Selecting the Proper Athletic Shoe - Podiatry M · 2017-05-29 · needs. A narrow heel, high or low...

OCTOBER 2006 • PODIATRY MANAGEMENTwww.podiatrym.com 147

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Continuing

Medical Education

The correct choice of footgear can enhance performance while preventing injury.

Goals and Objectives

After reading this arti-cle, the physician shouldbe able to:

1) Properly fit athleticshoes for various sportsactivities.

2) Know how to modi-fy the lacing of athleticshoes to accommodatedifferent foot types.

3) Recognize the signsof excessive wear ofshoes used for differentsports.

4) Understand thecharacteristics of a goodsock for the athlete.

5) Recommend appro-priate running, soccer,football, baseball, basket-ball, and tennis shoes toathlete patient.

enhance performance. Wearingthe wrong shoes, ones not de-signed for the playing surfaceand condition, or those that do

Continued on page 148A thletic shoes are an im-portant part of the equip-ment used by high per-

By Mark A. Caselli, DPM formance athletes and play a sig-nificant role in the outcome ofmany events. Good shoes pro-vide cushioning and stabil i tyand can prevent injury as well as

Selecting the ProperAthletic Shoe

too small are one of the majorcauses of foot pain, and thosethat are too large can cause blis-ters and lack of stability.

Not all brands of footwear fitthe same. An experienced sales-person can be of great help. Heor she can help fit shoes proper-ly to address the a th-lete’s concerns. A goodsalesperson would knowwhich brands a re cutwider in the forefoot ornarrower in the hee l .Your pat ients shouldhave their feet measuredeach time they purchaseshoes.

As one ages, foot sizeoften gradually changes.The measurementsshould include sitting,s tanding, and heel totoe , heel to bal l , andwidth. In spite of obtain-ing a number from theBrannock device, the ac-tual fit on the foot is themost important consider-ation. The measurementitself is only a generalguide. The athlete shouldbe reminded that a prop-erly fitting athletic shoeis often not the same size

as a dress shoe. The right sizerunning shoe is often a half to afull size larger.

Athletic shoes should be fit-ted at the end of the day, orafter rigorous activity when thefeet are their largest. Both feetshould be measured since they

are often differ-ent sizes and theshoes should befitted to the larg-e r foot . Theshoes should alsobe fitted with thesocks that will beused during thesport s ac t iv i tyand wi th anyspecial inserts ororthoses.

Sports shoesfor chi ldrenshould not bepurchased withthe thought thatthe next largers i ze wi l l a l lowthe a thle te togrow into them.The exact size ismost important.The shoes thatare being tr iedon should be re-laced, beginningat the fa r thes teyelet with evenpressure be ingapplied as theyare crisscrossed-laced to the topof the shoe. Theshoe should fitwi th approxi -mate ly 1/4 to1/2 inch be -tween thelongest toe andthe end of theshoe. It shouldhave adequateroom for thetoes . The shoeshould bend atthe bal l o f thefoot. If the heelto ball fit is off,then the breakwil l not matchthe foot and itwi l l c reate ab-Continued on page 149

148 www.podiatrym.comPODIATRY MANAGEMENT • OCTOBER 2006

Athletic Shoe...

not fit properly, can lead toinjury.The clinician treating athletes

must be familiar with the type offootwear used by the athlete pa-tient since the wrong shoe mightvery well be the cause of that pa-tient’s problem. One study byNFL team physicians and train-

ers looked at the performance of15 different athletic shoes ongrass and artificial turf underboth wet and dry conditions.They concluded that wearingshoes under condi t ions forwhich they were not designedcould lead to excessive forcesand cause serious knee and ankleinjuries.

Sport-specific, and even sportcondition-specific, shoes shouldbe used by anyone who partici-pates in a sport for more thanthree hours per week . Eventhough well-made, sport-specificshoes have become relatively ex-pensive, choosing the right shoeis important and is probably eco-nomical in the long run if fre-quent foot injuries can be pre-vented.

General Considerations inSelecting the ProperAthletic Shoe

One of the most importantaspects of selecting the properathlet ic shoe i s choosing theright size. Proper fitting sportsshoes can enhance performanceand prevent injuries. An ill-fit-t ing shoe can be the root o fmany problems. Shoes that are

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Figure 3: Lacing for HighArches: Begin lacing as nor-mal, criss-crossing and stop-ping after the first set ofholes. Thread the lacesstraight up each side, criss-crossing only before thread-ing the last hole.

Figure 4: Lacing for WideFeet: Thread the lacesthrough the first set of eye-lets and then straight upeach side without criss-cross-ing at all. Continue this wayfor two or three holes pastthe forefoot, and then begincriss-cross lacing as normal.

Figure 1: Lacing for NarrowHeel or Foot: Follow a nor-mal lacing pattern up to thelast pair of holes. For narrowfeet, use shoes with staggeredeyelets. Tighten from theouter eyelets, pulling thebody of the shoe towards thecenter. At the last hole, tight-en the laces and thread intothe last hole without criss-crossing. Do not pull thelaces all the way through,but leave a loop on each side.Cross the laces and threadthem each through the loopon the other side beforetightening and tying.

Figure 2: Lacing for LowArches: Criss-cross lace theshoes as normal halfway up.Use the loop lacing the restof the way.

Wearing the wrong

shoes, ones not

designed for the

playing surface and

condition, or those

that do not fit

properly, can lead

to injury.


portant part of the athletic shoe.It holds it all together by secur-ing the shoe to the foot. Improp-

er lacing can cause discomfortand injury . Pul l ing laces tootight cuts off circulation andmay cause tendinitis on the dor-

normal pressure and irritate thefoot. The heel should be stableand not move in and out of theshoe. The shoes should be wornfor at least ten minutes in thestore. They should feel comfort-able as soon as they are tried on.There is no break-in period. Themost common error in purchas-ing athletic shoes, and one thatcannot be corrected by padding,insole replacement, or orthotics,is buying a shoe that is too nar-row in the toe box. Thoughthese recommendations apply tothe fitting of most athletic foot-wear, there are specific shoe fitvar ia t ions for spec i f ic sport s(Table 1).

Lacing SystemThe lacing system is an im-

Athletic Shoe... sum of the foot . I fl aced too loose ly , theshoes fit sloppily and resultin foot and ankle instability.There are three types of lacingsystems: var iable width withstaggered eyelets to adjust width,speed lacing with plastic D-rings,and conventional eyelets. Vari-ous lacing methods, other thanthe standard crisscross system,can be used to meet individualneeds. A narrow heel, high orlow arch, or a wide foot can beaccommodated by changing the way the shoes a re laced (Figures 1-4).

Worn Out Shoes

Wearing worn-out shoes is ahazard in any sport. Worn-outshoes often result in aches andpains in feet , legs, knees and

hips, signaling thatit is time to replacethe shoes . As ageneral rule, mostrunning shoes pro-vide cushioning upto 500 mi les ,though many run-ners may f indbreakdown in cush-ioning after as fewas 350 miles. Shoeswith compression-molded EVA mid-so les vary indurometer . Thismeans that thecushioning elastici-ty and life span ofeach mid-so le i sre la t ive to theshoe . Most shoeswith polyurethanemid-so les breakdown at a s lowerrate. To avoid in-juries, it ’s a goodidea to rotate run-ning shoes every200-250 miles, hav-ing two pa i r s o fshoes to wear at allt imes . A runningshoe ’ s mid-so lecushioning may beworn out long be-fore the t readshows s igns o f

Continued on page 150

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Worn-out shoes

often result in aches

and pains in feet,

legs, knees and hips,

signaling that

it is time to replace

the shoes.

TABLE 1

Sport Specific Shoe Fitting

SPORT TOE AREA HEEL AREA

Running Allow thumbnail’s length of Heel can slightly movespace between the end of but should not slip.the longest toe on the largest foot and the end of the shoe.

Soccer Glove-like fit while standing Snug fit with no up straight. Allow room for movement.toes to move comfortably.

Football Allow room for toes to Snug fit with no move comfortably while movement.standing up straight.

Baseball Allow room for toes to Snug fit with nomove comfortably while movement.standing up straight.

Basketball Allow thumbnail’s length of Heel can slightly movespace between the end of but should not slip.the longest toe on the largest foot and the end of the shoe.

Tennis Allow thumbnail’s length of Heel can slightly movespace between the end of but should not slip.the longest toe on the largest foot and the end of the shoe.

Other Signs of WearSince most cleated athletic

shoes have little or no mid-solematerial, the in-tegrity of theheel counter,condition of theupper, and wearof the cleats mustbe evaluated. Ashoe with notice-ably “grounddown” moldedcleats should bereplaced. Anoth-er way of deter-mining whethera shoe should bereplaced is bytrying on a newpair of the model that is currentlybeing worn. Compare this to thecurrent shoes. If the new shoe

feels much betterthan the old,then the oldshoes are proba-bly worn out.Heavy athletesand over-orunder-pronatorsshould checktheir shoes fre-quently sincethey tend towear out theirshoes quickly.

SocksSocks a re

of ten over -looked as an im-portant compo-nent of proper

athletic footwear. Often, a poor-ly fitting sock or worn sock isone of the major causes of blis-

ters. In general, socks that fitproperly should provide ampletoe room, have a well padded

sole, f it snuglywithout wr in-k les , and fee lcomfortable. Ina longitudinal ,d o u b l e - b l i n dstudy, the effectof sock f ibercomposition onthe f requencyand size of blis-tering events inl o n g - d i s t a n c erunners was ex-amined. I t wasfound that sockscomposed of

100% acrylic fiber were associat-ed with fewer and smaller blis-ters when directly compared tosocks composed of 100% cottonfiber.

The tube sock has becomepopular over the last decade asone size generally fits all. Advis-ing the athlete to wear two pairsof socks is another method of re-ducing friction and preventinghot spots that may become blis-ters. The inner sock is usuallythinner and l ighter than theouter sock. Lastly, clean socksare a must in warding off fungalgrowth and mainta in ing theoverall health of the athlete’sfeet.

ResourcesThe practitioner treating ath-

letes can obtain a great deal ofinformation on athletic footwear



Athletic Shoe...

wear. Since the bottom andtread of the shoe may look

fine, identifying when the cush-ioning is no longer effective isimportant.

Press TestThe “Press Test” can be used

for this purpose. When an EVAmid-sole is compressed, it cre-ates visible lines or wrinkles inthe mid-sole material that canbe seen from the sidewall of theshoe. As the mid-sole is furthercompressed, the lines multiplyand grow closer together. Thefirst appearance of these linesindicates that the mid-sole iscompressing normally. A simplepres sure t e s t can de te rminewhether or not the mid-sole isc o m p a c t e d .Pushing the out-sole upward intothe mid- so leshould show themid- so le com-pres s ing in tothese l ines . Asthe shoe breaksdown, the mid-so le wi l l com-pres s l e s s wi ththe sameamount of pres-sure. When themid-sole showsheavy lines, andthe pre s s t e s tyields a minimaldegree of com-pres s ion , themid-sole has been compacted toa point where little or no cush-ioning remains.

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Figure 6: Semi-curved lasted runningshoe with gel enhanced mid-sole offer-ing excellent cushioning characteristics

Figure 7: Multi-studded soccer shoe withnumerous molded cleats offering bothgood support and traction

Figure 5: Straight lasted motion controlrunning shoe for over-pronators

Running shoes

strike the ground

about 800 times

per mile with

the force of about

three times the

runner’s body

weight.

It was found

that socks composed

of 100% acrylic

fiber were associated

with fewer and

smaller blisters

when directly

compared to socks

composed of

100% cotton fiber.


straight) and semi-curved (closerto curved) last.

Lasting TechniquesThere are three lasting tech-

niques used in running-shoeconstruction: board, slip, andcombination. Inboard las t ing ,the upper mate-rials are glued toa fiberboard be-fore they are at-tached to them i d - s o l e .Straight, board-las ted shoesaren’t very flexi-ble, but are firmand provide agood platform ifor thoses a reneeded for ex -cess ive prona-t ion. With s l iplas t ing , theupper materials are stitched to-gether and then glued to themid-sole. This makes a lighter,more flexible shoe with a softerfeel. Combination lasting usesthe board method in the heel forstability and the slip method inthe forefoot for flexibility. Manyrunners prefer combination-last-

ed shoes thatprovide somebenefits of bothtypes.

TreadedOutersole

The treadedouter sole is de-signed to resistwear , providetraction, and ab-sorb someshock. It shouldnot wear outquickly, and willoften be in goodshape after the

shoes are discarded due to loss ofmid-sole cushioning. The outersole should wear primarily onthe extreme outer edge of theheel and in the center of the ballof the foot. There are many soledes igns , most providing ade-quate traction. In general, solesare either hard or soft. Hardersoles are heavier, offer less cush-

by visiting athletic shoe stores,reading sports specific publica-tions, and visiting the Internet.For example, Runner’s Worldmagazine publishes a “Shoe Buy-er’s Guide” four times a year.The American Academy of Podia-tric Sports Medicine has shoel i s ts recommending running,aerobic, basketball, hiking, walk-ing, soccer, and volleyball shoeson its web site www.aapsm.org .These sources can be very help-ful in guiding athlete patients tothe sports shoe that meets theirneeds.

Sports-Specific Shoes

Running ShoesGetting a good pair of run-

ning shoes is the most importantinves tment any runner canmake. This is easy to understandwhen you realize that the onlything that separates the roadfrom the runner are the shoes,each of them striking the groundabout 800 times per mile withthe force of about three timesthe runner ’ s body weight . Aproperly selected running shoecan definitely decrease the num-ber o f runninginjuries. Each ofthe f ive majorcomponents ofthe runningshoe : the la s t ,outer sole, mid-so le , hee lcounter , andupper, should beconsidered in itsselection.

Last ShapeThe shape of

the last a f fectsthe shape , f i t ,f lexibi l i ty, andstability of the shoe. The twobasic shapes used for the last arestraight and curved. A straightlast has little or no curve fromthe hee l to toe and providesgreater support under the medialarch. A curved last turns inwardfrom the heel to the toes. Thereare var ia t ions that inc ludes l ight ly curved (c loser to

Athletic Shoe... ioning , and wearlonger. Softer soles arelighter, have more cushion-ing, and wear out faster.

Midsole ConstructionThe mid-sole is located be-

tween the outerso le and thefoot bed . I t i sthe most impor-tant part of therunning shoe. Itabsorbs shock,flexes at toe-off,and adds stabili-ty to the shoe.Mid-so les a rec o n s t r u c t e df rom var ioustypes of foams.Ai r -bags , ge l s ,and other mate-rials may also beinserted to in-crease cushion-

ing. Their shock absorbing prop-erties deteriorate with use. Stud-ies have shown that mid-solesmay lose a significant amount oftheir cushioning when exposedto running in cold temperatures.

Heel CounterThe heel counter stabilizes

the shoe, and therefore, the foot.A rigid counter covering the en-tire heel is desirable, especiallyfor pronators. It’s usually madefrom plastic. Above the counteris usually a cushioned ankle col-lar, which provides protectionand helps prevent Achilles ten-dinitis. A heel wedge, locatedabove the mid-sole, adds heightto the heel, increases shock ab-sorption, and reduces strain onthe foot and leg.

Shoe UppersMost running shoe uppers are

either nylon, nylon mesh, or acombinat ion. This c reates alight-weight, breathable, wash-able, soft shoe that is comfort-able and dries fast when wet.The mesh upper also makes theshoe cooler in the summer.

ConsiderationsWhen recommending a spe-

cific shoe, it is important to de-Continued on page 152

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When recommending

a specific shoe,

it is important to

determine the

runner’s basic foot

type and any

running-related

complaints and

injuries.

The mid-sole

is located between

the outer sole and

the foot bed.

It is the most

important

part of the

running shoe.

best for overpronators (Figure 5).These runners tend to have high-ly flexible feet with low arches

and they often breakdown shoeson the inner borders. For under-pronators, those runners who

have high, curved, rigid arches,curved-lasted shoes, which pro-vide plenty of cushioning and aflexible forefoot, is recommend-ed (F igure 6 ) . These runnersdon’t absorb shock well and areprone to lateral ankle sprains,stress fractures, shin splints andknee pain.

Soccer CleatsSoccer is a game that is pri-

mar i ly p layed wi th the fee t ;therefore, the most importantpiece of soccer equipment is thefootwear. A good pair of cleats,or boots, as they are sometimescal led, i s essential . There arevariations of the basic soccer

c leat des igned fordifferent skill levels,weather conditions,and field types.

Great care mustbe exercised in theselection of soccershoes s ince eachpar t o f the shoemust serve a uniquefunct ion. P layerswear cleated shoesfor better t ract ionwhi le running .Cleats give them in-creased speed andmaneuverability.

The outsoles ofthe c l ea t ed shoepe r fo rm a dua lfunction, providingboth suppor t andtraction. Since thecleats often do notpenetrate fully intothe playing surface,a base of support isfo rmed on top o fthe cleats. This con-dition is exaggerat-ed on hard dirt. Forthis reason, cleatedshoes should be se-lected such that thec l ea t s a long theshoe edges are posi-t ioned as c lose tothe edge as poss i -ble. Sections of thesole without cleatsw i l l be r e l a t i ve lyless supportive, es-pec i a l l y in the



Athletic Shoe...

termine the runner’s basicfoot type and any running-re-

lated complaints and injuries.Running shoes come in threebasic categories, those specializ-ing in stability, motion control,or cushioning. If the runner hasa medium-arched, semi-curvedfoot that properly pronates, thenshoes that offer stability shouldbe recommended. These shoesshould have adequate mid-solecushioning, as well as medialsupport.

A straight-lasted shoe with ahard heel counter and firm mid-sole offering motion control is

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Figure 8: Soccer shoe with exchangeable cleatsand studs that can be customized for differentfield conditions

Figure 10: High-top football shoe incorporatingscrew-in studs to deliver grip on very soft naturalfields

Figure 9: Football shoe with molded studs offeringboth good traction for a variety of playing surfacesand durability

Figure 11: Metal spikes on baseball cleats offer good traction but can cause injury whensliding.

Traction is

not desirable

when it resists shoe

rotation.


ing rotational fixation isto maximize cleat numberand diameter, and mini-mize cleat height. In gen-eral, multi-studded mod-els are preferred by mostplayers (Figure 7). Thesecan be worn both ongrassy fields and on hardground.

For ra iny weather ,screw-in studs are betterbecause their length canbe adjusted (Figure 8). Thesofter the f ie ld and thetaller the grass, the longerthe s tuds . The longerscrew-in studs should notbe used on synthetic turf,as they might get caughtin the fibers and cause se-rious knee and ankle in-

juries. On synthetic turf, special-ly des igned shoes with shortstuds are advisable. Since thefeet and legs often end up in a

tangle dur ingthe match, soc-cer cleats mustbe no less than1/2 inch in di-ameter and maynot pro jec tmore than 3/4inch f rom thesole.

Shoe UpperThe main

function of anyshoe upper is tocenter the foot

squarely over the base of sup-port . In order to accompl i shthi s , most soccer shoes have

mid-foot arch area.Shoes with fewer cleats often

include internalre inforcement .To accompl i shthis, a stiff syn-thetic or even ameta l p la te i sadded to theshoe to ensureadequate sup-port. This prac-t i ce has a l sobeen used in anat tempt to re -duce the inc i -dence of “ tur ftoe” on synthet-ic turf fields. The negative side-effect of this modification is areduction of forefoot flexibilityacross the metatar sa l headswhich could result in irritationof the plantar fascia.

TractionThe other funct ion of the

outsole is to yield adequate trac-tion on a given surface. The twomodes in which traction is de-sirable are along the length ofthe shoe and in resistance tolateral motion. Traction is notdesirable when it resists shoe ro-tation. Fixing the foot againstrotation has been cited as pre-disposing the knee and ankle toinjury.

The best method of minimiz-

Athletic Shoe...

overlays along the lat-e ra l edge o f the f i f thmetatarsal head and base,to serve as reinforcement andprovide a stiff heel counter toanchor the rear-foot. A uniquefootwear requirement for soccer

is to serve as an impact surfacefor the ball. To this end, extrastitching is placed along the me-d ia l and la te ra l s ides o f theshoe, which both reinforces theupper and forms a ball controlsurface.

Football CleatsFootball cleats are made both

for the position played and thetype of field played on. Footballcleats come in three styles, orheights , to accommodate thevarying needs of players by po-sition. High-tops extend up theankle to provide extra support,

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Turf shoes

usually use molded

rubber cleats

to give spring and

traction on

the harder turf

surface

Baseball and

softball are considered

low to medium

impact sports where

approximately

four to six times

body weight

is transferred to

the feet.


Figure 13: High top basketball shoe of-fering both good ankle support and ex-cellence for court traction

Figure 14: Low cut basketball shoes,sometimes preferred by fast players, arelight but offer less ankle support

Figure 12: Only molded baseball cleats are permit-ted for Little League play.

games are played on both grassand turf , mult ipurpose cleatscan be used. Molded cleats arepermanent ly a t tached to theoutsole on the shoes’ bottom(Figure 9).

Tur f shoesusua l ly usemolded rubberc leat s to g ivespring and trac-t ion on theharder turf sur-face (Figure 10).Molded c leat sare generally lessexpensive thanshoes wi th de -tachable cleats.D e t a c h a b l ecleats use studs that can be re-moved and replaced to fit fieldconditions on all types of grass,

hard and dry, or wet andsloppy. Their versat i l i tymakes detachable c leatspreferable for athletes whoplay pr imari ly on grass .Shorter studs can be usedfor hard, dry surfaces andlonger s tuds for a wet ,sloppy field. Replacementcleats generally run in 1/2,5/8-, 3/4, and 1-inch sizes.Having all four sizes givesthe player more optionsfor different field condi-tions.

Baseball CleatsBasebal l and sof tba l l

a re cons idered low tomedium impact spor t swhere approximately fourto six times body weight istransferred to the feet. Theimpact can even be greateron artificial surfaces. Un-like soccer cleats, baseballcleats have a mid-sole tohelp cushion some of thisimpact. There isn’t muchrepeated motion in base-bal l , but a lot of lateral(side-to-side) movement.Many p layers pre fe r ahigher or mid-cut cleat tooffer better ankle support.Baseball shoes are designedwith either metal or mold-ed cleats.

Meta l c lea t s fea turemolded soles with several

small metal spikes designed toprovide maximum traction onthe field (Figure 11). These arebenef ic ia l on extremely hardf ie lds . The shoes a re usua l ly

made of leather,have cushionmid-so les , andare fit much likea s tandardsneaker . Meta lc leat s a re notpermitted in Lit-t le League andi n s t r u c t i o n a llevels because ofthe potential forinjury, happen-ing most oftenwhen p layers

with metal cleats s l ide into abase and the spikes are exposed.Molded cleats feature moldedsoles with several small plasticcleats (Figure 12). Molded cleatsare most often used on Litt leLeague and instructional levelssince they are significantly lessdangerous than metal cleats.

Basketball ShoesBasketball shoes must offer

durability, support, stability, andshock absorption. The constantstarting, abrupt stopping, highjumps, and quick side-to-sidemovements involved with bas-ketball make these features abso-lutely essential in a shoe. Person-al playing style is also an impor-tant factor in shoe select ion.Power players will need shoeswith maximum cushioning andstability. They may have to playwith heavier shoes to get thosebenefits. The all-around playercan use shoes with moderateankle support and cushioning.There are many shoes to choosefrom in this category, and mostare fairly lightweight. The fastplayer will prefer a lightweightshoe that offers moderate sup-port, cushioning, and flexibility.Shoes wi th a lower cut a re of ten des i red by this type ofplayer.

Understanding Construction

Understanding the construc-tion of basketball shoes is essen-



Athletic Shoe...

especially for lateral move-ments. Linemen benefit from

th i s suppor t because o f thepressure put on their ankles bythe numerous l a t e ra l move -ments during the course of agame . A mid -cu t shoe o f f e r sgood support while still allow-ing maneuverability. This stylebest fits the game of skill play-ers; the defensive backs, run-ning backs, wide receivers, andquarterbacks. Low-cuts are pre-ferred by some players becausethey are light-weight. The lowercut provides extra maneuver-ability to allow for quick cutson the field.

Cleats are either molded ordetachable. Most are designedfor either grass or turf fields. If

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The main

function of any

shoe upper

is to center the foot

squarely over the base

of support.

Figure 15: Mid high cut basketball shoe offering awraparound leather stabilizing strap to protectagainst ankle rollover

Figure 16: “High tech” tennis shoe incorporatingan advanced cushion mid-sole, a mid- and fore-foot stability system, and a high abrasion courtgripping outsole


or untie, thus increasing stabilityduring play. Some shoes featurea strap that wraps around theupper arch of the shoe to addmore stabil ity and protectionagainst ankle rollover (Figure15).

Zippers are afa i r ly newchoice for secur-ing the foot in abasketball shoe.These are usual-ly covered bysome sor t o f protective mate-r ia l . Ve lc ro ,whi le good foryounger players,i s n o t r e l i a b l ein terms of stay-ing closed, anddoesn’t offer goodsupport.

MidsoleThe mid-sole

is often considered the most im-portant part of the basketballshoe because the constructionand the materials used will im-pact the levels of cushioning andshock absorption and can affectthe players’ ability to explode offthe floor. The mid-sole is usuallymade of EVA, compressed EVA,polyurethane, or a combinationof these materials. Proprietarycushioning technolog ies a re a l so found in many brands

o f basketba l lshoes . EVA of -fers lightweightcushioning, butnot as much sta-bility and dura-bility. EVA canbe compressedto make it some-what moredurable . Po ly -urethane i s amore dense anddurable cushion-

ing material. It can add stabilityto the shoe , but a l so addsweight.

Cushioning TechnologyProprietary cushioning tech-

nologies are usually found in theheel and forefoot of the shoeand add an extra degree of cush-

tial in determining which fea-tures are most important for thep layer . The funct ion o f theupper part of the shoe is to keepthe foot snug and securely inp lace dur ing p lay . There a rethree shoe cuts available, high-,mid-, or low-tops. The majorityof players, around 70 per cent,choose high tops for their abili-ty to provide maximum anklesupport (Figure 13). Power play-ers and all-around players usual-ly prefer the stabi l i ty of thisstyle.

For players who feel restrict-ed in high-tops, and who usespeed as their greatest asset, mid-tops, which extend right to theankle level , a re thei r choice .Only about 10 percent of playerswear low-tops for regular play(F igure 14) . These shoes a relighter, but don’t offer the built-in ankle support that high-topsdo.

UppersAll leather uppers have been

replaced with lightweight combi-nation uppers, mixing the stabil-ity and durability of leather withthe breathability and flexibilityof synthetic mesh. High-tech, allsynthet ic uppers , which aremore durable than leather, aregaining popularity for their abil-ity to offer stability in a super-lightweight ma-terial.

Closure SystemA good c lo -

sure sys tem i snecessary tokeep the footsnug and securein the shoe dur-ing the suddenstops and starts,frequent side-to-s ide mot ions ,and quick turns encountered inbasketball. Laces are an accept-able choice for keeping the footstable in the shoe. Several manu-facturers offer new lacing sys-tems designed to offer greaterstability. A good lacing systemshould lock the laces in place,making them less apt to loosen

Athletic Shoe... ioning without muchextra weight. Stiff materi-als are used in some basket-ball shoes on the medial orinner side of the shoe to reduceinward rolling of the foot. Heav-

ier densities ofcushioning ma-terials may alsobe used in themedia l a rea toincrease a shoe’ss tab i l i ty . Themid-so le cannegatively affects tabi l i ty i f thecushioning ma-ter ia l s a re toothick.

OutsoleThe outsole

o f a good bas -ke tba l l shoeshould be f l a tand moderatelywide to create a

s table base and help preventankle rollover. The herringbonepattern i s most common andprov ides enough t rac t ion tokeep the player steady duringquick s tops and s ta r t s . Mostshoes are designed for indoorplay. If play is most often onoutdoor courts, a shoe with amore durable outsole should beused. Some basketball shoes aredesigned specifically for outdoorplay and feature heavier rubberoutsoles

Gender-SpecificMost women should not buy

men’s basketball shoes. Men’sshoes are built on a wider lastthan women’s shoes and are gen-erally too wide for a woman’sfoot, and do not offer an appro-priate degree of stability.

Tennis ShoesTennis shoes are very impor-

tant to the player, owing to thequick start and stopping, cut-ting, pivoting, and jumping thatis part of the game. Tennis is asport that is rough on shoes, par-ticularly the sole and toe area, sofinding a shoe that is durableenough is important. The shoesshould have a fairly wide heel


Continuing

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Basketball

shoes must offer

durability, support,

stability, and shock

absorption.

Proprietary cushioning

technologies

are usually

found in the heel

and forefoot

of the shoe and

add an extra

degree of cushioning

without much

extra weight.

essential. Appropriate shoe-wearfor these players includes a largetoe -box to provide adequateroom so the toe will not slamagainst the end of the shoe .Without the appropriate shoe,

these players are susceptible todeveloping tennis toe (subun-gual hematoma).

When play ing on a hardcourt, shoes with more durablesoles are essential. Clay and grasscourts have softer surfaces whichare more forgiving on shoes, sodurability requirements aren’t asgreat. ■

References1. Academy.Com: Different types

of cleats. <http://www.academy.com/index.php?page=content&tar-get=sports_tips/baseball_softball/types_of_cleats>

2. American Academy of PodiatricSports Medicine: Selecting an athleticshoe. <http://www.aapsm.org/fit_shoes.htm>

3. American Orthopedic Foot &Ankle Society: Athletic shoes andplaying surfaces affect performanceand injury levels. <http://www.aofas.org/i4a/pages/index.cfm?pageid=3395>

4. American Orthopedic Foot &Ankle Society: Selecting athleticshoes. <http://www.aofas.org/i4a/pages/index.cfm?pageid=3393>

5. Caselli MA: How to recom-mend shoes for marathon runners.Podiatry Today 13(7), 2000

6. Caselli MA: Getting involvedwith soccer. Podiatry Management22(7), 2003

7. Ciullo JV, Ciullo CR: Track andField. In Fu FH, Stone DA (eds.),Sports Injuries, 2nd Ed, LippincottWilliams & Wilkins, Philadelphia,2001

8. Dib MY, Smith J, Bernhardt KA,Kaufman KR, Miles KA: Effect of envi-ronmental temperature on shock ab-

sorption properties of running shoes. Clin J Sports Med 15(3), 2005

9. Dick’s Sporting Goods: Deter-mining your shoe size. <http://www.dickssportinggoods.com/info/index.jsp?catagoryId=222865>

10. Dick’s Sporting Goods: Howto lace athletic shoes. http://www.dickssportinggoods.com/info/index.jsp ? c a t e g o r y I d = 6 9 0 4 8 2 & i n -foPath=222981

11. Dick’s Sporting Goods: Howto tell when your shoes are dead.<http://www.dickssportinggoods.com/info/index.jsp?catagoryId=412022>

12. Dick’s Sporting Goods: Howto buy football cleats. <http://www.dickssportinggoods.com/info/index.jsp?catagoryId=222820>

13. Dick’s Sporting Goods: Howto buy basketball shoes. <http://www.dickssportinggoods.com/info/index.jsp?catagoryId=222834>

14. Glover B, Glover SF: TheCompetitive Runner’s Handbook.Penguin Books, New York, 1999

15. Harring KM, Richie DH Jr:Friction blisters and sock fiber com-position. A double blind study.JAPMA 80:63-71, 1990

16. Health Link (Medical Collegeof Wisconsin): Consider use when se-lecting athletic shoes. http://www.h e a l t h l i n k . m c w . e d u / a r t i -cle/999211949.html

17. Ho SSW: Basketball and Vol-leyball. In Reider B (ed.), Sports Medi-cine, The School-Age Athlete, 2nd Ed,WB Saunders Company, Philadelphia,1996

18. Quinn E: When to replacerunning shoes. http://sportsmedicine.about.com/od/tipsandtricks/a/re-placeshoes.htm

19. Reider B, Belniak R, MillerDW: Football. In Reider B (ed.), SportsMedicine, The School-Age Athlete,2nd Ed, WB Saunders Company,Philadelphia, 1996

20. Safran MR: Racquet Sports. In Fu FH, Stone DA (eds.), Sports In-juries, 2nd Ed, Lippincott Williams &Wilkins, Philadelphia, 2001


Athletic Shoe...

and good heel counter forrearfoot control. The traction

surface of the heel should beshock absorbent and of a non-slip material.

The heel cup should fit snug-ly, which helps prevent the footf rom s l ipping forward in theshoe. The shoe should have amedial arch support that is ap-propriate for the individual ’sarch. There needs to be good lat-eral support for the forefoot. Thetoe-box of the shoe must notcreate pressure and should con-form to the general shape of thefoot. The vamp (upper front) ofthe shoe must never constrict orcause pressure across themetatarsal area or instep (Figure16).

Other Considerations

Court surface, style of play,and foot s t ructure should beconsidered when selecting a ten-ni s shoe . A compet i tor , whoplays mostly from the baseline,requires a shoe with a lot of lat-eral support to handle the side-ways motion. The shoe needsmore sidewall support to stabi-lize the foot during the quick

lateral, side-to-side movementsthat are encountered.

The base l ine p layer a l soneeds good support for forwardand rear forces as well as a shoewith a highly durable sole.

The serve and volley playergenerates tremendous levels offorward forces in the forefoot ortoe-box area of the shoe. Theseplayers tend to frequently chargethe net and slide the back footalong the court during the serve,so a shoe with a durable toe-cap(also called a reinforced toe) is

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Dr. Caselli isstaff podiatristat the VA Hud-son ValleyHealth Care Sys-tem in Mon-trose, NY is Ad-junct Professorin the Depart-ment of Ortho-pedic Sciences atNYCPM, and a Fellow of the AmericanCollege of Sports Medicine.

Most women

should not buy

men’s basketball

shoes.

Court surface,

style of play,

and foot structure

should be considered

when selecting a

tennis shoe.


B) Curved slip lastedC) Straight slip lastedD) Curved combinationlasted

6) Which of the following is nota characteristic of the treadedouter sole of a running shoe?

A) Designed to resist wearB) Primary shock absorber ofshoeC) Provides tractionD) The harder the material,the heavier

7) The best running shoe to rec-ommend for an athlete withhigh, rigid arches is:

A) A shoe offering maximummotion controlB) A straight-lasted shoeC) A stability categorizedshoeD) A curved combination-last-ed shoe

8) The proper fitting of a soccershoe includes:

A) 1/2 - 3/4 inch of space be-tween the end of the longesttoe and largest footB) Slight heel movementC) Snug, glove-like fitD) Fit one size larger thandress shoe

9) Which one of the followingdoes not affect the shock absorb-ing quality of a running shoe?

A) Running on a cold dayB) Running over 10 miles adayC) Running in a shoe with agel insertD) Both a and c

10) Soccer cleats should havelonger studs when playing in

1) Sports-specific athletic shoesshould be recommended:

A) Only for competitiveathletesB) Only when engaged in asport more than three daysa weekC) Only when used incompetitive playD) For anyone participatingin a sport more than threehours per week

2) Which one of the followingis not correct concerningproper athletic shoe fitting?

A) Feet should be measuredeach time shoes arepurchasedB) Athletic shoe size shouldbe the same as acomfortably fitting dressshoeC) Shoes should be fitted atthe end of the day or afterexerciseD) Shoes should be fitted tothe larger foot

3) A running shoe should bereplaced at least every:

A) 100 milesB) 250 milesC) 500 milesD) 750 miles

4) Studies have shown that thebest material for an athleticsock is:

A) CottonB) NylonC) AcrylicD) Polyester

5) The best running shoe lastfor an over-pronated heavyathlete is:

A) Straight board lasted

which one of the following conditions?

A) Soft field in the rainB) Hard cold groundC) Synthetic turfD) Long studs should not beused for any of the aboveconditions

11) Which one of the followingfootball positions usually prefershigh top cleats?

A) Running backB) Wide receiverC) LinemanD) Quarterback

12) A stiff plate is sometimes in-corporated into the sole of a soc-cer shoe to reduce the incidenceof which one of the followingconditions?

A) Subungual hematomaB) Turf toeC) Plantar fasciitisD) Ankle sprains

13) The main disadvantage ofmetal cleats on baseball shoes isthat:

A) They afford poor tractionon hard fieldsB) They result in an increasedrisk of injuryC) They can only be used inLittle LeagueD) They offer no cushionedmid-sole

14) Which one of the followingbasketball shoe cuts would besafest to recommend for most ofyour basketball playing athletes?

A) High topsB) Mid topsC) Low topsD) It makes no difference

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E X A M I N A T I O N

See answer sheet on page 159.


158 PODIATRY MANAGEMENT

15) Which of the following closure systems madefor basketball shoes is usually the least desirablefor offering good support?

A) LacesB) ZipperC) VelcroD) Laces and straps

16) Stiff materials are commonly used on the me-dial side of the mid-sole of a basketball shoe pri-marily to:

A) Increase shock absorptionB) Reduce inward rolling of the footC) Prevent ankle sprainsD) Increase shoe life

17) The main reason why many women shouldnot use men’s basketball shoes is that:

A) Men’s shoes are too heavyB) The lacing system is not designed for awoman’s footC) Men’s shoes are not permitted in women’sprofessional and collegiate playD) They often do not offer an appropriate de-gree of stability

18) A tennis shoe without adequate toe-box roomis likely to result in which one of the followingconditions?

A) Turf toeB) Subungual hematomaC) SesamoiditisD) Plantar fasciitis

19) Which one of the following conditions is not as-sociated with athletic shoes that are fit too large?

A) BlistersB) Ankle sprainsC) InstabilityD) Nerve impingement pain

20) The individual that should select the most ap-propriate sports shoe for the athlete is:

A) The sports medicine doctorB) The athletic coachC) The athleteD) Each of the above must be involved in theselection.

E X A M I N A T I O N

(cont’d)

See answer sheet on page 159.

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tinuin

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LESSON EVALUATION

Please indicate the date you completed this exam

_____________________________

How much time did it take you to complete the lesson?

______ hours ______minutes

How well did this lesson achieve its educational objectives?

_______Very well _________Well

________Somewhat __________Not at all

What overall grade would you assign this lesson?

A B C D

Degree____________________________

Additional comments and suggestions for future exams:

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

__________________________________________________

EXAM #8/06Selecting the Proper

Athletic Shoe(Caselli)

1. A B C D

2. A B C D

3. A B C D

4. A B C D

5. A B C D

6. A B C D

7. A B C D

8. A B C D

9. A B C D

10. A B C D

11. A B C D

12. A B C D

13. A B C D

14. A B C D

15. A B C D

16. A B C D

17. A B C D

18. A B C D

19. A B C D

20. A B C D

Circle:

Selecting the Proper Athletic Shoe - Podiatry M · 2017-05-29 · needs. A narrow heel, high or low...

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