Understanding Supportive Shoe Wear
by Debra Coglianese, DPT, OCS, ATC
In my physical therapy practice it generally does not take long before the discussion turns to shoe wear – specifically, supportive shoes. And, believe it or not, the easiest way to talk about feet and shoes is to talk about eyes and eyewear first.
Some people have perfect eyesight. They have no need for prescriptive lenses – or frames which hold the lenses in the most effective position. People with perfect eyesight may benefit from protective eyewear – sun glasses or safely glasses – in certain situations. Wearing frames with clear glass lenses could be a choice just for the look.
At the other end of the continuum, there are those who cannot function without putting on a pair of glasses with prescriptive lenses. Cannot. Function. Without glasses.
Everyone else fits on the continuum between the two examples above. Some wear glasses but may choose not to when attending a special event. (Of course, if they are a presenter at the Oscars then he/she has to temporarily put glasses on to read the teleprompter/cue cards!) Some wear glasses only to read.
You get the idea…some people have wide open options on whether to wear frames while others have no other option. And, these examples have not factored in the variables introduced by wearing contacts.
Feet and shoes are a similar situation. Some people have well-aligned, balanced feet with great supporting musculature. Wearing shoes becomes more a protection garment with no limits on style, fashion, etc.
Then others, through no fault of their own, need orthotics to balance the foot, with the assistance of supportive shoes. (This is important to note – altered foot alignment, similar to eye shape, is not anyone’s fault!) Balanced feet then assist to keep legs, knees, thighs and hips in the best alignment. Some need firm orthotics, some soft and any variation in between. The difference is, however, that shoe wear becomes prescriptive – not any shoe will do. The shoe has to provide enough support to hold the foot on the orthotic for the best outcome – much as glasses frames hold prescriptive lenses in optimal position for vision correction.
The rest of us, who may not require orthotics, can still benefit from supportive shoes – especially for activities when we are on our feet more than usual. To assess whether a shoe is a good choice, ask yourself two questions.
After trying on the shoes and walking around the store, ask yourself, “Does the shape of the shoe match the shape of my foot?
Shoes are cut on different lasts. Some shoe lasts are slightly wider in the forefoot than the rearfoot – sometimes described as a European last. American shoes have often featured a more parallel last. This has been changing over the years but this basic aspect of shoe shape needs to be considered. Other construction features related to fit are the height of the toe box, materials used, cushion in the foot bed, etc.
So, how do you know if the shape of the shoe matches the shape of your foot?
Simple, ask yourself if your foot fits comfortably in the shoe. If not, you are better off looking at other choices. If the shoe shape does seem to be a good match for your feet, then you are ready to move onto the next question, “Does the shoe support me?”
You figure this out by standing on one foot. If the shoe is providing support then you will notice that your foot wobbles less when wearing the shoe than standing on one foot without. The shoe should make you feel a bit more stable. Sometimes a supportive shoe can make the difference for someone of being able to stand and balance on one foot when, without a shoe, this is not possible.
So, why does standing on one foot matter?
At one point in the gait cycle, you stand on one foot while the other leg advances and gets ready to take the next step forward. If your foot is more stable and balanced, your leg (knee, thigh and hip) are better aligned. And, though some people can use strong foot musculature to aid foot alignment, wearing a supportive shoe means less reliance on those muscles. Ultimately, leg muscles become less fatigued. Joints are happier.
Generally, a lace-up shoe provides more support. On a fashion blog, this statement is probably a cue for groans. So consider this, if your feet still allow you to have options for your shoe wear then offer your feet support when wearing renovation clothes, or when on a full day’s outing. Then, your feet may have a bit more life in them when it is time to party!
Read more about finding shoes that fit orthotics here.
Debra Coglianese, DPT, OCS, ATC has thirty years of experience treating patients with musculoskeletal complaints and injuries in the USA. Dr. Coglianese lead a team of 22 authors in her role as the editor, and contributor, for the textbook, Clinical Exercise Pathophysiology for Physical Therapy published in 2014 by SLACK Inc.
Yes! That is why I love the current Brogue fashion. They are fun, wonderful colors can be found but do take some effort. Most are very supportive – the ties help. Some have little to no cushioning so you need to check that out and make sure you have enough room to add a cushioned pad if needed. I need to remember to bring one with me when I try shoes on or test with shoes I order online.
They even have lacy perforated leather for spring!
I wish shoe manufacturers would have “double last shoes” where there was a greater difference between the ball of foot width and the heel width. The difference in my AAA heel and “B” width ball of foot is too significant to ignore. This means I have to wear shoes with straps or ties all the time so I don’t fall out of my shoe, which interferes with my preferred style choice many times. I have had good luck though with buying boots, brogues, and ankle straps. I love the new comfy and supportive flip flops too. As long as I am listing wishes…. I also wish that the soles of supportive shoes were less thick and clunky looking. I am always looking for more dainty shoes to go with my smaller scale. I would love to know where others buy their shoes that have similar issues to me. With the exception of flip flops and boots, my only success has been on line, but it often takes multiple orders before I find a relatively good fit.
A timely article. I wore comfortable (but high) wedges for an entire day last week and ended up with a bruise starting from my toes right up to my ankle. I’ve had to ice and keep it elevated but it still looks terrible and aches at the end of the day. I’m going to try the one foot wobble test now!
There are some excellent points in this article! As someone who’s broken both her left ankle and her right heel, I’ve spent quite a bit of time doing PT and definitely appreciate this therapist’s POV. I do wish she had mentioned that, unlike eyes, feet can be strengthened with the right exercises. Weak feet and ankles can be improved upon and can make a huge difference in overall health.
I love my Clarks brogues and have them in multiple colourways. Unfortunately I can only wear them with trousers though some people can rock them with a skirt. With skirts I either have supportive sandals in the summer or knee length boots in the winter (specialist wide leg calf version). For me freedom is the ability to walk wherever I want to without discomfort.
This is a challenge for a good many of us, and a severe limitation to being able to dress stylishly. It looks really, as though shoes almost define style, for those of us that have problem feet. Tricky sometimes.
To Sherilyn – I too have that problem and I hear ya. I don’t live close enough to a large city to have a good variety of shoe stores to shop, so it’s on-line with (usually) all being returned. I will try to keep you informed of any progress. P.S. – I do love Vionic brand, but having that narrow heel kills the comfort of fit and staying on my foot, sans the sandals with ankle straps.
To Sarah – it really is sad for those of us with fit issues that it does seem that shoes define style 🙁
To Imogen – thank you so much for bringing to light this challenging dilemma some of us face. There is another blog some of your readers may find of help “Barking Dogs Shoes” that addresses foot issues. P.S. Your site is fantastic!
This is a great read! Heaven knows how I’ve ended up buying and suffering from shoes that look great but aren’t really comfortable!
Thank you for this! I’m going to give all of my shoes the wobble test. I went down a 1/2 size in shoes this year and have had to buy more than a
Thanks for this post, I wish I had seen it sooner, though. I’ve went down a 1/2 size and had to buy more than a dozen new shoes this year. My wallet is still wincing, but I need about 4 more pairs, at least. I’m going to try the wobble test and see if I chose well, I really hope I did! It has been a real struggle to find shoes that are comfortable and work with my wardrobe. I made matching my hemline a priority and that has increased the challenge considerably, but I’m really pleased with the effect, so it has been worthwhile.
When the brand is new to me or I want to purchase a different style than usual, I order multiple sizes at once since finding my popular size in stores is next to impossible. The last order was an 8 1/2 wide, 8 1/2 medium, 9 medium, and 9 wide. Whew! Let’s just say they know me at return counters, UPS, and the local post office. There really should be an easier way!!