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In 2019, male marathon runners recorded the five fastest times ever. Eliud Kipchogebroke broke the two-hour mark running the Vienna marathon in 1 hour 59 minutes 40 seconds. In the same weekend, Brigid Kosgei ran a 2:14 in the Chicago marathon. Two extraordinary feats, (pun intended), with one common denominator—the shoe. Shoe companies have been inserting (another pun… I know, the lowest form of humor) their technology into shoe construction for years. However, many health professionals and consumers do not understand the importance of these modifications. Chiropractors must be up-to-date on how shoe technology may affect athleticism, performance, and injury prevention.

Watch Dr. Steele explain shoe technology and how to choose the most appropriate style.

Today, let’s take a crash course in shoe construction. Then, explain how ChiroUp harnesses the collective knowledge of research, clinical experience, and emerging technology to efficiently transfer this information to patients, thereby improve clinical outcomes.

There are four main types of shoes, each manufactured by most major companies. Examination of shoe wear often yields a predictable pattern amenable to a change in shoe wear. Here are the four most common patterns of wear.



Motion Control / Stability

Cushioning / Neutral





 Runners with low or no arch often suffer from foot or ankle instability. Diminished foot intrinsic strength results in faster foot/ankle pronation, thereby stressing the foot, knee, and hip. These runners alter their gait and foot strike to accommodate instability. They will often land on the outside of their foot to take advance of the bony architecture of the lateral column. Unfortunately, they pronate through a greater range of motion at a higher rate of speed, perpetuating dysfunction.


Motion-control shoes utilize a more resilient durometer foam in the midsole to slow this rate and of pronation.

Tip: These shoes often have a different color foam in the instep of the shoe.


Runners with low arches have long-term foot or ankle instability (pes planus). These runners are unable to dissipate reactive ground forces appropriately. Repetitive stress is transferred up the kinetic chain to the knees and hips. 

Shoe Solution: STABILITY

These shoes contain robust cushioning to absorb shock and attempt to prevent injury through sole rigidity. Stability shoes may also include other materials like plastics to assist in sole stiffness.


Many seasoned runners have normal mechanics and arch height. These runners can adequately dissipate force, and their soles wear evenly. 

Shoe Solution: Neutral

Neutral shoes provide no external shoe support. If there is normal wear and tear on the sole, then don’t rock the boat. Also, consider using a neutral shoe if the patient already utilizes a prefabricated or custom orthotic. Adding aftermarket orthotics to the shoe with prefabricated orthotics may alter mechanics and the desired result.


Many people have high arched feet (pes cavus). Their footprint will typically leave a thin band along the foot’s lateral edge and the metatarsal heads. The outer edge of the foot and metatarsal heads represent a small surface area and therefore absorb the increased load.

Shoe Solution: Cushioned Shoes

These shoes are flexible and absorb more shock via increased foam. These shoes may prevent or reduce symptoms associated with tailor’s bunions and metatarsalgia.

Did you know that you can automatically create treatment plans specific to running for your patients in a matter of seconds?

And not only are ChiroUp’s patient reports condition-specific, but they can also be customized based on that specific patient’s lifestyle or life stage. These reports contain the specific exercises & ADL’s not just for your runners, but you can also customize reports to anyone; from expecting mothers with LBP to little league athletes with elbow pain.

Customize a report today in our free 14-day trial. No credit card required. No commitment. What do you have to lose?

“I love this product and service. Patients are very impressed with the professionalism of their reports. I have continuously updated database to help me do my best with what to do, how to do and maybe most importantly why I am doing it. It is also customizable for a topic or a technique that I might prefer something a bit different I can do that. This does not cost me money but is making me money.”

– ChiroUp Subscriber

  1. Hoogkamer W, Kipp S, Frank JH, Farina EM, Luo G, Kram R. A comparison of the energetic cost of running in marathon racing shoes. Sports Medicine. 2018 Apr 1;48(4):1009-19. Link

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