YOUR PODIATRIC PHYSICIAN TALKS ABOUT FOOTWEAR

Proper Footwear Can Reduce Foot Problems

From ancient Egyptian times down through the centuries, footwear has been designed to meet mankind's real and perceived needs -- protection, support, comfort, sturdiness, stylishness, and the rest.

Today, there is an almost endless variety of styles and materials can pose a major dilemma when it's time to buy a pair of shoes. The dilemma can be minimized, however, if you concentrate on the health aspects of the modern shoe: well-fitting, well-made, and used properly, it has an inherent capacity to help reduce foot problems.

Feet bear the tremendous pressures of daily living. An average day of walking brings a force equal to several hundred tons to bear on the feet. They are subject to more injury than any other part of the body, highlighting the need to protect them with proper footwear.

Children, women, men, and athletes all have different shoe requirements, and such requirements will vary considerably across a wide range of activities.

Doctors of podiatric medicine are health care professionals trained in the care of the foot and ankle. They are fully qualified to recommend selection of the right pair of shoes, or address other aspects of foot health, for all members of the family.

Children's Shoes

When a child begins to walk, shoes generally are not necessary, Allowing an infant to go barefooted indoors, or to wear only a pair of socks, helps the foot grow normally and develop its musculature and strength, as well as the grasping ability of toes.

As children grow more active, and their feet develop, the need for shoes becomes apparent. It becomes necessary to change shoe sizes at a pace which frequently surprises and even dismays parents, to allow room for growth.

Though fit is the most important consideration, function is also pertinent. For youngsters who have reached the stage of walking stability, footwear with crepe or rubber soles helps cushion impact on growing feet better than the soles of dressier shoes with thinner soles.

Women's Shoes

Women, inhabiting the work force in greater numbers, inflict more punishment on their feet, in part from improper footwear they feel obliged to wear at work, that can bring about unnecessary foot problems.

Some of those problems result from high-heeled shoes (generally defined as pumps with heels of more than two inches). Doctors of podiatric medicine believe such heels are orthopedically unsound, and attribute medical, postural, and safety problems to their use.

To relieve the abusive effects of high heels, women can limit the time they wear them, alternating with good quality sneakers or flats for part of the day.

They can also vary heel height. There are comfortable and attractive "walking" pumps (also called "comfort" or "performance" pumps) for work and social activities, that blend fashion considerations and comfort, offering pumps with athletic shoe-derived construction, reinforced heels, and wider toe room.

Activity has a bearing on the considerations; wearing the right shoe for a particular activity is probably as important a factor in the choice of shoes as any.

Perhaps the best shoe for women, from an orthopedic viewpoint, is a walking shoe with laces (not a slip-on), a Vibram-type composition sole, and a relatively wider heel with a rigid and padded heel counter, no more than three-quarters of an inch in height -- even though such a shoe may be scorned in fashion circles.

Men's Shoes

The best shoes for men are good quality oxford styles, shoes ordinarily associated with wing-tip or cap designs. Also suitable are slip-ons, dressy loafers, and low, dress boots.

Men as well as women should buy shoes for work, leisure, and special activities, matching the shoe to the activity.

Male (and female) office workers should earmark three to five pairs of shoes for business hours -- general oxfords and loafers for men; pumps and oxfords for women. Cushioned-sole shoes that give good support are essential for those who spend most of their working days on their feet.

There is no question about the need for foot protection for those who work in heavy industry. Safety shoes and boots -- those that are waterproof or water-resistant, with insulated steel toe caps and soles of non-conducting materials -- help prevent injuries to the feet, and reduce the severity of injuries that do occur.

Shoes for Athletics

Different sports activities call for specific footwear to protect feet and ankles. Sports-specific athletic shoes are a wise investment for serious athletes, though perhaps a less critical consideration for the weekend or occasional athlete; nevertheless, it's a good idea to use the correct shoe for each sport. Probably a more important consideration is the condition of the shoe -- don't wear any sports shoes (or any shoes) beyond their useful life.

Athletic footwear should be fitted to hold the foot in the position that's most natural to the movement involved.

For example, a running shoe is built to accommodate the impact that concentrates on the forefoot, while a tennis shoe is made to give relatively more support to the ankles, and permit sudden stops and turns.

Buying Tips

• Have your feet measured while you're standing.
  
• Always try on both shoes, and walk around the store.
  
• Always buy for the larger foot; feet are seldom precisely the same size.
  
• Don't buy shoes that need a "break-in" period -- shoes should be comfortable immediately.
  
• Don't rely on the size of your last pair of shoes. Your feet do get larger, and lasts (shoemakers' sizing molds) also vary.
  
• Shop for shoes later in the day; feet tend to swell during the day, and it's best to be fitted when they are at their largest.
  
• Be sure that shoes fit well -- front, back, and sides -- to distribute weight. It sounds elementary, but be sure the widest part of your foot corresponds to the widest part of the shoe.
  
• Select a shoe with a leather upper, stiff heel counter, appropriate cushioning, and flexibility at the ball of the foot.
  
• Try on shoes while you're wearing the same type of socks or stockings you expect to wear with the shoes.

For longer service, keep shoes clean and in good repair. Avoid excessive wear on heels and soles. Give your shoes a chance to breathe by rotating their use. Never wear hand-me-down shoes (this is especially important for children).

Seal of Acceptance

The American Podiatric Medical Association awards its Seal of Acceptance to a wide variety of shoes (and shoe-related products), which have been deemed to enhance a consistently applied program of daily foot care and regular professional treatment.

The intent of such endorsements is to make a significant contribution to the foot health and foot health education of the public.

This pamphlet is one of a series produced by APMA that discusses several foot health conditions and concerns, including diabetes, foot health, arthritis, high blood pressure, athlete's foot, occupational foot health, warts, foot orthoses, aging, children's feet, surgery, Medicare coverage, injuries, heel pain, nail problems, walking, women's feet, flying, fungal nails, and others. The pamphlets are available from many podiatrist members of APMA. Or call: