Most people would be surprised that a majority of foot problems are caused from poor shoe fitting. People choose shoes for many different reasons including comfortability, style and functionality. Just because a shoe appears to look comfortable and is expensive is not the criteria to use when purchasing shoes.
Shoes must fit properly, be made of sturdy materials, and have a solid construction. Due to the variability of people’s foot structure, a shoe may comfortable to one person and very uncomfortable to the next person.Shoes are designed to protect the feet during mobility and support. Unfortunately, improper shoe fit can limit joint movement, constrict circulation, decrease sensation and alter the way you walk. Poor shoe fit can also inhibit the proper functioning of custom-made foot orthotics.
If improper shoe gear is worn for a long term, the muscles, joints, and connective tissues in the feet begin changing shape, adapt to the shoe and cause many foot disorders.
Feet have been measured for years by a metal instrument called a Brannock Device. You have probably seen a Brannock Device in nearly every shoe store you have entered. The Brannock Device is used to measure 3 basic dimensions of the foot.
A. Heel to the ball of the foot
B. Heel to the tip of the toes
Each measurement is used in combination to custom fit the shoe. The most important measurement is the heel to the ball of the foot, because this measurement will closely resemble how the shoe is designed to function. The shoe is designed bend at the ball of the foot, and if the shoe bends in the arch or doesn’t bend at all, this must be taken in consideration. The heel to the ball measurement defines the position of the arch and if this measurement is incorrect, the shoe and the foot will never function in harmony. Instead, they will fight each other with each and every step.
When measuring the heel to toe length, allow a minimum of a 3/8 to ½ inch distance from the tip of the big toe to the front of the shoe. If the toes touch the end of the shoes, this can cause trauma to the toenails and possibly cause hammertoes and can lead to ingrown toenails.
The heel should fit comfortably in the shoe with a minimum amount of slipping. In other words, the shoe should not ride up and down on the back of the heel as you walk. The heel of the shoe helps control rearfoot motion. A straight, solid heel in the shoe is very important especially in those who are flatfooted or pronate.When measuring the width of the foot, you must allow enough room in the shoe to accommodate the foot structure. If the foot is rubbing on the sides of the shoe, blisters, calluses and other problems can occur. If a patient has bunions or tailor’s bunions, this deformity can become increasingly painful with a smaller width shoe.
Make sure the ball of the foot fits comfortably in the widest part of the shoe. Don’t buy shoes too tight and expect them to stretch to fit.Take in consideration the height of the toebox in the shoe. Sometimes the tops of toes can rub on the inside of the shoes. In some people, especially those with hammertoes, this can become a problem. Allow enough room in the shoe so the toes do not rub.A slight heel is important, however avoid high heeled shoes whenever possible. High heeled shoes allow for the forefoot or the “ball of the foot” to bear the entire body weight. This can cause intense forefoot pain and ultimately cause severe deformities of the foot.All foot measurements must be taken weightbearing or standing. Since the foot lengthens and widens under physiologic loading, a false measurement may be taken if the foot is measured while sitting.
Most people have one foot that is larger than the other. Fit the shoe to accommodate your larger foot. Don’t select shoes solely based on the size indicated on the tag inside the shoe.
Select the shoe according to how it fits your foot or shaped like your foot. The “last” of the shoe is the so-called footprint of the shoe. The last can be straight or slightly curved inward. Everyday dress shoes are normally built on a straight last, while athletic shoes are built with a slight inward curve of the forefoot. Straight last shoes are recommended for patients using orthotics in their shoes.
Shoe material is also a consideration when purchasing the proper shoe. Durability, flexibility and breathability of the material has to be accounted for in the upper material of the shoe. If the material is too soft and flexible, you may not get the support and durability you are looking for. On the other hand, if the materials are too stiff and don’t “give”, they can be very uncomfortable and cause pressure. If you have feet with significant arthritic changes, it is very important to choose shoegear that will “mold” to the foot in order to take pressures off the deformity.People who have feet that sweat a lot need to find materials that breathe in an effort to get air to the feet during the day. Some shoes are designed to absorb sweat from the foot, but many do not. Naturally for those people whose feet perspire a lot, you should allow your shoes to thoroughly dry out before wearing them again.
Do not store the shoes in dark closet immediately after using them. Instead, store the shoes near an open window or on the front porch to fully dry out.
The sole of the shoe is a major consideration. Many people complain that the sole of the shoe is too stiff or too flexible. It is important to find a shoe with a happy medium. If you had to choose between a very flexible sole or a stiff sole, I would personally lean towards a stiff soled shoe. Shoes with excessive bend can cause a variety of foot problems.
Also, try to find a shoe that will accommodate your arch height. Most people bear weight on the heel and the ball of the foot. When barefoot, the arch is usually not supported unless you have a very flat arch. Therefore, try to find a shoe that accommodates the arch height to distribute the pressure across the entire surface of the foot. Be careful though, because too much arch in the shoe will cause the patient to bear weight primarily on the arch region of the foot and can cause severe pain.If you stand on hard surfaces such as concrete or tile, a shoe with proper cushioning is necessary.
Also if you participate in athletic activities, finding a shoe with good shock absorbing qualities is important. If hard soled shoes are worn in these situations, pressure calluses can develop on the bottom of the feet. Also, choose shoes that have a sole that will not slip. Soles should provide solid footing and not be slippery.Buy shoes in the afternoon or towards the end of the day. At the end of the day, the feet have expanded and swollen through activity and will be its largest size. The Brannock Device does not measure the “volume” of the shoe.Also, don’t forget to bring socks or panty hose to the store when getting fit for shoes. Many stores have socks to wear, but be prepared by bringing your own in case the store does not have them for you.
It is important to realize when your foot deformity cannot be accommodated by shoes bought from a shoe store. Those patients with chronic non-healing ulcerations or severe arthritic deformities and malformations need extra protection and shoes that are custom-molded to accommodate deformities and offload pressure areas. Dr. Silvers has extensive professional experience providing custom-molded shoes. Casts of your feet are taken in the office, sent to a specialized shoe-making company in which a shoe is fabricated to you own personal specifications. If you are diabetic or have one of the previously mentioned foot deformities, you should come see Dr. Silvers to determine if custom-molded shoes are needed for you.