Choosing The Right Shoe

Overview

Choosing the right shoe means picking footwear that fits your feet well and suits what you are doing. Shoes that are too tight, too loose, too worn, or wrong for the activity can cause pain, blisters, and long-term foot problems. The good news is that most shoe-related problems get better once you change what you wear.

Yes. Foot pain and shoe-related problems are very common. Many people are wearing the wrong size without realising it, and foot problems are one of the most frequent reasons people visit a doctor or pharmacist.

Everyone wears shoes, so this affects all ages. It matters most for children whose feet are still growing, older adults who are more at risk of falls, people with diabetes or reduced feeling in their feet, pregnant women, people who stand or walk a lot at work, and anyone who is very active.

Symptoms

Common symptoms

• Aching, tired or sore feet by the end of the day
• Blisters, redness or rubbing on the heel, toes or sides of the foot
• Hard skin, corns or calluses where the shoe presses
• Pain in the ball of the foot, arch or heel
• Toenails that look bruised or dark after exercise
• Toes that feel squashed or overlap
• Ingrown toenails from tight shoes pressing on the toe
• Shoes that feel tight even though they used to fit

Symptoms in children

• Pulling shoes off or refusing to wear them
• Tripping more often or walking awkwardly
• Complaining that shoes feel tight or hurt
• Red marks, blisters or hard skin on the feet
• Toenails that curl or press into the skin
• Shoes that look misshapen or worn down unevenly

Symptoms in older adults

• Feet that feel less stable, increasing the risk of trips and falls
• Swelling in the feet later in the day, making shoes feel tight
• Reduced feeling in the feet, so a poor fit is not noticed
• Hard skin, corns and pressure marks that can turn into sores
• Feet that have spread or changed shape, meaning old sizes no longer fit

Causes

Main causes

• Shoes that are too small or too narrow, squeezing the toes
• Shoes that are too big, letting the foot slide and rub
• High heels or shoes with a very stiff, flat sole
• Soles and linings that are worn thin or uneven
• Shoes with no cushioning or arch support for the activity you do
• Hard, stiff materials that do not bend with your foot
• Wearing the wrong shoe for the job, such as running shoes for everyday walking or smart shoes for long distances
• Socks that are too tight or have thick seams

Risk factors

• Diabetes or reduced feeling in the feet
• Arthritis or other joint problems
• Being older, as feet spread and change shape
• Being pregnant, when feet can swell and ligaments loosen
• Foot shape such as very wide feet, flat feet or a high arch
• Standing or walking for long periods at work
• Doing lots of high-impact exercise
• Children going through growth spurts

When to see a doctor

See a doctor urgently if:

• You have diabetes and notice a new blister, cut, redness or swelling on your foot
• A wound is not healing or looks infected
• You have sudden severe foot pain or cannot bear weight
• You notice numbness, tingling or loss of feeling in your feet

Book a routine appointment if:

• Foot pain that lasts more than a few weeks or keeps coming back
• Blisters, corns or hard skin that keep returning in the same spot
• Your shoes no longer fit comfortably and you cannot find a good fit
• Your child complains of foot pain or seems to be tripping often
• Toenails that are painful, thickened or growing into the skin
• You have fallen or feel unsteady on your feet

Diagnosis

A doctor, nurse or podiatrist (a foot health specialist) will usually ask about your shoes, your daily activities and your symptoms. They will look at your bare feet, check the skin, nails and shape of your feet, and may watch you walk. They may also check the feeling and blood flow in your feet. This is a simple, painless appointment and you do not need to prepare in any special way.

Tests that may be done

• Measuring your feet, often both standing and sitting
• Looking at the wear pattern on your current shoes
• Watching how you stand and walk
• Checking feeling in your feet with simple touch tests
• Checking pulses and skin colour to assess blood flow
• X-rays only if a bone or joint problem is suspected

What to expect at your appointment

The appointment is usually quick and comfortable. You will be asked to take off your shoes and socks. Bring the shoes you wear most often, as they can tell the clinician a lot about your foot problems. You may be given advice on shoe styles, insoles or exercises on the same day.

Treatment

For most people, the main treatment is simply better-fitting, more supportive footwear. Along with that, resting sore feet, using padding to reduce rubbing, and slowly building up how long you wear new shoes can all help. If a foot problem has already developed, a clinician can advise on ways to ease it.

Self-care at home

• Measure your feet each time you buy shoes, as sizes change with age and weight
• Shop in the late afternoon or evening, when feet are at their largest
• Always fit the larger foot and try on both shoes
• Check there is about a thumb's width between your longest toe and the front of the shoe
• Make sure the widest part of your foot fits comfortably in the widest part of the shoe
• Walk around the shop on a hard floor to check for rubbing or slipping
• Choose shoes with a soft, flexible upper and a cushioned sole
• Wear new shoes for short periods at first to break them in gradually
• Rotate between pairs so shoes can dry out and last longer
• Replace shoes when the soles or linings are worn thin or uneven
• Wear socks that fit well and have no thick seams

Medical treatments

If self-care is not enough, a doctor, nurse or podiatrist may suggest ways to take pressure off sore spots, such as padding, shoe inserts or specially made insoles. They may also give exercises to strengthen the feet, or treat hard skin, corns and ingrown toenails. If pain is troublesome, ask your pharmacist or clinician about suitable options — they can advise on what is safe for you, particularly if you have other health conditions.

When is surgery considered?

Surgery is rarely needed for shoe-related problems. It may be considered for longstanding bunions, badly deformed toes or damaged joints when footwear changes and other treatments have not helped. Your clinician would discuss the risks and benefits with you first.

Living with this condition

Looking after your feet is a daily habit. Check your feet once a day for redness, blisters or cuts — a mirror or a family member can help if you cannot see the bottom of your feet. Change socks daily, keep toenails trimmed straight across, and have a couple of pairs of well-fitting shoes to rotate. If a shoe starts to rub, stop wearing it rather than waiting for a blister to form.

Lifestyle tips

• Keep active with walking and gentle foot and ankle exercises
• Build up new activities gradually rather than all at once
• Wear shoes designed for the activity you are doing
• Rest and elevate your feet if they swell
• Check your feet regularly, especially if you have diabetes
• Ask for help with shoe fitting if you have reduced feeling in your feet
• Keep toenails trimmed and see a foot specialist if they become painful

Diet and exercise

There is no special diet for shoe fit, but staying at a healthy weight reduces strain on your feet, knees and back. Regular movement such as walking, swimming or cycling keeps feet strong and flexible. Simple exercises like curling your toes, rolling a small ball under your foot, and gently stretching your calves can help keep feet comfortable. Build up slowly and wear supportive shoes while you exercise.

Mental health and emotional wellbeing

Foot pain can wear you down. It may stop you doing the things you enjoy, affect your sleep, and make you feel frustrated or low. This is common and nothing to feel embarrassed about. Tell your clinician how it is affecting you, because there is often more that can be done. If low mood or worry is lasting, ask for support — talking to your doctor is a good first step.

Prevention

Yes, many foot problems linked to shoes can be prevented. The key is to check your shoe size regularly, choose shoes that suit your foot shape and activity, and replace shoes when they wear out. Checking your feet often means you spot small problems before they become painful ones.

Screening programmes

If you have diabetes, you should be offered a foot check at least once a year. This looks at feeling, blood flow and the skin on your feet. Children's feet should be measured regularly, and anyone with ongoing foot pain or unsteady walking should ask for a foot assessment.

Complications

If left untreated

• Corns, calluses and blisters that keep coming back
• Bunions and toes that become permanently bent or crowded
• Ingrown toenails that can become infected
• Heel and arch pain that becomes long-lasting
• Foot ulcers, especially in people with diabetes
• Poor balance and a higher risk of falls
• Knee, hip or back pain from walking awkwardly
• Less activity overall, which affects general health

Long-term outlook

The outlook is very good. Most shoe-related foot problems improve once you find footwear that fits properly, and small daily habits go a long way. If a problem has been building for years, it may take a little time and some help from a foot specialist — but there is plenty that can be done to keep you comfortable and active.

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