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Footwear Guide

A huge public health risk, foot problems cost the U.S. $3.5 billion a year.

More than 43.1 million Americans--one in every six persons--have trouble with their feet, mostly from improperly-fitting shoes. We’re all susceptible to foot and ankle injuries, but we can reduce our risk for them by wearing properly-fitting shoes that conform to the natural shape of our feet. In selecting shoes, keep this basic principle of good fit in mind: Your feet should never be forced to conform to the shape of a pair of shoes.

Although style is often a key consideration in choosing a pair of shoes, the most important quality to look for in shoes-from a practical standpoint-is durable construction that will protect your feet and keep them comfortable. Shoes that do not fit can cause bunions, corns, calluses, hammertoes and other disabling foot disorders.

Recommendations for Footwear

The American Academy of Orthopaedic Surgeons has developed tips to help people reduce their risk of foot problems. Use this guide when you shop for shoes:

Have both feet measured every time you purchase shoes. Your foot size increases as you get older.
Women should not wear a shoe with a heel higher than 2 1/4 inches.
Try on new shoes at the end of the day. Your feet normally swell and become larger after standing or sitting during the day.
Shoes should be fitted carefully to your heel as well as your toes.
Try on both shoes.
There should be 1/2-inch space from the end of your longest toe to the end of the shoe.
Fit new shoes to your largest foot. Most people have one foot larger than the other.
Walk around in the shoes to make sure they fit well and feel comfortable.
Sizes vary among shoe brands and styles. Judge a shoe by how it fits on your foot not by the marked size.
When the shoe is on your foot, you should be able to freely wiggle all of your toes.
If the shoes feel too tight. don't buy them. There is no such thing as a "break-in period."
Most high heeled-shoes have a pointed. narrow toe box that crowds the toes and forces them into an unnatural triangular shape. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.

Generally, 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 towards the end of the day, when the feet have swelled. In properly fitting shoes there is 1/2 inch of space between the largest toe and the tip of the shoe. The toes should be able to wiggle upward. The feet should be sized while standing and the shoes should be bought for the larger-sized foot.

The Sole

Ideally, the shoe should have a removable insole. Thin hard soles may be the best choice for older people. Shoes with thick inflexible soles may not allow to sense the position of the feet relative to the ground, significantly increasing the risk for falling.

The Heel

High heels are the major cause of foot problems in women. Many fashionable high heels are designed to constrict the foot by almost an inch. If you do insist on wearing high heels, then it is best if shoes have wide toe room, relatively wide reinforced heels, and cushioned insoles. Keep the time you are wearing high heels to as little as possible.

Laces

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. 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.