Focus on Design, Fit When Choosing Shoes

If the shoe fits, wear it is not just a cliché. It could be one of the most valuable health tips you hear all year.

“Walking is extremely important,” says Roy DeFrancis, D.P.M., of Buffalo, a member of the New York State Podiatric Medical Association. “Anything we can do to keep walking is good.” But, he adds, “If you put something on your feet that makes your feet hurt, you’re not going to walk.”

Wearing last year’s shoes or shoes that have seen better days will likely hurt your feet, he says. For one thing, our feet change size, getting longer and wider as we age. That’s why it’s important to have your feet measured each time you go to buy shoes—“both the length and the width.” And when shoes wear out on the inside, they develop minute cracks that can irritate your skin.

A safety essential

Comfort isn’t the only reason to make sure your shoes fit. “Preventing falls is the most important function of proper footgear, especially for seniors,” says Santa Monica podiatrist Daniel Altchuler, D.P.M., a member of the California State Podiatric Medical Association.

“If the shoe is going to help someone maintain balance,” he says, “the heel needs to be close to the ground, even for nonathletic shoes.” With short, low heels, “weight is distributed along the whole length of the foot. Then, you can feel the contact with the surface you’re walking on.” The shoe also needs to bend where your foot bends, which means the widest part of the shoe needs to align with the widest part of your foot—the space between the knuckle of your big toe and the knuckle of your baby toe.

The shoe should have a firm middle sole, the layer of cushioning that sits on top of the outer sole (which touches the ground). “If it’s too cushioned, it’s unstable and causes your foot to sway from side to side,” Dr. Altchuler says. To make up for the loss of fat pads on the bottom of your feet, you can buy shoe inserts at most pharmacies and even shoe outlets. You can see a podiatrist if you have a condition such as diabetes that makes it necessary to wear a custom-designed insert called an orthotic.

Another consideration is that shoes have to fit properly.

Getting the right fit

Allen Lazerson, D.P.M., is board certified in podiatric surgery. He has practiced for the past 25 years in Cobb County, Ga., where he also specializes in sports medicine and diabetic foot care. He gives his patients a list of tips for ensuring they get the right fit:

• Try on new shoes—whether for casual wear or for exercise—at the end of the day. “Your feet swell during the day,” he says. “So shoes that fit in the morning may not fit at night. But if you buy when your feet are the largest, they’ll fit all day.”

• Try on shoes with the socks you will wear with them. Dr. Lazerson says that for walking or other exercise, socks with extra cushioning in the ball and the heel area are best.

• The shoe should be comfortable as soon as you try it on. There is no break-in period for shoes, Dr. Lazerson says. “Shoes do not get better with wear.”

• Always lace both shoes when you try them on. That way you can tell how snug they are and whether or not they are going to rub up and down.

The proper fit, all three doctors say, should have room in the toe area, and feel snug on the rest of your foot. Good toe room means about a thumb’s width between the end of the toes and the end of the shoes.

To make sure the width is right, use your thumb and forefinger to try to pinch the upper part of the shoe above the widest part of your foot. “You should be almost able to pinch it,” says Dr. DeFrancis. “If you can’t, it’s too narrow, and if you can pinch it completely, it’s too wide.”

Dr. Altchuler suggests you only buy shoes from a store that will let you exchange them if they turn out to be wrong.

Do you have to spend a fortune on new shoes?

"Absolutely not,” says Dr. DeFrancis. All three doctors agree that fit rather than cost or name brand is the important consideration.