Episode 1 | Ask the Expert | Guest: Maddie Tait BSc, MSc, Sports MSK Podiatrist, LBSM
Few questions come up more often in a podiatry clinic than: “what trainers should I be wearing?” It sounds simple, but the answer is anything but. The running shoe market is vast, constantly evolving, and full of technical language that can leave even experienced runners confused.
In the very first episode of the London Bridge Sports Medicine podcast, Dr Ajai Seth sits down with Maddie Tait, LBSM’s Sports MSK Podiatrist and gait analysis specialist, to cut through the noise. From heel drop to pronation, minimalist shoes to breaking-in protocol, Maddie covers everything a runner needs to know before their next shoe purchase.
Why footwear is more complicated than it looks
Maddie sees patients across the full spectrum of footwear choices – from business shoes to cleats to flip-flops – and she asks every patient to describe their typical footwear, often requesting they bring shoes to clinic. Her observation: most people don’t think about the biomechanical effect of what’s on their feet.
“If you look at your foot and what you’re trying to squeeze it into, it doesn’t always naturally fit,” she says. A weekend warrior might spend half the day in leather work shoes, go for an evening run in trainers, and then wear heels on a Friday night – each placing very different forces on the same foot.
The importance of footwear variety also became apparent during the pandemic. Many office workers who had commuted daily in business shoes suddenly found themselves at home in slippers or barefoot – and a wave of foot and lower limb pain followed. “There’s big components to think about when it comes to shoes,” says Maddie. “What stability that shoe is providing you, what’s the heel on it, is there any cushion – it’s very complex.”
Where to start when choosing a running shoe
For anyone getting into running – whether it’s a first Couch to 5K or training for a marathon – Maddie’s starting point is always the same: understand your goal and your terrain before you buy.
Beyond that, the key variables to consider are:
- Cushioning – how much impact absorption do you need? This depends on running surface, distance, and individual biomechanics
- Stiffness – a stiffer shoe provides more structure; a more flexible shoe allows more natural foot movement
- Drop – the difference in height between the heel and the forefoot (stack height). A higher drop places the heel higher than the toe; a zero-drop shoe is completely flat
- Fit – width and length, accounting for the fact that feet expand during running
Maddie recommends getting your biomechanics assessed – looking at foot flexibility, ankle mobility, and leg strength – before making a decision. This is something a podiatrist or sports physio can do properly, rather than the brief treadmill analysis offered in most running shops.
Should you trust the running shop gait analysis?
Most specialist running shops now offer a short gait analysis and will recommend shoes based on whether you pronate, supinate, or run neutrally. Maddie’s verdict: it’s a reasonable starting point, but take the advice with a degree of caution.
The reason is that pronation – the inward rolling of the foot on landing – is actually a natural and necessary movement. “We need natural pronation and natural supination for the foot to work correctly,” says Maddie. Simply stiffening the inside of a shoe to restrict inward movement isn’t always the right answer, and can create problems further up the kinetic chain.
“The old saying of ‘you’re a pronator, this is the shoe for you’ is quite an outdated approach,” she adds. If a shop does flag that you collapse inwards and suggests a stability shoe, her advice is to try it – but also try the neutral version. “A lot of it is preference. Take it with a pinch of salt and see what feels comfortable for you.”
The quality of advice also varies significantly between shops. A dedicated running shop stocking multiple brands will generally offer more impartial guidance than a general sports retailer.
Brand and fit: a practical guide
Without endorsing any particular brand, Maddie offers some useful pointers on fit characteristics:
- Brooks and New Balance offer wide-fitting options – worth looking at if you have a broader foot
- Asics tend to run narrower around the heel and forefoot, which can suit a more slender foot shape
- Most major brands offer a range across maximal support, mid support, and neutral – so the brand matters less than finding the right model within it
One practical point worth remembering: feet expand during running, increasing in both width and length. Your shoe should have enough room to accommodate this. A shoe that feels snug in the shop may feel uncomfortably tight by mile three.
What to do with a brand new pair of running shoes
Buying the right shoe is only half the battle – how you introduce it matters too. Maddie’s protocol:
- Wear them indoors first. Walk around the house for a few days with socks on. This lets you assess fit and comfort without committing to them outside.
- Check the fit carefully. Make sure length and width feel right – and remember your foot will expand once you start running.
- Keep them returnable. If worn only indoors with no marks or scuffs, most retailers will accept an exchange. Don’t take them outside until you’re confident.
- Start with a short run-walk. Build up gradually before increasing mileage. Give your feet time to adapt to the new shoe before pushing your training load.
Minimalist shoes: do they work?
The minimalist shoe trend – characterised by zero drop, minimal cushioning, and a more ‘barefoot’ feel – peaked several years ago and has since quietened, though these shoes are still widely available. Maddie’s take is measured: they can work well, but only for the right person.
The key requirements for minimalist running are sufficient ankle mobility, strong feet and legs, and appropriate running mechanics. Without these, the transition from a cushioned shoe to a zero-drop shoe places significant new demands on the Achilles, calf, and plantar fascia.
“I’ve seen a lot of injuries from people just buying a pair of minimalist shoes and going for it,” says Maddie. If you’re interested in transitioning, her advice is clear: see a physiotherapist to build the necessary strength and flexibility first, then consult a podiatrist to assess whether your mechanics are suitable. Don’t self-transition.
The bottom line
There is no universal “best” running shoe. The right shoe depends on your foot shape, your biomechanics, your running goals, and your training surface – and that combination is different for everyone.
A good specialist running shop is a reasonable place to start, but for a proper assessment – particularly if you have a history of foot, knee, or lower limb problems – a podiatry or gait analysis appointment will give you far more reliable guidance. Getting this right early can save a lot of frustration down the line.
Maddie Tait (BSc, MSc) is LBSM’s Sports MSK Podiatrist, specialising in gait analysis, biomechanical assessment, and lower limb injury management. She sees patients across LBSM’s London clinic sites.
To book an appointment with Maddie or another member of the LBSM team, visit lbsm.co.uk/booking
Listen to the full episode below ↓
