Stride Orthopaedics and Footwear

 

Getting the Right Fit

According to the American Orthopedic Foot and Ankle Society, more than 43.1 million Americans—one in every six persons—have trouble with their feet, mostly from improperly fit shoes. A serious public health concern, foot problems cost the U.S. a painful $3.5 billion each year.

Yet, according to the American Podiatric Medical Association, only a small percentage of the population is born with foot problems. Rather it’s neglect and lack of awareness of proper care—including proper shoe fit—that brings the problems on. Since fewer than 10% of shoe salespeople have had even basic training in foot anatomy or shoe sizing, the foot problems that result from poor fit are hardly surprising.

 

A Foot, By Any Other Name...

The foot is an amazing structure, capable of alternating between a supple, shock absorber when our heel strikes the ground and a rigid lever that propels when we push off and into the next step. In each foot, there are 26 bones, 33 joints, 107 ligaments and 19 muscles (not to mention numerous nerves and blood vessels) that must work together to propel us forward. 

When feet function normally during walking, they must both pronate and supinate which basically means that they must both roll slightly inward and then roll slightly outward, respectively. This is the dynamic nature of the foot referred to above. For some people, rolling one way or the other may become more pronounced. While all feet are unique, most fall into three basic types: Normal or rectus foot where the structure and alignment of the foot are well configured for the demands of daily living. Excessive wear, exceptional demands, or improper shoes can make this foot injured or painful. High Arched (supinated) foot also known as pes cavus is a foot with an unusually high arch. When the arch is high enough, the foot becomes shortened and rigid, making this type of foot a poor shock absorber. People with unusually high arches are prone to problems of the entire lower part of the body and back and may also suffer toe deformities (clawed toes) and calluses or pain on the sole of the foot. Flat (pronated) foot (pes planus) is a foot with an unusually low or collapsed arch and is one of the more common problems treated by foot doctors. People who have flat feet are prone to tired feet, arch strain, arthritis and various other structural problems.

 

Shoe Size

Size is not just about the heel to toe length, the length from heel to the ball of the foot is important, too. Your fitter can help you compare and choose the best size. There are three primary sizing scales used in the United States : the American scale, the Continental European scale and the UK scale.

All shoes are made over wooden models of the foot, called lasts. Lasts give shoes their shape and are unique between manufacturers and often even between styles. Each last is graded into different size/width combinations to allow people with different sized feet to wear shoes made over that last. For shoes to be properly fit, the last must match the wearer’s foot shape. In addition the proper size/width combination must be chosen.

 

Things to Look For In Comfortable Footwear

  • Stability -- The shoe should not easily twist or roll.
  • Support -- The footbed of the shoe should cradle the bottom surface of your foot. The footbed that comes with the shoe won't support your foot, it must be equipped to be removed and replaced with a custom insole or orthotic device.
  • Shock absorbency -- The materials in both the insole and outsole should provide adequate cushion.
  • Fit -- Choose a shoe shape that most nearly conforms to the shape of your foot and a size that is appropriate for you.

Don’t Buy That Shoe Unless It Slips At The Heel!

Sounds like the wrong advice, doesn’t it? In many cases, though, it is not. If you have a flexible, pronated, or loose-jointed foot, a properly fitted shoe will tend to slip at the heel. This is particularly true until the shoe conforms to your foot. 

When a person with this foot type has their weight on their foot, their arch rolls downward, their instep is lowered and their heel moves forward, away from the heel counter. Since the foot has moved away from the parts of the shoe that secures the heel, the shoe slips when you lift your foot.

Millions of people with this foot type mistakenly fit themselves too short to hold their foot back in the heel of the shoe because they assume that any shoe that slips in the heel is too big. Consequently, they develop or exacerbate foot problems by jamming their feet into shoes that are too small. This is often evidenced by bunions, calluses, neuromas or pressure spots on the toes.

Don’t do it!

Listen to your fitter. We are fitting you into the size that is best for your foot and will not fit your heel at the expense of the rest of your foot. Take care of your feet, you only get one pair!

 

10 Points of Proper Shoe Fit

  1. Buy fit, not size. Sizes vary among brands and styles so don’t be wedded to a particular size.
     
  2. Buy the type of shoe that is made for the use intended. A dress shoe means one thing, a shoe for standing all day means another. A shoe for walking is a different matter.
     
  3. Select the shoe that is designed to support and fit your particular foot type. Flexible/pronated feet require a different fitting strategy than rigid/supinated feet. Your fitter may have to help you with this.
     
  4. Have both feet measured and fit the larger foot (remember length and width).
     
  5. Have your new shoe fit with the particular socks, hosiery, or stockings that you intend to wear them with.
     
  6. Heel slip does not always mean that the shoe is too big. It may mean that you have a flexible foot. Ask your fitter for more information.
     
  7. When standing you should usually have 3/8” to 1/2” from your longest toe to the end of the shoe. Remember that your big toe may not be your longest toe.
     
  8. Choose styles that conform as nearly as possible to the shape of your foot. If you have a wide and/or square-shaped foot, pressure on the 5th toe (little toe) can be more important for fit than fitting the big toe.
     
  9. Shoes should feel good when you buy them. Don’t buy uncomfortable shoes hoping they will break in and feel good later.
     
  10. Take your time buying a new pair of shoes. Walk around the store and listen to your feet. Ask for a salesperson who is professional and understands feet as well as shoes.
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