On a daily basis I have to inform patients, that their leg and foot problems stem from their inappropriate footwear. The refrain is always, “this shoe isn’t appropriate, how? I paid a lot of money for this you know”. “This is an expensive brand you know. You find it is too narrow at the front, really?” “I bought it a size big to facilitate the pointy tip so it isn’t tight you know”. “You don’t find it looks comfortable?” “You find that heel too high?”

A proper fit, proper materials, and solid construction of the shoe is essential. A shoe that is comfortable for one person, may be totally uncomfortable for the next person, due to nothing more than the difference in foot structure between the two people. I constantly have elderly women saying that they wish they had worn proper shoes when they were younger, to avoid the problems they are now having.

Statistically, more women visit podiatrists than men, and part of the reason for that, is due to the difference in the type of shoes, both sexes wear. Again, it comes down to compliance. So what about those of you who are reading this discussion. and saying to yourself, that you do wear good shoes, but your feet still hurt? Again, most times, those “good” shoes, may not be the best, for your type of foot structure.

 Shoe fitting – the infant

Since all of us start out as infants, let’s start with their feet. At crib age only a loose fitting booty is necessary, and this is more for warmth, than anything else. Initially, when the toddler begins to walk at about one year, he/she should be encouraged to walk barefooted, at least inside the house, and with shoes outside the home, in order to protect the feet. Walking barefoot is the most natural way, for feet to develop.

It’s very important, that the child’s shoes should be properly fitted. Between wearing proper shoes, and going barefoot, the child’s feet will become conditioned to wearing shoes.

Between one to two years of age, the child should be in a flexible shoe, alternated with  boots. From two to three years of age, they should alternate between, a firm shoe, flexible shoe, and boots. After three years of age, they can go to an athletic type shoe, along with a flexible shoe, and a firmer shoe.

 Shoe fitting – teenagers and adults

In teenagers and adults, a properly fitted shoe, should have the widest part of the foot fit at, or just behind, the widest part of the shoe. The reason for some feet, it’s just behind the widest part of the shoe, is to make up for those who happen to have longer toes. When standing, there should be a small amount of room, between the longest toe, and the end of the shoe. Keep in mind, that the big toe, is not always the longest toe.

There should also be adequate height in the toe box. If any of the toes are rubbing on top of the shoe, the potential for foot pain and corns exists. Your heel should fit snugly into the back of the shoe. This is necessary to stabilise the heel when you walk, in order to cut down on excessive motion in the foot. This, by the way, is one of the main components in expensive running shoes.

Foot shape should fit shoe shape. Makes sense, right? In this day and age of mass production, most shoe manufactures have gone to a straight lass shoe, with no differentiation in the forefoot area. To compensate for that, many people will buy a shoe that is wider than they actually need, in a bid to acquire that particular shoe. The problem with that line of logic is, that the foot may slosh around in the shoe, causing irritation to the foot in the form of corns, calluses or blisters.

Many people make the mistake of buying a shoe with a lass that’s too narrow for their particular foot structure. I am constantly pointing this out. Stand in your shoe; if any part of the outside of the foot hangs over the outer sole of the shoe, you are inviting trouble in the form of pain.

Shoe material is also a consideration when purchasing the proper shoe. Durability, flexibility and breathability, should be accounted for, in the upper material. People with very arthritic, bony type feet, need to look for materials that will mold to their foot structure, thereby taking pressure off the deformity. Of course, as stated previously, a shoe with a high toe box, will also go a long way to protect this area of the foot.

People with sweaty feet, need to find materials that breathe, in an effort to get air to the feet during the day. In this day and age, there are innersole materials which are hydrophilic, meaning they absorb perspiration away from the foot. This can go a long way to cutting down on the incidence of athletes foot, and dermatitis. Naturally for those people whose feet sweat a lot, you should allow your shoes to thoroughly dry out, before wearing them again. Most people make the mistake of throwing their perspiration laden shoes in the dark closet, where they never dry out fully.

This is part one of a two part article. Next week we would discuss the sole of a shoe and its importance; weight bearing distribution issues; sizing of foot; time of day to purchase footwear; and issues with having large or deformed feet.

Your feet mirror your general health . . . cherish them!