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Ill-fitting footwear is the #1 cause of plantar fasciitis. In fact, if you don't address your footwear, you will never resolve this condition
Many people when they first begin to have that excruciating morning foot or heel pain will rely on suggestions from the internet for the "best shoes for plantar fasciitis".
The most common suggestions are brands such as Hokas, New Balance, Brooks, Asics, Birkenstocks, and Oofos.
Unfortunately, all of these brands have damaging features that could be keeping you from resolving your foot pain.
What Makes A Healthy Shoe?
A shoe should support the natural shape of your foot. The following is a list of the necessary criteria. These features are consistent with functional, natural footwear.
Widest At The Toe
Zero Drop: No Elevation of The Heel
No Toe Spring (Upward Angle Of The Toe Box)
Thin, Flexible Sole
No Built-In Arch Support
Minimal Stack Height: No Thick, Cushiony Soles
I have compiled a list of approved footwear for plantar fasciitis. Following these recommendations will prevent you from wearing shoes that could be sabotaging your PF recovery. Dr. Angel's Recommended Shoe List.
Criteria For Healthy Footwear
When discussing functional footwear, the design should include critical criteria. The following features are foot-positive:
1.) A Wide Toe Box
The #1 most damaging feature is a narrow or tapered toe box. Again, I’m not referring to women’s high heels, this applies to men’s shoes, casual shoes and even running shoes.
When we cram our feet and toes into footwear with narrow toe boxes, our feet can not function normally, and overtime, begin to weaken and atrophy.
Our toes even begin to deform and shift inward. Many of you may have noticed how your big toe has started to angle inward. This causes so many problems.
Sadly, most ALL footwear narrows at the toe creating tremendous stress on our feet.
The intrinsic muscles of the foot, your arch muscles, which I like to call, the foot core, will basically shut down and your foot will lose its ability to absorb shock.
Can you see how that would be a problem?
To function optimally, the foot should spread and splay wide at the forefoot. If this action is interrupted, our feet get weak this leads to PF.
We want a shoe that is widest at the toe to encourage natural toe splay and spreading of the toes
Want to know how to test and see if your shoes are wide enough? Go to your closet and pick your favorite shoes or the ones you wear most often
Take the insole out of your shoes stand on it and if any part of your foot extends over the insert, then that shoe is contributing to your plantar fasciitis.
2.) Zero Drop
Drop refers to the height difference between the heel and the forefoot. Zero Drop is The term used to describe a completely flat shoe from heel to toe. When a shoe has Zero drop, it distributes body weight evenly across the foot and encourages natural arch support.
Elevation of the heel in footwear is one of the most damaging characteristics. Sadly, it's not just high heels and women's shoes. It is present in casual shoes, men's shoes, and even running shoes.
You would think that if most shoe designers added this feature there would be solid evidence to support the presence, but there is none.
Elevating the heel causes excessive stress on the forefoot because it places the foot in a downward angle. It also causes a chronic shortening of the heel cord (the Achilles tendon and calf muscles). So, it contributes to Achilles tendon issues
3.) Minimal Stack Height
Stack height refers to the total amount of material or cushioning on the sole of the shoe.You may have noticed that one of the newest trends is to get these running shoes that have heavy cushioning. Brands such as Hokas and Oofos.
They may seem to be a good option because they look so comfy. However, the thicker the cushion is below your foot, the less your foot can move properly and it actually hinders your normal shock absorption which can lead to more injuries.
The amount of cushioning is referred to as stack height. I’m not opposed to some cushioning, but the excessive stack heights are unnecessary.
A running shoe with very thick cushioning is referred to as a "maximalist" running shoe. Maximalist running shoes have a stack height of 30mm or more.
Running shoe companies are convinced that you need a "maximalist" shoe to protect your feet and joints from impact, and offer anti-pronation correction.
However, a new study from Oregon State University has discovered that this concept could be unfounded.
The study involved 15 female runners. The researchers noted that the women almost uniformly landed harder in the maximalist shoes than the neutral pair.
They also pronated more, meaning that their ankles rolled inward slightly when they pushed off.
Here are the main points from the study:
Runners in “maximalist” cushioned running shoes hit the ground harder, and pronate more than runners in neutral shoes.
The super stacked soles of the maximalist shoes also affect balance. The higher the stack, the more unstable.
The researchers also noted that extra layers of foam could limit road feel, which is our bodies’ sense of where the ground is and alter biomechanics.
Read the full article posted in the New York Times, "Super Cushioned Running Shoes Are All The Rage, But Aren't Foolproof".
My conclusion is that extra padding and squishy shoes do not promote natural foot movement, and can create long term damage to your feet.
4.) Avoid Rigid, Inflexible Footwear
Our feet are designed to function and move freely as we walk and run. Our footwear should allow this motion to occur.
When our shoes have rigid soles, our feet can move fully and this can lead to weakness of our foot muscles.
5.) Avoid Built-In Arch Supports
Our feet are inherently strong and do not need built-in arch support. It seems that the less “technology” a shoe has, the better it is for the foot.
The more a shoe externally “supports” the feet, the less internal strength the the feet develop. The feet actually become dependent on "supportive" shoes with extra stabilizing features.
The intrinsic muscles of our feet become weak and no longer function normally. These supports also prevent your normal pronation. Pronation is not a bad thing, It is a necessary, normal action.
The less “technology” a shoe has, the better it is for the foot. The more a shoe externally “supports” the feet, the less internal strength the feet develop.
6.) Avoid Toe Spring
Toe spring is a toe-deforming shoe feature present in most shoes, especially running shoes. Toe spring is an upward angle of the shoe’s toe box. The current industry standard for toe spring for most types of footwear is 15 degrees.
It shortens the muscles from the top of the foot (toe extensor muscles) all the way up the front of the leg along the shin bones and can lead to shin splints.
Toe spring is essentially a rocker and rolls your foot forward during your walking and running gaits. It immobilizes your toes in an unnatural position for an extended time. .
This feature create mechanical problems in our feet and lower legs.
Our foot is designed to be flat and to adapt to the different terrain under foot. When stuck in a shoe for a long period of time. the foot will get lazy or develop unnaturally bad habits.
So, to put it simply, toe spring is a feature that is not needed in footwear and in my opinion is actually quite dangerous to foot and gait health.
What Are The Best Shoe Brands For Plantar Fasciitis?
The shoe brands that I recommend most often for plantar fasciitis are Altra, Topo Althetic, Xero Shoes, Flux Footwear, Lems, and Vivobarefoot. You can find the a complete list here.
How To Transition To Natural Footwear
My solution to this footwear epidemic is to remove the cause of your problem by removing traditional footwear.
Transition to natural, functional footwear that are made to accommodate the normal shape of our feet. The transition from normal footwear to minimalist should be gradual to avoid injury.
If you have been wearing thick, cushiony shoes with an elevated heel, you will need to slowly transition to zero drop shoes with less stack height.
In my program, the first type of footwear I recommend is a transitional shoe. A transitional shoe is a shoe that has all of the characteristics of a barefoot shoe such as zero drop and a wide toe box, but has a thicker sole/higher stack height.
Shoes such as Altras, Flux Footwear and Topo Athletic are considered transitional shoes. Xero Shoes and Vivobarefoot would be categorized as minimalist footwear
I suggest for most of my patients to start with a transitional shoe first before they shift completely to a barefoot shoe.
A smooth transition is important to avoid soreness. Listen to your body and consider slowly moving to functional footwear.
Can I Treat Plantar Fasciitis At Home?
If you have this debilitating condition, here are my top 3 recommendations to get you started on your home rehabilitation.
Download my free guide. This is the first step on your PF recovery journey. I show you the exact steps to resolve plantar fasciitis at home.
Follow my social media pages. I offer daily tips, exercises, and the latest insights on PF. You can also connect and learn from others with the same struggles. Join us: Facebook page & Instagram
Take a look at my approved footwear guide. Dr. Angela's Recommended Shoe List and make sure you are not sabotaging your recovery with wearing the wrong shoes.
Because there is a so much misinformation out there about plantar fasciitis, I spend most of my time educating people on what NOT to do.
Most rehabilitation efforts fail because they are relying on cortisone shots, night splints, orthotics, ineffective stretching, thick, cushiony shoes, and rolling on a frozen water bottle.
These methods are either ineffective or just short-term band-aids, and do not provide long-term correction.
In my (6) step free guide, I offer solutions through addressing multiple factors. Improving footwear, identifying areas of weakness in the foot and ankle, and restoring proper foot function.
Summary
Dealing with the pain of plantar fasciitis can be life changing--but it doesn’t have to be a life sentence. By arming yourself with knowledge and taking charge of your healing, you can get back to the activities you love and feel like yourself again.
If you have additional questions about heel pain and plantar fasciitis, don’t hesitate to reach out. I'm here to help get you back on your feet--literally.
Best of Health,
Dr. Angela
The Plantar Fasciitis Doc
I have also written extensively on the topic of Plantar Fasciitis. Take a look at these other related blog posts:
Hi, I'm Dr. Angela Walk
I have been involved in the health and wellness industry for over 20 years as a wellness physician, sports chiropractor, and foot health coach.
I have written extensively for health publications and I am keenly aware of trends and new developments. I embrace an active lifestyle combining diet, exercise and healthy choices.
By working to inform readers of the options available to them, I hope to improve your health and quality of life.
