Selecting the right pair of shoes is a very difficult task. A poor pair of shoes can not only aggravate existing foot conditions, but they can also create new foot problems. Some general rules to follow include choosing a shoe with a wedged heel, as seen in most athletic shoes and boots.
Heels up to 1.5 inches in height generally don’t cause foot problems, and a heel height of 1″ is encouraged, especially for conditions such as plantar fasciitis, Achilles tendonitis, and general arch pain.
Heels 2″ and higher contribute to forefoot problems and instability. Make sure the shoe is rigid and only bends at the toes. The sole of the shoe should not be too thin or flimsy. Purchase shoes in the morning as feet and ankles tend to swell during the day and make sure to have both feet measured.
The toe box is the area at the front of the shoe. The outsole is the “sole” of the shoe, the part in contact with the ground. The upper is more than the tongue of the shoe, it is everything that sits on top of the sole. The heel counter is the back of the shoe which cradles the heel.
Make sure your shoe is rigid
The shoe should have a stiff shank and be flexible at the toes. Take the shoe and flip it over. Grab the toe and the heel and try to bend them. If it bends in half, it is too flexible.
If you have trouble doing this, place the toebox on the ground, hold the heel, and press down, as shown in the picture to the right. If the shoe collapses on itself, it is too flexible and it won’t be supportive. In this picture of a boot, notice that the boot only bends at the ball of the foot.
Make sure the shoe is not too rigid
The shoe should bend at the toes. This is the area of the foot that bends when pushing off. If the shoe does not bend at all, it may be too rigid. Squeeze the heel of the shoe and then push forward on the heel counter as shown in the picture below.
The heel counter should be stable and retain its shape, but not collapse. If it does not bend at all it could be too rigid and cause blisters. In this picture below of a trail running shoe, when the heel counter is pressed down, it collapses. It is a little too flexible.
Check for toe spring
One rigid shoe that does work well for those with foot problems (especially neuromas and plantar fasciitis) is a Dansko shoe. Most Dansko shoes will not bend at the toes and the heel counter is very rigid. The rocker type sole helps compensate for the rigidity and many with foot conditions such as plantar fasciitis, do very well with Dansko shoes. In the picture to the right, you can see the “toe spring test” demonstrating the rocker sole and the lift at the heel.
Rest the shoe on a flat surface and press down on the tip of the toe with a small amount of force, the heel should rise. With this style of shoe, the heel rises and allows for a rocker motion. This puts very little stress on the arch and the forefoot. It’s not necessary to wear a Dansko shoe, but this style of shoe may be helpful for certain foot conditions.
The toe box should be wide
The front of the shoe is called the toe box. This area should be wide enough for the toes to wiggle. The toes should not touch the tip of the shoe.
Check the insoles
Many think the cushier the insole the more comfortable the shoe, but this is not necessarily true. In most cases, the foot will be more comfortable in a slightly more rigid insole with a softcover. Many of the spongy, bouncy insoles cause too much movement inside the shoe, especially at the heel.
Other manufacturers will build a high arch pad into their insole and advertise this to people with flatfeet. For individuals with flat feet, they will typically find a high arch insole extremely uncomfortable. An arch pad does not support the arch.
A soft cushion certainly cannot support the weight of the body, but it will cause excess pressure to the area. For a foot that is collapsing into a flatfoot, the arch pad will only cause discomfort. Take those insoles out and replace them with a sports orthotic or custom orthotic which are stiffer and will help correct the foot collapse.
Check for medial to lateral support
Medial means towards the middle of the body. Lateral means towards the outside of the body. Your big toe is medial and your little toe is lateral. To check for medial to lateral support, stick your hand in your and extend your hand out to the toe area.
Move your hand medial first and then lateral, trying to move the shoe material from side to side over the sole. If there is a lot of movement, the shoe will not support your forefoot. If your foot is not supported on the sole of the shoe, it has to work harder to maintain balance which results in overworking the tendons and stressing the plantar fascia.
In this picture below of a new running shoe, you can see that there is some bulging with pressure, but not much. For individuals with wide feet or bunions, this is actually a benefit. If there is a considerable amount of bulging, then the shoe will offer no support and there is a greater chance of injury. Since this shoe below is a new shoe, it is possible that this will stretch and break down within a few months. Having little to no stretch or bulging in this area is best.
Twist the shoe
Pick up the shoe and grab the toe area and the heel area. Twist your right hand clockwise and your left hand counterclockwise. The shoe should not twist around on itself. There should only be a few degrees of motion.