Feet and Shoes

Feet and Shoes

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What’s on this page?

Many people with arthritis develop foot problems at some stage. If you develop foot problems ask to see a Podiatrist. Having good shoes is vital. Good shoes help reduce aches and pains and enable you to walk more. If your job involves standing and walking, good shoes reduce foot, leg and back pain.

Check your feet regularly. Are you developing any foot problems? Toes bending up or drifting? Painful ball of foot? Dropped arch?  Ankle changing shape? Callouses? If yes then ask to see a Podiatrist. 

For an on-line foot health course see:

https://www.nras.org.uk/foot-health-online-course

How to choose footwear

What to look for:

  • insoles with good shock absorption,
  • thick but flexible soles to protect the feet from the ground underneath,
  • smooth lining without seams
  • plenty of depth to accommodate the toes,
  • soft uppers of leather or fabric
  • lightweight soles and heels.

Comfort should be the main consideration when choosing shoes, although for most people it’s important that their footwear looks good too. If your feet are painful or unusually shaped you may need to compromise a little on style. Shoes that don’t fit properly can damage your feet, and high heels or shoes that pinch your feet are likely to cause deformities such as bunions or hammer toes.

Your feet may change shape as you get older, especially if you have arthritis, so you may need to try a different size or width fitting.

 What to think about when buying shoes? 

  • Have your feet measured if they’ve become wider over the years or have changed shape. Have them measured while you’re standing because they may change shape when you stand up. Many shops have experienced fitters who can help you with this.
  • Try shopping later in the afternoon. If your feet tend to swell, they’ll be at their largest at that time.
  • Judge a shoe by how it feels on your foot and not just by the size marked on the shoe. Size varies between shoe brands and style. Think about how the shoe fits around your toes, under your soles and at the backs of your heels.
  • Always buy your shoes to fit your larger foot – many people have one foot bigger than the other. You can use an insole in the other shoe. There should be at least 1 cm (3/8 inch) of room at the front of your longest toe.
  • Try shoes on with the type of socks or stockings you normally wear or with any insoles or orthoses you normally use. Some insoles may need extra depth, especially around your toes.
  • Don’t buy shoes to break-in later – the right shoes for you will be comfortable when you first try them on.
  • Soles should be light, hard-wearing and flexible. The sole should be able to bend along an imaginary line drawn from the base of your big toe to the base of your little toe.
  • Buy shoes that have both leather uppers and inners (the inner lining) if possible. These are more breathable than inners made of synthetic materials and will help you to avoid dampness and fungal infections.

Look for dark colours and a suede finish if you’re worried about the appearance of your feet – they’ll help to disguise the problem.

Insoles

You may need insoles in your shoes for a number of reasons:

  • to pad out the shoe of your smaller foot if you have one foot bigger than the other
  • to support the arch of your foot
  • to help arthritis in the joint across the middle of your foot (the midtarsal joint).

Insoles will often take up half a shoe size, so take along your largest shoes when you go for an insole fitting. Sometimes you may need to buy bigger shoes to fit your insoles, although this isn’t always the case. Take your insoles along when you buy new shoes.

Fastenings

Lace-up shoes can be difficult to fasten if you have arthritis in your hands. Here are a few alternatives:

  • Elastic laces can be easier to use because one pull ensures a snug fit and they don’t need to be tied.
  • Many shoes are now available with Velcro fastenings, which can be done up and adjusted using only one hand.
  • A zip fastening can be easier to manage than laces or buckles, and a ring (such as a keyring) added onto the zip can make it easier to pull up.

Slippers

Many people prefer to wear slippers in the house. However, slippers aren’t a good idea for those who have to wear special insoles, and they may increase your risk of having a fall. The uppers of slippers are often soft, so they’re comfortable for hammer toes and prominent joints, but the soles may not have enough cushioning and grip.

Like outdoor shoes, slippers should fit properly and shouldn’t be too loose. You should avoid backless or high-heeled slippers. The features of the ideal slipper are generally the same as for the ideal shoe. Always wear shoes when you’re outside to make sure your feet are properly supported.

Please note:
If you need to wear a prescribed insole, don’t try to wear it all day when you first get it. Wear it for a short period at first and gradually build up to longer periods. If you change your shoes indoors, either have a second pair of insoles for your indoor shoes or remember to swap the insoles over. Your feet will return to their old shape while indoors and will never be comfortable if you don’t continue to wear your insoles.

Footware adaptations

If you have difficulties getting shoes to fit it is possible to have footwear prescribed for you by your consultant, GP or HPC registered podiatrist. You must have a medical reason for the prescription. People who have been given a prescription will be provided with either readymade, modular or made-to-measure footwear. These shoes are usually made by an orthotist. You can also choose to see an orthotist or orthopaedic shoemaker privately. . It may also be possible to have high-street footwear adapted by an orthotist  so ask them for advice. Each NHS hospital trust will have its own arrangements for footwear referral and entitlements

Common foot problems and solutions

Painful ball of foot
• Special insoles provide cushioning just behind the ball of the foot – these can be made for you by Podiatry or Occupational Therapy.

• A higher toe box: – ie deeper shoes at the toes. Moccasin-styles are good – ie with a sewn ridge.

• Or lace the shoe differently (see ‘Lift the Toe Box’ below)

• Avoid higher heels. Keep them low or flat. Heels push the body weight forward onto the toes, increasing pain and deformity

Bunions or Hallux Valgus
• Due to weaker ligaments at the big toe joint. Shoe shape and foot pressure can push the big toe sideways.

• Buy shoes with straight inner sides, not points or curves, to avoid sideways foot pressure.

• Avoid higher heels. Keep them low or flat. Heels push the body forward onto big toes, increase pain and deformity

Dropped arch or flat foot
• Arch supports
Heel pain
• Cushioned heel support and heel cup; shock absorbing heel in the shoe; “lace lock” if heels slipping (see below)
Midfoot pain
• Lace – “skip a hole or two” – (see below)
Valgus Heel (ie ankle turns in)
• Heel cup and arch support. See a Podiatrist for special support insoles.

The diagram below demonstrates different lacing techniques:

laces

To understand more about the role of a podiatrist please click here

Where to buy shoes

Looking for new shoes?
A number of shops are beginning to stock extra-wide and extra-deep shoes, which can help. Some mail order catalogues also specialise in shoes with extra depth and some will make to your measurements. Podiatrists often recommend brands such as Hotter, Ecco, Joseph Seibel, Padders and Clarkes.

The British Footwear Association has suppliers of specialist footwear listed under headings in the section consumer information:

British Footwear Association
3 Burystead Place
Wellingborough
Northants
NN8 1AH
Tel: (01933) 229 005
Fax: 01933 225 009
Email info@britishfootwearassociation.co.uk
Website http://www.britishfootwearassociation.co.uk/

Hotter Shoes
11 Pydar Street
Truro
Cornwall
TR1 2AX
Tel: 01872 279 463
generalinfo@hotter.com
www.hottershoes.com

Wider Fit Shoes Ltd
19–21 Inchester Road
Rushden
Northants
NN10 9XF
Tel: 01933 311077
Email: enquiry@widerfitshoes.co.uk
www.widerfitshoes.co.uk