I was at a dance event recently where I offered people free shoe advice. I heard lots of foot related complaints. I also noticed a lot of similarities in the shoe habits of men and women who had “foot problems”. They were squeezing their feet into tiny little shoes. “My big toe joint hurts during or after dancing” was a common complaint. Whether it be the joint of the big toe, the balls of the foot, arch or heel pain, or blisters. The percentage of people I see for foot problems that are caused by misfit shoes is very high.

Since shoe fit affects foot function, the marriage between foot and shoe needs to be a harmonious one. People with foot problems are very often people with shoe problems.
Shoes should allow the foot to do its job while still protecting it from the forces of walking 10,000+ steps you take a day. During this daily venture your feet will take on many tasks.

Your feet:

- help propel you;

- allow you to stand up straight;

- hold excess weight;

- take you a distance equivalent to at least eight times around the world during your lifetime;

- take you to places where you can interact with others;

-help you locate furniture in the dark.

Your foot needs to act as a loose, “bag of bones” when it hits the ground to adapt to uneven surfaces. Then, your foot will absorb shock equivalent to 250% of your own body weight, at times. It will then transform itself into a rigid, propulsive lever to move you forward. Your feet perform all these functions in a fraction of a second, thousands of times over. The shoes you wear can allow, or inhibit your feet from doing these functions efficiently.

The most common trait of shoe fit that people share is…..SHORT SHOES! People are wearing shoes that aren’t long enough. There are many reasons why. Wanting to feel the shoe on your foot because of a lack of sensation, not wanting to wear a larger size, as they don’t like the number, or believing the shoe will slip off. People’s feet elongate as you gain weight. It’s only logical that one’s shoe size will increase with time, and that one’s shoes will become tighter if you don’t adjust the size.

How tight shoes affect the foot can be a through a multitude of conditions. Short shoes can bunch up your toes, causing them to curl or “claw” while wearing them, and long term use can permanently affect their shape. This position can develop corns on the tops of the toes, and calluses on the undersides of the toe pads, as well as across the balls of the foot.

Short shoes can actually contribute to bunions. They force the big toe to bend out towards the lesser toes, while at the same time putting pressure on the inside of the foot, on the big toe joint. It does this because short shoes put the widest part of the foot in a slightly narrower portion of the shoe, up towards the front. This is not the only reason why people get bunions, but it’s a sure contributor.

WHAT style shoe should I wear? Is this my correct size? How can I tell if the shoes are really well made? These questions and many more must be answered each time a pair of shoes is selected and bought.

It is important to answer these questions wisely, for the purchase of a new pair of shoes can have a profound effect on a person’s overall health and happiness. Ill-fitting footwear can cause a great deal of pain and discomfort, even leading to headaches, backaches and leg cramps. To a large degree, painful foot ailments such as corns, nail troubles, toe deformities and flat feet can be avoided by a careful selection of footwear.

A person may walk over 75,000 miles in a lifetime. ‘Why not walk those miles in comfort?

Do Not Sacrifice Comfort for Style

How, then, should one go about buying shoes? Unfortunately, many choose shoes for style rather than for comfort. More often than not, this type of buying leads to considerable pain. Further, the owner will probably cast off the shoes, being no longer able to endure this form of self-torture in the interest of fashion.

In some cases serious problems and foot deformities can result if fashion is the primary factor in selecting one’s shoes. For example, some years ago the style was pointed toes, and in this regard a letter was printed in the Cleveland Plain Dealer under the heading “What Price Style? Girl Paid Too Much–Loss of Two Toes.” The letter said:

“Like most girls I wanted to be in fashion and bought the shoes that everyone was wearing. The pointed toes and high heels were uncomfortable, but I thought that this was the price of style. You can realize how shocked I was when I went to a doctor because of painful feet and was told that I would have to have two toes amputated. This was a year ago, and since then I have heard of many other girls who have lost one or two toes.”

So, in buying shoes, do not sacrifice comfort for style. Select appropriate shoes for ‘the purpose for which they will be used: walking, working, casual, special occasions, or constant wear.

Be Sure of the Right Fit

You can buy good shoes but still end up with painful feet if you are not careful to get a good fit. Helpful in this regard is checking the time of day before you buy a pair of shoes. Why? Because if it is very early in the morning, you may not get the right fit. Since feet tend to swell somewhat as the day wears on, it is wise to buy shoes in the late afternoon. Remember, too, that hot weather will cause one’s feet to expand.

Many persons find it desirable to have their feet measured when purchasing new shoes. For one thing, sizes may vary with different makes of shoes. Some have found, too, that it is wise to stand while their feet are being measured. The foot will expand, and one is more likely to get a better all-round fit. Further, since one foot is likely to be slightly larger than the other, have both feet measured and pick a size to fit the larger foot.

Heels should be snug but not tight. Also the height and shape of the heel need to be considered, especially in women’s shoes. Women generally have four times as much foot trouble as men, largely because of high-heeled shoes. The higher the heel, the more the body is projected forward, and to maintain balance the body is bent backward at the hips. This is unnatural and results in a variety of leg and back problems if unreasonably high heels are worn over an extended period of time. Generally speaking, heels should not be higher than one and a half inches and should produce a good broad base on which to stand. Almost naillike or so-called “spike” heels are not conducive to good foot care and posture.

The widest part of your foot should spread easily across the widest part of the shoe. There should be enough room for the toes to lie straight, and the shoe should be a little longer than the longest toe. If you cannot wiggle your toes to some extent, the shoe is too small. When shoes are too tight or too short, toes may be forced back into an inverted V position called hammertoe, a common deformity. A shoe ought to be comfortable when you buy it; it is unwise to rely on a “breaking in” process to ensure comfort.

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It’s not just barefoot running and minimalism versus running shoes, the either/or situation many portray it to be. It’s much deeper than that. It’s not even that running shoe companies are evil and out to make a profit. Shoe companies may be accomplishing the goals they set out for, but maybe the goals their aiming for are not what need to be done. The paradigm that running shoes are built upon is the problem.

Running shoes are built upon two central premises, impact forces and pronation. Their goals are simple, limit impact forces and prevent overprontation. This has led to a classification system based on cushioning, stability, and motion control. The problem is that this system may not have any ground to stand on. Have we been focused on the wrong things for 40+years?

I’ll start with the customary statistic of 33-56% of runners get injured every year (Bruggerman, 2007). That is kind of mind blowing when you think about it. Since there are a ton of injuries going on, let’s look at what shoes are supposed to do.

Pronation:

As said earlier, shoes are built upon the premise that impact forces and pronation are what cause injuries. Pronation, in particular has been constructed as the bane of all runners. We have become inundated with limiting pronation via motion control shoes. The central idea behind pronation is that overpronating causes rotation of the lower leg(i.e. ankle,tibia, knee) putting stress on the joints and therefore leading to injuries. Running shoes are therefore designed to limit this pronation. Essentially, running shoes are developed and designed to put the body in “proper” alignment. But do we really need proper alignment?

This paradigm on pronation relies on two main things: (1)over pronation causes injuries and (2) running shoes can alter pronation.

Looking at the first premise, we can see several studies that do not show a link between pronation and injuries. In an epidemiological study by Wen et al. (1997), he found that lower extremitly alignment was not a major risk factor for marathon runners. In another study by Wen et al. (1998), this time a prospective study, he concluded that ” Minor variations in lower extremity alignment do not appear conclusively to be major risk factors for overuse injuries in runners.” Other studies have reached similar conclusions. One by Nigg et al. (2000) showed that foot and ankle movement did not predict injuries in a large group of runners.

If foot movement/pronation does not predict injuries or is not a risk factor for injuries, then one has to question whether the concept is sound or working…

Looking at the second premise, do shoes even modify pronation? Motion control shoes are designed to decrease pronation through a variety of mechanisms. Most choose to insert a medial post or a similar device. In a study by Stacoff (2001), they tested several motion control shoe devices and found that they did not alter pronation and did not change the kinematics of the tibia or calcaneus bones either. Similarly, another study by Butler (2007) found that motion control shoes showed no difference in peak pronation when compared to cushioning shoes. Lastly, Dixon (2007) found similar results showing that motion control shoes did not reduce peak eversion (pronation) and didn’t change the concentration of pressure.

This is sort of a double whammy on motion control shoes. If excessive pronation does not cause injuries to the degree that everyone thinks, and if motion control shoes don’t even alter pronation, what’s the point of a motion control shoe?

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