Bunions, hammertoes, heel pain, forefoot pain, nerve trauma, blisters and bursitis are some of the common terms used to describe painful foot conditions. Ill-fitting shoes that fail to provide the correct environment for proper foot functioning can make shoe shopping a very frustrating and time-consuming process.
“When it comes to selecting properly fitting shoes, the first important thing to remember is that everyone’s feet are different. They can be different in overall length, width, height and orthopedic configuration,” said David M. Millili, D.P.M., Director of Podiatry at Cooper University Hospital.
“Having a basic understanding of the design and manufacturing of shoes and then matching it to the particular needs of the foot become an important step toward providing what needs are necessary for someone’s feet to feel good while performing their activities of daily life,” he said.
Dr. Millili offers this advice:
Consider Your Shoes
The first place to start in the evaluation of footwear is whether the actual shape of the shoe matches the shape of your foot. The shape of a shoe is determined by the “last”—the mold on which a shoe is made. Generally, shoe lasts come in three separate shapes: curved, semi-curved and straight. There are some instances and foot types in which a curved shoe is beneficial, and there are instances when an excessive curve in the front part of the shoe can be detrimental by applying excessive irritation to the outer structures of the foot. Matching the needs of the foot to the overall shape of the shoe is an important part of the fitting process to avoid such irritating conditions as tendonitis, bursitis, corns, calluses, and sometimes even tissue or skin breakdown. Also important is the “upper” – the material that surrounds the foot and attaches to the sole. “Uppers” can be made of both synthetic and natural materials, such as nylons, leathers, canvas, etc. As a general rule, natural materials, such as leather, tend to provide a more forgiving environment for the foot by allowing the foot to “breathe.” Natural materials allow air to pass through the shoe, helping to eliminate hyper hydration (sweating) of the foot. Another important consideration in “uppers” is the placement of seams and stitching. Generally, seams are unforgiving and will allow for very little foot conformity. In most cases, the skin will give or begin to break down long before a seam accommodates for excessive pressure.
Consider Your Feet
Finally, in the basic consideration for deciding on a configuration of a shoe that matches the foot’s needs is the degree of arch support built into the shoe. For the most part, when an individual is barefoot, the foot is a two-point weight-bearing system: weight is transmitted through the heel and the forefoot. Very often, however, additional support to the arch is recommended in order to create a full-contact weight-bearing system. This helps the structures along the bottom of the foot bear weight in order to tolerate the tremendous amount of impact that the foot goes through on a daily basis. In most cases, shoes that provide a higher degree of arch support become a beneficial environment for the foot. This is certainly achieved more easily in a full, closed-style shoe, such as a sneaker, and is sometimes difficult to achieve in a dress shoe, which provides a flattened last with no arch support. In these cases, the use of arch-support devices, either over-the-counter or custom orthotics, become helpful to provide that extra support the dress shoe cannot provide. This is a common problem in warm weather shoes such as sandals; however, various styles are available with built-in arch supports, which, in most cases, can assist the foot in keeping consistent offloading and arch support.
Consider Your Pain
As a whole, regardless of foot shape, persistent foot and ankle pain is never considered normal and should not be ignored. There are a variety of medical disorders that entail a higher degree of management and care, such as diabetes, circulatory disorders and advanced arthritic conditions. In these situations, extra-depth shoes or custom shoes may be indicated to provide a higher level of protection and support.
It is recommended that in the case of injury or unexplained pain to seek the advice of a podiatrist. Podiatrists are physicians who are trained in the medical and surgical treatment of the foot and ankle, and part of the healthcare team, which can assist you in making a more informed decision as to the needs of your foot and ankle.
Dr. Millili also provides these general tips to help you select properly fitting shoes:
- Keep in mind that as we age, the needs of our feet can change, including accommodative support measures, and overall size and dimension. Because of this, your feet should be evaluated periodically to make sure that your shoes are meeting the current needs of your feet.
- When being sized for footwear, it is important to measure both the length and width of both feet.
- Make sure that the shape of the shoe matches your needs and activities.
- Maintaining the proper length of approximately 3/8 inch to ½ inch from the longest toe to the end of shoe can help alleviate pain at the end of the toes.
- Do not equate expensive shoes with the correct shoe, and make sure that at the time of purchase, the shoe feels good to the wearer.
- It is important to “break in” or gradually wear new shoes to allow both the skin and materials of the shoe to accommodate for one another slowly.
- If physical damage such as blisters or tissue breakdown is occurring with the use of new shoes, stop use immediately. Have the area evaluated and discuss why this particular environment was detrimental to your foot.