Footwear For Healthy Feet

Overview

Footwear is simply what you wear on your feet - shoes, trainers, sandals, slippers and socks. Choosing the right footwear is one of the easiest ways to keep your feet comfortable and healthy. Well-fitting shoes support your feet, protect them from injury and infection, and help you walk and balance safely. Poorly fitting shoes, on the other hand, are a very common cause of everyday foot problems such as blisters, corns, calluses, bunions and aching arches.

Very common. Foot complaints are among the most frequent reasons people ask a pharmacist, doctor or foot specialist for help, and a large share of them are linked to shoes that do not fit well or are worn out.

Everyone who wears shoes. Some groups need to take extra care: children whose feet are still growing, older adults, people with diabetes or poor circulation, people with arthritis or joint problems, pregnant women, people who stand or walk a lot at work, and people who run or play sport.

Symptoms

Common symptoms

• Red, sore patches or blisters where a shoe rubs
• Hard, thickened skin (calluses) or small painful bumps (corns) on the toes or soles
• Aching feet, tired legs or sore arches after a normal day
• Pain at the heel or along the sole of the foot, especially with the first steps in the morning
• Toes that look squeezed together, or a bony bump at the base of the big toe
• Ingrown toenails, where the edge of the nail presses into the skin
• Numbness, tingling or a burning feeling in the feet
• Shoes that feel tight even though they used to be comfortable

Symptoms in children

• Not wanting to walk, or asking to be carried more than usual
• Shoes that leave red marks on the skin or have to be forced on
• Toes that curl under or look crowded inside the shoe
• Complaining of sore feet, or refusing to wear particular shoes
• Shoes that suddenly feel tight - a sign the feet have grown

Symptoms in older adults

• Feet that feel less sensitive, so a shoe that rubs is not noticed until the skin is damaged
• Swelling in the feet and ankles later in the day, making shoes tight
• Difficulty reaching the feet to check them or cut toenails
• Poor balance or unsteadiness - worn-down or loose shoes make falls more likely
• Feet that have become wider or flatter, so old shoes no longer fit

Causes

Main causes

• Shoes that are too tight, too short or too narrow at the toe
• High heels or very flat, thin soles that put extra pressure on the ball of the foot or the heel
• Shoes that are worn out, with little cushioning or support left
• Socks that are too tight or have rough seams
• Walking barefoot on hot or rough ground, or in places where sharp objects are found
• Wearing the same shoes all day, every day, so they never fully dry out
• Feet that have changed shape or size but shoes that have not been replaced

Risk factors

• Diabetes, which can reduce feeling in the feet and slow healing
• Poor circulation in the legs, or a history of smoking
• Arthritis or other joint conditions
• Being older, as foot shape and padding change with age
• Being pregnant, when feet often widen and swell
• Being overweight, which adds pressure on the feet
• A job that involves long hours of standing or walking
• Running or playing sports in worn or unsuitable shoes
• Children going through growth spurts
• A condition that affects the immune system or the skin

When to see a doctor

See a doctor urgently if:

• You have diabetes or poor circulation and you notice any cut, blister, bruise or sore on your foot that is not healing
• A wound looks red, hot, swollen or is leaking pus, or you feel feverish
• Your foot suddenly becomes very painful, cold, pale or numb
• You cannot put weight on the foot after an injury, or the foot looks deformed

Book a routine appointment if:

• Foot pain or aching that lasts more than a few weeks or keeps coming back
• Corns, calluses or blisters that keep returning in the same spot
• A bunion or a toe that is changing shape
• An ingrown or thickened toenail that you cannot manage yourself
• Numbness or tingling in the feet
• You are unsure whether your child's shoes fit properly, or you notice their feet look crowded
• You have trouble finding shoes that are comfortable

Diagnosis

A doctor, pharmacist or foot specialist (podiatrist or chiropodist) will usually ask what your feet have been doing - how much you walk or stand, what shoes you wear, and what kind of pain you have. They will look at both feet, check the skin, nails, shape and movement, feel the pulses and test the feeling in your feet. They will often look at your shoes too, because the wear pattern can show where pressure is building up.

Tests that may be done

• Measuring your feet, both length and width, while you are standing
• Watching you walk to see how your feet land and how your shoes move with you
• Checking the pulses in your feet and feeling for warmth and sensation
• Looking closely at the skin, nails and any areas of hard skin or rubbing
• An X-ray or ultrasound scan if a bone or joint problem is suspected
• Blood tests if a condition such as diabetes, arthritis or a thyroid problem might be involved

What to expect at your appointment

The appointment is usually quick, painless and does not need any special preparation. Wear or bring the shoes you normally wear, as they tell the clinician a lot. You may be asked to take off your shoes and socks and to walk a few steps. You should leave with practical advice about footwear, plus any treatment or referral you need.

Treatment

The main treatment for footwear-related foot problems is, not surprisingly, better footwear. Many people find their feet feel better within days of switching to shoes that fit properly, with a wide, deep toe area, a firm but cushioned sole and a fastening that holds the foot in place. Alongside this, simple foot care and over-the-counter padding or insoles can help. A pharmacist or foot specialist can advise on what suits your feet.

Self-care at home

• Have your feet measured properly when buying new shoes, and try them on late in the day when feet are at their largest
• Check there is about a thumb's width of space between your longest toe and the end of the shoe
• Choose shoes with a wide toe area, a soft but supportive sole and a strap, lace or buckle to hold the foot steady
• Wear new shoes for short periods at first and build up gradually
• Wash and dry your feet daily, especially between the toes, and check them for redness, cuts or blisters
• Cut toenails straight across and gently file the corners
• Wear smooth, seam-free socks that fit well and change them daily
• Rotate your shoes so each pair has time to dry out between wears
• Use padding or plasters on hot spots early, before a blister forms
• Replace shoes that are worn through at the heel or sole, or that no longer fit

Medical treatments

If self-care is not enough, a doctor, pharmacist or foot specialist can help. This may include professional removal of hard skin, corns or problem toenails; dressings for wounds or blisters; advice on insoles (orthotics) that spread pressure more evenly; exercises or physiotherapy to strengthen the feet and ankles; and treatment of any underlying condition such as diabetes, arthritis or poor circulation. Any medicines would be discussed with you by your clinician as part of your overall care.

When is surgery considered?

Surgery is rarely needed for footwear-related foot problems and is only considered when other options have not helped and the problem is significantly affecting daily life. Examples include some bunions, badly deformed toes or certain nail problems. A specialist would talk through the benefits and risks with you first.

Living with this condition

Looking after your feet is a small daily habit that pays off. A quick check each evening - looking for redness, blisters, cracks or swelling - takes less than a minute and catches problems early. Keep a comfortable pair of shoes by the door for everyday wear, and save less supportive shoes for short periods. If one foot is wider or one foot is larger than the other, always fit the bigger foot and use a thin insole in the other shoe.

Lifestyle tips

• Build up walking gradually rather than in one long burst after weeks of little activity
• Change your shoes partway through the day if you are on your feet a lot
• Choose shoes suited to the activity - trainers for running, supportive shoes for long walks, and something roomy for around the house
• Avoid going barefoot where the ground is hot, rough or likely to have sharp objects
• Check children's feet and shoes every few months, as they can grow a whole size in a season
• Give your feet a rest and a gentle wash after a long day, and dry them well

Diet and exercise

There is no special diet for healthy feet, but eating a balanced diet and staying at a healthy weight reduces the strain on your feet and helps wounds heal. Gentle exercise keeps the muscles and joints of the feet and ankles strong and supports good balance. If you have not been active for a while, or you have a health condition, ask your doctor or pharmacist what kind of activity is right for you before starting something new.

Mental health and emotional wellbeing

Foot pain can wear you down. It can limit how far you walk, keep you from hobbies, and make work or caring harder, which can lead to low mood or worry. That is a normal reaction and worth mentioning. If you feel persistently low, anxious or hopeless, or you are having thoughts of harming yourself, please reach out for help straight away - speak to your doctor or contact your local crisis or emergency service without delay.

Prevention

Yes - most footwear-related foot problems are preventable. The single biggest step is wearing shoes that fit well and are in good condition. Measure your feet rather than assuming your size, choose shoes that feel comfortable straight away, and replace them when they wear out. Check your feet regularly, especially if you have diabetes or reduced feeling in your feet.

Screening programmes

If you have diabetes, you should be offered a regular foot check as part of your routine care - this looks for reduced feeling, poor circulation and early skin problems before they become serious. Ask your doctor or foot service when your next check is due. Anyone with ongoing foot pain, numbness or a wound that will not heal should be assessed, whether or not they have a long-term condition.

Complications

If left untreated

• Blisters and rubbing can turn into open sores or ulcers, which are slower to heal and can become infected
• Corns and calluses can become very painful and make walking difficult
• Long-term pressure from tight shoes can worsen bunions and toe deformities
• Reduced feeling in the feet (common in diabetes) means injuries go unnoticed until they are more serious
• Poorly supported feet increase the risk of trips and falls, particularly in older adults
• Foot pain can reduce how active you are, which affects your overall health and wellbeing

Long-term outlook

The outlook is good. Most foot problems linked to footwear improve quickly once you switch to shoes that fit and look after your feet day to day. Even long-standing problems such as corns, hard skin and heel pain usually respond well to simple changes and advice from a pharmacist or foot specialist. If you have diabetes or poor circulation, regular checks make a real difference - small problems are much easier to sort out early.

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