Do Runners Actually Need Stability Shoes? A Physical Therapist’s Perspective
Here’s the truth most runners get wrong: not every runner needs stability shoes and in some cases, they can actually create new problems.
If you’ve ever been fitted for running shoes, there’s a good chance you’ve been told you need stability shoes.
Maybe it was because you “overpronate.”
Maybe a past injury flared up.
Or maybe someone watched you jog for 10 seconds on a treadmill and confidently declared, “Yep, you need more support.”
In this blog, we’ll break down:
What stability shoes actually do
How they differ from neutral shoes
Which injuries stability shoes can help with
When supportive shoes make sense…and when they don’t
This will help you make a smarter decision for your body, your training and your injury history. I want you to feel confident in knowing what shoe you need when you walk into your local running shoe store.
What Are Stability Shoes?
Stability shoes are designed to limit or slow excessive motion of the foot, particularly pronation, which is the natural inward roll of the foot after it hits the ground.
A key point here: Pronation itself is not bad. It’s a normal part of shock absorption. Stability shoes simply aim to control how much and how quickly that motion happens.
They’re often marketed as supportive shoes for runners who:
Have flatter arches
Feel unstable during stance
Experience recurring overuse injuries
But “support” can mean very different things depending on the shoe’s structure.
The Structure of Stability Shoes vs. Neutral Shoes
Understanding the design differences helps explain why stability shoes feel so different on the run.
Stability Shoes Typically Include:
Medial support on the inside of the shoe to limit inward collapse
Dual-density midsoles (firmer foam on the medial side, softer elsewhere)
Wider bases for added ground contact
Stiffer heel counters to improve rearfoot control
Less torsional flexibility through the midfoot
These features are meant to guide the foot into a more controlled movement pattern. Check out our favorite stability shoes for Atlanta runners.
Neutral Shoes Typically Include:
Uniform cushioning from medial to lateral side
More flexibility through the midfoot and forefoot
Less structural correction
Lighter overall weight in many models
Neutral shoes allow the foot to move more freely and rely more on the runner’s own strength and control. A lot of runners can actually do very well in neutral shoes as their main daily trainer if they are diligent with their individual strengthening and prehab exercises.
Who Do Stability Shoes Tend to Help?
Stability shoes can be helpful when they’re used for the right runner and the right reason. From a physical therapy and biomechanics standpoint, stability shoes tend to help runners dealing with:
1. Posterior Tibial Tendon Pain
This tendon helps support the arch and control pronation. If it’s overloaded or irritated in a runner with weakness in their lower leg muscles, stability shoes can temporarily reduce strain.
2. Plantar Fasciitis (In Some Cases)
For runners whose heel or arch pain is aggravated by prolonged pronation in standing, supportive shoes can reduce tissue stress especially early in rehab.
3. Medial Tibial Stress Syndrome (Shin Splints)
Stability shoes may help runners who collapse excessively at the midfoot and ankle, contributing to repeated tibial loading and the development of shin splints.
4. Knee Pain Linked to Poor Lower-Chain Control
In runners with weak hip or trunk control, stability shoes can reduce excessive knee valgus as a short-term assist, not a long-term fix. Structured strengthening programs will still be the gold standard for these runners.
When Stability Shoes Aren’t the Answer
Here’s where things get tricky. Many runners are placed into stability shoes without considering strength, mobility or running mechanics.
You may not need stability shoes if:
You pronate but have good strength and control
You’ve never had injury issues in neutral shoes
You feel restricted or awkward in supportive shoes
Your pain began after switching into stability shoes
In some runners, excessive shoe stiffness can:
Reduce natural foot motion
Increase load to the knees or hips
Delay activation of stabilizing muscles
Create dependency on external support
At Tempo Physical Therapy & Performance, we help Atlanta runners understand their unique running mechanics through our 3D running analysis in order to be sure they are in the correct shoe for their running needs.
The Problem With the “Overpronation” Label
Almost every runner pronates. That’s not a problem. The real question is how well you control it.
Two runners can look identical in a shoe store treadmill test, but one:
Has strong calves, feet, hips, and core
Controls pronation smoothly
And the other:
Collapses rapidly
Lacks strength or coordination
They may require very different footwear strategies.
This is why blanket recommendations for stability shoes can miss the mark for runners.
Stability Shoes as a Tool, Not a Permanent Solution
In many cases, stability shoes work best when used:
During higher mileage phases
While rehabbing an injury
As a transition tool while strength improves
As a physical therapist, I often tell runners: “Stability shoes can reduce stress, but strength is what actually fixes the problem.”
Long term, the only real fix is improving your body’s capacity to handle your training. Strength training and specific rehab exercises are key for any runner to have as part of their routine to best support their running.
How to Know If You Need Stability Shoes
Instead of asking “Do I overpronate?”
Ask these better questions:
Do I feel unstable or uncontrolled during stance?
Do symptoms improve or worsen in supportive shoes?
Am I currently dealing with a tendon or overload injury?
How strong are my calves, feet, hips, and trunk?
A running gait analysis combined with strength testing gives far more useful information than shoe category alone. Following the running gait analysis, our running specialized physical therapists can recommend specific shoes to try at your local running shoe store. Some of our favorites local to Atlanta runners include Big Peach Running Company (East Cobb & Brookhaven locations), West Stride (Buckhead) and Fleet Feet (Decatur location).
Final Thoughts: Choose Stability Shoes for the Right Reasons
Stability shoes aren’t bad. Neutral shoes aren’t better. The best shoe is the one that:
Matches your biomechanics
Fits your injury history
Supports your current training demands
If you’re constantly cycling through shoes hoping pain will disappear, it’s usually a sign that footwear alone isn’t the full answer.
That’s where a running-specific physical therapy evaluation can help you decide:
Whether stability shoes make sense
If supportive shoes are being overused
Or if strength and mechanics are the missing link
If you’re questioning what type of running shoe would work well for you OR you’ve been dealing with a nagging injury and want answers, book a FREE consultation call with us at Tempo Physical Therapy & Performance.
Written By: Dr. Morgan Kamau
