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About Foot Pain

My Shoes Don't Fit

by Spencer Weisbond

Orthotic Solutions

I was at a dance event recently where I offered people free shoe advice. I heard lots of foot related complaints. I also noticed a lot of similarities in the shoe habits of men and women who had "foot problems". They were squeezing their feet into tiny little shoes. "My big toe joint hurts during or after dancing" was a common complaint. Whether it be the joint of the big toe, the balls of the foot, arch or heel pain, or blisters. The percentage of people I see for foot problems that are caused by misfit shoes is very high.

Since shoe fit affects foot function, the marriage between foot and shoe needs to be a harmonious one. People with foot problems are very often people with shoe problems. Shoes should allow the foot to do its job while still protecting it from the forces of walking 10,000+ steps you take a day. During this daily venture your feet will take on many tasks.

Your feet:

  • help propel you;
  • allow you to stand up straight;
  • hold excess weight;
  • take you a distance equivalent to at least eight times around the world during your lifetime;
  • take you to places where you can interact with others;
  • help you locate furniture in the dark.

Your foot needs to act as a loose, "bag of bones" when it hits the ground to adapt to uneven surfaces. Then, your foot will absorb shock equivalent to 250% of your own body weight, at times. It will then transform itself into a rigid, propulsive lever to move you forward. Your feet perform all these functions in a fraction of a second, thousands of times over. The shoes you wear can allow, or inhibit your feet from doing these functions efficiently.

Orthotic Solutions: Shoes too short

The most common trait of shoe fit that people share is…SHORT SHOES! People are wearing shoes that aren't long enough. There are many reasons why. Wanting to feel the shoe on your foot because of a lack of sensation, not wanting to wear a larger size, as they don't like the number, or believing the shoe will slip off. People's feet elongate as you gain weight. It's only logical that one's shoe size will increase with time, and that one's shoes will become tighter if you don't adjust the size.

How tight shoes affect the foot can be a through a multitude of conditions. Short shoes can bunch up your toes, causing them to curl or "claw" while wearing them, and long term use can permanently affect their shape. This position can develop corns on the tops of the toes, and calluses on the undersides of the toe pads, as well as across the balls of the foot.

Short shoes can actually contribute to bunions. They force the big toe to bend out towards the lesser toes, while at the same time putting pressure on the inside of the foot, on the big toe joint. It does this because short shoes put the widest part of the foot in a slightly narrower portion of the shoe, up towards the front. This is not the only reason why people get bunions, but it's a sure contributor.

Short shoes can also affect how your big toe functions. When your heel lifts from the ground, your big toe raises. This is a moment when your foot must transform itself from a shock absorber, to a rigid propulsive lever. As your big toe lifts, it triggers a mechanism in your foot that raises your arch, locking the joints in the mid-foot, and prepare the foot to become rigid. If your shoe is short, then the big toe joint (which is the hinge that raises the big toe) will not line up with the bending point of the shoe. This can restrict your big toe from raising when it must, and the foot will then not be an effective rigid lever when it needs to be. The result is a foot that stays in its shock absorbing state at a time when it should be rigid. Joints of the mid-foot are more flexible at this moment and can strain. Muscles, attached to bone via tendons in the lower leg must then work overtime to compensate. Excessive strain of muscles, tendons, or ligaments can only occur for so long and remain pain-free. It's important to have your shoes fit your feet so they can perform as they were designed.

When getting the right size shoe, one should get their feet measured. Our feet actually have two length measurements. From heel to toe, or your "overall length," and from heel to ball, or "arch length." Let's say a person has a size 10 overall length, but measures a size 11 arch length. This person would benefit from wearing a size 11 shoe, even though their overall length is a 10, as the size 11 shoe will bend at the same point as the foot. this will provide an optimal situation for proper toe function. As far as the size 11 shoe then being 1 size bigger than the person's overall length, there are far fewer problems associated with a shoe being too big by one size than too small.

As a fit guideline, you should have enough room in your shoe at the end of your longest toe to fit the width of your index finger.

We can't discuss the length of shoes without discussing width. As a rule, shoes get wider as you go up in size within the same style. So, a size 10B shoe is wider than a 9B, and a 9B is wider than an 8B, and so on. People's feet that are too wide for a particular style of shoes in their size, must buy a longer size to get the width that fits. By this guideline, shoes that are too short can also be too narrow. Narrow shoes cause problems as well. Narrow shoes push the balls of your feet together and pinch nerves in-between the balls of your feet which can cause painful "neuromas" in the forefoot. Neuromas are horribly problematic, and if non-responsive to conservative treatment, require injections, and/or surgery which results in loss of sensation to the affected toes and wrinkles on your face from the pain. Recurrence of neuromas is probable, as people who experience relief from invasive treatment will go right back to wearing the same shoes that caused the condition in the first place. The same is true with bunions.

So, what size shoes do I need? What kind of shoes? What shape?

Orthotic Solutions: Shoes don't fit

When fitting yourself for a new pair of shoes, keep in mind that the size on the box is just a number. A guideline. Shopping online, although very convenient, doesn't give you much choice if the shoes are tighter than you expected. You will most likely go out and suffer. Get yourself to a store. When trying on shoes, you should try on both shoes and walk around. If the shoes are for dancing, do a little dance in the store. If a shoe fits, you should forget you even have it on. Believing a shoe should "break in", only relates to any leather or fabric that needs to soften. This is true with some shoes. But NEVER buy a shoe that you know is constricting, thinking that your foot is going to make a short, narrow shoe fit better over time. You may very well be able to break in a poorly fitting shoe, but your foot pays the piper. When choosing a shoe shape, try to pick something that is shaped more like your foot than pointy. Not all pointy shoes are bad, but many of them do force your big toe outward into a bunion shape. Be aware of that. Your big toe is a hinge joint, designed to only move up and down. When you force it outward, but still demand it function normally, it has long term degenerative effects.

When deciding if a shoe's shape is right for you, take the shoe and put it right next to your foot and compare shapes. Does the shoe look impossibly small? When you put the shoe on, is the leather or fabric around the front of the shoe super tight? It shouldn't be. Have you got toe room? Can the piggies wiggle? They should be able to.

Use these guidelines to find a shoe that fits and functions well. There are shoes out there that can suit many purposes, from work to the dance floor. you'll be surprised what shoes can be found if you just try some on. Many social dancers adopt regular shoes as their weapons of choice, and have them sueded to give the adequate amount of slip on the floor. If you suffer, and you feel that your shoes are causing the problem, you're probably right. You need to alter your shoe size and/or style to insure that your time dancing, and walking is a pleasure, and pain-free.

Spencer Weisbond, C.Ped.

Spencer is a Board Certified Pedorthist. He owns and operates Orthotic Solutions, a pedorthic facility.