I never really thought that I would find myself in a seemingly perpetual state of cognitive dissonance doing something as simple as selling people running shoes. Thing is, it's become rather infrequent that I am actually fitting a regular runner in shoes. Generally those people already know what they want and ask immediately for it, or they don't come in at all because what they know they need can be found cheaper online...such is the struggle of brick-and-mortar businesses. Story for another day. Okay, maybe those folks are not "infrequent" so much, but they're not nearly as frequent as those who come to us dealing with foot issues or other medical maladies that often leave me absolutely astonished that they would turn to a running shoe store to address for them.

Multiple times daily, the ding of the door brings in a customer who, upon being greeted, begins a story with, "My doctor sent me here..."

I am not a doctor. I'm an hourly retail employee, all of us here are. And yet, here they are, with the expectation of assistance with potentially serious medical issues very often exceeding mere "shin splints" and plantar fasciitis. People with diabetes, disc problems, poor surgical outcomes, balance issues, neuropathy, and the list goes on.

They want a shoe to fix it, or at least help it. Their doctor sent them. The expectation is sky high.

As much as part of me inwardly sighs in slight impatience at the end of a particularly busy day when someone comes in with a complicated issue to address and it's closing time and you know you'll be working an extra hour now, while I don't know how much I can help them, I'm glad they're here. Because just maybe you can help them change a poorly planned course of action, take a second look, and put them onto a better one.

A few of my coworkers and myself have been doing this running-shoe slinging thing for a while now, and we often talk about how we have seen our particular industry evolve into perhaps less of a service for athletes and fitness enthusiasts, and almost more of a medical profession. With that said, we are constantly trying to brainstorm ways to evolve to accommodate that need, how to evolve so that we remain relevant. The days of treadmill "gait analysis" are rapidly becoming obsolete, with countless flaws having been exposed in that approach to footwear-fitting, and research continually disproving what used to be a cornerstone of the shoe-fitting process.

Here's how it goes. Over and over. Everyday:

Customer needs a shoe to run, walk, or just live life in. We steer them to the treadmill. Customer proceeds to run or walk, whatever they're planning on doing in the shoe they ultimately wind up in. Then the script is roughly as follows:

"You 'over-pronate,' here's a 'stability' shoe with a post in it."

"You're 'neutral' here are some 'nuetral' shoe options."

"Your feet are WHACK bro, Brooks Beast for you!"

Okay maybe not that last one. Except yeah, kind of.

All the while, in the back of my mind, I think to myself that, sometimes, this feels like complete BS that I'm selling them on...like I am selling them a shoebox full of lies! When it comes to shoes, what looks "right" may not be right at all. What feels right very often is right, despite what it looks like. The body is smart and often knows what it wants.

Much of the time, it's not an issue. Compared to the shoe they have been using, whatever they end up in will be far better for them, regardless of a tiny "post" of more dense EVA foam that may or may not even affect them with the mileage they may or may not be running. But when it comes to addressing recurring injuries and issues, which is often the expectation, biomechanics are infinitely and endlessly complex.

You heard it here first (or maybe you've already heard it): traditional running stores who aim to get people into footwear by utilizing this utterly archaic method of doing so will be dead in less than a decade. They're rapidly becoming irrelevant in our fast-paced, instant-gratification, ultra-digitalized, 24-hour-delivery-turnaround-world not only because we simply can't keep up with the internet, but also of the methods we currently use to fit people, and because of the knowledge and skill that we currently lack to accommodate what so many people are now looking for. The community involvement aspect of running stores will always be important, but so is getting and keeping customers. The stores that evolve to understand the mechanics of the human body and how footwear can impact them--for better or worse--who are willing to think outside of the box to solve problems rather than simply sell things, those will thrive. You can't replace expertise with Amazon.

Podiatry has become my least favorite profession. With orthopedic surgeons a close second. I am not saying that there are not great ones out there who have patient's best interests at heart, those gems are definitely out there, no doubt about it. But I am saying that, coming from my own experience and what I've witnessed happen to others, at the risk of sounding cynical, I sometimes believe our healthcare system exists to make money, not always to fix people. Healthy people are not cash cows.

Circling back around, where my aforementioned cognitive dissonance kicks in multiple times per day, is when, for instance, the well-intentioned soccer mom brings her kid in, who has turf toe or whatever from, well, playing soccer, who took him to a podiatrist who then promptly diagnosed him with "flat feet" (his feet are clearly not flat...). Now, doctor wants to see him in a stiff, rigid, "motion control" shoe and a $700 custom orthotic that took 5 minutes and cost Dr. So and So $30 worth of materials to make, all in the name of "prevention" of foot problems. It should be noted that the shoe and beefy orthotic likely weigh roughly as much as the actual kid. Looking at said kid, there is quite literally nothing wrong with him, or his feet, but all of these things could certainly ensure that something becomes wrong with them. To do what is suggested by his doctor would be to do him a disservice.

Or there is the little old lady with just the slightest bunion issue, who could benefit tremendously from simply not being in a shoe 2 sizes too small, whose podiatrist has convinced her of getting a painful bunion surgery with a long recovery that may or may not work out so well. Oh, and also she has circulation issues, so yeah....that should heal up nicely. You don't casually mess with foot surgery.

Or the very overweight man whose surgeon is replacing his knee next week. Rather than devising ways to help him lose some extra weight so that he can not only take some tremendous stress off of his deteriorating knee so that he can be more active and do a far better job rehabbing--or who knows, maybe even offset the need for that joint replacement altogether for another decade--no, he's going to operate now. Right now. While the guy is already in terrible shape, and more or less ensure that he has to become even more sedentary and unhealthy while he regains mobility, and making his rehab far, far more difficult than it needed to be. Maybe even taking years off of his life, but most certainly taking life out of his years.

Or the guy who's going into his podiatrist tomorrow for his third cortisone injection in as many months into his plantar fascia even though the catabolic effects of repeated corticosteroid injections into soft tissues are extremely well-documented, often degenerating them to the point of rupture. But hey, then maybe he'll have to buy a pair of those $700 orthotics.

I understand that there are different theories surrounding various treatment options. I understand that I don't have an M.D. But the word that comes to mind for a lot of these situations is...irresponsible.

I could go on and on. Anyway, the bottom line is that all of these folks come in looking for a shoe to fix a problem or aid them in dealing with a problem. They tell us what their doctors told them and so many times I want to tell them that there are potentially better ways, even if those ways might take more effort and more time, and yes, it does come down to being willing to do what's necessary in that regard. Get a second opinion, get a third, do your own research, advocate for yourself. Just because someone has "Dr." in front of their name does not make their word law, and it does not mean they're looking out for you.

I always try to ensure that these folks understand that a shoe is a tool, and it can help with what they're dealing with, but that it's unlikely to truly "fix" things. But I think it is becoming imperative that we, as these "running shoe experts" step up our game exponentially and gain a far more in depth understanding of the complexity of biomechanics and injuries in order to "save" some of these hapless individuals from tremendous unnecessary difficulty and struggle...physical and financial.

Of course, there are all of these logistical business issues that come with that: how do we "train" this? What kind of schooling do we need? How does this impact our relationships with local podiatrists and doctors who send customers our way, but whose opinions we may now dispute? How do we compensate employees for this much higher level of skill and knowledge? Do we now need some kindness of malpractice insurance? This only scratches the surface.

I don't mean to demonize the medical field or make it sound like I think that it's all a big conspiracy or something. Half of my family are doctors (and yes, they've heard all of the "Dr. Payne" jokes). There are wonderful people in the field who are genuinely concerned with peoples' welfare and will do absolutely everything in their power to improve a person's quality of life. What I am saying is that, again, too often it's simply a money-maker, with no concern for anyone's actual well-being, too often it's an extremely cursory examination of symptoms that are not a cause but a result, with only one treatment option presented because "it's how we've always done it." I am saying that sometimes there is not a quick fix for something, or only one fix for something, but that there can be a better fix for something.

I thought about all of these things that as I finished a run earlier this morning. This time last year, half of that distance would've had me hobbling the rest of the day. Six months later, a third of the distance had the same effect. And now, for whatever reason, I find the complete opposite happening, where longer distances have gradually become more and more pain-free. Plenty of things changed; strengthening and cross training and shoes and scrapping a pair of orthotics that I had for a few years and "needed." I don't know what specific component effected things to this degree, or if it will continue on this trajectory. Coming up on a year ago a nationally-renowned orthopedic surgeon of a half-dozen professional sports teams took a 45 second look at an MRI and told me running was a terrible idea, suggesting an expensive and questionable surgery as well. I'm not saying he was wrong, I'm not saying that I'm in the clear just because I can run more now, but I am saying that maybe that wasn't the only way just because that's the typical course of action for that particular issue. I am also saying that I'm so glad I didn't take his advice. Sometimes the cookie-cutter way is not the best way.

When I saw that Michelle Yates crushed Run Rabbit Run yesterday, it brought me back to a blog post she had written following years of hip issues, when she was told more or less she was done running and destined for multiple hip replacements. While it's true that she has had many struggles since then, and has had to work incredibly hard to continue to train and maintain, and that it is likely she will have to address her issues surgically somewhere down the line and that it will be hard, I haven't asked, but something tells me that she doesn't regret not going with the first solution that was immediately presented to her at the time, which was to quit.

I don't know what it is with doctors telling runners to quit.

Anyway, off to sling some shoes.