Hi, Dr. Meredith Warner here –
What shoes to buy: this is a question that I am asked to answer on almost a daily basis. I am extremely biased and love The Healing Sole (because I designed it to treat foot pain and promote foot health), but I also know you can’t wear the same shoe every day. Certainly, a flip flop is not considered an appropriate work shoe for many too.
So, I must delve into all the possible shoes out there and decide the ‘best’ shoe for my patients, friends and family. I am a huge fan of science and scientific evidence, so this is hard for me.
Basically, everything I have been taught and that you have heard are myths. Most factors discussed by other doctors, the media and publications that define a ‘healthy’ shoe do not match scientific findings.
Rethink The Fit of Your Shoes
Shoes are worn for daily protection from the environment. They are also worn for fashion reasons. In certain cases they are also selected and worn for health reasons. This latter is particularly true for diabetic footwear. Most footwear is designed with fashion, not function in mind (sadly) and this leads to a lot of problems.
Today, up to 50% (I think it is even higher) of people do not actually know their true shoe size! This fact alone leads to a significant amount of pain and problems associated with footwear. Add to ill-fitting shoes the design features common today such as narrow toe box, high heels, rigid upper materials, poorly placed seams and bad materials and we have a recipe for disaster.
If a shoe is selected for comfort but the size is not right, this will immediately lead to long-term issues. For instance, if a longer shoe is selected because it is more comfortable overall, the internal arch mechanism will not be in the correct position; this can lead to future alignment issues. While there is not a lot of evidence surrounding the negative effects of ill-fitting shoes, it has been my experience that ill-fitting shoes can have long-term consequences.
For example, it has long been thought that high heels damage the foot. Studies have demonstrated no clear cause and effect beyond the development of a callus at the ball of the foot (although quite painful); this is minor issues and not true foot damage. In other words, there is limited data to support the statement that ‘high heels damage your foot’. Consider too that there is much stronger evidence that genetics and hereditary factors cause hallux valgus than that high heels are able to do so.
How To Pick The Right Shoe For You
There is very little consensus amongst physicians as to the true effect of designer shoes on foot health. There are a few studies that look at poorly fit shoes. There are a few more studies that look at things like higher heels and such. Both groups of evidence are essentially too small to make any actual decisions.
It is thought that if one selects a comfortable shoe there will be less chance that the gait will be altered and less chance of foot damage; however, even this statement has never been proven.
It is clear that ill-fitting or poorly designed shoes can cause pain. It is not overwhelmingly clear that they cause long term pathology, but it is best to avoid shoes that cause pain in general – as even the sensation of pain may change your gait.
Therefore, I select shoes for my patients based on the actual problem. For example, I love Altra running shoes for my patients with hallux valgus; I carry these in my clinic and patients can buy them online from my website. The toe box is shaped more like a foot and uses a good mesh material; this limits the pressure placed on the bunion.
Likewise, I carry Dansko clogs in my clinic and website for those that work on their feet all day. These shoes are rigid but allow for more natural foot muscle mechanics and incorporate a small forefoot rocker sole that is helpful. Also, we have the old-fashioned Brannock device in the clinic and we will actually measure feet to get a true and real size.
There is no ‘best’ shoe that will work for everyone. The important thing you must remember is to prioritize function and comfort over fashion. Thankfully, there are a variety of shoe brands that offer both stylish and comfortable shoes.
Make your appointment today so we can choose the right shoes for you:
