When you look for the perfect shoe, what are some things you look for? Comfort? Arch support? Flexibility? Have you ever gone to a shoe store, tried on a shoe, walked around in the store and then decide to purchase them because of how good they felt in the store only to regret buying them because your feet feel miserable after wearing them the first day? You then convince yourself that you just need to break them in and keep wearing them and hope they become more comfortable. As someone who has struggled with various foot and ankle issues her whole life, I’m always searching for the ultimate shoe. I have gone through Nike phases, Reebok phases and an Adidas phase the last few years. One thing that has not changed over the years is my continued foot problems and a worsening bunion I have had since I was a kid. I have even had a couple of unsuccessful injections in my foot when I moved to Arizona to start PT school.

Over the years of practicing as a Physical Therapist, I’ve seen a lot of people with foot and ankle pain. It seems the longer someone has had pain, the thicker their shoe soles are. Most people, myself included, always zero in on wanting the bottoms of our feet to have this soft cloud like feeling. We never stop to look at how narrow the toe box is and how much of a heel the shoe has. What most don’t realize is 90% of all athletic shoes have both of those which can be problematic for your ankle and foot. Over time, our feet start to morph into the shape of the shoes we wear. High heels are notoriously narrow shoes, coming to a sharp point and pushing your toes together. This leads to bunion formations, weakness in the foot, and shortened heel cords. That means I’m seeing more people with tearing or tendopathies (degenerative changes in their tendons), in the plantar fascia, achilles, peroneals-some of the major tendons in the lower leg. Think about how long you wear your shoes each day. A safe assumption is probably minimum of 10 hours and sometimes even longer. Aside from experiencing pain in your foot, signs your shoe wear is affecting your foot health include: callouses, blisters, hammertoes, corns, bunions on either the big toe or little toe, loss of ankle and foot joint mobility/range of motion, big toe stiffness, and the inability to spread your toes.

When choosing the right shoe, there are two things that are imperative when it comes to selecting a shoe:

The first one is a toe box that’s wide enough that it allows your toes to spread their natural way. The more spread your toes are, the more stability you will have. You don’t want any shoes that cram your toes together. An easy way to see if your shoe will allow for toe spread is to pull out the insole the shoe comes with and place your foot on it and see if toes spread passed the edges when you stand. If they do, this means the shoe is too narrow for your forefoot. Test a couple of your favorite shoes in your closet and see which ones pass the test. You will be surprised to find that a lot of your favorite athletic shoes don’t pass the test.

The second thing is finding shoes that have a zero drop heel-meaning the heel isn’t higher than the front part of the shoe. Most athletic shoes have a built in heel to them which can cause your achilles to shorten over time which also can impact your posture by shifting your weight forward. There are shoe options out there that aren’t ugly shoes that do both of those. Now there’s nothing wrong with finding shoes that have cushion in them and if you are going go that route, I would suggest alternating between a zero drop cushioned shoe and more of a barefoot shoe that allows you to be closer to the ground, that way you can slowly start to retrain your foot to move the way it should which is what barefoot shoes allow. Unfortunately, our adapted feet don’t always do well going cold turkey straight to a barefoot shoe and it may require some training and adaptation. I hear horror stories of people getting a barefoot shoe and then going for a run only to cause injury to their foot. Remember you need to walk before you can run and the same applies for any sort of training.

Here are some of my favorite brands of shoes that provide either one or both features mentioned above.

Altra Running Shoes https://www.altrarunning.com/

NOBULL https://www.nobullproject.com

Vivobarefoot https://www.vivobarefoot.com/us/

Feelgrounds https://www.feelgrounds.com

Xero https://xeroshoes.com/shop/product-category/gender/womens/

Reebok Nanos https://www.reebok.com/us

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-Dr. Torrez, PT, DPT, COMT

“The foot feels the foot, when it feels the ground”