Advice on Shoe Fitting
For many people, finding a shoe that fits properly can be a frustrating and time-consuming process. Because many people have subtle abnormalities of their feet, the process of finding a proper fitting shoe can be difficult. There are few simple guidelines that if followed can make the process a bit more tolerable. There are several good shoes on the market some of them even have styles you may like. With the availability of Internet shopping, the process of finding shoes for the hard-to-fit individual may be made a bit easier.
When purchasing shoes, it is always a good idea to have the salesperson measure your feet. It is also a good idea to have both feet measured, because in many instances there may be a difference in the size of your feet. If you have two feet that are not the same size, it is recommended that you buy shoes to fit the bigger foot. Our feet change just like our eyes as we get older. A person's feet tend to become a bit longer and wider. Women, during pregnancy have a tendency for their shoe size to change. This is because during pregnancy a woman's body produces a hormone called elastin. This hormone softens the ligaments about the pelvis to assist during delivery. Unfortunately, the hormone also affects other ligaments in the body. The ligaments in the foot are particularly affected. This coupled with an increase in weight and a change in the center of gravity causes many women to experience a change in their shoe size. Our feet also have a tendency to change size during the course of the day. Shoes that may feel comfortable in the morning may feel tight and uncomfortable later in the day. This occurs because of a variable amount of swelling in the feet that occurs as the day goes on. Therefore it is a good idea to buy your shoes later in the day.
The shape of the shoe is important, but surprisingly little attention is paid to this feature of the shoes we buy. The "Last" of the shoe determines the over all shape of the shoe. The shoe "last" may be straight or curved. To determine the "last" of the shoe, turn the shoe upside down and look at the sole. Imagine a line that goes through the center of the heel of the shoe and then out the center of the toe area of the shoe. You might be surprised what you find. In "curve lasted shoes" this imaginary line is in the shape of a curve, usually curving inward. Many shoemakers make curve lasted shoes. This is particularly true in sports shoes. A "straight lasted shoe" will have this imaginary line almost straight from the heel to the toes. Now, look at the shape of your foot. Have you ever wondered why your shoes seemed to wear out in the upper part about the toe box in such a funny way? The reason may very well be that you have a rather straight foot and you are wearing a curve shaped shoe. Curve lasted shoes can aggravate a number of foot problems. These shoes can cause an excessive amount of pressure on the outside of the foot. This has the potential of irritating existing problems like bones spurs in the fifth toe, soft corns between the fourth and fifth toe, and tailors bunions. Another area of the foot that can become irritated is along the outside of the foot called the "styloid process". The styloid process is the base of the long bone (metatarsal) behind the fifth toe. In some people the styloid process is more prominent and subject to irritation by shoe pressure. There is also a powerful tendon that attaches into the foot in this area from a muscle on the outside of the lower leg. This tendon and some other small tendons on the top of the foot can be irritated by the curve lasted shoe.
Shoe manufactures make curved lasted shoes because they believe that my curving the foot inward it causes greater stability to the foot. In theory they are correct but shoes rarely are made of materials that are strong enough to influence foot function. Instead, as a person wears the shoe, the shoe over time becomes misshapen and can cause irritation to areas on the outside of the foot. The shoe manufactures have been a bit more successful at producing "motion control" shoe wear in sports shoes, but even there the shoe will rarely be able to hold up to the deforming forces of the foot over time. If a person has an abnormality of their foot that requires some degree of "motion control" they are better advised to seek the advice of a foot specialist who can determine their needs and prescribe a device that corrects abnormal function of the foot. These devices called orthotics fit into normal shoes and last for several years. In many cases the use of an orthotic will correct abnormal wear patterns seen in a person's shoes.
When selecting a good sports shoe there are a few simple guidelines to follow. First of all fit the shoe to the shape of your foot. In other words, if you have a fairly straight looking foot choose a shoe that has a straighter last to it. Secondly, consider sport shoes that are relatively rigid in the heel portion of the shoe. Heel stability is important in almost all cases. Additionally, look for a shoe that is fairly flexible in the forefoot area. If the shoes does not easily flex in the forefoot then as the heel comes off the ground during walking and running the big toe is unable to flex properly. Adequate movement of the big toe joint is important for normal foot function. There are two more things to check before you purchase the shoe. Place the shoe on a firm flat surface and observe what the back of the heel of the shoe looks like. The heel of the shoe should be relatively perpendicular to the surface the shoe is sitting on. If the back of the shoe is angled in one direction or another this could indicate a defect in the manufacture of the shoe. Lastly, put you hand inside the shoe and check for any defects in the seams of the shoe. Seams that are prominent have the potential to cause irritation to areas on the foot.
Diabetic patients need to be particularly aware of the type of shoes that they wear. This is especially true if they have poor circulation, numbness or a loss of sensations in their feet (neuropathy). Shoes should be purchased that have adequate room in the toe box area. The upper of the shoe should be of soft leather with few or no seams. Extra depth shoes are available that meet the needs of many diabetic patients. In many instances Medicare will reimburse for one pair of shoes per year if the patient's doctor recommends extra depth or special shoes. There must be adequate documentation in the doctor's medical record for the need for the shoes and the doctor must provide the patient with a prescription for the shoes.