Wear patterns on shoes can be a useful—though often confusing—indication of problems with the feet.
By examining wear patterns, we can understand a patient’s gait cycle and recommend the appropriate adjustments and orthotics to enhance their performance.
The confusing part can be explaining why certain conditions lead to certain wear patterns. For example, it’s counterintuitive to patients to explain why their foot rolling inward can cause excessive outer heel wear.
But here’s the series of events that could lead to just that scenario:
- The patient overpronates—their foot rolls inward excessively after landing.
- Over time, repetitive stress causes their medial (inner) arch to collapse.
- As a result, they develop foot flare, causing excessive outer heel wear.
Another major factor in overpronation is valgus heel alignment—the calcaneus tilts inward (everts), causing a medial bowing of the Achilles tendon and contributing to the medial collapse of the foot and ankle.
But every shoe tells a story. What do your patients’ shoes tell?