Educational Articles

The Shoe Cushioning Myth

Posted By Marty Hughes, DC

Disclaimer:

The above content is for educational or informational purposes only and is not intended to replace or augment professional medical instruction, diagnosis, or treatment. Read full disclaimer here.

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Comments
February 22, 2021
Barbara

I am 68 and have many foot problems that all seem to have developed “overnight.” I have fat pad atrophy, two neuromas on my right foot, ball of foot pain, and a hammertoe on both feet. I am under the care of a podiatrist who wants to do surgery on the neuromas (after me already receiving cortisone shots). This will not help the fat pad atrophy, but I thought it would at least help with some pain. The first podiatrist I saw had me buy expensive orthotics, which did not help. I have not been able to find sneakers that feel good, and I wonder if you could recommend a pair that would feel good and also any other products that would help my foot problems? I did try the Altra sneakers and they were great for the toes but did not have enough support and hurt my feet, which I am assuming was because of the fat pad atrophy. Any help would be most appreciated.

February 22, 2021
Natural Footgear

Hi, Barbara,

Thank you for your comment. I’m sorry to hear about the multiple foot challenges you’re facing. I’d like to share with you several foot condition-related resources from our site that I think you might find beneficial:

Neuromas:
www.naturalfootgear.com/blogs/educational-articles/neuromas-conventional-vs-natural-approaches

Ball of Foot Pain:
www.naturalfootgear.com/blogs/educational-articles/ball-of-foot-pain-conventional-vs-natural-approaches

Hammertoes:
www.naturalfootgear.com/blogs/educational-articles/hammertoes-conventional-vs-natural-approaches

In addition to the above resources, here are two more articles that I think you’ll find helpful in your journey toward optimal foot health:

www.naturalfootgear.com/blogs/educational-articles/10-best-natural-foot-health-tools-tips

www.naturalfootgear.com/blogs/educational-articles/how-to-shop-for-shoes

Please give the above videos and articles a look and let us know if you have any additional questions!

All the best,
Marty Hughes, DC

February 22, 2021
Joe

Do feet widen as we age? Are they supposed to? When I was a young man, I was told I had a narrow foot. Therefore, I always bought shoes that were narrow or B width. I now wear D width shoes, but even with going to more width, I have had nothing but trouble with my feet over the years (left big toe bunion, callus on the right side of my left big toe, right little toe pain, neuromas on both feet, intermittent blisters on both soles in various places). But wider shoes still have a toe box that squeezes the toes. I assume that is a large part of my problems. However, I think a lot of people are concerned that going to a VERY wide toe box might feel good on the toes, but might be TOO wide and will eventually result in more problems because there’s simply TOO much room for the foot to slide around in. In other words, the shoe might ultimately be TOO big for them. Won’t wearing a shoe that’s too big in the toe box cause problems, too?

I am also concerned that wearing Correct Toes INSIDE my shoes when exercising will only make the callus on the right side of my left toe even worse, as well as the pain in my right little toe. I’m currently considering getting some Lems Primal 2s, but I am concerned that going to such minimalist footwear will only make my plantar fasciitis worse. I also have pain on the back right SIDE of my right heel, which doesn’t seem normal to me. I know I have PF, but I also have the heel pain on the side of my right foot. Some people have so many foot problems, they don’t know where to start. I have a set of orthotics that were very expensive and made by a podiatrist. I know you generally don’t like orthotics, but it’s one of the few things that make my feet feel better when walking. I’ve tried all sorts of insoles that are supposed to be helpful for various problems, but they all just seem to make the problems worse. And most podiatrists do, too! Most podiatrists disagree with the stuff you’re preaching. So what are people supposed to do? You recommend people go to a “foot specialist,” but they are part of the problem! They recommend the things you’re against.

February 22, 2021
Natural Footgear

Hi, Joe,

Thank you for your comment. And thank you for your questions. I think a lot of us would be surprised by the true width of our feet, if our feet had been allowed to develop without the constricting effects of conventional footwear. Many peoples’ feet do indeed begin to widen out over time after adopting the natural foot care approaches discussed on this site, and that’s a sign of positive changes afoot!

To your question about some wide toe box shoes possibly being too wide and causing problems as a result, I would say that this is usually a non-issue and that the more room the toes have to roam free, the better. I say it’s a non-issue because footwear is usually secured at the level of the ankle, and so there is only so much forward shifting of the foot that can occur in most shoes or boots (typically, very little or none at all). Also, most wide toe box shoes fit pretty snugly throughout the instep, which helps minimize any side-to-side shifting of the forefoot inside the shoe.

In terms of your concerns about adopting minimalist footwear, my recommendation is to simply take it slowly and monitor your feet closely! You might appreciate the info contained in this article from our site that discusses how to successfully transition from conventional footwear to minimalist footwear:

www.naturalfootgear.com/blogs/educational-articles/how-to-transition-to-minimalist-shoes

When it comes to sourcing a foot care professional in your area, it can indeed be challenging to find someone who is naturally-minded. With that in mind, we put together a resource on our site that lists some of the most important interview questions to ask any prospective foot care provider before your first in-person visit (to help get a sense of how a given provider’s foot health philosophy might mesh with your own). You can find that resource here:

www.naturalfootgear.com/blogs/popular-q-a/what-questions-should-i-be-asking-a-prospective-foot-care-provider

I hope you find this info helpful, Joe! We’re here if any additional questions arise.

All the best,
Marty Hughes, DC

February 22, 2021
Divya

I was born and raised in India, where everyone wears flip-flops at home. Back home, I never heard of conditions like plantar fasciitis, Morton’s neuroma, etc. I never wore cushioned sneakers growing up, and it’s only after moving to the US that I noticed “cushioning” being considered of the utmost importance. I got a labrador and started going for several long walks a day, and I felt my ankle and feet were losing their strength due to all the cushioning in the shoe. I could not feel the ground I was walking on, and this completely altered my stride. After 6 months, I woke up with severe pain and had to ice my feet every 30 mins just to make it through the day. I couldn’t walk my dog anymore, and I was housebound, lying on the couch for hours due to being in so much pain. This led to me researching footwear issues, and I concluded that my cushioned shoes led to this disaster. I love the feel of Converse sneakers, as I can “feel” the ground when I walk, but they are too narrow for me and don’t allow me to spread my toes.

A visit to the podiatrist led me to buy stability shoes, and they feel like a concrete block on my feet. They left indentations on my feet near the heels, and I will not be wearing them. I don’t know how stability shoes are the answer. The podiatrist blamed everything on genetics and said nothing is in my control. Also recommended were custom orthotics for $1,300, which my insurance will cover, but which I refuse to get. My feet served me well before, and if I strengthen them as well as my core, including glutes and hips, they will continue to work well for me. I was completely put off by the “podiatrist-recommended” shoe selection at the store, which consisted solely of models that incorporated extreme cushioning. I believe the foot can handle the stress placed on it from walking or running, as long as the shoes are appropriate. I am going to buy a shoe with a wide toe box, preferably canvas. I am tired of cushioned shoes. I might go minimalist, but I will transition slowly, over months. I do not run on pavement, or on any other surface, for that matter, so it will suffice for my walking needs.

February 22, 2021
Natural Footgear

Hi, Divya,

Thank you for sharing a bit about your experience with conventional foot care approaches. Unfortunately, what you’re describing is a fairly typical scenario, and it’s a perspective and methodology that often fails to consider the true underlying cause of most foot and toe problems. Take heart, though, that alternatives exist, and that’s what we explore and discuss on the Natural Footgear site! If you ever have any questions about natural foot health concepts and approaches, please don’t hesitate to reach out; we’re here to support you however we can!

Kind regards,
Marty Hughes, DC

February 22, 2021
Paul Fiolkowski

You could go back to some of the earliest research on this topic by Robbins. His work in 1988, which was titled “Sensory Attenuation Induced by Modern Athletic Footwear,” was what started me on my doctoral work. Incidentally, my early work on this topic was what won me the NATA doctoral dissertation award, in 1998, and led to this publication: “Athletic Footwear, Leg Stiffness, and Running Kinematics.”

February 22, 2021
Natural Footgear

Thank you for your comment, Paul! It’s always nice to hear from one of the pioneers in this field of research!

All the best,
Marty Hughes, DC

February 22, 2021
Bradley James Hollingworth

Hello. I am a student at Brigham Young University and am currently working on a literature review surrounding the correlation between shoe cushioning and foot health. I was wondering if you could tell me when this article was written so I can accurately cite it in my paper? Thank you for your time and help!

February 22, 2021
Natural Footgear

Hi, Bradley,

Thank you for your question. This article was published on our site in June of 2015. Please do let us know if you have any additional questions about the article or the topic of shoe cushioning and foot health. Good luck to you with your literature review!

All the best,
Marty Hughes, DC

March 20, 2024
Laurence

I did fast-read this interesting article, but I may have missed something that is currently making me think. I’ve run in Vibram FiveFingers for 10 years and love them, and I have no intention of stopping. My only thought as a 5K racer is the following: Are cushioned running shoes faster? I’ve no intention of going full-blown platform cushioning, but I’m curious about some thicker-soled models if they are faster.

March 20, 2024
Natural Footgear

Hi, Laurence. Thank you for your question! It’s an interesting one to consider, as it frequently comes up when the merits of minimalist vs. maximalist shoes are debated. If you’re accustomed to road racing in your Vibram FiveFingers and have been doing so for a decade, you’ve no doubt built up an incredible amount of foot strength and stamina. With the kind of ultraminimalist footwear you run in, you’re drawing upon the natural elastic properties inherent in your foot and lower leg tissues to propel you forward at a speed that is, no doubt, sustainable for your musculoskeletal system, including (perhaps most importantly) your joints.

It could very well be possible that a more padded shoe will permit you to run faster, but it’s most likely not because of the springiness of the material beneath your foot, but rather because the padding allows you to blow right past any warning signals your body might be sending you about the effects of the increased speed or impact on your muscles, tendons, ligaments, bones, and joints (which is not always obvious in the moment). It’s also important to consider the energy drain that comes with the spongy materials incorporated into the outsole of more padded athletic shoes. Energy that would otherwise go into forward propulsion is dispersed throughout the shoe’s padding and wasted, forcing you to do more work with each footfall.

So, if you’re already adjusted to the experience of racing in minimalist footwear—and it sounds like you are—then our recommendation would be to stick with that and try improving your race times through other possible avenues (training, recovery, form, diet, sleep, etc.). We hope this info helps! Please don’t hesitate to reach out with any follow-up questions.

Yours in Foot Health,
Drs. Marty & Robyn Hughes

January 14, 2025
Jeanne Kelly

I have osteoporosis (and cachexia), and I am curious to know if there are studies concerning walking barefoot as a way to increase the impact on the calcaneus, which I heard is a stimulus for bone deposition. I have a history of falls and fractures. What can you advise?

January 14, 2025
Natural Footgear

Hi, Jeanne,

Much appreciation for your comment. Barefoot walking can certainly have benefits for bone health! The impact from walking barefoot can help stimulate bone deposition in the calcaneus (heel bone), especially if you gradually increase your exposure. However, given your history of falls and fractures, it’s important to start slowly and consider any safety precautions (e.g., walking on a flat, safe surface) to avoid additional risks. If you’re interested in more personalized advice, it might be helpful to consult with a foot care specialist who can help guide you based on your specific health conditions. Foot strengthening exercises could also be beneficial for increasing bone density.

All the best,
Marty Hughes, DC

January 14, 2025
Barbara J. Stephan

I am almost 66 years-old. When I was much younger, I could wear shoes without worrying about extra padding. But it is a fact that as one ages the padding under the foot goes away. You could say that too much padding might make shoes too tight, which would not be good or healthy. But I really need padding around my toes even with flats now. Even the side of my big toe needs padding now. That is just how it is when one ages.

January 14, 2025
Natural Footgear

Hi, Barbara,

Thank you for your comment. Padding can indeed help ease discomfort in some cases and circumstances, especially around sensitive areas like the big toe. In your case, it’s important to find shoes that allow for both sufficient cushioning and proper toe space to avoid tightness around your forefoot. Consider looking for wide toe box shoes with removable insoles so you can add extra padding as needed without sacrificing fit. Every set of feet is unique, and it’s great that you’re being proactive about seeking both foot health and comfort from your footwear.

Kind regards,
Marty Hughes, DC

January 14, 2025
Bhavik

Hi. I have corns on my feet. I’ve tried all different types of shoes, but I’m still having problems. Also, I have used soft-cushioned shoes, but I think they caused me to develop more corns and pain under my feet. Can you suggest which type of shoes I should buy? Thanks.

January 14, 2025
Natural Footgear

Hello, Bhavik,

Thank you for your comment. I can appreciate that corns can be really frustrating, and it sounds like you’ve been trying a lot of options. It’s good to focus on shoes that allow for ample toe space and avoid any friction or pressure. Look for shoes with soft, flexible uppers and a wide toe box that doesn’t pinch or squeeze your toes. You might also want to experiment with soft gel pads or moleskin around the corn areas to minimize irritation.

All the best,
Marty Hughes, DC

January 14, 2025
Asher Gilmer

I have an issue where my femurs are internally rotated, so there is a constant torque on my knees, and I have tons of knee pain. Wearing custom orthotics that keep me from pronating due to the rotation of my femurs and well-cushioned sneakers has helped my knee pain. Do you think such cases might call for cushioning and orthotics? Or even in these kinds of cases, would theory suggest that no cushioning (and/or no orthotics) could still be best? Thanks so much!!!

January 14, 2025
Natural Footgear

Hi, Asher,

Thank you for your comment. I’m glad to hear that you’ve been able to find some relief from your knee pain. Our general approach is that, if something is working well for you, it’s probably best to stick with that. I will say, though, that adopting wide toe box, zero-drop shoes with some cushioning, like Altra shoes or certain models of Topo Athletic footwear, might provide you with some additional musculoskeletal health gains without negatively impacting the improvements you’ve seen in your knee pain. This is an important conversation to have with your foot care provider, though.

Here’s wishing you much continued success on your journey toward optimal alignment and pain-free living!

All the best,
Marty Hughes, DC

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