Choosing the Proper Shoes Can be as Easy as 1, 2, 3

by Matt Hall, PT, DPT, OCS

It’s time again for the kids to return to school, and if you’re like most harried parents that means that among the many last minute preparations for this yearly “right of passage” are the acquisition of clothes and shoes. When it comes to the latter, your child’s foot health is too important to allow your choices be dictated by fashion alone. After all, an over sized shirt or tight jeans are one thing but ill fitting shoes are quite another. Understanding a few basic principles when choosing your child’s or even your own next shoe can insure that besides looking “cool” their/your feet feel great too!

Properly designed and fitted shoes should provide support, protection, and in essence “link” the wearer with the ground. With this in mind the first considerations relate to shoe design. The curvature (straight, or curved-in) of the shoe’s sole should generally match that of the foot. Furthermore, it is wise to select shoes that provide control or shock absorption depending upon one’s foot type (normal, flattened, or high arched). A flat foot generally needs more control whereas a foot with a higher arch needs greater shock absorption capability. Control is provided via a stiffer sole or heel counter (that part of the shoe that surrounds the heel). Shock absorption comes primarily through the mid-sole and is dictated by such things as material density, and thickness.

Secondary to design are fitting/sizing considerations. The shoe must be of adequate length and width to accommodate the foot. To aid this determination your shoe salesperson should utilize a Brannock device which provides accurate measurements of these dimensions. When this tool is unavailable one can instead stand on paper and then trace the outline of each foot. These tracings can then be cut out and used as templates. First place them inside the shoe to be fitted. Then smooth them out fully and remove. If the edges are bent over at any point the shoe is too small in that dimension. For those who are less industrious, the old “stand by” method of simply standing in the shoe and feeling for the end of the toes can be helpful. There should be about one thumb breadth from the toe’s tip and the end of the shoe. This allows room for a sock and prevents potentially painful pressure against the toe nails.

The width can be similarly assessed while standing using the pinch test. If the shoe is of adequate width there is sufficient material to be pinched between the thumb and fingers. The depth of the shoes in the toe region known as the “toe box” should be sufficient to allow the toes to move freely. Deformities like bunions, claw or hammer toes may require specialty shoes with even greater toe box capacity. Thirdly, often overlooked yet important considerations involve socks selection, and proper lacing. While socks absorb perspiration both socks, and appropriately laced and tied shoes reduce friction, and improve overall fit. In those instances where additional control or accommodation is needed, custom orthotics can be an effective addition. These devices are now quite affordable and some brands like Vasyli can be fitted into the shoes during a single office with a local physical therapist or pedorthist. Of course if sandals are your “thing” then a brand like Vionic offers several stylish selections that are engineered to provide orthotic like support and control. These can be a viable alternative to shoes in warmer weather or when during those times when going barefoot is uncomfortable.