When the Wrong Running Shoe Causes Problems: A Case Study

Patient Background

• Middle-aged male runner
• Training for marathon
• Previously healthy with no prior foot/ankle injuries
• Sought help from multiple podiatrists without resolution
• Developing right lateral foot pain during training

Initial Presentations

First Podiatrist Visit

• Prescribed custom orthotics
• Pain worsened with orthotic use
• No improvement after several weeks

Second Podiatrist Visit

• Advised to continue orthotics
• Recommended cessation of running
• Pain returned upon resuming training

Clinical Examination

• No pain on palpation
• No pain during passive or resisted movement
• Absence of swelling or bruising
• Normal medical history
• Pain localized to dorsal cuboid area
• Pain described as deep aching
• No pain during daily activities
• Neutral foot type with bilateral lateral ankle instability

The Critical Finding

• Patient purchased new stability/anti-pronatory shoes
• Previous footwear: basic department store running shoes
• Pain began approximately two weeks after shoe change
• Lateral column overload identified from anti-pronatory design
• Orthotics likely contributed to lateral overload

Resolution

• Recommended switch to neutral running shoes
• Advised even medial and lateral sole
• Complete pain resolution achieved
• Patient resumed full training schedule

Key Takeaway

• Footwear choice can significantly impact:

• Injury development

• Pain management

• Training effectiveness

• Professional footwear assessment valuable for:

• Injury prevention

• Performance optimization

• Proper shoe selection