Innovation in manufacturing shoesby Mark Reeves, D.P.M., F.A.A.P.S.M.
Recently, shoe manufacturers have begun to utilize an innovation in manufacturing shoes that removes midsole and outsole materials from the midfoot region of athletic
shoes (commonly called midfoot cut-outs or midfoot scalloping). This was done in an effort to lighten the shoes and in some cases to actually increase midfoot torsional movement.
These midfoot cut-outs
have grown in popularity to include almost all manufacturers
and athletic shoe styles.
This innovation has brought the desired weight reduction of shoes but this design has also increased the frequency
and severity of foot injuries, especially medial column pathologies. In particular, the problems that seem to be caused or aggravated by this innovation are plantar
fasciitis, plantar fascial strains, posterior tibial tendonitis, sesamoiditis, functional hallux limitus, sesamoiditis, and stress fractures. Therefore, it is imperative in treating
athletes that shoegear be evaluated and careful attention given to the presence or absence of midfoot cut-outs.
In an attempt to maintain the lighter nature of shoes with midfoot cut-outs and also maintain stability (both torsional
and flexion) many manufactures have started adding reinforcement
materials including graphite, plastics, and rubber primarily.
This author has found that the graphite plate midfoot
reinforcement has proven the strongest while fulfilling
the manufacturer's desired loss in shoe weight. The greatest
problem associated with addition of graphite plates to
maintain midfoot stability is breakage
during normal shoe use. We have encountered several athletes
with a foot injury related to graphite plate breakage
on the affected side.
Careful
shoegear evaluation should be performed as part of the
normal evaluation of all athletes, especially in light
of these recent shoe design changes which can potentially
have a negative effect on athletic performance.
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