Are “stability shoes” helpful for reducing injury rates? Are all of the hyped technologies promising a stable ride worth more than the marketing ads they’re printed on?

Better yet, if there is something to the claims, are stability shoes something that YOU need?

A brief history of the modern running shoe

To begin answering these questions lets take a quick skim through how the running shoe has evolved over the years and see how “stability” fits into the picture.

After a custom-fitted and innovative time of emerging running shoes for the first half of the twentieth century, 1960 marked the year of the first mass produced trainers from New Balance, weighing in at 11 ounces and retailing for $15.

Meanwhile Track and Field coach Bill Bowerman was hard at work designing lighter, faster shoes for his athletes at the University of Oregon, resulting in the foundation of Blue Ribbon Sports, the precursor to Nike, in 1964. The first shoe review was published three years later.

Now only fifty years since the beginning of modern running, shoes and their reviews abound, so much so that consumers need help deciphering running shoe descriptors and wading through the countless options available to determine which shoes fit their specific needs.

What’s the difference between a shoe labeled “cushioning” and one marked as “stability”? Are “stability shoes” really necessary, and how do I know what to choose?

Enter Dr. P Coffin

To find answers to these questions about shoes and their history, I sought out a fellow runner who has been with the sport since before its boom in the 70’s and who began his career working in New York with his uncle Dr. Richard Schuster, a trail blazing podiatrist who specialized in treating running with orthotics starting in 1970. Dr. Schuster wrote a monthly column for the “The Runner” magazine for several years.

Dr. Paul Coffin now runs his practice in Sioux City, IA, and works with patients of all kinds including many professional athletes across the spectrum of sport. He’s a walking encyclopedia of knowledge on this topic, including names, dates, and shoe models going back to the beginning, always maintaining a special spot in his heart for runners.

The exponential growth in running coincided with a growth in overuse injuries

In 1971 Dr. Coffin remembers ordering a pair of New Balance “Trackster” running shoes. They were made to tracings of his feet as the company would match its shoe lasts to match each runner’s needs, pairing a narrow shoe last in the heel with a wider last in the forefoot and so on as needed. His college roommate ordered the “same shoes” as well, and what they received back were different, individualized running shoes based on foot type!

During this time, most people wore these custom kicks from New Balance, adidas (narrow) or Pumas (wider), the latter being German companies founded by feuding brothers who built shoes for athletes.

Between 1984 and 1986 the popularity of running exploded to include approximately 25 million Americans running regularly for the first time.

Increased running brought increased overuse injuries with Dr. Stan James coining the term “over-pronation” in a 1978 article in the American Journal of Sports Medicine.

More research followed as companies attempted to transform shoes from primarily performance-focused to therapeutic devices that reduced potential for injury.

The 90’s marked a decade of motion control shoes with “pronation” becoming a negative concept, an idea that a research study in 2002 found to be bogus; injury rates were not reduced, a finding confirmed in Dr. Coffin’s 35 years of experience working with runners and their shoes.

“All runners almost without exception land on the outside of their foot (ball back to heel, or because of cushioned shoes, directly on the heel*), move forward along the lateral edge and pronate as they reach the ball of the foot. It’s an embryonic development in the womb that shapes feet to function in this way. I don’t see a difference between all of the shoes and how the foot pronates: almost nobody wears out the inside of heels of their shoes. Anti-pronation features in the medial heel are purely for marketing. Despite popular running magazine lore, arch height is no predictor of over or under pronation.” – Paul Coffin, DPM

According to Dr. Coffin, we should not be labeling shoes as “cushioning” or “stability” as “the foot pronates just as much inside the shoe no matter what.

How do you find a shoe that’s good for you?

“The best way to find the right shoe for your foot is to wear it around the house for a couple weeks“. Even just walking in the shoes will tell you if they’re comfortable, and comfort is what you should go on along with finding shoes with the following three features:

a strong heel counter is needed in the heel of the upper to control the rearfoot and hold the foot straight up; it should bend only across the ball of the foot – where the foot bends naturally while walking, not through the middle; and a running shoe should contain non-compressible material in the midsole that does not “give” to finger pressure, especially on the outside of the shoe as soft materials soon collapse, leaving the foot in a tilted and unstable position.

Additionally, shoes should contain lasting cushion under the ball of the foot (think ASICS gel or Brooks DNA material that firms under pressure) that resists compression (most flatten by 200 miles on the shoe), which tilts the foot causing instability.

The shoe should be laced tightly across the widest part of the foot to prevent your foot from sliding forward or backward in the shoe.

Early models from New Balance actually had only four laces, situated toward the ball of the foot over the instep. A snug fit in this area decreases heel motion much more effectively than laces across the ankle which irritate nerves and constrict blood vessels, Dr. Coffin explains.

Each individual’s foot shape, bone formation, ligament laxity, Achilles flexibility, and degree the toes rise during foot swing (which is what causes black toenails, btw!) determine how much a person will over or under pronate.

The degree of drop height one prefers in a shoe is predisposed based on the Achilles aspect, and the height of toe box that best suits your foot is related to the degree your toes naturally rise when swinging your leg back for the next foot plant.

In over 35 years, Dr. Coffin cannot think of two runners’ feet that were exactly the same; essentially there’s no predictor of if this (high arch) then this (underpronation), and so on.

Can runners be injured by unnecessarily using stability shoes?

Most definitely they can be — Dr. Coffin recalls spraining his ankle on his first two (and only) runs in Brooks’ first shoe with a Varus Wedge when it debuted in 1976—but that’s true of using any shoe that isn’t right for you.

“A running shoe that is ideal for a 120lb runner would perform like a bedroom slipper for a 250 lb. person,” Dr. Coffin’s website proclaims.

With so many variables, it seems like the original custom-made shoes (or orthotics) are the wave of the future: Dr. Coffin has been experimenting with 3D imaging and 3D printing for orthotics since 2007!

“This is the future of a more customized running shoe designed specifically for each runner.”

With how far we’ve come, it’s both surprising and interesting that the future of the running shoe may be found back at its very roots. Until then, we’re going to have to stick with purchasing shoes from companies that allow free returns, trying them out, and finding the shoe where comfort is king, however it is marketed and labeled.

*Dr. Coffin believes that runners should land on the ball of the foot, move to the heel, and back off the ball pointing out that increased shoe cushion encourages heel striking, which increases shock to one’s joints that is compounded during downhill running. The barefoot running trend brought people back to how we’re designed to run, but this type of running should be paired with natural, uneven surfaces as well.