Shoegear:
The Right Shoe for the Right Activity |
Greg T. Graglia, DPM
Madison VA Hospital
Madison, Wisconsin |
Shoe Anatomy

Toebox: The area in the front of the shoe containing the toes. The size of the toebox is important
to accommodate bunions, hammertoes, and other maladies. Having adequate space can decrease the friction and irritation
from these problems. Toebox design varies from model to model. Some models are specifically made deeper and wider to
accommodate for various foot shapes.
Vamp: This is the area of the shoe where the laces are found. Lacing pattern can affect how the shoe
fits. Some people experience impingement of nerves and tendons on the top of their foot if the laces are not in the proper
place. The best way to see if this will be a problem is to try the shoes on and test them. There are alternative methods to
lace shoes up that can help prevent the heel from slipping during ambulation/running or relieve pressure points that can
result from a high instep.
Insole: The bottom inside portion of the shoe that is in direct contact with the foot. Most shoes have
removable insoles that aid in creating space when prescriptive inserts or orthotic therapy is needed. Good insoles are made
from compressible foam that will mold to the contours of your feet. It should be noted, however, that most insoles that come
with shoes will break down a lot faster than the shoe itself. There are a large variety of over-the-counter shoe inserts that
can aid in prolonging the comfort and life of the shoe.
Outsole: This is the portion of the shoe in direct contact with the ground. The traction pattern and
materials of the outsole are specific for the playing surface. For example, a court shoe will be flat and flexible with a
lot of traction, while a trail-hiking shoe will have a more rigid outsole with more aggressive traction pattern.
Midsole: This is the layer that lays between insole and outsole. Most of the technology of shoes is
focused on this area. The majority of the midsole contains ethylene vinyl acetate (EVA) foam, polyurethane foam or a
combination of the two (dual-density midsole). EVA foam provides better cushioning but has less durability than polyurethane.
In addition to foam, many companies have their own cushioning systems, such as air bladders, honey-comb cut foam, shock-absorbing
gel materials and various other high-tech materials.
The support of the shoe is very much based on the construct of the midsole. In the past, there was a tradeoff when it came
selecting between support and cushioning. In general, it used to be that the more supportive midsoles resulted in a heavier
and less cushioned shoe. Today, knowledge of foot function and advances in materials and shoe design has blended together to
produce shoes that offer maximum support without sacrificing cushioning or weight. Some shoes contain different densities of
foam or more rigid devices (such as plastic heel plugs) in the midsole that aid in controlling abnormal foot motion.
It should be noted that midsole cushioning can be too soft, leading to maximum compression of the material, which can in
turn result in a loss of support [1]. Also, with less cushioning comes less shock absorption-less shock absorption is linked
to degenerative changes in joints and low back pain [1]. Finally, one needs to be aware that the use of orthoses in shoegear
with extremely soft midsoles may decrease their ability to control abnormal motion.
Heel Counter: The heel counter wraps around the back of the heel and acts to stabilize the heel and aid
in motion control.
Sole: The sole refers to the insole, midsole and outsole combined.
Upper: The upper holds the foot to the sole and is generally the most aesthetic part of the shoe (colorful,
company logo, etc). One should be warned... while how a shoe looks is important; it should never take precedence over the
function of a shoe. The fact is that the "look" of a shoe will not prevent injuries associated with improper fit or function.
The good news is that most companies are designing great shoes with a decent blend of support, cushioning and style.
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