of all, the surfaces of today are no harder than in the past. Some civilizations lived mainly on rocky terrain that was so uneven there wasn't a flat enough spot to set up a bed. More importantly, the body adjusts accordingly to the hardness of the ground by landing with more knee flexion and more foot pronation. However, the more inhibiting the shoe, the less the body senses the hardness of the ground. For example, when wearing a working boot the body does not adjust to the great differences between walking on soft grass and walking on hard rock. Thirdly, barefoot runners of today consider pavement one of the easiest surfaces to run on, because it's so smooth and consistent. When you go off the road is when it gets tough. Natural terrain is unpredictable and the occasional rock can catch you careless.

    Feet are fragile and need protection.
    Myth Busted: 
    Contrary to common belief, your feet are not fragile. Most likely, they have been in shoes your entire life and you have just never given your feet a fair chance. Most of us wear flip-flops in the summer and you may have noticed by the end of the summer your feet are strong and built up. The feet are amazing in that they adapt to whatever you wear and don't wear on your feet. The skin on the sole of your feet is the fastest at regenerating of all the skin on your body. This skin is six times stronger than all other skin tissues. Your muscles, tendons, ligaments, and bones are just as incredible at recovering and building up a tolerance. The other problem with this myth is that protection in a shoe takes on a new meaning. Protection in a shoe design has gotten so overdone. Now we have toe bumpers, so we can carelessly go about bashing our toes. We have stiff plates in our soles, so we can mindlessly stomp our feet through the ground. And we have support and cushioning to insulate us from the world around us.

    Repetitive stress activities weaken the arch over time.
    Myth Busted: 
    First of all "repetitive stress" is a misleading term because what health practitioners usually mean when they use the term "high impact exercise," which makes up nearly all exercise. As we all know exercise is the best thing you can do for your body. However, for practical use lets use their term, "repetitive stress," to dispel this myth. When you apply repetitive stress to any part of the body, it does fatigue but only for a short time and then it BUILDS BACK STRONGER. The arch of the foot is no exception. So when the arch is naturally exposed to repetitive stress it will get stronger which raises the arch so the next time it can better handle more repetitive stress. This is yet another case that we see the foot is a more adaptable machine than we ever thought.

    Shoes prevent and decrease injuries.
    Myth Busted: 

    In fact the opposite may be true. There has never been a single well done study to support the theory that more shoe is better. Strong evidence shows that thickly cushioned running shoes have done nothing to prevent injury in the 30-odd years since Nike founder Bill Bowerman invented them (See published article). Some smaller, earlier studies suggest that running in shoes may increase the risk of ankle sprains, plantar fasciitis and other injuries. Runners who wear cheap running shoes have fewer injuries than those wearing expensive trainers. Meanwhile, injuries plague 20 to 80 percent of regular runners every year. A recent study, by the American Academy of Physical Medicine and Rehabilitation and published last December in the academy's journal, PM&R, found that wearing running shoes "increased joint torques at the hip, knee and ankle," when compared to barefoot running.


    I overpronate so I need a shoe to correct it.
    Myth Busted: 
    As described in our section on foot mechanics, pronation is a natural and functional movement. Overpronation is not when it is combined with weakness in the knee and hip...causing the runner to lose good alignment. To see extreme pronation that is completely functional watch this video of marathon world record holder Haile Gebresalasie. His foot is pronating and acting like a spring, but his core is aligned and solid. Strengthen your foot and support structure and you will run more like Geb in function, even if not in speed.  If you are weak in the hips and feet- you will pronate and deform your knee angle. Watch the girl this the video, she is pronating and her knees are "kissing".

    Myth: Children need a "good" shoe for healthy foot development.
    Myth Busted:  

    As Dr. Lieberman demonstrated so well in his landmark paper in Nature (Jan 26, 2010)- footwear can influence natural gait. See Dr Lieberman’s amazing site of research. Next time you are in a park, watch a child run barefoot.  Notice the relaxed movement and foot placement. They lean slightly forward and their legs fall out behind them.  They do not strike hard on their heels.  Then watch the child with the highly cushioned or supportive shoe.  The difference is easy to see. Anything on a child’s feet should support natural neuromuscular development (see the best article ever written on the topic). 


    Children’s footwear should have the following:


    •    Thin soles, allowing proper proprioception, neuromuscular activation in the entire kinetic chain, and complement the body’s natural ability to absorb ground forces.
    •     Low, flat to the ground profile- designed for all play activity that involves climbing, running, and jumping. 
    •     Enhance lateral movement and not place the foot on a platform or have a slope from heel to forefoot. The materials should be soft and supple- allowing natural foot function.
    •     The toebox must be wide enough to allow natural toe spread. Foot support is created by the natural arch of the foot with the great toe stabilizing the arch.  When the heel is elevated and great toe deviated toward the second toe (a common design flaw in many shoes which come to a point) - this stability is compromised.
    •     A single piece midsole/outsole allowing protection on unnatural surfaces (concrete, asphalt) and natural rough surfaces (rock,trail) while allowing proprioception and natural dissipation of ground reactive forces.
    •     A child does not need “traction” to grip.  Their foot does that.
    •     Upper material should be soft, breathable, and washable.
    •     Shoes should not be fit with thick, heavy socks- as these interfere with foot proprioception.


    Running shoes improve performance and absorb impact.
    Myth Busted:  

    Watch any international marathon with world class African and Japanese runners and this is proof in itself.  The best wear what is essentially a slipper on their feet. Enough shoe to protect them  from the urban streets of New York City, Chicago, Berlin, or other major cities that host the events. The marathon world record was run in Adidas Adizero by Haile Gebresalasie. (See video of amazing efficient running form) . This is one of the lightest non shoes on the market.  It has slight heel elevation, but for Geb he is going so fast and is so far forward with his lean…he is essentially running on his toes, settling down his heel, and springing for the full 26 miles with incredible elastic recoil of his Achilles and foot.

    You want a snug fit.
    Myth Busted:  

    Again, the opposite is true here.  Having a snug fit is like having a corset for your feet.  Tight lacing and snugness prevents the natural spread of the transverse arch on landing and the longitudinal arch on functional pronation. These two functions are critical for shock absorption. Snugness in the toe box prevents the natural spread of the toes, neglecting them of their function in propulsion and stability.  You see many yoga instructors recommend “yoga toes” to correct the deformities a snug toe box has created in modern feet.

    I have heel pain so I need cushioning.
    Myth Busted: 

    One of the main causes of plantar fasciitis is elevation of the heel with a more cushioned midsole.  When the heel elevates the plantar fascia and Achilles shorten and becomes susceptible to injury when stressed with running activity which tends to stretch them out and stress them.  Another negative effect of a cushioned elevated heel is the loss of the involuntary stretch reflex of the Achilles and posterior lower leg muscles. This stretch reflex is designed to aid the forefoot with propulsion, yet it can only be activated if the heel comes close to the ground. The elevated heels of most available footwear, including athletic shoes, prevent this stretch reflex from occurring. The foot muscles and plantar fascia must activate more to make up for the loss of this stretch reflex.

    I need arch support for standing on hard surfaces all day.
    Myth Busted: 
    (reference Dr. McClanahan) An arch is a structure that is able to support weight over an open space, by providing support on either end of that open space. This applies to the arch of the foot too where we must support on either end of the arch with proper position and function. This is exactly the opposite of the type of "arch support" that is available to consumers, either over the counter (Dr. Scholl's for example) or from their healthcare professional (rigid orthotics). These products attempt to "support" the arch, not by supporting the ends of the foot arch, but rather by lifting up under the open space of the foot arch. This does not make sense. Consumers feel they need to do this and at times feel more comfortable in these type of arch supports since we are essentially walking on ramps which disturb the supportive ends of the arch. Individuals who grow up barefoot, naturally have the support they need for both ends of their foot arch, and this is likely part of the reason why their foot arches function perfectly throughout their lifetimes, and their feet do not break down, unlike 80% of Americans who by nature of their habitual shoe wearing and compromised arches, will suffer some form of foot problem at some point in their lives.

    Average life expectancy has increased, shoes are necessary to preserve the life of our feet.
    Myth Busted:  

    Cultures that run and walk their whole lives in flat functional footwear (or barefoot) do not have the problems that habitual wearers of elevated heel shoes have through time.  Fallen (or failing) arches rarely if ever occur in the Tarahumara Indians, Asian farmers and rickshaw walkers, and farmers in Costa Rica, Sardinia, and Icaria- the longest living places on the planet and places where moat of the day is spent on ones two feet. (seeThe Blue Zones).  More importantly is that in these cultures osteoarthritis of the hips, knees, and back is extremely uncommon, perhaps another attribute to the benefits of the proper postural alignment from being flat to the ground.

    Excerpts from USATF Coaching Article #168 a Must Read.

    Modern running footwear is well endowed with cushioning purportedly to reduce impact forces absorbed by the body. However, there exists no scientific study providing evidence that cushioning has a significant effect on impact forces. On the other hand, there is evidence that an increase in impact forces is associated with softer shoes (Shorten, M.R. "The Myth of Running Shoe Cushioning." Keynote Lecture given at the 4th International Conference on the Engineering of Sport, September 2002; Robbins. "Overload protection: avoidance response to heavy plantar surface loading." Medicine and Science in Sports and Exercise, 20.1(1988): 85-92). Combine this evidence with the previously mentioned sensory deprivation aspect of shoe cushioning and the role of athletic footwear as a protective device must be questioned.

    How does running economy compare between the barefoot and shod state? Oxygen consumption has been shown to be 4.7% higher while wearing shoes (approximately 700 g per pair) and running at 12 km/h.(Warburton, Michael. "Barefoot Running." Sportscience, 5.3;2001). Reasons for this include the mass of the added footwear requiring additional energy to move the shoes through each stride, energy being absorbed by the shoe’s cushioning, and the energy expense of flexing the sole of the shoe. When these energy drags are combined with the previously detailed loss of a stretch reflex from the lower leg it becomes understandable that barefoot running is more economical.

    Content used with permission from Mark Cucuzzella ( and Andrew Rademacher (