Anatomy of a Shoe
Shoes are made up of five major components:
The toe box is the tip of the shoe that provides space for the toes. Toe boxes are generally rounded, pointed, or squared and will determine the amount of space provided for the toes.
The vamp is the upper middle part of the shoe where the laces are commonly placed. Sometimes Velcro is used instead of laces.
The sole consists of an insole and an outsole. The insole is inside the shoe; the outsole contacts the ground. The softer the sole, the greater the shoe's ability to absorb shock.
The heel is the bottom part of the rear of the shoe that provides elevation. The higher the heel, the greater the pressure on the front of the foot.
The last is the part of the shoe that curves in slightly near the arch of the foot to conform to the average foot shape. This curve enables you to tell the right shoe from the left.
Athletic Shoe Guidelines
Athletic footwear should be fitted to hold the foot in the position that is most natural to the movement involved. Athletic shoes protect your feet from stresses encountered in a given sport and to give the player more traction. Well-fitted athletic shoes need to be comfortable, but well-constructed and appropriate for a given activity.
A running shoe is built to take impact, while a tennis shoe is made to give relatively more support, and permit sudden stops and turns. Cross training shoes are fine for a general athletic shoe, such as for physical education classes or health club exercising, such as on stair machines and weight-lifting because they provide more lateral support and less flexibility than running shoes. They also tend to be heavier than running shoes, but most people don't need light, flexible shoes for cross-training. If a child is involved more heavily in any single sport, he or she should wear shoes specifically designed for that sport.
Our practice recommends sturdy, properly fitted athletic shoes of proper width with leather or canvas uppers, soles that are flexible (but only at the ball of the foot), cushioning, arch supports, and room for your toes. Try a well-cushioned sock for reinforcement, preferably one with acrylic fiber content so that some perspiration moisture is "wicked" away.
As your child begins to walk, your first question will be about what shoes he or she should wear. A growing child will need new shoes fairly frequently, and more questions will arise.
Pay attention to the shoe's proper length, width and depth when fitting your child's shoe. Poorly fitting children's shoes can cause toe problems, ingrown toenails, hammer toes, calluses and bunions.
The upper part of the child's shoe should be made of leather, canvas or the newer mesh materials.InsoleMake sure the insole is made of absorbent material. You may want padded insoles. Most children do not need a special arch support.
The outer sole provides traction, cushioning and flexibility to the shoe. Some very sticky and thick outer soles can make young children clumsy and cause falls and should be avoided.
Toddlers do not need heels on their shoes. Flat outer soles make it easier to begin walking. Older children can wear shoes with heels, but they should not be too high (taller than one inch), as tall heels can cause the foot to slide forward and cramp the toes against the inside of the shoe.
School-Age Children's Shoes
Style and shoe fit is important for school-age children and, at this age, they can choose from a variety of shoe styles such as athletic or hiking shoes, and sandals.
It is best to look for a reasonably priced, flexible and well-ventilated shoe that allow some room for growth. If you have a great deal of difficulty finding shoes that fit your child, or if your child develops blisters, calluses, sores or other foot conditions, always consult your physician.
Children's Foot Problems
During the first several years, when your child's foot continues to take shape, problems such as flat foot or high arch may become noticeable, but usually no specific treatment is necessary. Howevver, if severe, these problems may possibly be symptoms of other and more serious conditions; your child may need a physician's examination and diagnosis.
Custom-made shoes. When severe deformities are present, a custom-made shoe can be constructed from a cast or model of the patient's foot. With extensive modifications of shoes, even the most severe deformities can usually be accommodated.
External shoe modifications. In these cases, the outside of the shoe is modified in some way, like adjusting the shape of the sole or adding shock-absorbing or stabilizing materials.
Healing shoes. Immediately following surgery, special shoes may be necessary before a regular shoe can be worn. These include custom sandals (open toe), heat-moldable healing shoes (closed toe), and post-operative shoes.
In-depth shoes. An in-depth shoe is the basis for most footwear prescriptions. Generally an oxford-type shoe or an athletic shoe with an additional 1/4-inch to 1/2-inch of depth throughout the shoe. This extra volume accommodates inserts, or orthotics, as well as deformities commonly associated with a diabetic foot. In-depth shoes are usually designed to be light in weight, have shock-absorbing soles, and come in a wide range of shapes and sizes to accommodate virtually any foot.
Orthoses or shoe inserts. Also known as orthotics, an orthosis is a removable insole which provides pressure relief and shock absorption. There are pre-made and custom-made orthotics or shoe inserts, including a special total contact orthosis, which is made from a model of the patient's foot and offers a high level of comfort and pressure relief.
What to Look For When Selecting Shoes:
Avoid shoes that have seams over areas of pain, such as a bunion.
Avoid shoes with heavy rubber soles that curl over the top of the toe area (such as seen on some running shoes), because they can catch on carpets and cause an accidental fall.
Flat shoes (with a heel height of one inch or less) are the healthiest shoes for your feet. If you must wear a high heel, keep to a heel height of two inches or less, limit their wear to three hours at a time, and take them off coming to and from an activity.
Laced, rather than slip-on shoes, provide a more secure fit and can better accommodate insoles, orthotic devices, and braces.
Look for soles that are shock absorbing and skid resistant, such as rubber, rather than smooth leather.
Shoes should be made of a soft material that has some give.
Getting a Proper Fit
Everything from serious foot disorders to more common foot and ankle conditions can be exacerbated by one, avoidable cause: inappropriate, poor quality, and/or ill-fitting shoes. The most important quality to look for when buying shoes is a durable construction that will protect your feet and keep them comfortable.
The Fitting: Here are some tips to help reduce possible foot problems when shopping for shoes:
Do not force your feet into a pair of shoes in order to conform to the shape of the shoe. The shoe needs to conform to the shape of your foot.
Fit new shoes to your largest foot.
Have both feet measured every time you purchase shoes. Foot size increases as you get older.
If the shoes feel too tight, don't buy them. There is no such thing as a "break-in period."
There should be a half-inch of space from the end of your longest toe to the end of the shoe.
It's best to try on new shoes at the end of the day. Your feet normally swell and become larger after standing or sitting during the day, which makes for a better fit.
Be sure to try on both shoes. Walk around the shoe store in them to make sure they fit well and feel comfortable.
When the shoe is on your foot, you should be able to freely wiggle all of your toes.
Most men's shoes conform to the shape of the feet and have a roomy toe box with sufficient horizontal and vertical space and a low heel, which is usually about half an inch high. Soles made of hard materials (such as leather) or soft materials (such as crepe) can be worn, but softer soles tend to be more comfortable. If you stand for extended periods of time, shoes with soft, pliable and cushioned soles will protect your feet.
The best shoes for men are typically good quality oxford-style shoes ordinarily associated with wing-tip or cap toe designs. Also suitable are slip-ons, dressy loafers, and low dress boots.
It is advisable to have three to five pairs of shoes for business so that you can alternate your shoes on a daily basis.
The best shoe for women's feet is a walking shoe, one with laces and not a slip-on, and a composition sole, as well as a relatively wider heel with a rigid and padded heel counter that is no more than three-quarters of an inch in height.
Some women inflict punishment on their feet from improper footwear that can bring about unnecessary foot problems. Some of the problems result from high-heeled shoes, which are generally defined as pumps with heels of more than two inches.
A study conducted by the American Orthopaedic Foot and Ankle Society found that:
Nine out of 10 women wear shoes too small for their feet.
Eight out of 10 women say some of their shoes are painful.
More than 7 out of 10 women have developed a bunion, hammertoe, or other painful foot deformity.
Women are nine times more likely to develop a foot problem because of improper fitting shoes than a man.
Nine out of 10 women's foot deformities can be attributed to wearing tight shoes.
High-heeled, pointed-toe shoes can cause numerous orthopedic problems, which lead to discomfort or injury to the toes, ankles, knees, calves, and back. Many high-heeled-shoes also have a pointed, narrow toe box that crowds the toes and forces them into an unnatural triangular shape. These shoes distribute the body's weight unevenly, placing excess stress on the ball of the foot and on the forefoot. This uneven distribution of weight, coupled with the narrow toe box characteristic of most high heels, can lead to discomfort, bunions, hammertoes, and other deformities.
The height of the heel will make a dramatic difference in the pressure that occurs on the bottom of the foot. As the heel height increases, the pressure under the ball of the foot may double, and this places greater pressure on the forefoot which is forced into the pointed toe box.
To relieve the abusive effects of high heels, women should limit the amount of time they wear them and alternate these shoes with good quality sneakers or flats for part of the day. Select comfortable, and still attractive walking pumps for work and social activities. Low-heeled shoes (one inch or lower) with a wide toe box are the ideal choice for women.
When you take a step, your foot typically hits the ground heel first and rolls toward your toes, flattening the arch slightly. As you push off the ball of your foot, your arch springs back and does not touch the ground. Normal feet work this way. Not all feet work this way.
Overpronation occurs if your foot rolls too much toward the inside. This can cause arch strain and pain on the inside of the knee. Underpronation occurs if your foot rolls too much to the outside. Underpronation can lead to ankle sprains and stress fractures. You can relieve foot pain by compensating for these tendencies, but first you need to determine which way your feet roll.
One method for determining which kind of pronation you have is the watermark test: Put your feet into a bucket of water, then make footprints on a piece of dark paper.
If your footprint looks like an oblong pancake with toes, you pronate excessively or may have flat feet. Try molded-leather arch supports, which can be purchased in many drug stores. When shopping for athletic shoes, check for styles with "control" features—soles designed to halt the rolling-in motion. If arch supports or sports shoes don't help, please contact our office for a custom-molded orthotics.
If there is little or no connection in your footprint between the front part of the foot and the heel, you under-pronate or have a high arch. This is when a lot of your weight is landing on the outside edge of your foot. When shopping, check out "stability" athletic shoes. These are built with extra cushioning to remedy this problem. Also, if you are prone to ankle sprains, wear high-top athletic shoes that cover the foot and ankle snugly to minimize damage from twists.
Examining old shoes before buying new ones can help you evaluate your wear patterns and buy new shoes with a better fit and style that compensates for the stresses you place on shoes.
What are your shoes trying to tell you? Here is a translation of basic wear patterns:
A bulge and wear to the side of the big toe means too-narrow fit or you have a bunion.
Outer sole wear means you turn your foot out. Orthotics may help.
Toe-shaped ridges on the upper means your shoes are too small or you have hammertoes.
Wear on the ball of the foot means your heel tendons may be too tight.
Wear on the inner sole means you pronate or turn your foot inward. Inner liners or orthotics may help.
Wear on the upper, above the toes means the front of your shoe is too low.