Showing your shoe smarts

Ladies, there is a reason certain grandmas wear the shoes they do: comfort.

There are many over-the-counter options for orthotics, so it does take a little experimentation to find the right one. Once you’ve tried a few (soft, firmer, different brands, etc.) and still can’t find something that gets rid of your pain, then I’d suggest consulting a physician to ask about moving to custom orthotics.

by Kate O’Connor MD, The Philadelphia Inquirer June 19, 2016

If a pair of shoes is cute and fashionable, there is a good probability that they aren’t good for your feet and likely aren’t that comfortable – a frustrating reality. Luckily, some manufacturers are starting to realize that they need to figure out how to serve up both style and comfort.

But until all shoes are stylish, comfortable, and actually good for your feet – which I suspect will be never – I’ll keep fielding some common questions in my medical office, especially around wedding and beach season.

Are flip-flops bad for my feet?

Not necessarily, because not all flip-flops are created equal. Some – the ones that are really just a half-inch of foam – have no support. Many people find them uncomfortable and they are likely not good for anyone with foot troubles. There are, however, manufacturers that make flip flops with a stable foot bed with plenty of cushioning and support like a regular shoe. Many people can be very comfortable in these flip-flops and they are fine for your feet.

But no matter how much support they may offer, flip-flops rely on the use of intrinsic muscles of your toes to grip them and hold them on your feet. Therefore prolonged wearing may cause your feet to be a little sore or achy.

How bad are heels for my feet?

I hate to break it to you, but heels are not good for your feet – or your knees! But this doesn’t mean you can never wear them. A wedding, a dinner, a date, once in a while is fine, if you can tolerate it.

Wearing heels on a daily basis, however, can contribute to multiple foot problems ranging from bunions to Achilles tendinitis to arthritis. When you do wear heels, look for a low wedge with a rounded toe. A wedge helps distribute force throughout the foot, and a lower heel puts less pressure on your toes. Studies show that a rounded toe-box helps decrease pressure on the toes, as well.

If you can wear heels without pain day in and day out, you are certainly one of the lucky ones, but it may come to bother you down the road.

What are the best running shoes to buy?

I’m a runner myself and I’m still trying to figure that out. Shoes are constantly changing and being updated, so you always have to keep searching. Not all running shoes are correct for everyone. Lots of my patients talk about having a “motion-controlled” shoe for “over-pronation.” This is good for some people, but for others this kind of shoe might not work.

If you have a tendency to sprain your ankles or have a particularly high arch, you may actually need a more neutral shoe. The best way to find a good fit in running shoes is to go to a running store with a wide selection, and one that has a treadmill you can really try them out on.

Personally, I’ve run in shoes ranging from $60 to $200, and have found that there isn’t necessarily a correlation between price and comfort. My advice is to try a lot of styles, and go with what feels good. If something doesn’t feel right, I would suggest trying a different shoe before you develop a problem.

What shoes are best for someone with foot arthritis?

People with arthritis may do better with a shoe that is stiff – the stiffer the sole, the better. Give your shoes a bend and see how flexible they are. Very stiff shoes with a curve to their sole let the shoes do some of the work, so that your joints don’t have to. A stiff sole and ample cushioning inside tend to be what most of our patients find comfortable.

What shoes do you recommend for someone with a bunion?

Most bunion pain can be relieved with some simple footwear modifications. Many women don’t realize that they may need to buy a wider shoe if they have a bunion. This can be a little tricky if you have a narrow heel, but shoes that tie usually work well to accommodate both needs.

The fabric of a shoe can make a difference, too. Shoes with a stretchy fabric or soft leather may be able to better accommodate the bump. But if you do have shoes with stiff leather, get to know your local cobbler, as they often have ways to stretch the shoes to make extra room.

Do I need custom orthotics?

For the average person, an over-the-counter orthotic can do a lot. Sometimes small modifications – a little wedge here, or a little pad there – can make a big difference in comfort and support. There are many over-the-counter options for orthotics, so it does take a little experimentation to find the right one.

Once you’ve tried a few (soft, firmer, different brands, etc.) and still can’t find something that gets rid of your pain, then I’d suggest consulting a physician to ask about moving to custom orthotics. I usually recommend full-length orthotics so the whole foot can be supported, and so that if there are specific toe modifications that you might need, then we have a platform to build them on.

For patients with diabetes, what shoes are best?

This is an extremely important question. People with diabetes need to take especially good care of their feet. I recommend that if you have diabetes you talk to your endocrinologist or primary-care provider to go over foot safety. And, unfortunately, no flip-flops or heels for you. If you have diabetes, it is important to protect your feet from blisters and calluses that could lead to infections. Sneakers or custom diabetic shoes are usually the safest options.

Editor’s Note: We went shoe shopping with Dr. O’Connor’s advice in hand to see what gear would fit her suggestions. Read more here »

Kate O’Connor MD, is an assistant professor of clinical orthopedic surgery, Perelman School of Medicine at the University of Pennsylvania

Source The Philadelphia Inquirer