Let’s face it. Patients want to look stylish and have footwear that is easy to get on and off no matter what their foot pathology. Certain styles of footwear, however, can actually predispose patients to pain and injury. This is especially the case when it comes to slip-ons with elastic goring that are worn by patients with flat feet.

Goring is the name of the elastic inserts shoe manufactures incorporate into the throat line or the sides of slip-on shoes or boots. Goring serves to create a snug fit without the use of shoelaces. In patients with flat feet and a medially deviated subtalar joint axis, this type of shoe provides little to no support.

This picture at top left shows posterior tibial dysfunction in the foot of a 29-year-old male patient I recently treated. The picture at the bottom shows his shoes with goring in the throat line.

Even with a highly supportive orthotic, he would still experience midfoot collapse due to the elastic goring, which would stretch medially and gap laterally, allowing the foot to pronate. Once this patient understood the incompatibility of his foot type with his current style of shoe, he readily changed his shoes to a lace style, especially since it would mean less foot pain.