In general, the best shoes are well cushioned and have a leather upper, stiff heel counter, and flexible area at the ball of the foot. The heel area should be strong and supportive, but not too stiff, and the front of the shoe should be flexible. New shoes should feel comfortable right away, without a breaking in period.
Getting the Correct Fit
Well-fitted shoes with a firm sole and soft upper are the best way to prevent nearly all problems with the feet. They should be purchased in the afternoon or after a long walk, when the feet have swelled. There should be a 1/2 inch of space between the longest toe and the tip of the shoe (remember, the longest toe is not always the big toe), and the toes should be able to wiggle upward. A person should stand when being measured, and both feet should be sized, with shoes bought for the larger-sized foot. It is important to wear the same socks as you would regularly wear with the new shoes. Women who are accustomed to wearing pointed-toe shoes may prefer the feel of tight-fitting shoes, but with wear their tastes will adjust to shoes that are less confining and properly fitted.
Ideally, the shoe should have a removable insole. Thin, hard soles may be the best choice for older people. Elderly people wearing shoes with thick inflexible soles may be unable to sense the position of their feet relative to the ground, significantly increasing the risk for falling. Some research suggests that thick soles may even be responsible for foot injury in younger adults who engage in high-impact exercise.
High heels are the major cause of foot problems in women. Although people believe that foot binding is a problem limited to Chinese women of the past, many fashionable high heels are designed to constrict the foot by up to an inch. Women who insist on wearing high-heeled shoes should at least look for shoes with wide toe room, reinforced heels that are relatively wide, and cushioned insoles. They should also keep the amount of time they spend wearing high heels to a minimum.
The way shoes are laced can be important for preventing specific problems. Laces should always be loosened before putting shoes on. People with narrow feet should buy shoes with eyelets farther away from the tongue than people with wider feet. This makes for a tighter fit for narrower feet and looser for wider. If, after tying the shoe, less than an inch of tongue shows, then the shoes are probably too wide. Tightness should be adjusted both at the top of the shoe and at the bottom. Where high arches cause pain, eyelets should be skipped to relieve pressure.
Breaking in and Wearing the Shoes
If shoes do require breaking in, moleskin pads should be placed next to areas on the skin where friction is likely to occur. Once a blister occurs, moleskin is not effective. Shoes should be changed during the day and rotated in their use. As soon as the heels show noticeable wear, the shoes or their heels should be replaced.
People should avoid extreme variations between their exercise, street, and dress shoes.
Exercise and Sports. Shoes purchased for exercise should be specifically designed for a person’s preferred sport. For instance, a running shoe should especially cushion the forefoot, while tennis shoes should emphasize ankle support. Athletic socks are almost as important as shoes. Experts often recommend padded acrylic socks.
Occupational Footwear. Because a number of occupations put the feet in danger, workers in high-risk jobs should be sure their footwear is protective. For example, non-electric workers at risk for falling or rolling objects or punctures should wear shoes with steel toes and possibly other metal foot guards. Electric workers should wear footgear with no metal parts (or insulated steel toes) and rubber soles and heels. Chemical workers should wear shoes made of synthetics or rubber, not leather.
Shoes for Sports
|Aerobic Dancing||Sufficient cushioning to absorb shock and pressure, which should be many times greater than shock from walking. Arches that maintain side-to-side stability. Thick upper leather support. Box-toe. Orthotics may be required for people with ankles that over-turn inward or outward. Soles should allow for twisting and turning.|
|Cycling||Rigid support across the arch to prevent collapse during pedaling. Heel lift. Cross-training or combo hiking/cycling shoes may be sufficient for the casual biker. Toe clips or specially designed shoe cleats for serious cyclers. In some cases, orthotics may be needed to control arch and heel and balance forefoot.|
|Running||Sufficient cushioning to absorb shock and pressure. Fully bendable at the ball of the foot. Sufficient traction on sole to prevent slipping. Consider insole or orthotic with arch support for problem feet.|
|Tennis||Allows side-to-side sliding. Low-traction sole. Snug fitting heel with cushioning. Padded toe box with adequate depth. Soft-support arch.|
|Walking||Lightweight. Breathable upper material (leather or mesh). Wide enough to accommodate ball of the foot. Firm padded heel counter that does not bite into heel or touch anklebone. Low heel close to ground for stability. Good arch support. Front provides support and flexibility.|
Cosmetic Foot Surgery
Taking fashion to extreme limits, some women have turned to cosmetic surgery as a drastic way to fit into high-heel shoes. Procedures include surgical shortening of the toes, narrowing of feet, or injecting silicone into the pads of feet. The American Orthopaedic Foot and Ankle Society (AOFAS) and other medical podiatric associations have expressed concern over this apparently growing trend. The AOFAS strongly advises against cosmetic foot surgery and urges consumers to carefully consider the relative risks and benefits of undergoing unnecessary surgical procedures.