Tips about shoe features/selection

Some serious back disorders and even more common conditions, such as muscle strain, can be linked to one avoidable thing: inappropriate, poor quality, or ill-fitting shoes. A good quality, properly fitting shoe pays big dividends for your spine down the road.

When shopping for shoes, always make sure not to force your feet in order to conform to the shape of a pair of shoes.

The most important quality to look for in shoes is durable construction that will protect your feet and keep them comfortable.

Here are some tips to help reduce the risk of back problems from poorly fitted or inappropriate shoes:

• Fit new shoes to your largest foot. Most people have one foot larger than the other.
• Have both feet measured every time you purchase shoes. Your foot size increases as you get older. If the shoes feel too tight, don't buy them.
• There is no such thing as a "break-in period"!
• Most high heeled-shoes have a pointed or narrow toe box that crowds the toes and forces them into an unnatural triangular shape. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.
• Shoes should be fitted carefully to your heel as well as your toes.
• Sizes vary among shoe brands and styles. Judge a shoe by how it fits on your foot, not by the marked size.
• There should be a half-inch of space from the end of your longest toe to the end of the shoe. Try on both shoes.
• Try on new shoes at the end of the day. Your feet normally swell and become larger after standing or sitting during the day.
• Walk around in the shoes to make sure they fit well and feel comfortable. When the shoe is on your foot, you should be able to freely wiggle all of your toes.
• Women should not wear a shoe with a heel higher than 2.25 inches

What to look for in a good shoe

• Avoid shoes that have seams over areas of pain, such as a bunion.
• Avoid shoes with heavy rubber soles that curl over the top of the toe area (such as seen on some running shoes), as they can catch on carpets and cause an accidental fall.
• Flat shoes (with a heel height of one inch or less) are the healthiest shoes for your feet. If you must wear a high heel, keep to a heel height of two inches or less, limit them to three hours at a time and take them off coming to and from an activity.
• Laced, rather than slip-on, shoes provide a more secure fit and can accommodate insoles, orthotic devices, and braces.
• Look for soles that are shock absorbing and skid resistant, such as rubber rather than smooth leather.
• The shoe should be made of a soft material that has some give, like glove leathers.

A word about high heels

When a normal person is standing flat-footed or bare-footed, their body is completely balanced. Their hamstrings are taut and both parts of the pelvis are stabilized so that the support is normal. Bringing the heel up in shoes, such as high heels, encourages the hamstring muscles to shorten.

High-heeled, pointed-toe shoes can cause numerous orthopedic problems, leading to discomfort or injury to the toes, ankles, knees, calves, and back. Most high-heeled shoes have a pointed, narrow toe box that crowds the toes and forces them into an unnatural triangular shape. These shoes distribute the body's weight unevenly, placing excess stress on the ball of the foot and on the forefoot. This uneven distribution of weight, coupled with the narrow toe box characteristic of most high heels, can lead to pain or discomfort, and possible injuries to your back down the road.

The height of the heel makes a dramatic difference in the pressure that occurs on the bottom of the foot. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.

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.