En español | The next time you slide your feet into your favorite pair of loafers or sling pumps, consider this: Research suggests that about 70 percent of us are wearing shoes that don't properly accommodate either the width or length of our feet.
The reason, says Ray Margiano, CEO of Foot Solutions, a footwear and orthotics franchise, is in the way we shop — and the fact that adults often pull the wrong shoes off the rack from the get-go. The result can be discomfort after checkout — and pain that goes beyond tortured toes. “Our feet are the foundation of our body,” he explains. “Poor body alignment, caused by a misalignment of the feet, can impact the knees, hips, lower and upper back and even the neck.” Here's how to a better fit for the long haul.
Go to an actual store
Sure, picking out shoes on the internet is quick and easy, but it's important to try on footwear the old-school way — in a store — rather than dropping a pair into your virtual shopping cart. Adam Stuhlfaut, owner of Shoes-n-Feet, a specialty shoe retailer in Bellevue, Washington, is a big believer in his kind of store. “Shopping for shoes is like finding a mechanic for your car,” he says. “Look for a smaller, local business, where the fitters are trained and experienced.” They should take the time to work with you and have a conversation about your lifestyle: What is your typical day like? Do you spend a lot of time outdoors — pounding the pavement, or live in a carpeted residence in a senior living community?
Get your feet measured
"A lot of people tend to be locked into one size,” says Margiano. “We deal with women all the time who are trying to fit their feet into the same size shoe they wore in college, insisting their feet haven't changed.” But change they do. “There are lots of ligaments in our feet, holding those 26 bones tightly together,” says Beth Gusenoff, a podiatric surgeon in the Department of Plastic Surgery at the University of Pittsburgh. “As we age, we lose elasticity in the ligaments and our feet spread out.”
Something else to consider: “A shoe size in one brand almost never matches the size in another brand,” says Alex Kor, a Lebanon, Indiana-based podiatrist. This is particularly true, he says, for athletic shoes, which are often made in countries with different sizing standards.
Shop in the afternoon
"Your feet tend to accumulate fluid and swell during the day, as you stand and walk around,” says Kor, who suggests trying on shoes after 3 or 4 p.m. to find shoes that won't feel tight some days. And watch the socks. “You want to be sure the sock you're wearing at the store fits the type of shoe you'll ultimately be wearing it with.”
Flex the footwear
"Even in a casual shoe you need structure,” says Jenny Sanders, a San Francisco-based sports medicine biomechanist. “Women will wear ballet flats and other types of shoes that aren't supportive, and they're doing a ton of walking.” Ideally, you're looking for a shoe that's stiffer in the midsoles. “Try to bend the shoe between the heel of the shoe and the ball of the foot,” says Kor. “If it bends easily, you're not going to get enough support.” And never mistake cushioning for support, says Stuhlfaut: “A lot of older people, particularly if their feet are sensitive, tend to err towards things that are really, really soft. But a shoe in a store shouldn't feel like a slipper — it should feel like it has a little breaking in to do. I tell people, ‘Your house is made with a foundation of cement, not marshmallows.'”
Check it out — heel to toe
Yes, you should have room between the tip of your toes and the top of the shoe (look for a space about the width of your thumb). But consider the shape of a shoe, as well as the size. Pointed pumps and wing tips will cramp toes and possibly lead to bunions and hammertoe. A wider toe box will provide more room. “A lot of people think that means the width of the shoe, but it does not,” Kor says. “The toe box is side-to-side around the toe area; the width of the shoe is measured at the ball of the foot. You can have a shoe that has significant width, but still has a narrow toe box, and it's going to put pressure on the toes.” (Stuhlfaut notes that you should feel like you could “play the piano with your toes.")
Teetering on lofty heels can lead to pain on the balls of the feet and an Achilles tendon that will tighten over time. “That's going to happen anyway as you age, but you're going to exacerbate it at a faster rate,” says Kor, who suggests nothing higher than 1 1/2 inches.
Consider your bottom line
"In retirement communities, people spend a lot of time on carpeting, and that can be a tripping hazard,” says Stuhlfaut. But while you need traction, beware of shoes with rubber soles, which can be heavy and not ideal for less-mobile seniors who have trouble lifting their feet or rely on walkers to get around. A better option: polyurethane, which is durable but more lightweight. Once broken in, the material also offers traction, without the sticky feel on carpeting that rubber can bring. Those dealing with the pain of arthritis may find it easier to walk in shoes with rocker bottoms, from brands like HOKA and Clarks. Designed with a thick sole and rounded heel, “they help propel the foot forward,” says Alan Bass, a podiatrist based in Manalapan, N.J.
Let some air in there
Cracked skin between the toes — which can be caused by trapped moisture — can be a nuisance or even a health risk. “When people ask for a breathable shoe, I go over to the athletic shoes,” says Stuhlfaut. “Shoes made of an airflow mesh are some of the best.” Your choice of socks also matters, because if they won't allow moisture to be wicked away, your feet won't stay dry. Socks with some wool ingredient — say, a mix of wool and acrylic cotton — tend to be better than just pure cotton, says Kor.
Ask about special features
Be sure to clue a salesperson in to specific foot conditions you might have. Chances are, there's a footwear feature that can accommodate it. For example, those who have diabetes, hammertoe or other friction issues might consider shoes that are seam-free on the inside to prevent chafing. Another option: extra-depth shoes in which the shoe or toe box is taller, creating a looser fit and more room for sensitive areas. “For bunions,” says Stuhlfaut, “we have a slide-in shoe that has a stretch leather panel built into the bunion area.”
Inserts and Orthotics
When you might need them, and when Medicare may pay
Shoes right out of the box may be work for some, but others may need to have their footwear modified with upgraded inserts. “The insert can be critical because in a majority of shoes we buy today, the inserts are just a little inexpensive piece and don't support the foot properly,” says Margiano.
Though inserts are often used for support, they also can be used to create volume or take it away. “If somebody has thin fat pads on the bottom of their feet, you can slip pads into their shoe to make it fit better,” says Stuhlfaut. People with serious foot issues — say, diabetic foot ulcers, hammertoe, or plantar fasciitis — might consider prescription orthotics, custom-made devices that provide support and reduce pressure on the bottom of the foot. They typically cost about $300 to $800.
Diabetics who are at risk for foot ulcers should look into Medicare's Therapeutic Shoes & Inserts program, says Bass. Medicare will pay 80 percent of the cost of diabetic shoes and orthotics for those who meet the criteria. To learn more, ask your podiatrist or go to medicare.gov/coverage/therapeutic-shoes-inserts.