For many people, finding a shoe that fits properly can be a frustrating and time-consuming process. Because many people have subtle abnormalities of their feet, the process of finding a proper fitting shoe can be difficult. There are few simple guidelines that if followed can make the process a bit more tolerable.

When purchasing shoes, it is always a good idea to have the salesperson measure your feet. It is also a good idea to have both feet measured, because in many instances there may be a difference in the size of your feet. If you have two feet that are not the same size, it is recommended that you buy shoes to fit the bigger foot.

Our feet change just like our eyes as we get older. A person’s feet tend to become a bit longer and wider. Women, during pregnancy have a tendency for their shoe size to change. This is because during pregnancy a woman’s body produces a hormone called elastin. This hormone softens the ligaments about the pelvis to assist during delivery. Unfortunately, the hormone also affects other ligaments in the body. The ligaments in the foot are particularly affected. This coupled with an increase in weight and a change in the center of gravity causes many women to experience a change in their shoe size.

Our feet also have a tendency to change size during the course of the day. Shoes that may feel comfortable in the morning may feel tight and uncomfortable later in the day. This occurs because of a variable amount of swelling in the feet that occurs as the day goes on. Therefore it is a good idea to buy your shoes later in the day.

The shape of the shoe is important, but surprisingly little attention is paid to this feature of the shoes we buy. The “Last” of the shoe determines the over all shape of the shoe. The shoe “last” may be straight or curved. To determine the “last” of the shoe, turn the shoe upside down and look at the sole. Imagine a line that goes through the center of the heel of the shoe and then out the center of the toe area of the shoe. You might be surprised what you find. In “curve lasted shoes” this imaginary line is in the shape of a curve, usually curving inward. A “straight lasted shoe” will have this imaginary line almost straight from the heel to the 2nd toe.

Curve lasted shoes can aggravate a number of foot problems. These shoes can cause an excessive amount of pressure on the outside of the foot. This has the potential of irritating existing problems like bones spurs in the fifth toe, soft corns between the fourth and fifth toe, and tailors bunions. Another area of the foot that can become irritated is along the outside of the foot called the “styloid process”. In some people the styloid process is more prominent and subject to irritation by shoe pressure. Therefore it is important to fit the shoe to the shape of your feet, whether curved, semi-curved, or straight lasted.

If a person has an abnormality of their foot that requires some degree of “motion control” they are better advised to seek the advice of a Podiatrist who can determine their needs and prescribe a device that corrects abnormal function of the foot. These devices called orthotics which fit into most shoes. In many cases the use of an orthotic will correct abnormal wear patterns seen in a persons shoes.

Guidelines to follow for Shoe Fitting;

1/- It is important to fit the shoe to the shape of your foot. In other words, if you have a fairly straight looking foot choose a shoe that has a straighter last to it, or a semi curved last.

2/- Most sports shoes are relatively rigid in the heel portion of the shoe. This is called the heel counter, and is felt at the back of the shoe. Some heel counters are extended to give more support. Heel stability is important in reducing or controlling foot pronation, (flat feet), by supporting the heel joint and overall function of the foot.

3/- The next thing I look for is support and contour of the midoot. A supportive shoe will hug the inside of your arch and give further stability and support to the heel joint. Some shoes like Skate shoes are too wide through the midfoot allowing the foot to pronate in the shoe. A good supportive sports shoe will reduce likelihood of injury and aid running.

4/- Additionally, look for a shoe that is fairly flexible in the forefoot area. If the shoe does not easily flex in the forefoot then as the heel comes off the ground during walking and running the big toe is unable to flex properly. Adequate movement of the big toe joint is important for normal foot function.

5/- Place the shoe on a firm flat surface and observe what the back of the heel of the shoe looks like. The heel of the shoe should be relatively perpendicular to the surface the shoe is sitting on. If the back of the shoe is angled in one direction or another this could indicate a defect in the manufacture of the shoe.

6/- It is a good rule to put you hand inside the shoe and check for any defects in the seams of the shoe. Seams that are prominent have the potential to cause irritation to areas on the foot.

7/- Shoes should be purchased that have adequate room in the toe box area. One should be able to measure a thumb nail’s width from the end of the longest toe to the end of the shoe. This insures the possibility of trauma to the toenail, particularly if the foot slides forward when walking down hill. Short shoes can cause ingrown toenails and corns on the end of the toes.

8/- The width of the shoe is important to ensure no pressure on the toes that may lead to corns between the toes or cause the nail of one toe to cut into the skin of the neighboring toe. I like to feel a small crease as I run my fingers across the top of the shoe. If the shoe is too wide the foot tends to pronate or flatten through the arch causing the toes to slide out towards the side of the shoe. Excessive width can cause too much movement in the shoe during walking / gait resulting in callus build up or blisters.

Diabetic patients need to be particularly aware of the type of shoes that they wear. This is especially true if they have poor circulation, numbness or a loss of sensations in their feet (neuropathy). The upper of the shoe should be of soft leather with few or no seams. Extra depth shoes are available that meet the needs of many diabetic patients. See Diabetes for further information on foot care.

Children’s Feet

Children’s feet are soft and pliable making them prone to damage from abnormal pressure, such as shoes which are too small.

Tips for fitting Children’s shoes:

  • Always have both feet measured for length and width
  • The shoe should fit the natural shape of their foot especially around the toes
  • The toe of the shoe should allow toes to move freely and not be squashed from the top or the sides.
  • Make sure there is about 10mm growing room for children between the end of their longest toe and the end of the shoe.
  • Shoes should fit comfortably around the heel and not be too loose or too tight.

For more information on running shoes click here

The Fluoroscope

The shoe fitting fluoroscope (called pedoscope in the UK) first appeared in US shoe stores in the 1920’s, and by the 1950’s approximately 10,000 units were in use across the USA, 3000 in the UK and 1000 in Canada. The units allowed the customer’s feet to be viewed within the shoes, supposedly to ensure accurate fit. However, they were mostly regarded by sales staff as little better than a gimmick, and their popularity waned. Most US states banned the machines in the 1960’s, and their use ceased in the UK by 1970. The frightening thing was the amount of radiation used for each exposure. According to the show “Engineering Disasters” on History Channel, the exposure from a typical machine was 20 to 75 rems (or 200 to 750 mSv) per minute. That is to be compared with the current maximum allowed occupational exposure to workers in nuclear power stations in the USA of 5 rems (50 mSv) per year and 20 mSv (2 rems) per year for classified radiation workers in the UK. Whilst customers were unlikely to have been adversely affected by using the machines, countless shop staff are likely to have suffered the results of excessive exposure to radiation.