Four pairs of running shoes are shown on a wood floor.
With renewed interest in fitness, Americans need to carefully choose shoes that fit their chosen activity. (For Spectrum Health Beat)

When patients and athletes ask Brian Buchanan, DPM, about how to choose appropriate footwear, his advice is always the same.

“I just direct them to a specific store,” said Dr. Buchanan, who specializes in foot and ankle pain at Spectrum Health Medical Group Orthopedics & Sports Medicine.

Fitness culture has exploded in America, with 54% of Americans exercising at least three times per week, according to a survey from Gallup Inc., which has been measuring that metric since 2008.

And primarily because of the rise of fitness culture, athletic shoe sales continue to grow, with some $23 billion in annual revenue.

But while athletes put a lot of thought into most aspects of their fitness, from diet and training regimens to workout playlists, sneaker choice—and the effects it can have on one’s performance and health—is often an afterthought.

“I usually just pick the one that looks the best and is most comfortable,” said Jennifer Lee, 23, at a Target outside San Jose, California. Lee, a petite college student, says she runs three to four times per week and also does lightweight training.

“I’ve never really given the specifics of the shoe much thought beyond aesthetics,” she said.

Size and shape

The most basic, must-have knowledge for choosing a shoe is foot size, which changes over time, even for adults, Dr. Buchanan said.

“First thing we always tell everybody is, make sure your foot is measured by a professional. Particularly, the older athletes,” Dr. Buchanan said. “Typically as we get older our foot will flatten a little, and it’ll get a little longer and wider. I just saw someone, in his 60s, he wore a size 10 all his life. Now he wears a size 12. If you don’t adapt, you will have foot problems.”

Understanding the shape of your foot is also important.

There are three basic types of running shoes to choose from, depending on the shape of your foot:

  • Cushioning shoes are for runners with higher arches, a condition known as underpronation.
  • Motion-control shoes help with overpronation, also called “flat feet.”
  • Stability shoes are meant for those between the two ends of the spectrum.

To help you determine your foot shape, Runner’s World offers a simple test.

Choose wisely

Lastly, selecting a sport-specific shoe is essential.

Running shoes are for “north-south” movement, Dr. Buchanan said. They provide cushioned toe and heel areas to reduce impact from heel-to-toe strikes on the ground, which helps the body deal with the rigors of running.

Those shoes are inappropriate for say, basketball or tennis, which have a lot more “east-west, side-to-side” movements, Dr. Buchanan said.

The lower a player’s foot is to the court, the more stable it will feel laterally, so there’s much less cushioning in basketball or tennis shoes to prevent athletes from rolling their ankles.

“With a regular running shoe and doing lateral movement, you could roll your ankle or suffer a stress fracture,” Dr. Buchanan said. “Matching shoe to sport is really important for performance and to prevent injury.”

Dr. Buchanan said there are many stores where employees can measure your feet and help you select an appropriate shoe, depending on the activity you engage in.

“We have really good shoe stores (in Michigan) with really knowledgeable employees who match them up,” he said. “It may mean spending a little bit more money, but it’s better than the alternative of an injury.”