T Nation

Bigger Guy/Knee Pain: Shoe Advice

So I’m a bigger guy, usually hovering between 235-250lbs. This means I burn through shoes pretty quickly, as they seem to go flat and provide no cushion while walking. I walk and am on my feet a lot of the day, and have been experiencing knee pain lately.

Shoes are expensive, and they wear out, so would inserts be advisable? Can anyone recommend some good inserts? Gels, foam, stick both in there? I’ve already started megadosing glucosamine, MSM, fish oil, but the repeated impact is just brutal.

Ideas?

What is the use of the shoe? Are you talking about a good all around gym shoe? Or everyday kinda shoe? Work shoes ??

Personally I keep different shoes for different things. I have shoes for the gym. Shoes for the club. Shoes for work. And shoes to go running around doing stupid stuff like walking over rocks to get to a good fishing spot. I never use inserts or anything like that. I only use a foot de-oderiser on them. Good luck !

I’m assuming we’re talking about work/casual/dress shoes?

I’ve tried the Dr Scholls inserts (gel, foam they all work about the same) and provided your footwear is high quality, they will definitely help.

Problem is, sometimes adding the insert changes the way the footwear fits…which may not be such a good thing in the end.

Dr. Scholls also produces a line of very reasonably priced footwear (oxfords, wingtips, loafers and such) that are very comfortable, long wearing and provide great support. They look good too -not like ‘grandpa shoes’ or anything.

At 235, I can wear just about anything…but over that and my footwear takes a beating -just as you say Schwarz’.

I’m 260 now and have three pairs of the Dr. Scholls in rotation.

Huge difference…huge!
No knee or lower back pain and I can go all day.

I think I pay about $50 a pair…sometimes less if I can catch a sale.

Very good investment, as you might suppose.

I use FootMaxx insoles and they help a lot. I’ve found New Balance shoes are nice to my feet also.

I’ll second the New Balance shoes. Did alot of research as I also hover around 250 or so, and suffer from knee pain. And as Schwarz does, I take fish oils which does help. I’ve got a pair of Dr. Scholls that helped tremendously. But they too, need replacing. Not trying to go too off topic here but, something that really worked for me was cutting way back on sugar and coffee. Something I also do to relieve the pain is i’ll get into a kneeling position (so basically sitting on my feet) and lean as far back as I can to stretch the quads and loosen the tendons and ligaments a bit. All in all, works great for me.

I typically wear some form of tennis/gym shoe all day, as I work in an athletic setting and walk almost everywhere. I’ll check out Dr. Scholls products, probably the inserts as they’ll be more cost effective and I can replace them a couple times at the same cost of purchasing a new shoe. Thanks for the suggestions.

[quote]Schwarzenegger wrote:
I typically wear some form of tennis/gym shoe all day, as I work in an athletic setting and walk almost everywhere. I’ll check out Dr. Scholls products, probably the inserts as they’ll be more cost effective and I can replace them a couple times at the same cost of purchasing a new shoe. Thanks for the suggestions.[/quote]

If you start up with the “I’m gellin’” shit, I will have to hunt you down and kill you.

Governor,

I think you would be better off with more structure and support, not cushioning. Most likely you need shoes that help control the internal rotation of your feet and lower legs. Excessive tibia rotation can cause patellar tendonitis, IT band syndrome, and patello-femoral syndrome. What sort of knee pain are you experiencing?

The best shoes in this scenario would be straight-last and provide high levels of torsional control (resists twisting along the long axis of the shoe). Some specific examples are New Balance 817, 1010, 1011, and 1123, Brooks Addiction 7 and 8, Asics Gel Evolution 3, Mizuno Wave Renegade 3, and Saucony Grid Stabil 6. Shoe types vary within brands and have different functions so you can’t rely on generic brand recommendations.

I had orthotics made because I was having severe foot pain and knee issues. They reduced the pain, but didn’t make it go away.

The ONLY shoe that has truly gotten rid of foot pain is the Nike Free 5.0. I have flat feet for the most part. My feet feel worse with more support. Any tennis shoes with high arches were painful.

Clearly, my feet weren’t the problem… the fact that most shoes are made to REDUCE the activation of the muscles in the feet was the problem.

Once I built up strength in that area, I was good to go.

[quote]Professor X wrote:
I had orthotics made because I was having severe foot pain and knee issues. They reduced the pain, but didn’t make it go away.

The ONLY shoe that has truly gotten rid of foot pain is the Nike Free 5.0. I have flat feet for the most part. My feet feel worse with more support. Any tennis shoes with high arches were painful.

Clearly, my feet weren’t the problem… the fact that most shoes are made to REDUCE the activation of the muscles in the feet was the problem.

Once I built up strength in that area, I was good to go.[/quote]

Did you keep wearing the orthotics with the nike free’s?

[quote]Regular Gonzalez wrote:

Did you keep wearing the orthotics with the nike free’s?[/quote]

NO. That would defeat the purpose of seeing if the Nike Frees would help solve the problem.

[quote]Professor X wrote:
Regular Gonzalez wrote:

Did you keep wearing the orthotics with the nike free’s?

NO. That would defeat the purpose of seeing if the Nike Frees would help solve the problem.[/quote]

Yeah, that’s what I thought. Just wanted to make sure.

Was there any extra pain initially as your body adapted to the reduced support?

I also have flat feet and was prescribed orthotics that didn’t do shit. I will probably try switching to free’s.

I wear a pair of Nike Free 5.0, and sometimes I’ll roll around in a pair of Vibram Five Fingers, and both have seemed to help a lot with my feet feeling good. I actually bought a new pair of Asics GT-2130, a running shoe with some decent stability, and they actually make my feet hurt, presumably for the reasons Prof X gave.

The trouble is in the knees. I stretch, foam roll, walk everywhere, you name it. The problem isn’t so much a muscle balance as much as I think it’s just an impact thing.

If I walk slower I can sort of walk on my toes, and it’s really not much of a problem, but when I zoom around the gym working and walk around town I tend to walk heel to toe, and the repetitive heel strike at my weight, with poor cushioning, is what I’m attributing my knee pain to.

Specifically I have patellofemoral syndrome. There is no specific location of pain outside of just feeling it “in” my knee, under the patella.

RJ, I actually did get some gel inserts (cheap ones, they didn’t have the good ones in stock), and they pretty much sucked. When I return them I’ll look for Dr. Scholls stuff.

On a side note, running doesn’t actually hurt my knees if I run barefoot and on the balls of my feet. If I run in those shoes I mentioned above I tend to feel off balance and my mechanics change, but if I stay on the balls of my feet I have much reduced knee pain.

It’s only heel to toe and the heel strike impact that seems to really bother me. In fact, my knees feel a lot better for a day or two after running barefoot. If I do it too much I fatigue and my knees will hurt, but as long as I run and stop before I get fatigued enough for my form to degrade I feel like a million bucks.

I would suggest going to a podiatrist and getting custom made orthoitcs.

[quote]Regular Gonzalez wrote:
Professor X wrote:
Regular Gonzalez wrote:

Did you keep wearing the orthotics with the nike free’s?

NO. That would defeat the purpose of seeing if the Nike Frees would help solve the problem.

Yeah, that’s what I thought. Just wanted to make sure.

Was there any extra pain initially as your body adapted to the reduced support?

I also have flat feet and was prescribed orthotics that didn’t do shit. I will probably try switching to free’s.

[/quote]

There was pain from muscle soreness initially because my feet weren’t used to responding to my entire weight on their own very often. Regular shoes tend to take this away to a large degree by providing so much support.

That soreness went away within a week or two.

I’ve seen some Free-like shoes that are supposed to be better at keeping you from running on your heels. Sorry I can’t recall the name, but you may be able to find them if you search for barefoot running or stop into a running store.

[quote]Schwarzenegger wrote:
I wear a pair of Nike Free 5.0, and sometimes I’ll roll around in a pair of Vibram Five Fingers, and both have seemed to help a lot with my feet feeling good. I actually bought a new pair of Asics GT-2130, a running shoe with some decent stability, and they actually make my feet hurt, presumably for the reasons Prof X gave.

The trouble is in the knees. I stretch, foam roll, walk everywhere, you name it. The problem isn’t so much a muscle balance as much as I think it’s just an impact thing. If I walk slower I can sort of walk on my toes, and it’s really not much of a problem, but when I zoom around the gym working and walk around town I tend to walk heel to toe, and the repetitive heel strike at my weight, with poor cushioning, is what I’m attributing my knee pain to. Specifically I have patellofemoral syndrome. There is no specific location of pain outside of just feeling it “in” my knee, under the patella.

RJ, I actually did get some gel inserts (cheap ones, they didn’t have the good ones in stock), and they pretty much sucked. When I return them I’ll look for Dr. Scholls stuff.

On a side note, running doesn’t actually hurt my knees if I run barefoot and on the balls of my feet. If I run in those shoes I mentioned above I tend to feel off balance and my mechanics change, but if I stay on the balls of my feet I have much reduced knee pain. It’s only heel to toe and the heel strike impact that seems to really bother me. In fact, my knees feel a lot better for a day or two after running barefoot. If I do it too much I fatigue and my knees will hurt, but as long as I run and stop before I get fatigued enough for my form to degrade I feel like a million bucks.[/quote]

Do you mean that you get the knee pain after running too long in the Nike Free’s? or just the Asics?

You MAY be right that your issue is weight and impact related, but from what you describe I doubt it. If you can do a certain amount of barefoot running pain free, then I think that movement mechanics are the issue. If it were just impact from your weight, I would think you could see reduced cartilage or arthritis on a scan. But the good news is, if movement mechanics are the problem, it is highly fixable.

My experience is similar to Professor X’s in that Nike Free’s helped me get rid of some pain (back pain in my case) while rigid support now reproduces the pain.

It took several months for my movement mechanics to adapt to barefoot/Nike Free foot freedom. First I wore only socks for about 2 months (because I had sliced a chunk of flesh off the top of my foot). Since then for about 6 months I have worn Nike Frees almost exclusively.

And now, I can feel a dramatic difference in just walking mechanics if I wear stiff shoes or supports instead. Bottom line, freedom of motion for the feet can mean dramatic difference in movement mechanics.

But another critical factor is the hips. Michael Boyle believes that people with patellofemoral syndrome have glute medius issues and puts them through some progressive single-leg work to eliminate it, as well as soft tissue work with a tennis or lacrosse ball. I have been following this protocol, and it has worked.

For example, do pistol squats while absolutely 100% controlling knee position, allowing ZERO wobble side to side. If my knees drift at all during the movement, it causes patellofemoral pain. Controlling that drift eliminates pain. After a little bit of this unsupported single-leg work, the impact activity which used to cause knee soreness for me, the downhill part of steep hiking, no longer bothers my knees at all.

[quote]Professor X wrote:
Regular Gonzalez wrote:
Professor X wrote:
Regular Gonzalez wrote:

Did you keep wearing the orthotics with the nike free’s?

NO. That would defeat the purpose of seeing if the Nike Frees would help solve the problem.

Yeah, that’s what I thought. Just wanted to make sure.

Was there any extra pain initially as your body adapted to the reduced support?

I also have flat feet and was prescribed orthotics that didn’t do shit. I will probably try switching to free’s.

There was pain from muscle soreness initially because my feet weren’t used to responding to my entire weight on their own very often. Regular shoes tend to take this away to a large degree by providing so much support.

That soreness went away within a week or two.[/quote]

So are your feet actually pain free? I have had foot problems forever, flat footed also, and just kinda deal with it now. If Frees actually help I would be insanely greatful.

[quote] Matt wrote:
Professor X wrote:
Regular Gonzalez wrote:
Professor X wrote:
Regular Gonzalez wrote:

Did you keep wearing the orthotics with the nike free’s?

NO. That would defeat the purpose of seeing if the Nike Frees would help solve the problem.

Yeah, that’s what I thought. Just wanted to make sure.

Was there any extra pain initially as your body adapted to the reduced support?

I also have flat feet and was prescribed orthotics that didn’t do shit. I will probably try switching to free’s.

There was pain from muscle soreness initially because my feet weren’t used to responding to my entire weight on their own very often. Regular shoes tend to take this away to a large degree by providing so much support.

That soreness went away within a week or two.

So are your feet actually pain free? I have had foot problems forever, flat footed also, and just kinda deal with it now. If Frees actually help I would be insanely greatful.

[/quote]

Yes. They are pain free. That is WHY I hype these shoes so much. I couldn’t even find my orthotics now. I’m a fan and hope they don’t quit making them.

[quote]Professor X wrote:
Matt wrote:
Professor X wrote:
Regular Gonzalez wrote:
Professor X wrote:
Regular Gonzalez wrote:

Did you keep wearing the orthotics with the nike free’s?

NO. That would defeat the purpose of seeing if the Nike Frees would help solve the problem.

Yeah, that’s what I thought. Just wanted to make sure.

Was there any extra pain initially as your body adapted to the reduced support?

I also have flat feet and was prescribed orthotics that didn’t do shit. I will probably try switching to free’s.

There was pain from muscle soreness initially because my feet weren’t used to responding to my entire weight on their own very often. Regular shoes tend to take this away to a large degree by providing so much support.

That soreness went away within a week or two.

So are your feet actually pain free? I have had foot problems forever, flat footed also, and just kinda deal with it now. If Frees actually help I would be insanely greatful.

Yes. They are pain free. That is WHY I hype these shoes so much. I couldn’t even find my orthotics now. I’m a fan and hope they don’t quit making them.[/quote]

Thanks Prof, I’m gonna try and pick some up this weekend.