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Shoes

Shoes


In general, 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 in the afternoon or after a long walk, when the feet have swelled. There should be a 1/2 inch of space between the longest toe and the tip of the shoe (remember, the longest toe is not always the big toe), and the toes should be able to wiggle upward. A person should stand when being measured, and both feet should be sized, with shoes bought for the larger-sized foot. It is important to wear the same socks as you would regularly wear with the new shoes. Women who are accustomed to wearing pointed-toe shoes may prefer the feel of tight-fitting shoes, but with wear their tastes will adjust to shoes that are less confining and properly fitted.

The Sole

Ideally, the shoe should have a removable insole. Thin, hard soles may be the best choice for older people. Elderly people wearing shoes with thick inflexible soles may be unable to sense the position of their feet relative to the ground, significantly increasing the risk for falling. Some research suggests that thick soles may even be responsible for foot injury in younger adults who engage in high-impact exercise.

The Heel

High heels are the major cause of foot problems in women. Although people believe that foot binding is a problem limited to Chinese women of the past, many fashionable high heels are designed to constrict the foot by up to an inch. Women who insist on wearing high-heeled shoes should at least look for shoes with wide toe room, reinforced heels that are relatively wide, and cushioned insoles. They should also keep the amount of time they spend wearing high heels to a minimum.

Laces

The way shoes are laced can be important for preventing specific problems. 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. If, after tying the shoe, less than an inch of tongue shows, then the shoes are probably too wide. 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.

Breaking in and Wearing the Shoes

If shoes do require breaking in, moleskin pads should be placed next to areas on the skin where friction is likely to occur. Once a blister occurs, moleskin is not effective. Shoes should be changed during the day and rotated in their use. As soon as the heels show noticeable wear, the shoes or their heels should be replaced.

Special-Purpose Footwear

People should avoid extreme variations between their exercise, street, and dress shoes.

Exercise and Sports. Shoes purchased for exercise should be specifically designed for a person's preferred sport. For instance, a running shoe should especially cushion the forefoot, while tennis shoes should emphasize ankle support. Athletic socks are almost as important as shoes. Experts often recommend padded acrylic socks.

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Review Date: 12/04/2006
Reviewed By: Harvey Simon, MD, Editor-in-Chief, In-Depth Reports; Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).
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