Shoe Information

Some serious foot disorders, and even more common conditions, can be linked to one avoidable thing: inappropriate, poor quality or ill-fitting shoes. Any podiatrist will tell you that a good quality, properly fitting shoe pays big dividends for your feet down the road.

When shopping for shoes, always make sure to not force your feet in order to conform to the shape of a pair of shoes.

The most important quality to look for in shoes is durable construction that will protect your feet and keep them comfortable. Shoes that do not fit properly can cause bunions, corns, calluses, hammertoes and other disabling foot disorders.

The Fitting

Here are some tips to help reduce the risk of foot problems. Use this guide when you shop for shoes:

• Fit new shoes to your largest foot. Most people have one foot larger than the other.
• Have both feet measured every time you purchase shoes. Your foot size increases as you get older.
• If the shoes feel too tight, don't buy them. There is no such thing as a "break-in period."
• Most high heeled-shoes have a pointed or narrow toe box that crowds the toes and forces them into an unnatural triangular shape. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.
• Shoes should be fitted carefully to your heel as well as your toes.
• Sizes vary among shoe brands and styles. Judge a shoe by how it fits on your foot - not by the marked size.
• There should be a half-inch of space from the end of your longest toe to the end of the shoe.
• Try on both shoes.
• Try on new shoes at the end of the day. Your feet normally swell and become larger after standing or sitting during the day.
• Walk around in the shoes to make sure they fit well and feel comfortable.
• When the shoe is on your foot, you should be able to freely wiggle all of your toes.
• Women should not wear a shoe with a heel higher than 2 1/4 inches.

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A shoe has many different components. If you understand basic shoe construction, you can make a more informed decision from among the thousands of available styles.

The toe box is the tip of the shoe that provides space for the toes. Toe boxes are either rounded or pointed and will determine the amount of space provided for the toes.

The vamp is the upper middle part of the shoe where the laces are commonly placed. Sometimes Velcro is used instead of laces.

The sole consists of an insole and an outsole. The insole is inside the shoe; the outsole contacts the ground. The softer the sole, the greater the shoe's ability to absorb shock.

The heel is the bottom part of the rear of the shoe that provides elevation. The higher the heel, the greater the pressure on the front of the foot.

The last is the part of the shoe that curves in slightly near the arch of the foot to conform to the average foot shape. This curve enables you to tell the right shoe from the left.

The material from which the shoe is made can affect fit and comfort. Softer materials decrease the amount of pressure the shoe places on the foot. Stiff materials can cause blisters. A counter may be used to stiffen the material around the heel and give support to the foot.

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• Avoid shoes that have seams over areas of pain, such as a bunion.
• Avoid shoes with heavy rubber soles that curl over the top of the toe area (such as seen on some running shoes), as they can catch on carpets and cause an accidental fall.
• Flat shoes (with a heel height of one inch or less) are the healthiest shoes for your feet. If you must wear a high heel, keep to a heel height of two inches or less, limit them to three hours at a time and take them off coming to and from an activity.
• Laced, rather than slip-on shoes, provide a more secure fit and can accommodate insoles, orthotic devices and braces.
• Look for soles that are shock absorbing and skid resistant, such as rubber rather than smooth leather.
• The shoe should be made of a soft material that has some give, like glove leathers.

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When you take a step, your foot typically hits the ground heel first and rolls toward your toes, flattening the arch slightly. As you push off the ball of your foot, your arch springs back and does not touch the ground. That's how normal feet are supposed to work. Unfortunately, many feet aren't normal.

Over-pronation occurs if your foot rolls too much toward the inside. This can cause arch strain and pain on the inside of the knee. Under-pronation occurs if your foot rolls too much to the outside; under-pronation can often lead to ankle sprains and stress fractures. You can relieve foot pain by compensating for these tendencies, but first you need to determine which way your feet roll.

One method for determining which kind of pronation you have is the watermark test: Put your feet into a bucket of water, then make footprints on a piece of dark paper. If your footprint looks like an oblong pancake with toes, you pronate excessively or have flat feet. Try molded-leather arch supports, which can be purchased in many drug stores. And when shopping for athletic shoes, ask a sales clerk for styles with "control" features - soles designed to halt that rolling-in motion. If arch supports or sports shoes don't help, contact our office about custom-molded orthotic shoe inserts.

If there's little or no connection in your footprint between the front part of the foot and the heel, you under-pronate or have a high arch. This means a lot of your weight is landing on the outside edge of your foot. Ask for "stability" athletic shoes, which are built with extra cushioning to remedy this problem. And if you are prone to ankle sprains, wear high-top athletic shoes that cover the foot and ankle snugly to minimize damage from twists.

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Bringing in old shoes when you're buying new ones can be helpful if you have a knowledgeable salesperson. She can evaluate the wear patterns to help you get a better fit as well as a style that will compensate for the stresses you place on shoes.

What are your shoes trying to tell you? Here are the basic wear patterns:

• A bulge and wear to the side of the big toe: A too-narrow fit or you have a bunion.
• Outer sole wear: You turn out. Orthotics may help.
• Toe shaped ridges on the upper: Shoes are too small or you have hammertoes.
• Wear on the ball of the foot: Your heel tendons may be too tight. Stretch with heel raises.
• Wear on the inner sole: You pronate or turn in. Inner liners or orthotic supports may help.
• Wear on the upper, above the toes: The front of your shoe is too low.

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