The Importance of Proper Footwear

The Importance of Proper Footwear by Jeffrey S. Hurless, DPM Foot health is extremely important in the overall health of your body. Moving our body is critical in diminishing the chances of chronic disease. Without healthy feet, we are unable to move our bodies and, therefore, more likely to develop chronic disease.

The foot is an amazing structure composed of 26 bones, 33 joints, and multiple soft tissue structures. Although I do believe it is healthy for the non-painful foot to be without shoes or barefoot to help maintain its natural strength and flexibility, our accepted culture has driven us to wear shoes.

I see patients all the time who, unfortunately, in their fourth, fifth, or sixth decade, have acquired some extra body weight and still work very demanding jobs requiring them to be on their feet for 8, 10, sometimes 12 hours standing or walking. I had a patient a few weeks ago tell me that he averages 25,000 steps a day. With this type of demand, to help prevent foot problems and certainly to help heal a foot injury, a shoe that is extra supportive and properly fitting will help.

The key criteria for choosing the right footwear either help prevent foot injury or to help heal foot pain would be:

• Proper Fit: Shoes are designed to have a flex point where the toes meet the foot. These joints are called the metatarsophalangeal joints. If you buy a shoe that is too long or too short, the flex point will cause higher pressure at the wrong area of the foot. Also, width is very important. Most shoes come in a variety of widths. If you have never ordered shoes online and aren’t sure what size to get - next time you’re at your podiatrist’s office or pass by a local shoe store, ask the shoe salesperson to measure your foot, not only the length but also the width. Make sure you are standing during the measurement - get your measurement and then you’ll know what size to order online. The best apparatus to measure the human foot is called the Brannock device.
• Supportive Sole: A sole that is extra supportive can aid in preventing foot problems and/or healing foot pain. When evaluating shoes, try to bend the shoe by placing one hand at the toes and one hand at the heel, and then try to flex the shoe in half. After you do this to a half dozen pairs of shoes, you will quickly appreciate the difference most shoes have in the stability and support of the sole.
• Rigid Heel Counter: The heel counter is the area of the shoe that is in the back and surrounds the heel bone. We prefer this area of the shoe to be stable and rigid. As we walk, all of our feet go through a motion called pronation and supination. This is how our arch collapses and then is re-created. This is a normal motion in all of our feet and serves as our shock absorber. If you would like to control excessive or abnormal motion or stabilize the rear foot and arch, a rigid heel counter will help to stabilize the heel bone, which in turn will reduce pronation and supination, reduce arch collapse, and reduce excessive or abnormal motion of the foot.
• Adjustability: Adjustability in a shoe is very important. I always prefer laces as opposed to slip-ons, buckles, or even Velcro. Laces provide better adjustability to allow for different size feet, swelling, or even adding a potential arch support to the shoe.

It is also important to choose your shoes based on the type of activity. If you’re going to dinner and a movie, that’s a very different type of shoe than if you’re going to spend the day shopping and cleaning.

One of the most common problems that I see in my office is a painful bunion or pain associated with that bunion joint. A bunion is a structural deformity of the metatarsals. The first metatarsal has maligned, causing the big toe joint to work inefficiently. When the big toe joint is unable to work in the capacity that it was designed to work, the demand and pressure that normally go through that joint will go elsewhere, which can cause other problems, such as hammertoes, neuromas, stress fractures, or soft tissue injuries like tendinitis. If a patient is unable to undergo surgical correction of this deformity, most patients end up relying on shoes to help keep their pain and discomfort under control. The criteria just described is very important for these patients. For example, proper width - usually a shoe with a wider width will feel more comfortable for a patient with a bunion. Having that extra support with a rigid sole and a firm heel counter will also allow the big toe joint to rest and, therefore, reduce pain and inflammation. Having the adjustability of laces will also help this shoe fit the foot better and cause less pain. This is just one example of how proper footwear can help a foot problem.

Some further tips on finding the perfect fit: If you can get a measurement using a Brannock device, make sure to not only get the length but also the width. The best time of day to try on shoes is towards the end of the day when your feet may be slightly more swollen. If you have two different size feet, it’s always better to buy the shoe for the larger foot. We recommend walking around on carpet after getting your shoes to make sure they feel comfortable, there are no abnormal pressure points, and you have adequate room in the toe box.

We hope this helps in choosing shoes to support your health.

Written by
Dr. Jeffrey S. Hurless
DPM, FACFAS Board Certified Foot & Ankle Surgeon/Podiatrist
Medical Director, HealthyFeetStore.com