Running Shoes for Plantar Fasciitis: Cushion, Arch Support and Heel

You're listening to the Restoring Human Movement podcast. Thanks for joining the movement, movement. I'm Sebastian Gonzales, show curator and head clinician at Performance Play Sports Care in Southern California. This show's for active people, those who refuse to let pain and injury get in the way of their life and how they want to live it. Trails and trips, fields and courts, whatever moves you. Each episode features rotating host, expert guest, and real clinical conversations that help you move better and trust your body again. Here we go. Today we are interviewing the trail running doc, Mandy Riehl, about plantar fasciitis and some of the questions that you guys have asked regarding shoe types.

The first one was, do I need max cushioning? The second one is, do I need more arch support? And the third is, does the toe box or heel stability matter? All right, everyone, this is Mandy Riehl. We're going to cover some of the questions about shoes today. So the first one is, we both, you have your shoe, I have mine. And so does the amount of cushioning matter for plantar fasciitis? Yeah, we talked about this a little bit in another video, but if you are pressure sensitive, it can matter. So pressure sensitive being, if you are sticking your thumb where it hurts, and it hurts a lot more, then you are technically pressure sensitive.

So in cases like that, more cushiony shoes, the most common example would be most Hoka shoes can help. I've heard recently that a lot of nurses use Hoka shoes for this, actually, other than runners, just because they're standing all pressure sensitive. I thought you were going to say Crocs. Crocs? Hey, some people swear about it. So yeah, if you're pressure sensitive, more cushion can help because it's less pressure, and it's distributing it more evenly. If you're not, it's kind of whatever you're comfortable in, and whatever feels like it's natural to you. So I run in these right now on the road.

They're not max cushion for 2026. The trends always ebb and flow. And I have had plantar fasciitis problems in the last year. These helped me, but when I tried on some of the bigger Hoka shoes, it made it a little worse. But that was because I was a nerve referral to fasciitis, not a true itis of the plantar fascia. And we've covered that in other videos, too. I'll put some in the description. So for this shoe right now, since you don't really have any problems at the moment. Correct, yeah. You're choosing to keep it, but would you ever move back to something like this? Yeah, so this is like a super minimalist, wide toe box sort of thing.

I may. So right now, the running shoe trends have gone towards max cushion. They will surely go back to barefoot running soon. I tend to like something in between these two. So this is medium cushioning on the scale right now. That is absolutely none. You're basically in the five-finger shoes, if you remember those. Yeah, well, they are vibram. I mean, you've got something there, yeah. Yeah, I would potentially go back to those. At that point, the only difference is if your foot muscles are strong enough to handle that. So if you are going back into those, you have to titrate back and go gradually.

And then if you're running on rocks, then probably don't want to be in something without any cushion. Yeah, I think my only personal experience with like, I used to do something like that, and now I do this. But then there was a period where someone said, you should try, it was a, by the way, this is not sponsored by any shoe company. Sure. Vivos. Uh-huh. And I wore them into the office here, and I had to go out to the car to get something, and I hit a pebble. And it was the most uncomfortable, and that happened a few times, and I finally just gave them away to somebody. Yeah. I didn't want to, and these ones were a little stiffer.

They were still minimal, but they felt way more acceptable to me, and I wasn't even pressure sensitive. Yeah. So in general, the, this is my opinion more than anything, but your shoes should be comfortable. So whatever you're running in should feel like, hey, I should be running in these. It shouldn't feel clunky. It shouldn't feel like you're stepping gingerly to avoid things. I actually do have a pair of shoes like that. I don't use them for running, although I tried them, but I use it for lifting. So if you're doing, like say you're a runner that has shoes like that, just collecting dust because you don't like them, or they're in the back of your closet, using them for lifting is the best place to get some use out of them.

Yeah. I like these much better to lift than Converse. I know people do that a lot, but, um, so the next question is, is about arch support. Yeah. Some of these shoes, do they have built-in arch support or what do you think about? Some of them, there was a school of thought, and this is mostly falling out of practice about motion control shoes versus neutral shoes. Um, these are neutral. Um, that would be classified as neutral. Um, motion control shoes are really stiff. They used to have like gel in them. Like Asics had gel in them for a while that have more arch support. So the idea is that your foot, if you go into like a running store, they'll do a little gait analysis.

They, they teach their employees how to look for either pronation or supination. So your foot going arch collapse or almost like ankle sprain motion. Um, and then they'll suggest motion control or not based on that. I don't find a big difference and this is not an opinion that a lot of people like to hear, but I think it's mostly coming down again to what you're comfortable in. I do think people who use motion control shoes, I have seen a slight difference in how strong they are lower leg wise. So particularly intrinsic muscles of the foot. So people who would, people who have stronger foot don't, muscles don't need the motion control or they do or does it matter?

It depends on, we would go over this in the book a little bit. There's a link below on, on our ebook on plantar fasciitis, but people who have stronger feet in general have less plantar fasciitis problems. Like the frequency of that is less. If you are in motion control shoes, it's kind of like using like an orthopedic boot. If you sprain or break your ankle and they put you in that big stiff boot, it's kind of like the running version of that. So your foot isn't doing much while it's in there because the shoe is doing it for you. So your intrinsic foot muscles are not stressed as much, which can be good in the meantime.

Like if you have problems and if your plantar fasciitis symptoms are caused by a lack of strength in the foot. But if you don't have problems and you stay in those, you're not actually getting strong in the foot at all. Now for a quick pause before we keep going. Hey everybody, it's Sebastian. If what we've been describing in the show so far sounds very familiar and you've been dealing with some ache, pain, or stiffness that keeps coming back no matter what you do and no matter what you try. We're offering a free discovery call today where we brainstorm with you what has been working for you, what hasn't been working, and we also try to unravel what is a critical part of the puzzle that you've actually been missing that's keeping you from full recovery and getting back to full activity.

The link's in the description. It only takes a few minutes to fill out the form. Okay, back to the show. So like, I'm assuming that there's, so there's an assessment to figure out if your foot is strong or not to see if there's a deficiency. Yeah. There's a whole string of tests, but the one we use most commonly is wink sign. So if you kind of lean forward. It's in the book too. Yeah. Like the Michael Jackson lean. You remember that Briller video? Yeah, this thing? Yeah. I saw some Elvis videos last night, by the way. I think he was the real deal. Yeah. I mean, yeah. Side topic. The progenitor of it.

But yeah, if you do that Michael Jackson lean and you don't have the hooks under your shoes, which is how he did it. If you're barefoot, you can actually see little creases in the joint that's just up from your toenail. If you have those creases, that usually means you're using your intrinsic foot muscles. Intrinsic means they're starting and ending in the foot. But if you don't see them, you may not be utilizing them as much. Well, see if people are listening to this on the podcast, then I will. You can go to YouTube and there'll be a picture. Yeah. We'll see if we can put a picture in here somewhere.

But it is in the book. Yep. Okay. Last question is, we covered a little bit, I think, so with the heel stability. Yeah. And the toe box. Yeah. Do you care about those at all for planificized people? I care less about the heel stability, in part because it doesn't seem to make a difference anecdotally, clinically. So I've had patients in shoes that are huge heel, like wider than the actual ankle hole. That has been a trend in the past and is starting to fall out of fashion again. But it's all kind of... Was that those shoes that I showed you in that picture that I thought the guy was wearing shoe and shoe?

Oh, yeah. The clown shoes. Yeah. The huge flared out things. But it doesn't matter a ton on that. That, again, is like whatever's comfortable. But for the super narrow heel, particularly in racing shoes right now, so Vaporflies are the gold standard right now. The heel is really narrow. So it feels unstable if you're not running fast. So the only time that I've found this really relevant is if people are wearing racing shoes, like Vaporfly, when they're not racing. So if they're not running fast for them, their mechanics change. The shoe is designed to push off of your toe. So if you're not running fast and you're not needing to push off of your toe, then you have very minimal heel stability.

And that's where it's kind of like the same risk of spraining your ankle, but you're just changing the area of where the pain could show up. It's like running in, what do they call them, wedges? Not high heel, but wedges. Yeah. It's a carbon plated wedge, for lack of a better analogy. Yeah. Well, great. Well, we have other videos on this. You'll see them on the description below. And also, we do have that e-book that Mandy Riehl wrote. It's pretty intensive. There's pictures and videos, et cetera. A little more organized than something like this. If anything in today's episode resonated with you, visit the link in your podcast player.

There you'll find any free resource that we mentioned in the show, any guest links, and a link for a free discovery call with us. We're licensed to work with our outdoor active people via telehealth across many states in the U.S. at this point. In fact, we cover almost half of the population in the U.S., and we add more states every year. Thanks for listening, subscribe to the show and we'll see you in the next one.