Three Canada-based physiotherapists have urged the footwear industry to start designing running shoes specifically for women, rather offering them slightly modified versions of those made for men.

The trio – Christopher Napier, Gurmeet Dhillon and Allison M Ezzat – make a series of recommendations in an open-access article written by a four-member team that is published today (15 October) in BMJ Open Sports & Exercise Medicine.

Dr Napier – an assistant professor in the Department of Biomedical Physiology and Kinesiology at Simon Fraser University in British Columbia – and his fellow authors argue that sports footwear manufacturers should ditch their ‘shrink it and pink it’ approach to women’s running shoes.

This is because the approach fails to appreciate the distinct anatomical and biomechanical needs that women have across the life course compared to their male counterparts. The authors conducted a small qualitative study, holding focus groups with women runners in Vancouver.

Female-based designs might not only boost women runners’ comfort, but also enhance injury prevention, and their performance, say the researchers.

Over the past 50 years, manufacturers have invested billions of dollars on developing running shoes that can prevent injury, maximise comfort, and improve runners’ performance. 

Yet both industry and academic research to inform these advances has predominantly been designed for, and tested on, men and boys, point out the researchers.

‘Lasts’ made according to male template

Running shoes are designed by creating a three-dimensional foot-shaped mould called a ‘last’, which is typically based on male foot anatomy, Dr Napier and his fellow researchers explain. 

Most brands use the same last for their entire range, and beyond making the shoes smaller and changing the colour – a process known as ‘shrink it and pink it’ – often only minimal modifications are made to create women’s shoes, they note.

The researchers therefore wanted to hear from recreational and competitive women runners which features they prioritise in a running shoe and how these might differ across the lifespan, with a view to informing future shoe design.

‘The footwear industry should move beyond simply scaling down men’s shoes to fit women’s feet … there is a need for sex- and gender- specific designs that accommodate the distinct foot morphology of women and their social constructs and preferences, all of which evolve across the lifespan’ [Christopher Napier et al]

What did the women in the study want?

Dr Napier and colleagues recruited 21 study participants via posters displayed at local running stores in Vancouver, Canada, with the aim of including a broad range of ages, running experience, and weekly running volume and frequency in two focus groups.

Eleven women were recreational runners who clocked up a weekly average of 30 km, while 10 were competitive runners, who averaged 45 km. Nine of the women ran during pregnancy or soon after giving birth. Their ages ranged from 20 to 70, and their years of running experience ranged from six to 58.

The women were asked to rank in order of importance the factors informing their choice of running shoes. The responses showed that their primary considerations were the comfort and feel of the shoe, injury prevention, and performance.

In terms of comfort, most of them said they wanted a wider toe box, a narrower heel, and more cushioning; competitive runners also wanted shoes incorporating performance enhancing features, such as a carbon plate, as long as these didn’t compromise comfort.

The women said that they actively sought out running shoes that they believed would help prevent running injuries, and with this in mind, both groups emphasised the high value they placed on buying shoes from trusted retailers or personnel.

They highlighted the need for different shoe designs or components to align with different running contexts – taking part in races, training, speed work, or running with an injury, for example. 

And those who were mothers, reported needing a larger shoe size and wider fit as well as more support and cushioning during pregnancy and after giving birth. Competitive runners also said they needed added cushioning and support features in their footwear as they got older.

Caveats and conclusions

This study involved only a small number of participants, and the researchers acknowledge that participants came from a specific geographical area, which may limit the generalisability of the findings.

Nevertheless, they suggest: ‘Overall, our findings highlight a critical gap in the design of running footwear, which has been traditionally based on male anatomy and biomechanics.

‘While participants did not always report an inability to find footwear, their narratives reflected a process of trial-and-error adaptation, often without guidance or purpose-built solutions. This suggests that their needs are not proactively addressed through current footwear design or communication.’

Dr Napier and his co-writers conclude: ‘We strongly recommend that the footwear industry should move beyond simply scaling down men’s shoes to fit women’s feet. Instead, there is a need for sex- and gender- specific designs that accommodate the distinct foot morphology of women and their social constructs and preferences, all of which evolve across the lifespan.’ 

Gurmeet Dhillon is based at Simon Fraser University and the University of British Columbia; Allison M Ezzat is based at the University of British Columbia and the BC Children’s Hospital Research Institute. The article’s fourth and final author is Anna-Catharina Wilhelm, a clinical research interventional cardiology coordinator at the University of British Columbia.

To access the full version of the article – titled If a shoe had been designed from a woman’s foot, would I be running without getting the injuries?’: running footwear needs and preferences of recreational and competitive women runners across the lifespan Doi: 10.1136/ bmjsem-2025-002597 – click

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