Shoes are designed for two primary purposes: protect your feet and prevention of injuries. In order to perform these functions they must first fit properly. Improperly fit shoes can cause pain and possibly lead to permanent deformity.

Style should not be the most important consideration in choosing shoes. More importantly, shoes should be chosen for their construction, proper fit, comfort, and designed use. In other words, basketball shoes should not be worn for running, and running shoes not used for basketball.

Proper fit and comfort are the two most important considerations in choosing footwear. The shoe should conform to the shape of your feet. Soreness, blisters, calluses, and with time, permanent disfigurements can be caused by forcing your foot to conform to a poorly fit shoe.

Fashionable dress shoes, especially women’s high heels, are often the worst shoe for your foot. High heels shift the force of each step (an average of 10,000 per day) onto the ball of the foot and bones at the base of the toes. A three inch heel will create three to six times more stress on the forefoot than will a shoe with a one inch heel.

This increased stress can lead to the formation of bunions (a deformed great toe that slants toward the second toe), heel pain, shortened Achilles tendon, and entrapped nerves. Women account for about 90% of the 800,000 bunion, hammertoe, and nerve impingement surgeries performed each year.

The shortened Achilles tendon is a highly important consideration for athletes. A shortened Achilles tendon can lead to debilitating injuries such as Achilles tendinitis or a ruptured Achilles tendon.

The foot is not the only body part affected by high heels. The pain and injury can move up the leg to the knee, hip, and back. Walking in heels results, as with the foot, in the knees, hips, and back staying in a slightly flexed position. This does not allow the muscles to move through their normal range of motion and changes the stress bourn on the joints.

Choosing Appropriate Athletic Shoes

Athletic shoes are designed to protect the foot from the stresses resulting from a specific sport and to provide more traction. The differences in design and variations in material, weight, and lacing characteristics are meant to protect the foot in areas where stresses are highest.

The most important consideration in athletic shoe choice is COMFORT. A well fit athletic shoe will reduce blisters and other skin irritations. Style, logos, endorsement deals and color should NOT be considerations when purchasing an athletic shoe. Choose the shoe that is appropriate for the sport it is designed to be used for and choose an appropriate fit.

Not all shoes are cut the same way. A size 10 Nike® will not be a size 10 Addidas® . Also, even within the same brand of shoe, size variations occur. The following are some tips for purchasing shoes of any kind:

• Have a properly trained shoe salesman measure the length and width of your foot.

• Feet expand with weight bearing, so stand while your feet are being measured.

• Due to swelling that occurs in your feet during the day, size feet and purchase shoes later in the day.

• Shoes should be fit to your longer and wider foot. The toe box (front of the shoe) should be spacious, too much space can cause the foot to slide.

• Fit shoes carefully to the heel and toes. Your heel should not slip up in the heel cup of the shoe.

• Don’t select a shoe by size alone. Remember a size 10 is not a size 10 for every manufacturer or type of shoe.

• Select a shoe that conforms to the shape of your foot.

• Have feet measured regularly. Your feet change in size as you age.

• If the shoe feels too tight, don’t buy them. There is no such thing as a “break-in” period.

• If there is a big difference in the sizes of your feet, an insole can be added to the shoe of the smaller foot.

• Fashionable shoes can be comfortable, too.

Even though your shoes are fit appropriately, there may be some specific problems with your shoes that lacing techniques can resolve.

Narrow Feet

Use the eyelets farthest from the tongue of the shoes. It will bring up the side of the shoe.

Wide Feet

Use the eyelets closest to the tongue of the shoe. This technique gives the foot more space.

Narrow Heels or Heel Problems

Use every eyelet, making sure that the area closest to the heel is tied very tightly while less tension is used near the toes. When you have reached the next to last eyelet on each side, thread the lace through the top eyelet, making a small loop. Then, thread the opposite lace through each loop before tying.

Narrow Heel and Wide Forefoot

Use two laces. Thread through the top half of the eyelets and the other lace through the bottom half of the eyelets. The lace closest to the heel should be tied more tightly than the lace closest to the toes.

Visit these web sites to learn more about shoe choices or foot problems: American Orthopaedic Foot and Ankle Society at www.aofas.org or Am. Podiatric Medical Association at www.apma.org for more information.