The Hruska Clinic Integrator
Recent E-Mail: Shoe List Question
Posted on 03/20/2018
We recently received an e-mail from a manager of a Running store outside of the area inquiring about the details of our recommended shoe list. We felt it was a great e-mail and Lori's response was a great teaching moment for you, our patients and referral sources, for explaining your shoe needs to those experts in the field who know shoes! Here is the conversation. And thanks to those who are using and spreading the word of the shoe list.
To whom it may concern,
My name is Brett and I manage a running specialty store... I have gotten numerous referrals to the store I work at from various Physical Therapists with a Hruska Clinic Recommended shoe list. While we are very grateful that PT's in the area are referring patients to us, It has sometimes been difficult to provide customers with proper footwear choices with such a limited number of shoes on the recommended list. I noticed that the only brands on the Hruska Clinic Recommended shoe list are from Brooks, Asics, Altra, and New Balance. I imagine your clinic has tested a huge variety of shoes. Is there a specific reason in particular that companies like Nike, Saucony, Hoka, and Topo are not on the list? I understand that all of these companies make footwear that fall into the 'qualities of a poor shoe' category, but many companies that are not on your list make many shoes that fall into the 'qualities of a good shoe' category. For example, the Saucony Triumph 4 runs very parallel in measurements and cushioning/stability to the New Balance 1080 and Brooks Glycerin. I would just love more clarity in regards to the subject matter for this shoe list, and why some shoes would be recommended over others. Thank you for your time, and I look forward to learning more about proper footwear and the continuing education within the biomechanics of the human body.
Thank you for your email regarding the shoe list. You are correct that there are a lot of shoes that fit the qualities of a “good shoe” on the list. However, we pick the best ones that will integrate the best with a PRI (Postural Restoration Institute) approach at the neck, trunk, and pelvis. We have objective tests that we look at that determine how a shoe integrates with our patients. In the end each patient is different and there should be some communication back and forth between you and the PT in what works best for each patient.
For instance, the Hoka shoes while they bend at the toe box they are stiff and limit full range of motion at the big toe joint. If this shoe is given to someone with full range of motion at this joint it will turn on their hip flexors and increase low back tension. I do use this shoe, but only for patients limitations in their first big toe joint. I didn’t put this shoe on the list as it serves a limited population in my field. Saucony’s have changed their heel counter and it is typically too shallow to provide adequate calcaneal stability for most of our patients. I have worked with the Nike Pegasus, but again worked for only a couple of my patients. Muzuno Wave Rider does not provide enough support on the forefoot and individuals tend to roll in too much. These are factors for why some of the shoes don’t make the list.
I hope the therapist are working with you and making some recommendations that work for their patients. We have shoes in our clinic and have objective tests behind the shoe we recommend for our patients. It beyond just looking at the foot, but looking at the entire system and integration with the patient.
I hope this helps and sheds some light behind the list. Again, I would reach out to the Physical Therapist as they should be offering some recommendations to assist you and their patient to maximize outcomes.
Have a great day and thanks for the email,
For more information also see Lori's yearly video description of the shoe list here