Dr Mark Nelson
Foot & Ankle
Specialist

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Foot Medical Information
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Footwear & Shoe Buying Tips
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Information From The American Podiatric Medical
Association
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Proper footwear can reduce foot problems
From ancient Egyptian times down through the centuries,
footwear has been designed to meet mankind’s real and perceived
needs—protection, support, comfort, sturdiness, and stylishness.
Feet endure tremendous pressures of daily living. An average day of walking
brings a force equal to several hundred tons on them. They are subject to
more injury than any other part of the body, underscoring the need to
protect them with proper footwear.
Doctors of podiatric medicine are health care professionals trained for both
palliative and surgical care of the foot and ankle. They also are fully
qualified to recommend selection of the right pair of shoes, or address
other aspects of foot health, for all members of the family.
Children’s Shoes
When a child begins to walk, shoes generally are not
necessary, allowing an infant to go barefooted in doors, or to wear only a
pair of socks, helps the foot grow normally and develop its muscles and
strength, as well as the grasping ability of toes.
As children grow more active, and their feet develop, the need for shoes
becomes apparent. It becomes necessary to change shoe sizes at a pace that
frequently surprises and even dismays parents, to allow room for growth.
When purchasing shoes for children, remember these tips:
 | Examine the shoe itself. It should have a firm heel counter (stiff
material on either side of the heel), adequate cushioning of the insole,
and a built-in arch. It should be flexible enough to bend where the foot
bends—at the ball of the foot, not in the middle of the shoe.
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 | The child’s foot should be sized while he or she is standing up with
full weight-bearing.
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 | There should be about one-half inch of space (or a thumb’s width)
between the tip of the toes and the end of the shoe. The child should be
able to comfortably wiggle his or her toes in the shoe.
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 | Have the child walk around the store for more than just a few
minutes wearing the shoe with a normal sock. Ask the child if he or she
feels any pressure spots in the shoe. Feel the inside of the shoe for
any staples or irregularities in the glue that could cause irritation.
Examine where the inside stitching hits the foot. Look for signs of
irritation on the foot after the shoe is worn.
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 | Shoes should not slip off at the heels. Children who tend to sprain
their ankles will do better with high-top shoes or boots.
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 | Both feet should be measured, and if two different sizes, shoes
should be chosen that fit the larger foot best.
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Women’s Shoes
Women inflict more punishment on their feet in part from
improper footwear that can bring about unnecessary foot problems. Some of
the problems result from high-heeled shoes (generally defined as pumps with
heels of more than two inches). Doctors of podiatric medicine believe such
heels are medically unsound, and attribute postural and even safety problems
to their use.
To relieve the abusive effects of high heels, women can limit the time they
wear them, alternating with good quality sneakers or flats for part of the
day.
They can also vary heel height. There are comfortable and attractive
“walking” pumps (also called “comfort” or “performance” pumps) for work and
social activities, that blend fashion considerations and comfort, offering
pumps with athletic shoe-derived construction, reinforced heels, and wider
toe room.
Activity has a bearing on the considerations; wearing the right shoe for a
particular activity is probably as important a factor in the choice of shoes
as any.
Perhaps the best shoe for women is a walking shoe with laces (not a
slip-on), a polymerized composition sole, and a relatively wider heel with a
rigid and padded heel counter, no more than three-quarters of an inch in
height.
Men’s Shoes
The best shoes for men are good quality oxford styles, shoes
ordinarily associated with wing-tip or cap toe designs. Also suitable are
slip-ons, dressy loafers, and low dress boots.
Men as well as women should buy shoes for work, leisure, and special
activities, matching the shoe to the activity.
Male (and female) office workers should earmark three to five pairs of shoes
for business hours—general oxfords and loafers for men; pumps and oxfords
for women. Cushioned-sole shoes that give good support are essential for
those who spend most of their working days on their feet.
There is no question about the need for foot protection for those who work
in heavy industry. Safety shoes and boots—those that are waterproof or
water-resistant, with insulated steel toe caps and soles of non-conducting
materials—help prevent injuries to the feet, and reduce the severity of
injuries that do occur.
Shoes for Athletics
Different sports activities call for specific footwear to
protect feet and ankles. Sports- specific athletic shoes are a wise
investment for serious athletes, though perhaps a less critical
consideration for the weekend or occasional athlete; nevertheless, it’s a
good idea to use the correct shoe for each sport. Probably a more important
consideration is the condition of the shoe—don’t wear any sport or other
shoes beyond their useful life.
Athletic footwear should be fitted to hold the foot in the position that’s
most natural to the movement involved.
For example, a running shoe is built to accommodate impact, while a tennis
shoe is made to give relatively more support, and permit sudden stops and
turns. For sports, “cross trainers” are fine for a general athletic shoe,
such as for physical education classes. But if a child is involved more
heavily in any single sport, he or she should have a shoe specifically
designed for that sport.
Shoe Care
For longer service, keep shoes clean and in good repair.
Avoid excessive wear on heels and soles. Give your shoes a chance to breathe
— don’t wear the same pair two days in a row (you prolong the life of shoes
by rotating their use). Never wear hand-me-down shoes (this is especially
important for children).
Seal of Acceptance
The American Podiatric Medical Association awards its Seal
of Acceptance to a wide variety of shoes (and shoe- related products), which
have been deemed to enhance a consistently applied program of daily foot
care and regular professional treatment.
The intent of such endorsements is to make a significant contribution to the
foot health and foot health education of the public.
For a list of shoe companies holding the APMA Seal of Acceptance, visit
www.apma.org.
Shoe Fitting Tips From
The APMA |
Buying Tips
 | Have your feet measured while you’re standing.
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 | Always try on both shoes, and walk around the store.
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 | Always buy for the larger foot; feet are seldom precisely the same
size.
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 | Don’t buy shoes that need a “break-in” period; shoes should be
comfortable immediately.
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 | Don’t rely on the size of your last pair of shoes. Your feet do get
larger, and lasts (shoemakers’ sizing molds) also vary.
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 | Shop for shoes later in the day; feet tend to swell during the day,
and it’s best to be fitted while they are in that state.
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 | Be sure that shoes fit well—front, back, and sides—to distribute
weight. It sounds elementary, but be sure the widest part of your foot
corresponds to the widest part of the shoe.
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 | Select a shoe with a leather upper, stiff heel counter, appropriate
cushioning, and flexibility at the ball of the foot.
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 | Buy shoes that don’t pinch your toes, either at the tips, or across
the toe box.
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 | Try on shoes while you’re wearing the same type of socks or stockings
you expect to wear with the shoes.
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 | If you wear prescription orthotics—biomechanical inserts prescribed by
a podiatric physician—you should take them along to shoe fittings. |
Shoe Care
For longer service, keep shoes clean and in good repair.
Avoid excessive wear on heels and soles. Give your shoes a chance to
breathe — don’t wear the same pair two days in a row (you prolong the life
of shoes by rotating their use). Never wear hand-me-down shoes (this is
especially important for children).
Seal of Acceptance
The American Podiatric Medical Association awards its Seal
of Acceptance to a wide variety of shoes (and shoe- related products),
which have been deemed to enhance a consistently applied program of daily
foot care and regular professional treatment.
The intent of such endorsements is to make a significant contribution to
the foot health and foot health education of the public.
For a list of shoe companies holding the APMA Seal of Acceptance, visit
www.apma.org.
Your podiatric physician/surgeon has been
trained specifically and extensively in the diagnosis and treatment of all
manners of foot conditions. This training encompasses all of the intricately
related systems and structures of the foot and lower leg including
neurological, circulatory, skin, and the musculoskeletal system, which
includes bones, joints, ligaments, tendons, muscles, and nerves.
Reprinted with permission from the American Podiatric Medical Association
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