If the Shoe Fits: Effects of Shoe Cushion on Plantar Fasciitis Pain among Female Runners

Despite a high prevalence of plantar fasciitis in runners, the exact mechanism of injury is not well understood, complicating treatment strategies. While some shoe types are chosen to help manage plantar fasciitis pain, there have been few longitudinal studies to assess whether cushioned footwear may reduce pain compared to neutral cushion shoes. PURPOSE: To determine if ultra-cushioned footwear is a more effective treatment option than neutral cushion footwear for plantar fasciitis in female recreational runners over a 12-week period. METHODS: Female runners (n = 12; 40.7 ± 8.0 y) diagnosed with plantar fasciitis within the last two years and experiencing pain within a month of study onset participated. Runners were randomized to a neutral cushion (NEU) or ultra-cushion (CUS) group and provided with shoes. Mileage was tracked for 12 weeks, with participants maintaining at least 10 miles per week (16.1 ± 9.3 mi/wk). Pain levels were reported on a 0-100 scale at pre- and post-intervention. Pain outcomes were analyzed using a 2 (group) x 2 (time) mixed ANOVA (α = .05). RESULTS: There was no significant difference in pain levels between the two groups prior to the intervention (NEU: 40.8 ± 22.9; CUS: 27.0 ± 13.5, p = 0.12). There was no group-time interaction (p = 0.57) or main effect of group (p = 0.07). However, there was a significant main effect of time (p = 0.03) with a decrease in pain occurring from pre (33.9 ± 19.4) to post (17.8 ± 20.2). At the end of 12 weeks, pain scores for the NEU shoe (28.3 ± 23.1) and CUS shoe (7.2 ± 9.7) were lower than pre-test. CONCLUSION: Both groups experienced a reduction in pain over the 12-week intervention, yet the ultra-cushioned shoe did not yield significantly greater pain relief compared to the neutral cushion shoe. While maximal cushioned shoes are often marketed as beneficial for foot pain, the current study does not support claims for plantar fasciitis relief in this sample of female recreational runners. Although these findings do not favor one cushion type over the other, decreased pain scores over the intervention may support that regular running shoe replacement be beneficial for individuals with plantar fasciitis. However, these results highlight that plantar fasciitis pain management likely requires more than just a footwear change and should incorporate additional treatment strategies. Supported by: American Society of Biomechanics