Advice on Shoe Fitting
For many people, finding a shoe that fits properly can be a frustrating and time-consuming process. Because many people have subtle abnormalities in their feet, finding a properly fitted shoe can be difficult.
Fortunately, a few simple guidelines can make the process more tolerable. There are several good shoes on the market, some of which may even be styles you like. With the availability of Internet shopping, finding shoes for the hard-to-fit individual has also become a bit easier.
Measuring Your Feet
When purchasing shoes, it is always a good idea to have the salesperson measure your feet. Be sure to have both feet measured, because there may be a difference in size between them. If your feet are not the same size, buy shoes to fit the bigger foot.
How Feet Change Over Time
Our feet change just like our eyes do as we get older. A person’s feet tend to become a bit longer and wider with age.
During pregnancy, a woman’s shoe size tends to change. This is because of a hormone called elastin, which softens the ligaments in the pelvis to assist during delivery. Unfortunately, this hormone also affects other ligaments in the body, and the ligaments in the foot are particularly affected. Combined with weight gain and a shift in the center of gravity, this often causes women to change shoe size.
Why Time of Day Matters
Our feet also tend to change size over the course of the day. Shoes that feel comfortable in the morning may feel tight and uncomfortable later on, because of variable swelling that occurs as the day goes on. For this reason, it is a good idea to buy your shoes later in the day.
Understanding the “Last” of a Shoe
The shape of the shoe is important, but surprisingly little attention is paid to this feature of the shoes we buy. The “last” of the shoe determines its overall shape, and it may be either straight or curved.
To determine the “last” of a shoe, turn it upside down and look at the sole. Imagine a line that runs through the center of the heel and out through the center of the toe area. In curve-lasted shoes, this imaginary line forms a curve, usually curving inward. In straight-lasted shoes, the line runs almost straight from the heel to the toes.
Many shoemakers — particularly those who produce sports shoes — make curve-lasted shoes. Now, look at the shape of your foot. Have you ever wondered why your shoes seem to wear out in the upper part of the toe box in such a funny way? The reason may be that you have a rather straight foot and are wearing a curved shoe.
Problems Caused by Curve-Lasted Shoes
Curved-lasted shoes can aggravate several foot problems by placing excessive pressure on the outside of the foot. This may worsen existing problems such as:
- Bone spurs in the fifth toe
- Soft corns between the fourth and fifth toes
- Tailor’s bunions
Another area that can become irritated is along the outer side of the foot, near the “styloid process.” The styloid process is the base of the long bone (metatarsal) behind the fifth toe. In some people, the styloid process is more prominent and is subject to irritation from shoe pressure.
A powerful tendon also attaches to the foot in this area, originating from a muscle on the outer side of the lower leg. This tendon — along with other small tendons on the top of the foot — can be irritated by curved shoes.
Why Manufacturers Make Curve-Lasted Shoes
Shoe manufacturers make curved-lasted shoes because they believe curving the foot inward provides greater stability. In theory, they are correct, but shoes are rarely made of materials strong enough to influence foot function. Instead, as a person wears the shoe, it becomes misshapen over time and can irritate the outside of the foot.
Manufacturers have been somewhat more successful in producing “motion control” sports shoes, but even those will rarely withstand the deforming forces of the foot over time. If you have a foot abnormality that requires motion control, you are better advised to seek the help of a foot specialist who can determine your needs and prescribe a corrective device. These devices, called orthotics, fit into normal shoes and last for several years. In many cases, using an orthotic will correct abnormal wear patterns in a person’s shoes.
Choosing a Good Sports Shoe
When selecting a good pair of sports shoes, there are a few simple guidelines to follow:
- Fit the shoe to the shape of your foot. If you have a fairly straight-looking foot, choose a shoe with a straighter last.
- Look for a relatively rigid heel. Heel stability is important in almost all cases.
- Check forefoot flexibility. The shoe should flex easily in the forefoot. Otherwise, when the heel comes off the ground during walking and running, the big toe cannot flex properly, and adequate movement of the big toe joint is important for normal foot function.
Final Checks Before You Buy
Before you purchase the shoe, there are two more things to check:
- Inspect the heel. Place the shoe on a firm, flat surface and observe the back of the heel. It should be relatively perpendicular to the surface. If the back of the shoe is angled in either direction, it could indicate a manufacturing defect.
- Feel the inside. Put your hand inside the shoe and check for any defects in the seams. Prominent seams can irritate areas of the foot.
Special Considerations for Diabetic Patients
Diabetic patients need to be particularly aware of the type of shoes they wear. This is especially true if they have poor circulation, numbness, or a loss of sensation in their feet (neuropathy).
Shoes should be purchased with adequate toe box room, and the upper should be made of soft leather with few or no seams. Extra-depth shoes are available that meet the needs of many diabetic patients.
In many instances, Medicare will reimburse for one pair of shoes per year if the patient’s doctor recommends extra-depth or special shoes. There must be adequate documentation in the medical record for the need for the shoes. Many foot doctors offer diabetic shoes as part of their practice.