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 peoples 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 Dont
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 Jordans 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
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 runnersthe
ones who went to the Olympicswere 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 Bowermans waffle
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.
Todays 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 runners knee. This led the way to podiatric
sports medicines 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.
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
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 Hlavacs cobra pad into the companys
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 firms
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
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.
that did not come from podiatric medicine
with or without pressurization for shock absorption.
lights on shoes.
running shoe made of hemp.
1988 Reebok advertising campaign for its energy return
system, ERS, with the bold statement, Were
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.
shoe fitting: Advice for patients
shoes for the specific sport in which you intend to
at a reputable store with a knowledgeable staff.
socks that you plan to wear with the new athletic
your orthotics or other inserts with you to try on
with the shoes.
approximately 1 fingers width (or about 3/8
inch) at the front of the shoe, in front of the longest
certain that the shoe flexes only where your toes
bend, which should also be the widest part of the
the inside and outside of the shoe for defects.
The shoes should sit level when checked on a
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
shifted medially or laterally, or (d) persistent
injuries. Replace shoes every 350 to 500 miles,
even in the absence of notable wear.
a listing of shoes that have been evaluated,
visit the Web site of the American Academy
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