Show Notes

Paul and Howard talk about shoes and their consequences.

Topics: 

  • Why do we wear shoes? 
  • The evolutionary history of the foot
  • The anatomic consequences of shoe wear
  • Mistakes people make buying athletic shoes
  • The explosion is athletic shoe varieties, from minimalist shoes, to maximalist shoes, and everything in-between
  • Common shoe-related foot injuries

Readings:

Music:

“Crossing the Chasm” by Kevin MacLeod (incompetech.com) licensed under Creative Commons: By Attribution 3.0

Disclaimers apply (at the end of the episode).

About The Show

Paul Kedrosky is a frequently injured athlete and a venture capitalist. Howard Luks is a top sports orthopedic surgeon. Smart, candid, and experienced analysis, ideas and tips about health, fitness, and longevity from two athletes and sports orthopedic surgeon—and guests.

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Transcript

Paul: [00:00:00] How many  pair of athletic shoes do you think you own, Howard?

Howard: [00:00:02] About 12.

Paul: [00:00:06] break them down. What are they all running shoes, hiking shoes. I don’t know. What, how do they split up?

Howard: [00:00:13] So, so as you know, I enjoy running trails and trails here wickedly different than yours. So I have those for muddy trails with deep teeth. I have those with really soft rubber for a rocks and granite. I have, higher controlled shoes. I have more cushion shoes. I have minimalist shoes for the road.  Shoes for short runs, long runs. It’s nuts.

Paul: [00:00:45] It starts to sound like a golf bag. I have a pitching wedge. I have a sand wedge. I have a four iron and you know what I mean?

Howard: [00:00:51] It’s really insane. I, I actually get embarrassed when I look in that corner of my closet.

Paul: [00:00:57] my kids make fun of me because my, my wife has a lot of shoes and I always make jokes about all these shoes and my kids pointed out that I actually had an entire rack in the garage, four levels high, just of my shoes. And I was like, Oh crap. Well, that’s not the same. Those are all really useful. It’s completely different.

Howard: [00:01:18] I try to use the excuse that well I’m using them to exercise. So it’s different than your boots that are worn once and go to the back of the closet.

Paul: [00:01:28] Right. These are tools. Dammit. It’s like screwdrivers.

So I’m the same. I’m roughly a dozen pair of shoes. Although mine are more eclectic. I have like, I think six or seven pair of running shoes, mostly. Similar to your setup,  minimalist stuff, more control stuff  higher drop, lower drop. we don’t have a lot of wet conditions, so don’t even think to have anything too much for that, but I have things that are more oriented towards longer run, shorter runs. And then I have a two one, two, three, three pair of cycling shoes, one pair of road, two pair of mountain bike.

It’s just madness and then a pair of climbing shoes. Cause  once in a while I’m out on some rocks somewhere. We have a lot of running shoes, which makes us  domain experts they’re our interface to the world.  we have a graphical user interface on your computer while your interface to the world,  for the most part, as you’re just moving around on a day to day basis, we don’t walk on our hands very often, assuming you don’t have a problem with your lower limbs you’re on your feet. And the thing that connects them to the ground is shoes.

Howard: [00:02:34] I think shoes do protect our feet. I’m a fan of evolution, so I can’t necessarily give you a great explanation as to why else we have them other than fashion. However, saving ourselves from cutting or burning ourselves is a good thing.

Paul: [00:02:53] there’s a series of books and articles about this. but being persistence, hunters, hunters, who were, we weren’t faster than anything else we could just keep going longer and so we wore our prey out. And  one of the possible advantages to having shod feed \twas that we could go across more terrain,  sharper rocks, hotter stuff, whatever else. And so to the extent that you adopted shoes, maybe that had an advantage, this is all we have no videotapes, so this is all  speculative, but you could at least imagine it’s possible.

But your point is that evolutionally speaking shoes are not. They’re not required. This is not something we needed to have this isn’t about modesty or anything else, but you can take it further they’re actually potentially bad for us in many ways.

let’s talk about what goes wrong. for a long time, I was just terrible at buying shoes. And I think most people are in terms of running shoes

Howard: [00:03:52] I’ve been talked into buying the wrong shoe. I find that to be a big problem, instead of, buying the shoe that simply feels best, or of course, look, we all have our favorite colors or favorite shapes or favorite patterns. And we see something on this wall of 150 shoes and it draws our attention to it.

Paul: [00:04:14] and then you get into this pattern of now I’ve got to justify to myself, I’ve spent $140 on this pair of shoes. Damn it. I am going to like them. And, that tends not to work out so well. Cause your foot’s not really that interested in how much you spent on this shoe. Your foot is more interested in whether or not it’s cutting off circulation or causing cramps or whatever else the mistake that I used to make the most was I consistently bought too small.  And I remember people telling me that yes, that I needed to have  a finger or maybe a thumbs with in front of your big toe, on your longest foot. And I didn’t believe it. I thought that was too much room. Like you could put a squirrel in there . I don’t need all that extra space. What’s it there for?

And you know what changed? It was probably four or five years ago. I kicked a rock harder than I have ever kicked a rock in my life to the point that I literally thought I shattered the big toe in my left foot, into that thousand pieces, just fragments only left. and I realized, you know what, it’s not such a bad idea to have a bit of space in front of me. If I’m not going to run in steel toed shoes, I’ve been, I think about having a little bit of space in front. It’s not such a good idea to have,  toe thin rubber velocity, kinetic energy, large rock,

Howard: [00:05:19] you need a buffer. I th I think it’s also people don’t realize their feet swell. They splay, and runners actually need a larger size than their regular shoes. It’s absolutely true.

Paul: [00:05:38] I there are other changes in the foot. It’s not just this anatomically correct. And the influence of these constricting shoes, the foot itself changes over time. I used to be a 10 and a half 11. , I have one pair of those ancient shoes laying around that I used to wear for gardening , cause they’re just beaten up runners. I can’t even put them on anymore. I was thinking, what the hell? How is this even possible? If my foot hasn’t gotten fat, is that your your foot changes over time. And it can be as much as not just the half size. It could be a full size, a size and a half.

Howard: [00:06:06] yeah, I’ve gone, from a 10 and a half 11 to a 12 as well. and for shoes that run small at 12 and a half,

Paul: [00:06:14] incredible. And the reason for that, it’s not that your foot has gotten fat. Let’s, let’s take that out of here. It’s the cause is, or maybe your foot has gotten fat. I don’t know, but I’m just going to say that because it’s not the normal cause. Right.

Howard: [00:06:28] It’s no, you foot we’ll see play with time. your foot will change. If you do develop a bunion or another deformity, it’s going to widen. your arch can collapse a little. That’s going to change the size of your shoe. It’s going to thrust your big toe toe forward a little. So  your foot anatomy is going to change.

Paul: [00:06:50] Yeah. and we’ve, we’ve all run into this where you’ve got a favorite shoe and the idiot manufacturer updates it and changes the last size, the size inside the shoe and the shoe that fits you last year. The new model doesn’t fit anymore, but that’s it. So the cause can be that your feet are getting longer or, or longer over time, but it can also just be that a brand or a shoe that you used to like has actually changed sizes from year to year. And that’s where online reviews and things can help you see if you’re the only one. Cause people just lose their minds when that happens.

Howard: [00:07:22] hate when they do that. And funny story is  I had run in Brooks for a long time and I love this one pattern. And. they had a history of changing it. So I bought like five pairs. and then I decided to go to a minimalist shoe. So I still have three of those five sitting in my closet somewhere.

Paul: [00:07:44] Oh, I’ve actually had it just hunt down old brands of shoes where they’ve updated twice. And I keep hoping they’ll go back to something that was like the one that I used to like, and I had to go back and pay absolutely larcenous prices on eBay for a shoe that’s now three model years back, because that was the one that I liked.

the other ones that I think I’ve done is buy too infrequently. I have a pair of shoes and I’ll realize I’ve re I’ve been running on them for like six, seven, 800 miles. You know what I mean? It’s like what? These aren’t shoes anymore. They’re completely compressed. I might just be running on my hands or something.. These have got nothing. No treads.

the other mistake is it is  the twin one is that people use the wrong shoes for the wrong thing. I’m notorious for showing up playing tennis with my kids and I’ll show up in a pair of trail runners. This is a really bad idea for all of you tennis players out there. Don’t be doing that. It turns out that having tennis shoes is a really good idea when you’re playing tennis, because trail shoes just don’t grip very well on those courts. And you’ll end up on your ass faster than you can imagine.

Howard: [00:08:43] yeah, I agree. I think it’s, it often comes down to the right rubber, the right rubber and the right pattern, I think is important for certain sports, specially with turfs, hard to, such cetera. You want to be able to slide sometimes and sometimes you want that grip.

Paul: [00:09:06] . Running shoes used to be fairly simple. It was running shoes versus things that weren’t running shoes. it’s completely changed not only are there shoes for every spor, and shoes for every foot type,  wide, narrow length, high arch, low arch, whatever else, control shoes. There’s also minimalist shoes we’ve alluded to. We haven’t said it yet. So I’ll say it there’s maximalist shoes. There’s, there’s more anatomically accurate shoes that are more foot shaped and give you a larger toe box. Then you get into things like stack height and drop and sole composition. It’s madness.

Howard: [00:09:39] confusing. and if you’re buying a shoe and a salesman is talking to you, they can make a pitch for any shoe. And you’re going to think that that’s appropriate for you.

Paul: [00:09:51] .Especially if it’s the new, new thing . And it was now what, six years ago, maybe seven years ago, it might’ve been longer. was the arrival of these, of minimalist shoes, right? Where it was the first time that running shoes really broke with the past. Did you get pulled into the minimalist movement?

Howard: [00:10:07] So I did get it pulled into the minimumalist movement, but more in line with my approach to managing people in general. I started to think about my shoes in a different way. I said, if I’m not locking up, knees anymore or ankles, as little as possible, I really shouldn’t be locking up my feet. all you gotta do is hold your fingers together, your metacarpals, and try to. Then you’re and then make a fist.

You won’t be able to.  Your hand wants to splay. So I didn’t think that binding our feet, was in our best interest. and then I started to see the mentions and I started to see all of these brands arrive and I decided to try them.  Typical fashion. I made the mistake of going too fast and I hurt myself . But, I think there’s a big role.

Paul: [00:11:01] I was very similar story.  I started off by thinking that I had read some of the, what is it? The natural board runner, what’s the newborn to run, sorry. The book born to run the book, born to run.

And I had read some of that stuff, like every other  person on the planet and thought,  this makes a lot of sense. And so that, that helped pull me in and the explanations were very bio plausible and I ended up, I think, a pair of Merrell trail gloves back at the time.

The point being that we recognized, there’s a, there’s a reason why feet are shaped the way that they are. And the reason is a reasons why having them shape that way tend to be, from an evolutionary standpoint, turned out to be advantageous as evidenced by our continuing presence.

We were able to get enough calories to not die despite not having shoes. So this I should at least have made us question why we were having these shoes that were so bound up and controlling and have providing arch support and not allowing a toe toe splay. And so that was a really interesting moment in the recent history of shoes, but the spirit of it was let’s let shoe feet move in a more, anatomically defensible way that this is what they want to do. So let them it .

Howard: [00:12:13] We went too far. I think we tried to define the perfect foot. And if your foot was a little flatter,  it was pathological. If your arch was too high, it was pathological. We had such a narrow window, in what we observed as the perfect foot that we tried to fit these, shoes on to, feet by giving them way too many different types of shoes. and it ended up creating problems for us.

Paul: [00:12:44] In any other part of the body, if we think there’s a problem, we may temporarily provide some form of support, maybe a splint, maybe something else. But our goal is not to have it be permanent. Our goal is to have it go there, alleviate whatever the source of inflammation or stress is or whatever it might be, and then take it away. Whereas in foot, for some reason, we had convinced ourselves that all of these things had to be splinted for life, whether it was control shoes and ankle stabilization, or arch height, and pronation, and all of these different things were, were, were errors that were best fixed by permanent splints.

Howard: [00:13:20] people can’t see their muscles on their feet well. But they can see their thighs and legs. And many people have been in splints or braces on for their knee, for, from the emergency room or after an operation or a cast. And when that splint comes off of that cast comes off you see how skinny your leg is. That’s just loss of muscle mass. Now imagine. Imagine your feet that have been bound like this for 20, 30, 40, or 50 years.

Paul: [00:13:49] there’s like what? 20, 26 bones, 30 joints, something like 25, 30 muscles and tendons ligaments, a bazillion ligaments in inside your foot. Just cause you can’t see them doesn’t mean they aren’t there.

Howard: [00:14:02] Yeah, the structure of the foot is incredibly complex. The structure of the arch is maintained by the bony architecture by some very strong ligaments, as well as, some significant tendons, attached to the muscles of our legs. and if we don’t allow these muscles to exercise, they atrophy,

Paul: [00:14:24] so the equal and opposite reaction to minimalist shoes was maximaist shoes. So we went from a minimalist shoes, like the trail gloves, or you mentioned the altras, and these more anatomically designed shoes that have larger toe boxes, we  kept the toe box part. The people didn’t like banging away with just rubber between them and whatever they’re running on. And so we saw the emergence of these maximalist shoes that were still a little bit more anatomically correct, but had like, I don’t know, Kiss, 1977, God of Thunder platforms underneath them. 

Howard: [00:14:57] it makes sense, intuitively that if you give us more cushion, we have less force, but it just doesn’t turn out that way. You actually ended up having more force on your knee wearing more cushion because of how it makes you strike.

Paul: [00:15:15] Let’s get, let’s get into that right now. That’s a really good point to make here that it changed your stride.

Howard: [00:15:20] If you run barefoot or in a minimalist shoe, the vast majority of you are gonna run on your toes. evolutionarily speaking, in order to run, we developed a long Achilles tendon and a powerful gastroc, calf muscle, And the ability to cushion the blow. Oh. So that when we land on our toes, the, the Achilles and the gastrocs stretch eccentrically to cushion our load as the heel comes down and it gathers force so that you can push off from there. What happens when we do change to a maximalist shoe or shoe with more cushioning is we tend to land on our heel. and now we’re not cushioning,  the blow that our knee sees. So the ground reaction force, the amount of force that we put across the foot, every time we land doesn’t change, whether we toe strike or heel strike, but the rate at which that force comes at us is much higher if we heel strike. So the knee can see an extraordinary amount of force, in a heel strike versus, a toe striker or a forefoot striker.

Paul: [00:16:42] And you’ve said this, this is your line, not mine, but the tendons and ligaments, don’t like a surprise party. And that can pretty quickly turn into a surprise party.

Howard: [00:16:51] Very much so. Yes.

Paul: [00:16:59] . so what kinds of injuries, what, what sorts of things do we tend to see that are just foot specific and may or may not be caused by a  poorly fitting shoe, and, and maybe start off with, well, you’ve, you’ve already just gone through been going through this, right? The stress fracture is a good example.

Howard: [00:17:16] Yeah. So the type of shoe that we wear can also influence how we land. So if you’re aware in a traditional shoe or maximalist shoe and you’re landing on your midfoot or heel, you’re landing more on the outside of your foot, and the treadwear on a shoe will always tell you that. So. You’re putting more stress on the outer side of the foot.

and you can, be more prone to, to stress fractures there. it also changes the way that the stress is, is distributed through the foot as you move forward to toe rise. so you putting other metatarsal walls. At risk. If you’re landing on your heel, the muscles in the front of your leg, like the anterior tibialis, et cetera, much smaller muscles, but now they have to work  to slow the rate at which your foot comes down.

Instead of, instead of using your, a calf, a gastrocs, which are much more powerful and.evolutionarily  speaking those are the ones that were meant to slow the foot. So if we’re using our anterior muscles, the ones in the front of the leg to slow the foot, because we heel strike. That’s why we get shin splints and other, associated injuries.

Paul: [00:18:41] Because we’re using, we’re using evolutionarily speaking, we’re using the wrong, the wrong muscles for the wrong things, but it really comes back to gait and running dynamics.

Howard: [00:18:50] Right. and it’s amazing how just changing your shoe will make you run. Definitely every time I put in a minimalist shoe,

I’m landed on my toes and my, and my calves hurt the next day because they’ve had a great exercise. and as soon as I go back, to my maximalist shoes, my knees will ache and bother me. I see a tremendous difference.

Paul: [00:19:14] Yeah. And, and there’s also this notion of drop, the difference between your heel and your toe in terms of how level the shoe is across the bottom, where the heel sticks out a little bit more and the toes a little bit less, that’s the drop of your shoe. And even that can, can, cause let’s say you think you’ve got less padded shoes, but it still has six or seven or eight or 10 millimeter drop on the shoe. You’re still going to be a heel striker because the heel protrudes more.

Howard: [00:19:40] right. Ah,  I don’t, I’m not sure where heels came from an original design of footwear, but, the place that shortens our Achilles. So our Achilles is not used to standing at its normal length if you’re wearing a heel. so you gotta be careful when you play with drops. Going from a one to a zero, can get to you out of running for six months easily.

Paul: [00:20:08] I I’ve got my hand up over here. It did, it got me out for a little while, but it’s, but these are the things that people miss, this surprise party problem. The other, the other one that I find really interesting, and this goes back to these more anatomically accurate shoes, like the Altras and some of the minimalist shoes is that the sh the toe box itself can make a big difference.

I didn’t realize for them longest time that I,  I just bunions was a word I’d heard T felt vaguely to do with grandparents possibly. I wasn’t really sure. I had no idea that one of the main causes of it in at least in runner is, is a  toe box that’s too small and is persistently forcing your toes to  converge in particular, the big toe, which leaves this, this protrusion on the outside of the foot, alongside the big toe, which can become very, very painful for people and even cause them some serious consequences over time.

Howard: [00:20:58] Right. And once a bunion occurs, it’s not going to correct itself. So it’s going to progress to the point where you’re going to want to have an operation, and you never want to have an operation on your foot unless you need one. But you’re right. A lot of these problems such as hammertoes and bunions, except for rare neurological conditions, et cetera, our problem of shoe wearing populations.

Now, if you stand up on a piece of paper and you outline your foot in a standing posture and then put your shoe over that, you’ll see why,  it’s not unusual to have it. Inch difference on the sides, between the size of your foot that your foot wants and the size that it’s being forced into.

Paul: [00:21:41] yeah, it’s, it feels like almost medieval when you spend too much time thinking about I was running this morning and I have a pair of Nike’s. I really like, and Nike’s from notorious for being narrower and I’ll say than an awful lot of other brands. And I looked down and I thought this outline looks nothing like my feet.  I don’t know what this shape is, but anatomically it’s not the shape of my feet. I like them. They’re colorful and everything else, but it’s not the shape of my feet, but that has, that has consequences.

I argue sometimes that if let’s say you’ve had a history of ankle sprains, that some of these maximalist shoes might not be the best thing for you to be running around on no more than you’d want to be running around in platform shoes. Is that just my voodoo or does that make any sense to you?

Howard: [00:22:22] No, you’re a hundred percent correct. So we’ve talked about for straight up and down, right, the ground reactive force, but we have a lateral force and we have anterior and posterior force, forward and back. So if your foot is high, higher off the ground, because of a lot of padding, you’re adding a lot of lateral stresses and risks.

you’re adding some instability and there will be more medial and lateral motion, in a shoe at foot strike. With a higher, shoe, a higher stack shoes and a lower stack shoe. So you do throw risks in there because that will transfer up to the ankle very quickly.

Paul: [00:23:07] Yeah. And  once you’ve had one, you’re the likelihood of having future ones goes up pretty dramatically, unless maybe you’re eight years old. And these things are still the tendons and ligaments are still in good shape.

For those of us who are not, I once had aorthopedic guy telling me, I said, Oh, I had just, I went over really badly on my ankle. He said, well, that’s good. I said, what do you mean? He said, well, now you don’t have any more ligaments to worry about. That was probably the last of them. That’s right. I was like, Oh great. That’s super reassuring. One more sprain was all I have left in that ankle.

So, yeah. so, but then there’s another example of where shoe wear. Where we’re, we’re doing something with the best of intentions, wearing something maximalist for more padding, has consequences that you might not expect, that it might increase the likelihood of having a high ankle sprain. Maybe it’ll solve another problem. It’s more important for you, but

Howard: [00:23:56] Right. We think,  using a higher arch or a lower arch or, a heel counter that stiffer, is better for us. But it’s not your foot doesn’t want to be controlled. And if you let your foot adapt to the ground and adapt to the world, you’ll build your own ability to resist lateral motion and to resist the sprains a heck of a lot better than the shoes are gonna do it for you.

Paul: [00:24:25] right and cheaper.

Howard: [00:24:27] Most definitely.

Paul: [00:24:28] So

 if you plays Sherlock Holmes and look, and look at someone’s shoes. You can tell an awful lot. You can tell just by the wear patterns, whether they’re a heel striker or a toe striker, if they’re have a tendency to pronate, you can see all of that in the wear patterns on the shoe. And if I’ve had it where I’ve shown people that, and they act like I’m literally Sherlock Holmes showing up at their houses, right?

How the hell did you know that? Well, dude, look at the bottom of your foot. Look at your shoe. It’s super obvious. And yet people don’t book and the evidence of the way, how they run and the consequences are right there in front of them.

Howard: [00:25:08] Right. I actually, if a runner schedules a visit with me, I generally ask them to bring their shoes in with them. if it,  if they have enough miles on them and you do look for lateral where you look to see if they’re landing on the back of their heel, if they’re taken off on the toe  properly, you can tell.

Paul: [00:25:30] Yeah, you can tell, and you can tell a lot just by their feet as well, or by my feet. You may think is  entertaining that you’ve built up all these calluses, but the foot’s response to repetitive stress in particular, in a frictional form,. Is a callous. So having all these callouses, it’s not some  badge of honor that look at me, I run long miles. I’ve got these calluses. No, it’s a sign that something’s wrong. Something’s rubbing somewhere where your foot’s not entirely happy about it. So it’s built up a tougher layer of, or a couple of layers of tissue to protect itself.

So there’s another example of where by paying attention to what’s happening around your foot, you can actually get a pretty good idea whether right. Something’s slipping. Your shoes are too short. You’re developing calluses on the front of your toes. This is all evidence sitting there, right there, right there in front of it.

I don’t need someone else to tell me.

Howard: [00:26:17] Right. That’s definitely an issue where the location matters. So if I see them on toes, if I see them on the outside of the foot, then it’s a sign of problems. If I see it on under the big toe, I’m not necessarily worried cause that’s your landing and takeoff point. but it definitely comes into play.

Paul: [00:26:37] Yeah, but if it’s on the side of your big toe or something like that, I’m right away. This is a problem. Your foot is trying to splay. Whatever you’re wearing is preventing it. And bam, you can sand it down. I knew a guy who used to sand it down like every month or something it’s like stop belt-sanding your foot, and get shoes that fit. This is ridiculous. Anyways, people are, people are unhinged.

So that’s, that’s one of the examples I give is you listen to them, pay attention and look at what’s going on. And others are, I never used to do this, but I do fairly religiously now rotate shoes. What’s your feeling about rotating shoes other than obviously for different terrain, but going back and forth between minimalists and others and just not always wearing the same shoe every time you go out.

Howard: [00:27:21] yes. I’ve gone to try and run in more minimalist shoes more often than not. unfortunately as you probably know, there’s a very fine difference,  you can’t go possibly or. partial minimalist shoes, you can’t use quote unquote minimalist shoe with some midfoot padding. As soon as you start to add anything to a minimalist shoe, it changes you back to a heel striker. But. definitely, trying to run in a more minimalist pattern more and more. and I must say that I’m finding a difference. My feet feel differently the next morning. they hurt less after a long run. but you’re absolutely correct. Every shoe is engineered differently. and so it’s better to rotate through them. If you’re going to stick with a normal shoe, because it’ll change the forces that were applied to your feet.

Paul: [00:28:24] I mentioned a bit earlier  retiring them sooner than you think, just cause you don’t have holes in the bottoms or sides or whatever else that doesn’t mean this shoe is good for another 200, 300 miles.

Howard: [00:28:36] Yeah. Yeah. There’s no doubt. Especially with a lot of the more cushiony ones, they are only lasting 150 to 200 miles. And some like the Xeros will guarantee their sole for 5,000 miles.  But I think 300 miles is a good threshold for you to change your shoes at

Paul: [00:29:01] Yeah. I was saying this to someone the other day and they’re like, yeah, well, how am I supposed to log all of this? Well, it’s actually pretty easy. Just put them all in. I use Stripe, right? I use Strava. We both use Strava. Put it, put it in log, the shoe that you used. And whenever you did, and eventually you’ll see the distance you ran. I have friends who, who. I use Strava and haven’t changed their shoes that they have logged on there. And I know one guy has like 10,000 miles on one pair of shoes. I sent him a note the other day saying, I think it’s unlikely. You’ve run 10,000 miles on those shoes. He’s all I keep forgetting to change, but the feature is there. So,  feel, feel free to use it cause it’s gonna, it’s gonna make a big difference.

 if you want to proactively watch out for signs of injuries in the foot. If I’m a runner, it’s normal to feel aches and pains in your foot. I always joke if I run long enough, every part of my body hurts at least once that day.

so for me, it’s perfectly normal. Something’s going to hurt. It’s just as long as it keeps moving around, it’s not the same thing on the entire run, but on the foot. What are the, what are the, the ringing or maybe the distant alarm bells and then louder alarm bells that people should watch for in terms of indicators that something’s wrong and you might want to stop.

Howard: [00:30:14] So to me, it, it deals with the location a lot.  I see a fair number of c stress fractures, metatarsal, stress fractures. If, if you have a pain that alters the way that you run or you’re taking something for it, or you’re making your run shorter, you need to see someone. If you have some achiness, At the end of Iran, I’m really not concerned if the next morning, the pain is minimal.b y the time you’re up and moving around and out of the bathroom, you probably don’t have to worry about it. If the pain, the next day is worse than the pain was the previous day, you may want to have someone 

Paul: [00:30:59] So. Let’s summarize, how important are shoes? Do they prevent injury? Do they cause injury? Is this all just fashion? Where do we come down on this?

Howard: [00:31:10] These shoes patterns, don’t matter. there’s no change in injury prevalence, whether you’re wearing a maximalist shoe, a minimalist shoe, well, padded, arch, etc. it turns out you need to run in the shoe that feels right. Right for you, it shouldn’t feel tight, it shouldn’t feel constricting. you shouldn’t feel like you have too much or too little, little room in it. Don’t listen  to the people who are trying to push you into a certain shoe

Paul: [00:31:44] Yeah. I’m a sucker for everything thats new.  another box of shoes, just showed up at the house today and my kids just rolled her eyes at me. So someone else could take your advice. Cause I’m clearly not using it, but anyways, thanks, Howard.

Okay,

Howard: [00:31:56] Paul

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About the author:

Paul Kedrosky & Howard Luks

Paul Kedrosky & Howard Luks

Paul Kedrosky is a frequently injured athlete and a venture capitalist. Howard Luks is a top sports orthopedic surgeon. Smart, candid, and experienced analysis, ideas and tips about health, fitness, and longevity from two athletes and sports orthopedic surgeon—and guests.