A runner came in today with a moderately worn pair of Asics running shoes. Having solved her left heel pain with orthotics some time ago, she was now in my office because she started having increasingly painful ball of the foot pain during her runs.
A quick runway walk down my hall in her Asics shoes showed a stable rearfoot with no excessive pronation in site. Her orthotics were performing like a dream, so that couldn’t be it…what then? Had she changed her mileage or running surface?…No. Had she started to run at a different time of day?..No.
I thought to myself, there had to be a hidden clue – something telling about her shoes. And for me, this is where the fun comes in. I had her shoes off in a flash and got to work. Bending, flexing and twisting her shoes. Vertical heel counter – check. Proper volume – check. Mesh over her bunion – check. and then I saw it, like a lazy snake in the grass. What about the shoes outsole flex point? Could that be the problem? Yes, yes, yes!
Sure enough, when I had her put the shoes back on, I realized that the ball of her foot lay directly over the flex point. Furthermore, this area had no overlying rubber on the outsole and was simply soft EVA, which is pumped full of air for lightness but not necessarily shock absorption. Aha, that was it, the shoe was bending up at at the forefoot flex point, which hammered the ball of her foot against the ground.
This was confirmed by the fact that I had her bring her prior running shoes in which had two flex points instead of one. And neither flex point on the old shoe was centered across the ball of her foot. Another shoe success story, another injury averted and another happy patient.
Take home message – New onset foot pain is not normal. First check the feet and if they’re fine, then check the shoes. Every little thing counts, and you have to be your own best advocate and intimately get to know your shoes.
Dr. Jenny Sanders Shoe Blog 