Healthy Shoes for Healthy Feet
Practical Approach to post Bunion Surgery and Shoes
Okay, so I didn’t just have one bunion surgery, I had two. I had surgery on both feet, with two months in between (don’t do both at once - trust me).
If you are in the same “boot” as I was and you want to know the real truth about what to expect, hopefully, I can fill you in. Plus, as a result of going through this and never ever wanting to wreck my feet again, I did (and still doing) extensive research on shoes I think are good for your feet and are nice to look at. My husband, bless his heart, thought I was just shoe shopping. Well, I was, but writing this makes up for all that time shopping.
As a result of being in a surgical boot, which for some reason made everyone feel compelled to ask why I was wearing it, I talked to a lot of women with bunions and answered a lot of questions about bunions and surgery. I can’t believe how many women have the condition or know someone who does. Also, as a result of reading a lot of misinformation and unhelpful information, I thought it might help if I shed some light on what to expect about bunion surgery and the recovery process.
DISPELLING THE MYTHS
It’s a boney growth, like a wedge of bone that grows in/on the joint Not true
It is a malformation of the foot. In my case the long toe bone grew abnormally long forcing the bone to grow outward at an angle. Because the top of the bone is no longer sitting straight, the adjoining joint of the big toe can no longer sit aright on the bone and topples over to the side. As the years go the foot ligaments stretch on the outside of the foot and the ligaments on the inside tighten.
Bunions are caused by narrow-toed shoes Not true
Narrow toed shoes could cause the same problem, but not really. The toe could get pushed over causing an outward protrusion of the joint, but the long bone is not affected.
Bunions are inherited True
My “bunions” are inherited. All four girls in my family inherited them from my dad’s mother. Her feet were seriously crinkled, but she still managed to walk. I don’t know how, but she did. I always thought as long as mine didn’t look like hers I was doing okay. I also always thought it was something I just had to live with, and as long as I didn’t wear high heels and narrow toed shoes I was pretty much okay. When I was 23, I wore heels. Until one day I went to an orthopedic doctor and was basically laughed at as I explained that the ball of my foot hurt. That was almost the last of the heels. It wasn’t until I was 30 that I abandoned my heels, well almost. I would still occasionally wear 2-3 inch heels for weddings and special outings. I read a lot of posts that swear bunions are only caused by wearing narrowed toe shoes. Sorry, I would have the problem even if I walked barefoot. The degree of push over, however, might have been exacerbated by the girly shoes.
They get worse Yes, this can be true
I went along for 30 years without any change or any real issues. I hiked, walked, and worked out extensively over the years. If my boots were too loose or too tight the joint would be sore or my second toe would hurt.
Then I went on a 2-mile walk in my gym shoes instead of my hiking shoes. When I took my shoes off my right big toe was stuck under my second toe. First time that ever happened. My gym shoes were made for working out, not hiking or walking long distances.
More Truth
Essentially, when you have bunions and your big toe is pushed over at an angle, it is no longer weight bearing, forcing the second toe to try to do its job (know people like that? – never mind that’s another story). When I went hiking a few summers ago (pre-surgery), my boots were broken in, but by the end of the hike my second toe was in serious pain. It felt like my nail was cutting into the tip of my toe. It wasn’t but it felt that way. And the bone just below my pinky toe hurt, felt bruised. What was happening was that my second toe was trying to pull my boots and me up the mountain. It’s not made to do that. Lazy big toe was just along for the ride without doing any of the work. I had a similar experience a couple years prior when I went hiking on a smoothish trail in I what I thought were decent hiking shoes. By the end of the hike and for weeks after that, the joint below my second toe was in serious pain. Again it was trying to do the work that the big toe should have been doing – and – my shoes were not really hiking shoes. I learned a really great stretch for the top of my feet as a result, which I still do, and eventually the pain was stretched away.
THE JOURNEY
Knowing I would be doing the second foot - and because so many women asked me about it, I took notes.
Overview: If you have a nerve block, by injection, you won’t feel a thing – for about 8 hours. But as it wears off, if you don’t start your meds early enough, you will be in serious pain. Sorry doc, I know you don’t want people scared. I was anyway and better to know how to avoid the pain than to deal with it.
The moral of the story is, listen to your doctor and start your meds on time. I won’t pretend to tell you when and what meds to take. I think that’s considered some kind of fraud.
I will tell you that it’s a PROCESS. Give yourself a break; it’s hard. While it’s lonely and grueling, you will get through it. Don’t watch the online video about stretching your toes when you are only 1 week out. It will only make you feel bad. Don’t worry about whether it will ever stop being swollen. It will. And you will be walking better than before. It will take diligence to do your PT but do it. Listen to your doctor when he tells you how far you can stretch it. You won’t believe it, but doing so will make all the difference in your recovery.
Depending on your doctor’s orders what you are allowed to do may vary, so I will just tell you what it was like for me. When I had the second foot fixed, a friend had the same surgery. We compared notes. Our feet were wrapped differently and the post op process was different. She saw her doc every week, I saw mine at two weeks when staples were removed, then at six weeks. Staples - yes, I was surprised too, but my friend had stitches.
By day four I was hobbling around in the boot, learning to walk on my heel and outside of my foot. I used crutches for the first few days because it’s downright painful and the drugs make you a loopy.
By the end of the first week, tho, I was able to get around in my boot. Not much, but I could hobble to the bathroom and kitchen, then back again. I also didn’t have to wear my boot if I was in bed, as long as the dog wasn’t around. My friend had to wear her boot 24/7. Honestly, I can’t imagine that.
I slept with my foot elevated on a pillow for a long while – Whichever foot had the surgery I slept with it on the outside of the bed so I could keep it out of the covers. I wore a very loose wool sock to keep my foot warm and wrapped it loosely with a large ace bandage so I didn’t have to worry about doing something to it while I slept. Still there were times when I woke up ‘cuz I snuggled it under the covers.
Call your doc anytime you are just unsure of something. We all hesitate to be that person, but that’s why you are paying them the big bucks.
DAY ONE: late morning surgery
Definitely liked having the nerve block knee down
DO NOT use ibuprofen (it interferes with bone recovery)
The block wore off at 16hrs - lots of sharp intense pain starting with the second toe incision, then inside of foot and bone.
DAY THREE: With the surgical boot on, I could walk with crutches on my own and I took a shower - sitting on the floor of the shower, mind you, with my foot sticking out on the floor. But boy did that feel nice!
DAY FIVE: Very little pain. Less swelling but groggy in the am.
Able to walk on heel in boot this afternoon. Still lots of swelling had to get it elevated after a board game.
DAY SIX: Able to walk better
With foot #1, I had lots of bruising on inside of ankle. Needed 20 min ice therapy that night. I did not have the same bruising with foot #2, but I kept ice on that area from the get go. (side note - found out that they put me in a surgical boot that was too small for the #1)
DAY SEVEN: able to be up longer periods of time.
At night lots of twitching as foot was healing - lots of good life!
DAY EIGHT: Able to be up more - did dishes and laundry. Oh yah, because my foot was stressed it looked like my big toe was considerably lower than my other toes. Turns out my other toes were stressed out and crunched up. Eventually they relaxed and all was well.
TWO WEEK MARK: Each day gets better. Managed three hours at school. Foot swollen and some pain. After school, elevated it while hubby shopped, but couldn’t walk after putting weight on it.
Staples out! Close to twenty - very intense pain along the medial incision especially along the problem joint. Short lived tho and foot appreciated breathing.
Foot #2 A different PA removed the staples and there was little to no pain. Thank you, Jason. Doc showed me how to wrap my foot and from there out I was left to do the wrap, keeping the big toe in the right angle, mostly to maintain the space between the big toe and the second toe. I wanted to say, “Really, you are making me responsible for this foot?” It was scary taking it off for the first time, but my daughter video recorded it the first time I took it off so we could get it back on correctly. That helped.
Whole foot still very swollen and bruised. Kinda knarly if you aren’t expecting it. The staples leave indents, which look worse than the actual incision. But they will soon begin to disappear.
I could shower for real for the first time. I still had trouble standing in the shower, but for the first time I was able to get my foot wet.
Note: Toe #2. At this point I started doing leg stretches. I found that the inactivity was actually keeping me from sleeping. Leg stretches from a sitting position really helped. Have to be careful not to stretch deep into the foot. This also kept my Achilles tendon from tightening up as much as it did on my first foot.
THIRD WEEK: Mornings were good. Tired by late afternoon. No serious pain.
Took a shower this morning, letting foot get a little wet. No direct hit from the shower. Had to sit on bottom to get out of shower.
Toe #2: Week three mark so much less swelling. Toe one was now 13 weeks out and I could fit it into low heeled boot for the first time. It’s all about flexibility. When it’s stiff it needs to stretched.
Monday before 4 week mark: Frequent strong zings thru the joint (that means the nerves are waking up!). Less bruising. Considerable swelling on bottom Other toes are a bit lower now.
WEEK FOUR: More progress. By now I was semi-confidently wrapping my ace, noticing less swelling, able to walk considerably more (but not on cement floors). By end of week 4 I could go to the bathroom at night without boot BUT I also removed any potential hazards and wrapped my bed posts with a blanket. Could you imagine stubbing your new toe?
Keeps getting better. Still random strong zings through the joint and bone or artery across the top of foot. Energy level pretty good. Hip joint needed lots of stretching by week four because of the outward pronation.
WEEK FIVE: Feeling stronger. Often not using boot at home but carrying the weight on my heel and outside foot. More flexibility but not pushing it too much. Still zings - often strong, not super painful but gets my attention.
Energy level good. I noticed my foot saying, “Hey, I can rotate back to a neutral position now.” Be patient. With only one or two weeks to go, you will be doing it for real so enough.
WEEK SIX: You can be on you foot most of the day now without being exhausted. Still need to elevate by end of day. Can almost walk “normal“ in the boot.
Two days after six week mark - I could see foot bones for the first time! Big toe nearly rests on floor. My final appointment was week 7 so I didn’t push it until my appointment. Still bruising especially big toe, second toe, ankle and 2nd joint. Still some swelling at night. But I can feel the strengthening increasing. By this time, my foot was saying “I can bear the weight now" and was naturally rolling back towards the toe.
Still covering incision with a four by four to keep from rubbing on some of the raw areas
A lot of the scabbing has fallen off. You now have a perfectly manicured foot with no callus buildup.
I asked my doctor what I was allowed to do and he said moderate exercise but no running or jumping until 12 weeks. That was a joke. Running – maybe some women are at 12 weeks.
I could finally make it through shopping. For the past 4 weeks, my husband went with me and we split the list. That’s the only way I would have made it. Cement floors were the worst for me (wearing my hiking shoes might have helped, but I'm vain).
WEEK SEVEN: Out of the boot. No more wrap! I can slowly go up stairs. Achilles and back of calf too tight to go down, also foot did not roll upward.
Note - you may not be able to fit into a shoe yet. I asked for a surgical shoe to wear until I could, which took a couple more weeks. Then the shoes I wore were wide toed boots and slippers.
NINE WEEKS OUT: Wearing slippers for past week. Iced and elevated at night, but that was also because I was on my feet teaching. Most swelling gone and in the mornings I had ankles!
9 WEEKS: Definitely needed to do more calf stretches. Still could not go down stairs most days.
Post boot each foot had a different set of quirks - like w/ the first surgery my Achilles was super tight, and I had pain in my heel. I learned the pain in the heel was due to Plantar fasciitis, (like runners get) and my second toe was really the only place that was point painful. I learned that it needed to be stretched as much as the big toe. Once this happened the pain in the second toe went away.
Toe #2 There was less swelling in the foot. In general it seemed less traumatized by the whole thing. Toe #2 the pain was centralized in the upper toe bone and the tendon on the medial side of my foot (that was shortened) was super tight. So things are probably going to be a bit different for you.
Fast forward to 4 Months. no pain, minimal swelling, working out (not running yet, but able to bend toes to about 60’. Able to bear weight on ball of foot and go up and down stairs. Your progression may be a bit different than mine, but notice THERE’S PROGRESS!
6 Months: no pain when I bear weight on my toe joint. Foot has a neutral pronation for the first time EVER and feel like my muscles have recovered. There is mild swelling after a long day on my feet.
There’s some brown skin around the incisions, but that’s disappearing more each month.
1 Year Later: Feet look and feel normal, scaring is nondescript.
2 Years Later: Feet look and feel great, scaring is unnoticeable. I've been working out, running, and hiking without problems.
With good shoes and continued stretching and strengthening exercises, you are well on your way to new adventures - And wearing cute shoes – maybe for the first time, ever!
MILESTONES
MILESTONES:
(I measured everything in weeks)
By the end of Week 1: Learned to walk in boot without crutches. No boot in bed
2 Weeks: The original dressing removed, and staples out. Shower without bandage for the first time. Begin stretching
4 Weeks: More progress.
5 Weeks: Foot is naturally wanting to roll back toward a neutral position.
6 Weeks: The boot comes off, the wrap comes off, a lot of the scabbing has fallen off.
Fast forward to 4 Months. no pain, minimal swelling, working out (not running yet, but able to bend toes to about 60’. Able to bear weight on ball of foot and go up and down stairs. Your progression may be a bit different than mine, but notice THERE’S PROGRESS!
6 Months: no pain when I bear weight on my toe joint. Foot has a neutral pronation for the first time EVER and feel like my muscles have recovered. There is mild swelling after a long day on my feet.
There’s some brown skin around the incisions, but that’s disappearing more each month.
1 Year Later: Feet look and feel normal, scaring is nondescript.
With good shoes and continued stretching and strengthening exercises, you are well on your way to new adventures - And wearing cute shoes – maybe for the first time, ever!
EXERCISE AND STRETCHING
As soon as you are released to start doing exercises DO your exercises - like 3 times a day (I set my alarm).
Push into the discomfort. It’s not really painful, per se, but everything is tight.
Carefully stretch your toes, the top of your foot, your Achilles tendon, your ankle and your calf muscle. They are all in atrophy and need loving care. Move and Stretch. It will make all the difference.
The tendency is to rotate your foot out to protect your big toe from doing the stretch - DON'T; you just prolong the agony.
If your doctor is like mine, you have to ask for some exercises. You don’t need to go to PT but it might be a good place to learn the stretches if he doesn’t demonstrate them for you.
With foot #1 I had plantar fasciitis, causing my heel to feel bruised. I started doing exercises to address it too and it went away within a week.
Before my second surgery I told my doctor that everything was going okay with my first foot, except I had significant pain at the base of my second toe. So, he “lovingly” grabbed it and showed me just how far I should be stretching it. I replied, “Really?” When I woke from surgery, I never had pain in that toe again. I didn’t ask him but I think he “stretched” it more during surgery.
At four months, my second foot was not at the same place of healing, and didn't have the strength and coordination as my right foot was. It felt floppy, and honestly, it was because I slacked off. I regretted it. It took me twice as long to strengthen my left foot and calf. I also noticed that a tight calf contributed to the problem.
Why go through the surgery if you don’t want to walk even better than before. It’s not about having pretty narrow feet; it’s about having strong healthy feet.
To be honest, I think my feet are wider than before, sans the bunion, because I am really developing them. There’s no way I want to go through that again. And believe me, I’m not a tough butt. I’ve done my share of whining and crying in frustration, but I did it. You can too. And it will pay huge dividends.
Prior to surgery, I realized how much my weight had shifted to the outside of my feet, nearly, sort of, developing bunions at the base of my little toes. I used to always get corns on the outside of my feet.
Now I understand why. I didn’t wear down my shoes on the sides, but I definitely carried my weight outwardly. I didn’t realize it, but prior to surgery, when I did lunges I rotated my feet out over the other toes because my big toe simply didn’t bend.
After surgery, as my feet healed, and I started moving again, I purposefully worked on carrying my weight over the big toe, rotating inward and stretching the inside of my feet and pressing down on the joint below the big toe. I practiced that in the shower too. As a result, I have gained a neutral pronation.
Realize this really does take a full year. They told me that, and it’s true.
Not only does it take time to rebuild your foot, during the process your body will retain stress without realizing it. It may build up or build on other stress. Be loving to yourself. No one else is really going to understand, but it is a grueling process, acknowledge it, and practice de-stressing.
Also, while you are rebuilding your foot, take this time to rebuild your overall strength. You are so worth it. New feet, new you.
Suggested exercises:
When I was released to start foot exercises, these are the ones I did – and still do many of them:
Warm up first – I rubbed my feet and joints before starting and then started slowly, eventually moving into a deeper stretch.
I started with
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Toe curls count of 20 3X
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Toe back bend count of 20 3X (grasping the base of the big toe and middle joint and stretching toward you)
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Stretch top of the foot (it’s important to stretch your toes the other direction too) lay on your stomach, with your legs straight, tuck your toes under (pointed) and stretch your foot – it hurts just as much as stretching your toe the other way, but it will pay off!
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Achilles stretch from sitting Count 30 3X
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Toe flexors from sitting Count of 20 3X
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Ankle circles 30X each way
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Ankle pumping 30X
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Ankle side to side 30X
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Arch stretch 30X
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When sitting in a chair put weight into your toe and foot, and gently stretch your calf and Achilles. (eventually, you can do this from a standing position).
I Added
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Leg stretches
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Shoulder stretches
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Neck stretches
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Back stretches
When you are able to add physical exercise, and since long distance walking is out of the question for a while, I started with the elliptical. It was a smooth transition to exercising again and teaching my feet to learn how to move again.
I added biking and swimming. At first, the quick movement of biking caused my foot to swell. Swimming did the same. By four months I did a combination of all three. Biking causes you to flex your foot, while swimming extends your foot stretch.
At 6 months I was working on the treadmill too. It’s good because it forces your feet to move naturally and you can concentrate on making sure you have a good foot movement and pronation. Again, the tendency is to baby your toe – don’t. Make it do its job.
Because your ankles are weak, make sure you can walk through your yard without rolling an ankle before heading to the trail. But before you know it a year will come and go and you will have beautiful strong feet. And WITHOUT crippling pain in your bunion and second like before.
Continue stretching your toes and feet both directions. It's kind of like wearing your retainer for the rest of your life after you had braces. Don't stop taking care of your feet.
After time you will forget you had surgery and your toe will get lazy and try to return to its pre surgery behavior of not bearing the weight and not being flexible. You will have to remind it of its job with a little round of stretching.
Keep watching your form. I’ve noticed I still have a tendency to rotate my feet out for some exercises that require toe flexibility. Think yoga feet. Stretch your toes out when you are sitting.
POST SURGERY WEEKS
POST BUNION FOOTWEAR
Most shoes, even well fitted shoes, are created with a curve at the toe which forces your big toe to curve inward. After bunion surgery, my big toe is beautifully straight for the first time in my adult life. And as a result of lots of foot therapy I have a beautiful toe spread, and strong toes and feet.
I had to do some hunting, but there are innovative shoe companies whose focus is creating shoes with zero inward slant, also known as a straight last. Some makers, like Birkenstocks, have been around for years. Others are new to the field and their stories are fascinating.
I am not getting any kickback for mentioning these brands, but I can recommend the following:
Note: One thing I learned about buying shoes online is that not all 10s are the same length, just like not all size 10 jeans fit the same. I tried using the EURO size but it’s not consistent either. Try this for a better fit: measure your longest foot in centimeters. Many countries size their shoes this way. Then go online and type in the brand and “shoe size conversion chart.” Try finding the one put out by the maker not an ecommerce shoe store. Then compare what you think you wear with the size in centimeters.
Athletic & Minimalist Shoes
CASUAL SHOES AND SANDALS (alphabetical order)
ALEGRIA, (and Dansko) – similar in style, just beware that many of their styles do not have the wide toe. This is especially true of Dansko.
BIRKENSTOCK – True patriots of the straight last shoe. (In my opinion, they are a little clunky but they are parents to two other sub-brands
BETULA and PAPILLIO, which have a few more feminine styles
CHACO – all have a wide toe base and straight last. Because they make most of their sandals styles in both men’s and women’s you can buy the wider fit men’s, which is what I did. There are a couple women’s styles that come in wide. I compared the footbeds of the sandals: the women’s wide is the same width as the men’s regular.
I was originally a big fan of Teva, owned them for years, but have made the switch to Chacos. The compromise is heavy soles on most of their sandals – but they don’t wear out, like ever, and for some reason my feet feel good after a whole day in them, like the weight is not even an issue. They also make lighter weight styles, clogs, and some cute flats and boots.
G.H. BASS – While the toe of their shoes are not straight last, they carry cute sandals in multiple widths. They are also the proud parents of penny loafers – in case those ever come back in style.
HAFLINGER – This brand is a lot like Birkenstock, this brand sells straight last clogs, specializing in wool clogs, and sandals
KEEN – lots of straight last shoes, full range from hiking boots to sports sandals to very cute casual dress sandals.
LEMS – practical shoes. They have a growing inventory.
MERRELL – they carry the full range from hiking boots to sports sandals and very cute casual dress sandals.
SANUKS – lots of cute sandals and yoga thong options, but loafers aren’t truly straight last
SAS - have some cute flats and sandals, also come in wide sizes
TEVA – men’s While they make top quality women’s shoes, they do not have a straight last, but the men’s shoes are a bit wider across the toes and may serve the purpose. I purchased a pair of their men’s canvas shoes, which are cute enough to be women’s.
VIVOBAREFEET – lots of styles. I like this brand for some reason. I’m probably going to buy a pair of their loafers.
Another idea – look for sandals with elastic bands/straps instead of leather, etc… or thong type. I ran across a few cute ones.
CASUAL /WINTER BOOTS (alphabetical order)
ALEGRIA not all, but some of their styles are straight last
CHACO – make clogs, loafers, and boots all with straight last
KEEN – not all, but most of their styles are straight last. I own Keens. Well made w/ leather.
KODIAK – I own a pair of their winter boots, well made and straight last
MERRELL not all, but most of their styles are straight last. I own several pairs of Merrell - well made w/ leather.
You may also be able to use:
BAFFIN
CROCS – small collection of straight last boots
KAMIK
KHOMBU – not all, but some styles have wide toe box
THE NORTH FACE
Most of these only have medium fit, but, depending on the individual style, they tend to have a wider toe box so might work for you.
DRESS SHOES AND SANDALS (alphabetical order)
None of these are straight last but might work for occasional wear
SAS - They have a few cute styles. Unfortunately, most of their shoes have hoop and last closing, which, in my opinion, makes them a bit less dressy. They do have some styles in wide widths, which may help, especially when looking for a dress shoe/sandal that is only worn occasionally.
DAVID TATE and WALKING CRADLES
David Tate and Walking Cradles ARE ESSENTIALLY THE SAME SHOES UNDER DIFFERENT NAMES. They make very pretty dress shoes, many with low heels. They make wide and extra wide widths, which doesn’t guarantee that the toes will be roomy, but for short periods of time they might work.
LIFE STRIDE- inexpensive, non-leather shoes, good option because some of their styles come in wide and some are made with elastic across the ball of the foot/toes, which is ideal for giving your feet a little more breathing room.
COMFORTIVA – Like David Tate – come in wide widths and square toes that might give your toes enough wiggle room
OTHER POS: Ros Hamerson, Joan and David
HIKING SHOES AND BOOTS (alphabetical order)
KEEN – Mid-priced, good quality boots with a straight last. Beware their "hiking boots are for urban trail hiking boots.
For backpacking and rocky trail hiking go with OBOZ or SALOMON
OBOZ – Great quality mid-priced option
HANWAG –as is all European boot makers, this German company is known for quality. They make a few lines specifically with a truly straight last.
MERRELL – I own a pair of their hiking/trail shoes, which are very supportive and holding up very well
SALOMON – Top quality mid-priced I own a pair of SALOMON hiking boots great support no break-in
ALTRA – Trail shoes A relatively new company that focuses on the straight last and giving your toes lots of room for running and hitting the trails. I own a pair of their running shoes and love the toe space. Note: their trail shoes offer minimal protection for rocky trails
ATHLETIC SHOES (alphabetical order)
ALTRA I have a pair of Altra running shoes. They offer a wide range of fits that accommodate different pronations, which is what drew me to this brand. Knowing that my feet were undergoing a major change in structure and pronation, I wanted something that would provide the best support. Altra shoes offer neutral pronation styles. My only problem with Altra shoes are the zero drop. With a high arch I need a heel insert - which slips nicely under the insole. Really, I’m not getting a commission from them - I just love their shoes.
REEBOK – Their Crossfit shoes have a wide straight toe box
SALOMON – Talk about quality and cool colors
MINIMALIST and BAREFOOT SHOES (alphabetical)
VIBRAM FIVE FINGER SHOES – These are probably the best know in the states, but there are some new kids on the block
LEMS – practical shoes. They have a growing inventory.
VIVOBAREFEET – lots of styles. I like this brand for some reason.
I’m probably going to buy a pair of their loafers.
MERRELL and NEW BALANCE have also jumped on board