A new type of “super-cushioned” shoe has recently come to the market and for certain people these shoes have proven to be helpful and decreasing foot pain. Hoka Cushioned ShoeThe first company to bring these to market was Hoka One One. Now many of the running shoe companies are coming out with similar models.

The video below provides a good overview of the technology and science behind the Hoka and other maximally cushioned shoes. The video makes it seem, however, as if the shoe is only for runners. We have also found it very useful for walkers with certain types of foot pain.

Video: Hoka Shoe Technology

The super-cushioned shoes are, at best, unusual looking. Some would consider them ugly. But they incorporate two features that can be helpful for people with foot pain that does not respond to other treatments.

  • They have much more cushioning than average shoes. This cushioning acts to slow the velocity of the foot as it hits the ground. This can decrease pressure under the heel and under the ball of the foot. For this reason these shoes can be helpful for people with ball-of-foot pain and heel pain such as plantar fasciitis.
    Hoka One Cushioning and Rocker

    Extra cushioning and rocker sole

  • The super-cushioned shoes also incorporate a “rocker sole”. Rocker soles also decrease pressure under the heel and the forefoot plus they act to decrease joint motion in the foot. For this reason they can be helpful for people with foot arthritis and with tarsal tunnel syndrome.

In the past many shoes that have been the most cushioned have also been very unstable. The Hoka One One shoes get around this problem by using an extra wide sole that wraps around the shoe. Still, they are meant for walking and running only and should not be used for side to side sports like tennis.

At our foot clinic in Seattle we have also found these shoes helpful for Boeing workers who stand on hard surfaces for long periods of time.

Which Hoka Model Should You Get? Look for a Rigid Rocker

walking shoe with rocker sole

Bondi LTR

When we recommend Hoka to our patients we usually do so because we want them to have the benefit of a rigid rocker in the forefoot. Some Hoka shoes do not have this rocker so it is critical that you get the correct model. Make sure that the forefoot does not bend when you push on the front of the shoe.

hoka hiking boots

Hiking

As of 2017 the following models have a rigid rocker. Other models may also, but check to make sure. You can use the links to see the shoes.

Video: Review of the Hoka Trail Running Shoe

I have been recommending the trail runner to many of my patients who simply walk for exercise. I find it somewhat more stable than the standard Hoka running shoe. But in general, if we have recommended a maximally cushioned shoe to you then any of the Hoka shoes should work. In the future we will be evaluating super cushioned shoes from other brands.

We do not think that these shoes are for everyone. But for those who benefit from extra cushioning, they can be very helpful. For help in determining if these are the right shoes for you, make an appointment to see us in our Seattle foot and ankle clinic. Be sure to bring samples of your shoes and any orthotics or arch supports you currently wear.

Dr. Larry Huppin
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37 thoughts on “Can Maximally Cushioned Shoes like the Hoka Relieve Foot Pain?

  1. Do you recommend the Hoka for someone with Peroneal tendonitis? was thinking of trying the Hoka Clifton 3.

    1. Some Hokas are unstable laterally and may not be the best choice for peroneal tendonitis. The Clifton is better than most. You can try it but make sure you are not rolling to the outside.

  2. I bought a pair of Hokas Infinity, I work on concrete every night,I walk 13 +miles a night at my job.And I have had surgery on both of my feet for heel spurs.Had to wear inserts in my shoes,until I bought my Hokas,Now no inserts in my shoes.I would recommend infinity.If you don’t like them you can always send them back.I LOVE MINE.

  3. Which Hoka (if any) would you recommend with sesamoiditis? I have been dealing with pain for 2 years, and I have tried three different Hokas. Now I’m experiencing knee pain with the same leg. Thanks!

  4. Which Hoka do you recommend for Lisfranc fracture/dislocation, months postop after cleared to walk in sneaker? Was looking at WIDE shoes due to swelling and Hoka has Arahi in Wide. Would this do? Bondi looks awesome but doesn’t come in wide. Also not sure if they have enough arch support for lisfranc or whether I can/should but orthotics in them.

    Also I am trying to figure out there early (before metatarsal head) vs late stage (after metatarsal head) rocker and which would be better for lisfranc unloading. I assume early?

    Thank you.

    1. That’s a wide open question. Many people do not need orthotics and do fine with a good shoe alone. Many others need orthotics for relief and comfort. There is no way to answer your question without getting a complete history on your issue.

  5. I fell through my attic and broke my heel into four pieces. Also an injury to my Achilles’ tendon. I think I might have also broken my 5th metatarsal. This happened 7 years ago. I am now 65 years old and I don’t let it stop me from doing anything but I cannot push up on my foot and have minimal in/eversion.

    Would one of these types of shoes help me? Thank you.

      1. Is there a professional organization with a US directory to find the biomechanic orthotics podiatrist? The podiatrist i saw locally just wants to do surgery for top of foot pain.

    1. I am 50 Years old and shattered my heel into several pieces and have same problems as you. Also broke all 5 metatarsal in that foot twice. I lives with constant pain and limited foot movement as you do. Hokas have made it very tolerable. I have 10 screws, 2 pins and a plate still in my heel and foot. This happened 8 Years ago. I try not to let it slow me down as I am a very active outdoor person. Hoka shoes have changed my life. I still have pain, ankle joint catches sometimes and achilles hurts me regularly. But with these shoes I do not worry about how much my foot will hurt when deciding to do something. Personal I wear the any Mid upper hiking shoes with the plush cushion. I will say the first ones i had did not hold up well at work but they have discontinued that model as I’m sure they became aware of the problems. You can’t go wrong with any of the hikers in my opinion. I also have a pair or regular hokas. Not sure which ones. They are great for concrete and pavement.

  6. Hello
    I have an mpv big toe stress fracture which am avoiding a cartiva implant as well as bad osteoarthritis in both knees, mild scolisis and spinal stenosis, pronation and heel pain. I have tried 3 types of custom orthotics over the past few years and i canmot tolerate the hardness on my feet. I also have mild fibro and very bad nighttime muscle cramping when intry tonwear the orthotics even for an hour a day. Which shoes do you recommend as the xelro shoes have a rocker bottom but am wonderimg if that destanilizes my feet and knees. Thanks.
    Nancyfc

    1. This is too involved to try to give advice online. You need to see a podiatrist who specializes in orthotic and shoe therapy to get a complete evaluation, diagnosis and treatment plan.

  7. I have a job that requires me to do a lot of walking in a 12 hour period. Last week I got home and found that both my feet were on fire, heels and balls of feet aching. I bathed them in Epsom salts and had them professionally massaged. I have put schol gel insoles in my working shoes but my feet and am wearing compression socks. My colleagues at work say that I should try the Hoka to seed if this shoe will help. My shoes at present are Accents and have had Brooks in the past. The Brooks shoes were hard on my feet and its only in the last few days of being on my feet so long that the problem has started.

  8. Hello, I’m a patient of Dr. Hale’s diagnosed with bunion, metatarsalgia and neuroma. I tried the Bondi but unfortunately, even the ‘wide’ version was not wide enough for me so I ended up returning them. If they ever come out with a width one notch higher I should be able to fit into them nicely. Until then, the Dr. recommended I try the Altra Olympus and I can safely say that these are the ONLY shoes (and I’ve tried dozens) that I’m able to wear comfortably at the gym, especially for treadmill activity. Of course, I much prefer the style of the Bondi over Altra. I’m looking forward to finding a shoe someday that not only has style but also plenty of cushion and width. Thanks for your blogs!

  9. Which Hoka is good for normal everyday use, occasional walks? I see there are more styles since this was 1st written, Clifton, Elevon, ,March, Cavu.. My local store carries the Bondi, but is that the best? I feel like I might be getting planter fasciitis, and want to prevent it.

  10. Hi,
    I’ve had ankle fusion on both feet. A subtalar on the right, and a talonavicular on the left. The left one resulted in a non-union. I also supinate. Can you tell me that Hoka would be best. I use an AFO on the left foot. It’s very painful to walk, and with no shoes on it’s horrible. I’m having a triple arthrodesis in May. Thanks

  11. Currently the Hoka Stinson and Bondi are the only shoes that work for my ball-of-foot pain. I tried out the Speedgoat for hiking but it didn’t work. MBT’s and Sketchers are too unstable for me. I am eagerly awaiting more recommendations from you for cushioned rockers as selection is so limited. Still looking for some decent walking shoes that aren’t “sneakers”. So far, the Dansko Willa is the best I’ve found but am still evaluating it. Appreciate your insights!

  12. I have achilles tendonitis, high arches and ball of foot ,would the Hoka work for me ?I have the Vionic sneakers, as well as the high arch Vionic sandal. These work for a while but feet burn after wearing.Can you recommend any podiatrist in the Syracuse, New York area ?

  13. I have hallus rigidus and my podiatrist said to get a pair of Hoka.. Now I’m overwhelmed with all the options.
    Im 49 I have a desk job but I will squeeze in15k-20k steps in a day either 1-2 mile run or walking breaks. I used to wear Dansos for work now Nurse Mates bc of swelling. Which model is best? To wear for every day walking g and work. Which for concrete street short runs/walks..

  14. I just want to add that I bought a pair of Hoka’s and put in my custom made insole. I didn’t think much of it but when I had my yearly check up with my podiatrist and previously that year had plantar fasciitis, he wanted to look at my shoes. The custom made insert did not fit properly in the Hoka’s. When he showed me how the extra cushion in the Hoka’s along with my insole turned my foot the wrong way. I never noticed it but it was quite obvious after he showed me. I sold my Hoka’s.

  15. I am a65 year old female with flat feet and bunions and do to left knee replacement my right leg is 1/2 inch shorter so I wear a lift. Which Hoka shoes would you recommend?

  16. I’ve tweeted the company they need a double X Wide for those of us who need greater than a 4E. Tried their x wide feels great rocker is greater cushioning is awesome. I have some big toe pain and a NM.
    Thanks

  17. Dr. Huppin is correct, uber cushioning and rocker soles are not the answer for everyone. I have been buying and wearing hiking shoes that pass muster with Outdoor Gearlab (independent reviewers). A pair of Hokas topped their list in 2020. Compared with also top-rated La Sportiva, Salomon and Arc’Teryx hiking shoes, I get foot fatigue sooner with the Hokas. Left foot problem is pretty mean midfoot joint osteoarthritis. Right foot has advanced hammertoe.

  18. I don’t think rocker bottom shoes are recommended for Achilles Tendonitis. I have Insertional Achilles Tendonitis and was told by my podiatrist not to wear Hokas. They stretch and pull on the IAT and make the condition worse. I wear New Balance 990v5 now. Like them a lot.

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