Over the last several weeks, I have found myself talking about the shoes we wear and how important it really is to get a good pair of shoes. The hard part of course is identifying what characteristics make up a “good” pair of shoes. This applies to all ages and if you have not ever heard what shoes are best for you, let me start by saying there are more variables than cost and style when identifying the best shoe for your foot. It is more important to have a shoe that works best for your needs, than one that may have the style you are hoping for.
Like a lot of things in life, shoes are being advertised as “the best shoe for walking” or the “best shoe for running” or “the best shoe for people on their feet all day” (like nurses and waitresses or waiters and even factory worker). Most of the time these claims are based purely on marketing strategies to get you to buy the shoe.
Let me start with my least favorite shoe...and I apologize if it happens to be your favorite…. but the shoes with memory foam actually impair your gait and balance rather than help it. The concept that more cushion is good for you is simply not true regardless of the brand. Based on this concept we should be walking on pillows all day; which is ridiculous of course. In physical therapy we use foam cushions to CHALLENGE someone’s balance so the idea that more cushion is better is a flawed concept.
Every week I work with patients that come to me with complaints of balance problems. And every week I have the same conversation…. more cushion is NOT helpful. Not only is it more difficult to walk but I have several patients right now that altered the way they walk, at least in part, due to their choice of shoes. Many people are surprised to learn that the shoes they bought that felt good in the store may be part of their walking/balance issue.
The next shoes on my list of pet peeves is the one that is made by a reputable shoe manufacturer that promotes the shoe as a “walking” shoe. The shoe has a stiff exterior and a wide sole, which is meant (I think) to give the appearance of a stable shoe. That stiffness does not allow our foot to roll properly when we are walking which is not good for our gate. In addition, these shoes also offer too much internal cushion resulting in the above-mentioned balance difficulties.
In both styles of shoes, I often identify a wider stance, turned out toes and a shorter step length. These are all common alterations that people make subconsciously to feel more stable while walking. These are also alterations are also more common in people with the above-mentioned style of shoes.
Another common problem modern/stylish shoes are the size of their toe box. People love their stylish shoes despite the fact that the shoe’s toe box is so narrow it is cramping their toes and contributing to the painful bunion they have. I am amazed at how many patients come with shoes that are ill fitting. And even more surprised at how willing we are to continue buying shoes that clearly affect our feet negatively.
In addition, it seems like most weeks someone is coming in with an “orthotic” that they had fitted decades ago or ones that found at a “big box store” that claimed to be good for people with particular foot issues. Or worse yet the kind that someone sold them for $400 without even looking at their foot or assuming the unusual gait was coming from the foot instead of the hip or some other source. This happens all the time.
Now, of course, there are reasons for orthotics/inserts, but if you have having pain, or have balance/gait problems, it is important to have someone that will watch you walk and will assess whether or not the insert (orthotic) is right for you.
As recently as last week I was treating a patient with bilateral knee pain. (his right knee is worse) He has inserts that appear identical (they cost over $400) and yet when I watched him walk barefooted, it was clear things were different right compared to left. This is fairly common to have one foot worse that the other, but it is strikingly different. So much so I decided to videotape him and play it is slow motion so he can also see the differences. I have recommended he seek out physicians and/or podiatrists that will actually watch him walk and assess his gait before and after inserts before purchasing a new pair, which he clearly needs.
What I recommend when it comes to buying shoes is to find one that really fits your foot. Meaning there is room in the toe box for your toes to have some space…. I am not an advocate of narrow shoes. I also recommend low to no heels...but this may take time for someone to wean out of shoes that have higher rises. I recommend people buy quality sneaker and find discount prices by shopping for last year’s models. It is definitely easier to find a decent sneaker. Shoes require a bigger net and may be more challenging to find a pair that fits your foot properly.
I am not advocating the most expensive shoe, but I am advocating quality. So, there are ways to find good brands without spending an arm and leg, but I also want to remind people that what you wear on your feet can absolutely affect your foot health, your knee health, your hip health and even your spine health. So, don’t go cheap on your feet.
My brother and I went shopping for mattresses back when we were fresh out of college. He was looking at really expensive mattresses and read about the ones that were good quality. I remember asking him why he would spend so much time and effort on his bed. He gave me a great answer...he said, “Well I figure I spend 6-8 hours a night in the bed I am going to buy and only 1-2 hours in the car I am going to buy. So, I decided that I should spend at least as much time shopping for a good bed as I do car.” (He always had nice cars too!!)
Well, I feel the same way about shoes. Find the ones that are best for your foot. Comfortable but not because of excessive cushion. More because they fit properly and your feet actually like being in them and still feel good when you come out of them.
When you are walking around town and come back with foot pain, I suggest you examine your shoes! If you’re still not sure, I would be happy to assess your feet and gait and give you my recommendations.
(I didn’t list the name brands mostly because I wasn’t sure if I am legally able to do so in an article.)
Matthew Goodemote can be contacted by calling (518) 306-6894. Goodemote Physical Therapy PLLC is located at 3 Maple Dell in Saratoga Springs.
