Friday, 8/4/2011

How To Fit Shoes

Ensuring that our patients are wearing the right shoes is one of the most important aspects of treating our patients. Shoes are an integral part of treating nearly all foot complaints and anyone experiencing foot problems should have an evaluation to determine the proper shoe for their foot. We determine the proper shoes for each patient by evaluating the patient's foot shape, foot biomechanics, symptoms, activities, weight and other factors. We often watch the patients walk on slow-motion video to determine exact foot mechanics. We then provide the patient with a list of appropriate shoes based on our evaluation of their feet and available shoes. Below is a number of tips to ensure you get the best fitting shoe possible:

The width of the shoe should not constrict the foot. The toes should be able to wriggle freely (use the ‘foot tracing’ method below to assess for proper width)
1. Step 1 – place your foot on top of a piece of paper
2. Step 2 – trace around your foot ensuring not to undermine the foot edges
3. Step 3 – Place the removeable shoe insert/sock liner or the shoe on top of the foot tracing. Ensure the back of the shoe (the heel counter), lines up with the tracing of the heel.
4. Step 4 – Trace around the shoe where the foot overlaps the shoe edges. If the shoe doesn’t overlap the foot, than it is too small for you foot.
There should be one thumb width between the end of the longest digit and the end of the shoe (the shoe wearer’s thumb width not the shop assistant or mum/dad)
The heel counter of the shoe should be firm and yet cushioned.
Lace up shoes offer the greatest support, but velcro and shoes with straps are preferred over slip on shoes
Pointed shoes are to be avoided at all costs. These will squeeze the toes together and contribute to the development of bunions (Hallux abducto Valgus) and other injuries such as morton's neuroma (nerve entrapement)
Shoes should have good torsional stability. Meaning they do not twist along the longitudinal axis of the shoe excessively.
Shoes should have good stability in the sagittal plane. Meaning they should bend wear the toes bend only. You should not be able to bend the shoe in the opposite direction or thorugh the middle/arch of the shoe
Shoes without seams are better as they reduce friction
Choose shoes that allow your feet to breathe when your feet sweat. Avoid plastics and vinyl shoes. Leather is better.
Shoes "DO NOT" need a "BREAKING IN PERIOD". If your shoes fit well and they are the right shoes for your feet, it will be comfortable straight away. If the shop owner says it needs a breaking in period they are just trying to sell you the shoe. It should be comfortable straight away.
Walk around the store and run in the store (preferably go to a shop that has a treadmill) before buying the shoe to ensure it is comfortable.
Buy shoes at the end of the day, as your feet swell as the day goes on.
Wear your usual socks/hoisery when buying shoes to ensure correct fit and where the thickest socks you plan on wearing.
Stand up when trying shoes on, as the foot expands when we stand
Shoe sizes generally increase as we age. So your shoe size when you were 25 will be different to at 40.
During pregnancy the foot size increases, so pregnant ladies should have their feet re-measured during and after pregnancy.
If you wear insoles or orthotics take these with you to try with the shoe
Have both feet measured. Most people have one larger foot. Fit to the largest one?
The counter around the heel should be reasonably snug? and the forefoot should not be crowded?. There should be a 2-3mm gap between the edge of the shoe and the edge of the big toe joint and little toe joint.
Don't worry about the stated "size" of the shoe. Worry about the "fit." It doesn't matter that you wore a size 5 when you were 22 and the clerk is telling you to try a size 9. Only Cinderella always wears the same size shoe. Your foot size will change as you grow older. Also, sizes vary between brands?
Don't buy a shoe if it feels too tight. It will NOT stretch to fit your foot.