AUGUST FOCUS – SHOES

Shoes are accessories that most of us are going to utilise, at least for parts of our day. They obviously can affect the way we hold our bodies, and have the potential to cause us problems.
SHOES


Poorly fitted shoes can cause problems. They may be local problems in the foot and ankle area. Or may cause issues elsewhere in the body, if they alter our gait, or cause a change in body position.
98% of babies have perfect feet, yet by adulthood 65% of us are experiencing problems with our feet. A lot of damage can be done in our teenage years where we really don’t concern ourselves with ideal footwear. Girls (predominantly) in their teens run the risk of damage if they wear high-heeled shoes. The bones of the feet aren’t fully ossified until age 17 or 18, and so more vulnerable to damage before this.
When considering footwear we should consider general health issues. A diabetic, or possibly someone with other vascular issues will need to take greater care to protect their feet.
Perhaps we should also consider keeping our body weight within an ideal range. There are clearly many health benefits for this, not least, reducing strain through our joints.
Our footwear should also be appropriate for the activity we intend to do. So this may be related to a sport, for protection at work, going for a walk, standing all day at work, or may be getting dressed up to go out.
Some considerations for trying on shoes


Try on at the end of the day when our feet are at their largest.
Bring the socks or tights you intend to wear with the shoes to try on.
Look at the heel counter. Try and find shoes that contour well with the heel to prevent slipping.
Leather on the inside and outer of the shoe is ideal. First for breathability, and also for it’s ability to mould to the foot.
Try and find shoes that are seam free on the inside to prevent irritation.
Fastenings are important. Laces, Velcro or straps will secure the shoe far better. Are slip-on shoes staying on because they’re too tight, or are you having to curl your toes to keep the shoe on?
There should be a 1cm gap between your longest toe and the front of the shoe. The front of the shoe should match your foot in shape. Make sure the width of the shoe accommodates the widest part of your foot.

High Heels
Try and reduce the time spent in heels each day. Take them off where you can.
Aim for no bigger than 1.5/2 inches.
The heel takes a great proportion of weight when it strikes the floor in walking. Aim for a broad heel to give greater pressure distribution.
Sports
Buy the specific footwear necessary for the activity.
For running activities, or if you suffer with persistent problems, gait analysis may be useful to assess your specific needs.
In the running world, there is ongoing debate between wearing trainers, or running barefoot/specialised barefoot shoes. There is some evidence that indicates reduced pressure through the foot with the weight bearing position of running barefoot. With the knock-on effects of reduced lower extremity injuries, better proprioception, and increased ligament and muscle support at the foot arch. More research needs to be carried out. Any runners thinking of changing should do so slowly, as adaptations to barefoot running may take a while. It wouldn’t be recommended for those with reduced sensation in their feet, a very rigid foot, and to those that have osteopenia and osteoporosis.
On the flip-side of this. There is little evidence to support the decision-making process in relation to foot position when choosing trainers. Buy what feels comfortable to you, and/or seek advice.

Orthotics/Insoles
These can be inserted into footwear to alter the position and mechanics of the area. They also may be used to address problems higher in the body. Changing the position of your foot, will inevitably have an effect elsewhere.
If you feel this may be an option for you, seek advice from your Osteopath and/or Podiatrist.