2002: A Sneaker Odyssey

by Stephen M. Pribut, DPM and Douglas H. Richie, DPM

The US athletic shoe market is a $13 billion-per-year industry that sells more than 350 million pairs of sports shoes annually. Sports shoes have penetrated into all facets of mainstream America, covering the feet of both the high-level competitor and the fund-raising marathoner. They have also become a fashion statement and even assist in the everyday task of conveying the rest of us to work.

The driving force of new athletic-shoe design is not merely performance. The use of athletic shoes for casual wear and fashion play a large role in shaping their appearance and features. Since the youth market is frequently targeted by advertisers, field surveys have been done to study young people’s behavior in selecting shoes. High school students have even been brought into the offices of manufacturers to get a handle on “how cool” contemplated models look. Colors, styles, fashions, and what is likely to be “hot” are important factors in the design of athletic shoes. A few manufacturers have discovered the extensive role that athletic shoes play in the workplace. It has also been noted that the aging boomer population is a good potential market.

The influence of youth culture on athletic shoes has been around for a long time. The 1981 movie Fast Times at Ridgemont High, with Sean Penn wearing Vans checkboard-print slip-ons, created considerable demand for these high-selling skateboard shoes. As a result, Vans became a leader in extreme-sports footwear. Indeed, Vans has inspired such brand loyalty that when Nike attempted to enter the market for skateboard shoes, it found skateboarders wearing buttons proclaiming “Don’t Do It.”

Performance and new technology for athletic shoes were highlighted as long ago as 1961, when Fred McMurray, playing the Absent-Minded Professor, brought “Flubber” (“flying rubber”) to basketball shoes long before Michael Jordan brought his Air Jordan’s to the market. The movie, which predates the concept of the “energy return system” and the new “spring shoes,” came along immediately following the victory of barefoot Abebe Bikila in the 1960 Olympic Marathon of Rome gliding along the cobblestones and not even stubbing a toe.

The special role that marketing would play and the sophisticated manner to which it would be taken was presaged when Phil Knight announced with panache that four of the first seven finishers in the 1972 US Olympic trials wore Nikes. Of course, the press release never mentioned that the top three runners—the ones who went to the Olympics—were all wearing Adidas, a dominant shoe in the Olympic arena at that time! The best hype was yet to come: Everyone knows that the initial pairs of Nike soles were cooked up in Bill Bowerman’s waffle iron.

Before the late 1970s, running shoes were not high-tech items. With rare exceptions, until the middle of the 19th century, shoes were made on a single straight last and there was no differentiation between left and right shoes. During those years, not many international competitions were held, and the modern Olympics did not appear until 1896. Keds began as a product produced by US Rubber in 1917. Keds was chosen as a name because the desired name, “Peds,” was already trademarked by another company. Keds were the first sneakers, so-called because of the stealth and quiet manner in which you could creep up on someone when you wore them. Keds, and later Converse, captured much of the US “Sneaker Market.” Keds was purchased by the Stride Rite Corporation in 1979.

PF Flyers was named for “Perfect Foundation,” with the intention of making the sneakers appear to have been crafted with the latest scientific ergonomic principles in mind before anyone had even heard of “ergonomic.” At that time, PF Flyers, Keds, and Chuck Taylor Converse sneakers were used by the kids of America for most of their running and walking needs. Today, these shoes are frowned upon by our biomechanical experts. Shoes need to be devised to assist the athlete in the specific demands of the sport and to meet the individual biomechanical of the participant.

Within the context of modern athletic-shoe development, podiatric biomechanical thought and terminology have sunk deeply into the psyche of the athletic-shoe industry and the buying public. Words such as pronation, stability, and motion control are now widely used in the description and ranking of running shoes. The significance of types of feet and lasts, the use of motion-control devices, new shock-absorbing materials, and many other ideas have become common as a result of both podiatric sports medical influence and the realization that foot and lower extremity biomechanics plays a vital role in the performance of the casual athlete as well as the world-class athlete.

Today’s running shoes are designed with an eye toward accommodating various types and shapes of feet. Shoes are made that allow for the differences between men and women, light- and heavyweight runners, pronated and supinated feet, and narrow and wide feet. Sport-specific shoes also attempt to meet the diverse needs of differing sports.

The casual athlete with poor biomechanical structure needs even more assistance from his or her shoes than does the professional athlete. In an early and widely heard message, George Sheehan, MD, proposed limiting excessive foot pronation as the cure for “runner’s knee.” This led the way to podiatric sports medicine’s playing an early and dominant role in the treatment of many running injuries incurred by athletes, while the orthopedists were still focused on auto accidents and collision sports such as football.

Although the terms used by the industry had their origin in biomechanics, their usage and meaning often changed so much that they needed translation upon coming back to those who coined them. In this manner, excessive pronation became overpronation, and supination became underpronation. However, the concepts of torsional and flexural stability have finally made it into the best motion-control shoes. It took much of the industry many years of failure to concede that motion control was a feature that had to be supplied in an appropriate manner for those athletes who required it.

Podiatric Thought in Athletic-Shoe Design

Podiatrists first participated in the development of athletic shoe technology in the 1970s. As biomechanical knowledge of foot and leg interactions gained huge momentum in the podiatric medical profession during that decade, the use of corrective devices in shoes achieved widespread popularity. Podiatric medical practitioners commonly added wedges, arch supports, heel cradles, and various cushioning devices to the existing footwear of athletic patients to treat their injuries and enhance their comfort. Soon, some podiatrists offered these technologies to athletic-footwear companies. The subsequent incorporation of such devices into athletic shoes led to monumental success for the manufacturer and redefined the standards within the industry.

The most notable technologies developed by podiatrists in the 1970s were the Dynamic Heel Cradle, for Etonic, by Rob Roy McGregor, DPM, and the varus “kinetic” midsole wedges for Brooks, by Steve Subotnick, DPM. In the 1980s, Nike incorporated Dr. Harry Hlavac’s cobra pad into the company’s highly successful running shoe, the Equator. Also, Howard Dannenberg, DPM, developed and patented the Kinetic Wedge® addition to the midsole and outsole of a line of Brooks running shoes that became very successful for several years and that formed the foundation of the entire Brooks running-shoe line.

In l981, Joe Ellis, DPM, of La Jolla, California, working closely with Asics, developed the first midsole technology that incorporated medial posting in the midsole section of the running shoe. Today, dual-density midsoles are the standard motion-control feature utilized by virtually every athletic-shoe company in the world. Asics has continued to work with sports podiatrists since the 1980s. Michael Polchaninoff, DPM, the father of the electrodynogram (EDG), also consulted with Asics during the early phases of the implementation of the firm’s Gel technology. Together with Asics, the Langer Biomechanics Group codeveloped the Rx running-shoe model that was specially designed to function with a custom functional foot orthosis.

Fitting orthotics into running shoes can sometimes be a challenge, but New Balance has consistently made shoes that readily accept orthotics. New Balance has also made certain that its shoes came in various widths, a need that most other manufacturers have not attempted to deal with until recently.

During the 1990s, William Olson, DPM, worked closely with many major athletic-shoe manufacturers who wanted to incorporate his TL composite invention into various athletic shoes, including running, basketball, and in-line skating shoes. The TL composite was a proven success in the orthotic marketplace and thus had great credibility and appeal as a high-performance material for use in constructing athletic shoes. The device was first used in the “Air Jordan 12” basketball shoe during the middle of the 1990s and has been used in every Air Jordan model since.

Many of the companies that utilized podiatric medical technologies also consulted with sports podiatrists to assist in marketing and education. Companies often have proudly promoted new designs, giving full credit to the sports podiatrist who provided the initial invention. During the 1980s, for example, Tom Amberry, DPM, became involved with, and visible in, Vans’ educational and marketing programs.


While podiatric thought has not been the primary driving force of the athletic-shoe industry, both the direct and indirect influences of podiatric sports medicine have markedly changed athletic shoes for the better. With the important role that feet and athletic shoes play for the millions of people who exercise, podiatrists and podiatric medical students must carefully study the sciences of biomechanics and sports medicine. Enhancing knowledge in these areas will add a good deal of variety, interest, and even patients to a practice.

Ideas that did not come from podiatric medicine

1. Air with or without pressurization for shock absorption.

2. Flashing lights on shoes.

3. Adidas running shoe made of hemp.

4. The 1988 Reebok advertising campaign for its energy return system, “ERS,” with the bold statement, “We’re not so foolish as to think we could create a revolution out of thin air; revolutions require bigger ideas.” Like polyurethane capsules for the air? Perhaps not revolutions, but great marketing campaigns do appear to be able to arise out of thin air alone.

Athletic shoe fitting: Advice for patients

1. Buy shoes for the specific sport in which you intend to use them.

2. Shop at a reputable store with a knowledgeable staff.

3. Bring socks that you plan to wear with the new athletic shoes.

4. Bring your orthotics or other inserts with you to try on with the shoes.

5. Allow approximately 1 finger’s width (or about 3/8 inch) at the front of the shoe, in front of the longest toe.

6. Make certain that the shoe flexes only where your toes bend, which should also be the widest part of the shoe.

7. Check the inside and outside of the shoe for defects. The shoes should sit level when checked on a flat surface.

8. Check your shoes often for excessive wear, such as (a) the outsole worn to midsole, (b) the heel counter tilted in varus or valgus, (c) the forefoot upper shifted medially or laterally, or (d) persistent injuries. Replace shoes every 350 to 500 miles, even in the absence of notable wear.

9. For a listing of shoes that have been evaluated, visit the Web site of the American Academy of Podiatric Sports Medicine at www.aapsm.org. For a list of shoes carrying the APMA Seal, see www.apma.org.

About the Authors: Both of the authors serve on the Board of Directors of the American Academy of Podiatric Sports Medicine (AAPSM). Dr. Richie is the developer of the Richie Brace, which is widely used for posterior tibial tendon dysfunction and lateral ankle instability. Dr. Pribut is chair of the Shoe Committee of the AAPSM.

Originally published in: July/August 2002 APMA NEWS

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Copyright 2003 Stephen M. Pribut