Why Sport-Specific Athletic Shoes Matter

Sport-specific shoes are important because they can help prevent injuries, while enhancing performance and comfort, with mechanical properties: cushioning, flexibility, fit/snugness/room, and traction to address the distinct biomechanical patterns inherent in the particular sport. Sport-specific shoes have uppers with midfoot support and most importantly, specially designed outsoles created for a given playing surface. In addition, we have recently noted some companies even offering additional widths in court and field shoes.

Glancing at the pickleball courts and basketball courts around the country, it is not uncommon to see recreational players wearing running shoes to participate in these sports instead of pickleball, tennis, or basketball shoes, respectively. Podiatrists treating pickleball injuries often find out that their patients were using running shoes (created specifically for forward motion) instead of pickleball shoes that have the traction, stability and support for the side-to-side, quick pivoting movements and frequent changes of direction in a court much smaller than that used in tennis. Similarly, podiatrists addressing basketball injuries sometimes learn that their patients were using running shoes while playing basketball. Not only are running shoes designed solely for forward motion, in our experience, their vertical edges can contribute to lateral ankle sprains and Achilles tendon ruptures when a person is pivoting, backpedaling, or changing direction. The development of running shoes with taller and softer midsoles may complicate this issue even further.

Dr. Elizabeth Bondi, a podiatrist, Board Member of the AAPSM and accomplished collegiate tennis player, explained in a recent article that, “Court shoes are designed with a toe guard, reinforced upper, and forefoot lateral flange to provide some durability and stability to the foot during lateral motion and toe drag. These shoes also include a midsole shank that helps to maintain the shape of the shoe and provide some “rebound” back into the legs when pushing off to change direction.”¹  

Below you will find a quick rundown on the latest technologies in each sport to help you recommend the features your patients should be looking for when they purchase a sport-specific shoe and/or are recovering from an injury. In the last few years, almost every sport has developed carbon fiber sport-specific technology, including innovative zonal support in the upper material. Some sports have women’s-specific models and some even come in multiple widths. We encourage you to educate patients about the pros and cons of midsole shanks and carbon fiber plated technology, especially for patients with navicular bone stress injuries or calf strains.

Tennis and Pickleball: Key Considerations

As previously mentioned, there is a huge difference in the biomechanical design of tennis and pickleball shoes versus running shoes. Court shoes have rounded edges, a lateral flange and specific court herringbone outsoles for traction to allow lateral side-to-side and pivoting movement, while running shoes have vertical edges for forward motion only. We have noted a lot of debate as to whether there is a true difference between pickleball and tennis shoes. Since pickleball has recently soared in popularity, there is a huge spread in the design and technology of related shoe offerings, so we recommend that patients do their research before purchasing.

Pickleball shoes: We note the availability of 3 types of models: no shank, midfoot shank, and carbon fiber plate. Since the court is smaller than tennis and there is less room to accelerate, which can lead to crossing feet more often, tread and traction is very important. You can use tennis shoes for pickleball, but only some such shoes would be optimal for playing pickleball. We have also been asked about using a training shoe or basketball shoe for playing pickleball. In our estimation, some training shoes won’t have the traction, stability, or cushioning you would need to play pickleball. Very few basketball shoes would really work for pickleball because they are made more for forward and backward movement on a longer court. In our experience, you may want to suggest that patients look for flat, full-length tread and not decoupled outsoles, as well as enough midfoot containment support. Pickleball shoes with shanks give added midfoot torsional support and stability and prevent the shoe from flexing under the patient’s arch, which may help those with stability issues or pes planus foot types. Pickleball shoes with carbon fiber plates may help those with hallux limitus or rigidus (which have found are an increasingly common concern for pickleball players).

Tennis shoes: Here we also see 3 types of models: no shank, midfoot shank, and carbon fiber plate. There are also low-top and mid-top options, as well as half bootie construction, wider heel flanges, and improved heel lockdown such as split sharkskin lining, which offers a glove-like feel around the ankle and even lighter-weight innovations in midfoot lock down. We feel companies have really upped their midsole technologies, adding improved responsiveness and energy return and lower to the ground construction, as well as additional widths and wider-fitting options. Tennis shoes with shanks may benefit those with plantar fasciitis or who need more stability. Many of the top-tier tennis models are moving to a lower heel-to-toe drop, so if your patient has issues with Achilles tendonitis or limited ankle range of motion, educate them on the exact heel-to-toe drop you want them to use. We find that some top-tier models have also moved to a more flexible forefoot to allow for explosive power, which is great for those without any hallux limitus or rigidus issues.

What You Need to Know About Basketball Shoes

One of the biggest innovations in basketball happened in 2009 when Kobe Bryant, inspired by the low profile of soccer boots, launched low-top basketball shoes. These shoes increased his range of motion, speed, and had a reduced weight, while permitting more timely activation of anterior and lateral ankle joint stability muscles than high-tops.² While many have opted for the responsiveness of the low-top movement, it is important to keep in mind that the choice between low-top and high-top should consider the player’s position. Low-tops work well for point guards, shooting guards, and small forwards, as they are lightweight and emphasize mobility. High-tops offer stability and ankle protection, but may increase demands on the knee for power forwards and centers who are involved in rebounding and physical post-play.³ Versatile “2-way” players may opt for mid-tops, which provide a balanced option between low- and high-tops. Innovations in the outsole, such as concentric circles over the original herringbone design, have allowed for improved grip and stability while still allowing nimbleness. There are top-loaded shanks, bottom-loaded shanks with leaflets, medial shanks that wrap up to the lateral forefoot, as well as nylon and even carbon fiber plates in basketball shoes. In general, carbon fiber plates will have more energy return and rigidity than nylon plates.

Pertinent Pointers on Other Sport-Specific Shoes

Soccer cleats: Innovations here include ultra-thin foot conforming uppers and carbon fiber integrated outsoles. The latest speed-focused cleats use asymmetrical stud patterns that angle outward to grip the ground during lateral cuts. Additionally, some companies include the ability to adjust stud configurations, collar heights, and even insole support based on a player’s position or playing surface. Strikers could choose a streamlined stud pattern for explosive acceleration, while midfielders can use a stud configuration that prioritizes rotational traction for quick pivots.

With the high increase in women’s knee (anterior cruciate ligament) injuries in soccer and 70% of all women’s soccer knee injuries being noncontact, one company is creating a women’s-specific soccer cleat which features wider toe boxes, lower cleats, a narrower heel, and more arch support than the conventional soccer cleats. The goal of this design is to decrease knee valgus collapse and pronounced tibial rotation seen in these noncontact ACL injuries.⁴

Football cleats: One of the most talked about innovations, we find,  is cleats that can move (which reduces rotational forces) have longer, more aggressive studs, often a toe spike for traction when blocking or evading a tackle and will vary depending on natural versus artificial turf. In addition, it will depend on the demands of the position of the player, (ie running back versus lineman).

Lacrosse cleats: These shoes often have a multidirectional design and molded studs. We find they have flexible, lighter cleats and traction plates that give grip during lateral cutting movements.  

Golf shoes: One may find these shoes have enhanced traction and stability with strategically placed hybrid spikes combining permanent and removable cleats to adapt to varying course conditions. There is also a golf specific carbon fiber plate used. Midsole innovations have enhanced cushioning and rebound, in our experience. Some companies even offer memory foam insoles that mold to the shape of one’s foot. BOA lacing system technology can help with quick, easy on and off, but doesn’t allow for distribution of pressure if needed. Some golf shoes have even added integrated sensors that can analyze a player’s stance and swing. One should also note the importance of waterproof or water-resistant uppers in this shoe type, especially for patients with diabetes.

For golfers, it may be wise to ascertain when to use a spiked versus a spikeless shoe:

• Spikeless: May provide increased comfort, reduced pressure points, and best suit drier conditions. Generally, spikeless is better than spiked for those with diabetes, because they can offer more comfort, flexibility, and better fit.
• Spikes: These may be appropriate for wet, muddy, or hilly courses, for strong swings, and when the player needs more grip or stability.  Many public courses do not allow spikes due to damage to greens.  
• It is always wise to encourage patients to check course rules regarding golf shoes.

Understanding the Intersection of Shoe Technology and Fit

In addition to understanding the latest technologies in each sport, we wanted to offer our best practices in shoe fit tips, since the most advanced shoe technology in the world will not benefit patients unless they are properly fitted in sport-specific athletic shoes.

1. When being fit by a specialty retailer with expertise in that particular sport, have both feet measured for size and width, either with a Brannock device or a digital foot scanner, ideally annually. The correct size may vary between shoe brands and models. The correct size and width is incredibly important for all patients, but especially with diabetes or similar at-risk statuses.
2. Ask the athlete to reflect on their favorite shoe and note which features were comfortable and supportive.
3. Children ages 5-14 should be measured at least twice yearly to ensure best fit.
4. We recommend patients try on shoes after exercise or at the end of the day (when the foot is the most swollen).
5. We also advise them to try on shoes with their orthotics/inserts and their usual thickness of sock, since these factors will all impact shoe fit.
6. When creating orthotics for a patient, keep in mind that court shoes will not have as stretchable an upper as running shoes. Often cleats do not have removable insoles so the patient will require thin orthotics.

We also recommend the following:

1. Shoe rotations: The patient alternates more than 1 pair throughout the week, according to their activity level.
2. Teach patients about the 3-point shoe test: checking the flex point, torsion, and heel stability of shoes. Additionally they should confirm these features when wearing them.
3. Teach patients about heel-to-toe drop, especially for Achilles tendonitis.
4. Lacing techniques can help customize the fit and relieve some pressure points (after proper fitting). In addition, shoelace tightness may influence lower limb mechanics and perception.⁵

Conclusion

Midsoles, outsoles, upper materials, and heel and midfoot lockdown differ for each sport due to different containment, cushioning, and traction needs. Recommending sport-specific shoes to our patients is a challenging and integral part of our practice, as we can help reduce injuries and increase performance for our patients. It is important to keep up with the latest technologies and changes in the industry and familiarize yourself with the different brands and models in the different sports, as well as how orthotics will fit and function in the specific shoes. Partnering with knowledgeable retailers can help podiatrists with this knowledge. Biomechanists and podiatrists have also pointed to the importance of having a mixture of carbon fiber plated and non-carbon fiber shoes in a shoe rotation to allow for muscles and bones to continue to maintain their integrity, not leave them in a weaker state, and ultimately give one longevity in their sport.

Tim Dutra, DPM, is an Assistant Professor at Samuel Merritt University College of Podiatric Medicine. He is a Podiatric Team Physician at the University of California, Berkeley. He is the Clinical Director of Special Olympics Healthy Athletes Fit Feet. Dr. Dutra is the Past President of the American Academy of Podiatric Sports Medicine.

Stephen Hill, PhD, is an Associate Professor and Manager of Motion Analysis Research Center at Samuel Merritt University.

Jennifer Wong, CPed, is the Certified Corporate Wellness Specialist & Business Development Rep at New Balance. 

References
1.    Bondi E. Pickleball injuries in the foot and ankle. Podiatry Management. 2024. Available at: https://podiatrym.com/pdf/2024/9/Bondi924Web.pdf. Accessed April 10, 2025.
2.    Fu W, Fang Y, Liu Y, Hou J. The effect of high-top and low-top shoes on ankle inversion kinematics and muscle activation in landing on a tilted surface. J Foot Ankle Res. 2014;7(1):14. doi: 10.1186/1757-1146-7-14. PMID: 24548559; PMCID: PMC3943374.
3.    Lam WK, Cheung CC, Leung AK. Shoe collar height and heel counter-stiffness for shoe cushioning and joint stability in landing. J Sports Sci. 2020;38(20):2374-2381. doi: 10.1080/02640414.2020.1785728. Epub 2020 Jun 30. PMID: 32600128.
4.    Krosshaug T, Nakamae A, Boden BP, et al. Mechanisms of anterior cruciate ligament injury in basketball: Video analysis of 39 cases. Am J Sports Med. 2007;35(3):359-367. doi:10.1177/0363546506293899.    
5.    Tang Y, Guo X, Zhou T, et al. Effects of shoelace tightness on lower limb biomechanics and subjective perception during lateral shuffle in basketball. Acta Bioeng Biomech. 2023;25(4), 2023. doi:10.37190/ABB-02400-2024-02.