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Do Shoes Matter?

As a Podiatrist, I deal with feet.  “What type of shoe should I purchase” is probably the most common question I’m asked… after of course, why would anyone want to look at feet all day!  To answer that question properly, it requires most people to think differently.

My patients, and people in general, seem to be consumed by the features that the shoe companies promote.  Shoes can provide support, control pronation, give extra cushioning and even help you tone your butt and calves!  Every major brand has hundreds of shoes to choose from and seemingly every day there is a new niche company or niche shoe that being introduced.  With so many options out there, how can we possibly know what is right for us?  Furthermore, does it even matter?

The feet have a job to do.  They assist the body with locomotion and help keep us upright.  Therefore, if the shoe helps the foot do its job, then that shoe is the right choice, period.  My principles of the proper shoe are as follows:

  1. Proper fit. The shoe needs to fit the shape of the foot, not the other way around.  Especially when dealing with the growing (and adaptable) feet of children.  If a foot is wider in the toes, then the shoe needs to be wider in the toes.  If the foot is curved, the shoe should be curved, etc.
  2. Maintain Proper Posture. Posture is the key to movement efficiency, and therefore, if a shoe impairs your posture, then there are better choices available.  For children, because we are born barefoot and we learn posture being barefoot, the best shoes are NO shoes! (if you want to read more, click here)  The best shoe, therefore, is one that will not change the relative position of the body to the Earth, and one that is soft and supple to allow the feet to feel as much as possible.  As we become adults, and develop our poor postural habits (read more here), we often find that shoes with higher heel heights become more comfortable.  A life of sitting leads to tight hips.  When we have tight hips and stand, our hips our tilted forward.  With heels flat on the ground, the hamstrings and calves are lengthened and functionally tight.  If our heels are raised, then the hamstrings and calves can relax.  In other words, with the heels raised and muscles relaxed, our posture is better balanced.  The shoe that feels most comfortable for many people is the one where the angle of heel to toe in a shoe matches the angle of forward tilt in the pelvis.
  3. All things being equal, choose the lighter shoe. Weight of the shoes matter!  The heavier the shoe, the more work one must do to walk.  More work and more effort leads to more fatigue and more chance of being injured.  Walking is supposed to be effortless (you can imagine how I feel about the toning shoes, right?).  If you add weight to the end of your leg, it will rapidly increase the effort expenditure with every step, and significantly decrease walking and running economy/efficiency.  People with larger feet, and larger relative to their height, need to pay particular attention to this.

Notice that I left comfort off this short list.  Comfort is a natural byproduct of these principles.  I wrote an article several years ago on The Perception of Shoe Fit.  The premise is that we get comfortable in what we are used to, not necessarily what fits.  Shoes that fit today may not fit 10 years from now as feet do tend to spread and change a bit.  Patients often buy the same size shoe year in, and year out for decades without ever checking to see if they need a different size.  In those cases, what’s comfortable may be 2 sizes too small!

Shoes, for better or worse, do matter.  The best shoe can help you function more like you are supposed to function, while the wrong shoe can really screw things up!  So try not to get caught up in all of the wonderful features shoe companies promote, because they’ll never be as good as what you have inside of you.  My personal belief is that the best shoe is the same shoe we were born with.  They are lightweight, fit perfectly and are ideal for maintaining posture!  If you must, however, cover what the good Lord gave you, then please try and adhere to the principles outlined above.

Dr. Neil Feldman Dr. Neil Feldman is a Podiatrist at Central Massachusetts Podiatry, in Worcester and Westborough. As an ultramarathoner, runner and triathlete, he loves to help his patients remain consistent with their regular activities, assist in getting patients back to health and dedicates himself to patients achieving their goal events and races from walking the Camino de Santiago, to a first 5k run, to Ironman to a 250 mile run…and yes, that’s a thing!!

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