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How to Choose the Best Running Shoes, According to a Foot and Ankle Surgeon
November 02, 2026
If you’ve ever finished a run with sore knees or aching feet, there’s a chance that your shoes may have had something to do with it.
The right running shoe comes down to three things: your foot type, the surface you run on and how much you run. If you get one of these wrong, injuries tend to follow.
We asked Megan Wolf, MD, a foot and ankle surgeon with Hartford HealthCare’s Connecticut Orthopaedic Institute, to walk us through what actually matters when you’re shopping for running shoes.
“The shoe is the only piece of equipment between your foot and the ground,” says Wolf. “Getting it right matters more than most people think, and getting it wrong catches up with you fast.”
1. Your foot type determines which running shoe is right for you
Foot type determines how your foot absorbs and distributes impact with every step. Flat feet tend to overpronate, meaning the foot rolls too far inward. High arches tend to supinate, meaning the foot rolls outward. Neutral arches fall somewhere in between.
The simplest way to find out is the wet foot test. Step on a piece of cardboard with a wet foot and look at the print. A wide, flat print means low or flexible arch. A thin print with a big gap in the middle means high arch. A moderate print is neutral.
“Foot type affects how every mile feels and how injuries develop over time,” notes Wolf. “It’s the first thing I ask a patient about when they come in with a running-related injury.”
> Related: The 6 Best Shoes for Your Knees, According to an Orthopedic Expert
2. A gait analysis can tell you exactly what shoe you need
Most running specialty stores offer gait analysis. You jog on a treadmill for about 10 minutes while staff watch your foot strike and movement patterns.
What it tells you is whether you overpronate, supinate or run with a neutral gait. That determines whether you need a stability shoe, a motion control shoe or a neutral shoe.
“A quick treadmill assessment gives you information that most runners never think to get,” explains Wolf. “It points you toward a category before you ever touch a shoe.”
> Related: Running Gear for Beginners: What You Actually Need (And What to Skip)
3. More cushioning is not always better
The assumption that more cushion equals more protection is one of the most common misconceptions when it comes to running shoes.
In fact, runners with proper form often do better in lower-cushion shoes. Extra foam can change how you feel the ground, which then alters your mechanics and actually increases impact on your joints. For new runners, heavier runners or anyone with joint issues, more cushion makes sense. But for higher-mileage runners, a lighter shoe with better ground feel may cause fewer problems.
“I see runners who think a maximal cushion shoe will fix their pain,” adds Dr. Wolf. “Sometimes it does. But sometimes it masks the mechanics that caused the pain in the first place.”
4. Your shoe should match the surface you run on
Road shoes have a smooth outsole and are built for pavement, sidewalks and treadmills while trail shoes have aggressive tread and usually include a rock plate to protect against roots, rocks and uneven ground.
Running a trail shoe on pavement wears the tread down faster. Running a road shoe on trails creates the risk of ankle sprains. Match the outsole to the surface you actually run on.
“Terrain is one of the easiest things to match correctly and one of the most often overlooked,” shares Wolf. “I see a lot of ankle injuries that come down to the wrong shoe for the ground.”
> Related: 6 Strength Training Tips to Protect Your Knees From Running
5. Running shoes wear out after 300 to 500 miles
Many runners hold on to shoes too long. The foam in a running shoe midsole compresses over time and stops absorbing impact the way it should, even when the shoe still looks fine on the outside.
If you start noticing new aches on familiar routes, visible wear on one side of the outsole or a midsole that looks flattened, it may be time for a new pair. If you run three to four times a week at moderate mileage, you’re likely looking at replacing them every four to six months.
See a provider if you develop new knee, hip or foot pain after switching shoe models. The transition can cause injury on its own if the change in cushioning or heel height is too abrupt.
“Most people wait until a shoe looks worn out,” continues Wolf. “But the midsole breaks down long before the upper does. By the time you can see the damage, you’ve already been running in a compromised shoe.”
> Related: Is Running Bad for Your Knees?
6. Rotating between two pairs of running shoes extends the life of both and reduces injury
Running in the same pair every day doesn’t give the foam time to fully decompress between runs. Rotating between two pairs allows each shoe to recover and varies the load on your feet from one run to the next.
Varying your shoe from run to run reduces repetitive stress on the same tissues. Running in the exact same shoe every day applies the same forces in the same pattern with every stride. Swapping pairs disrupts that pattern.
“I recommend rotating to almost every patient who runs regularly,” reminds Wolf. “It’s a low-effort habit that pays off in fewer injuries and lower long-term costs.”