The primary purpose of shoes is to protect your
feet and prevent injury. But in order to do so, they must fit Well.
Poorly fitted shoes-shoes that are too narrow, too short. or too large-can
cause discomfort, injury and even permanent deformity.
Understanding the components of proper fit can help
you make sensible shoe purchases for yourself and your family. This brochure
describes the parts of a shoe and how they can affect fit. It also discusses
special considerations related to children's, men's, women's,. work and
athletic shoes, and provides recommendations on footwear selection.
Although style is often a key consideration in choosing
a pair of shoes, the most important quality to look for in shoes-from a
practical standpoint-is durable construction that will protect your feet
and keep them comfortable. In selecting shoes, keep this basic principle
of good fit in mind: Your shoes should conform to the shape of your feet-your
feet should never be forced to conform to the shape of a pair of shoes.
Soreness. blisters, callouses, and, with time, permanent disfigurements
can be caused by habitually crowding, your feet into shoes that don't fit
A shoe is composed of different parts. Understanding
the basics of shoe construction can help you choose intelligently from among
the thousands of available styles.
The toe box is the tip of the shoe that provides
space for the toes. The toe box may be rounded or pointed and will determine
the amount of space provided for the toes.
The vamp is the upper middle part of the shoe where
the laces are commonly placed. Sometimes Velcro
is used instead of laces.
The sole consists of an insole and an outsole. The
insole is inside the shoe; the outsole contacts the ground. The softer the
sole, the greater the shoe's ability to absorb shock.
The heel is the bottom part of the rear of the shoe
that provides elevation. The higher the heel, the greater the pressure on
the front of the foot.
The last is the part of the shoe that curves in
slightly near the arch of the foot to conform to the average foot shape.
This curve enables you to tell the right shoe from the left. On occasion.
an orthopaedic surgeon may prescribe a child's shoe that has a straight
or reverse last.
The material from which the shoe is made can affect
fit and comfort. Softer materials decrease the amount of pressure the shoe
places on the foot. Stiff materials can cause blisters. A counter may be
used to stiffen the material around the heel and give support to the foot.
- Because your feet may vary in size,
ask the salesperson to measure the length and width of each of your
- Your feet expand when bearing weight, so stand
while your feet are being measured.
- Because swelling during the course of the day
can enlarge your feet, have your feet measured at the end of the day.
- The shoes you buy should be fitted to your
longer and wider foot. Although the toe box should be spacious. too
much space can cause the feet to slide around in the shoes, possibly
causing blisters or abrasions.
- Shoes should be fitted carefully to your heel
as well as your toes. Check to make sure your heel does not slip out
of the back of the shoe.
- Walk around in the shoes to make sure they
fit well and feel comfortable.
- Don't select a shoe by size alone. A size 10
in one brand or style may be smaller or larger than the same size in
another brand or style. Buy the shoe that fits well.
- Select a shoe that conforms as closely as possible
to the shape of your foot.
- Have your feet measured regularly. Their size
may change as you grow older.
- If the shoes feel too tight. don't buy them.
There is no such thing as a "break-in period." With time,
a foot may push or stretch a shoe to fit. But this can cause foot pain
- If one of your feet is considerably larger
than the other, an insole can be added to the shoe on the smaller foot.
- Fashionable shoes can be comfortable, too.
Children don't need shoes until they begin walking,
usually at around 12 to 15 months of age. Until then, socks or booties are
enough to protect a crawling infant's feet and keep them warm. When your
child does begin standing and walking, however, shoes provide an excellent
form of protection from injury. After your child begins wearing shoes, there
is nothing wrong with letting him or her go barefoot indoors.
A good time to buy your child's first pair of shoes
is when he or she starts standing and walking. Shoe stores that specialize
in children's shoes are likely to offer the widest range of sizes and styles,
and will usually take more time to make sure a pair of shoes
Never try to force your child's feet to fit a pair
A soft, pliable shoe with plenty of room, such as
a sneaker, is the ideal shoe for children of all ages. The toe box should
provide enough space for growth, and should be wide enough to allow the
toes to wiggle. (A finger's breadth of extra length will usually allow for
about three to six months' worth of growth, though this can vary depending
on your child's age and rate of growth.)
If your child frequently removes his or her shoes,
those shoes may be uncomfortable. Check your child's feet periodically for
signs of too-tight shoes, such as redness, callouses or blisters. And have
your child's feet measured periodically at the shoe store to determine whether
his or her feet have grown enough to warrant a larger pair of shoes.
Remember that the primary purpose of shoes is to
prevent injury. Shoes seldom correct children's foot deformities or change
a foot's growth pattern. Casting, bracing or surgery are often needed if
a serious deformity is present. If you notice a problem, have your child
examined by an orthopaedic surgeon.
Because high-top shoes tie above the ankle, they
are recommended for younger children who may have trouble keeping their
shoes on. Contrary to common belief, however, high-top shoes offer no advantages
in terms of foot or ankle support over their low-cut counterparts.
Most men's shoes conform to the shape of the feet
and have a roomy toe box with sufficient horizontal and vertical space and
a low heel (usually about half an inch high). Soles made of hard
materials such as leather or soft materials such as crepe can both
be worn, but softer soles tend to be more comfortable. If you stand for
extended periods of time, shoes with soft, pliable soles will protect your
feet and help keep them comfortable.
Work shoes are also available with varying characteristics,
depending on the wearer's occupation. Boots made of thick leather with steel
toe boxes can be worn to protect the feet from injury. Boots with varying
degrees of traction also are available.
Low-heeled shoes (one inch or lower) with a wide
toe box are the ideal choice for women. An ample toe box that can accommodate
the front part of the foot is as important as the heel in determining fit.
High-heeled, pointed-toe shoes can cause numerous
orthopaedic 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 discomfort, painful bunions, hammertoes. and other deformities.
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.
Even low-heeled shoes can cause problems if they
don't fit well. Years of wearing too-small shoes can lead to permanent deformities.
The purpose of athletic shoes is to protect the
feet from the specific stresses encountered in a given sport and to give
the player more traction. A jogging shoe will be designed differently from
an aerobics shoe, for example. The differences in design and variations
in material, weight, lacing characteristics and other factors among athletic
shoes are meant to protect the areas of the feet that encounter the most
The key ingredient in a well-fitted athletic shoe
is comfort. A good fit will reduce blisters and other skin irritations.
Your orthopaedist is a medical doctor with extensive
training in the diagnosis, and nonsurgical and surgical treatment of the
musculoskeletal system, including bones, joints, ligaments, tendons, muscles
This brochure was prepared by the American Academy
of Orthopaedic Surgeons and is intended to contain current information from
recognized authorities. It does not, however, represent official policy
of the Academy, and its text should not be construed as excluding other
1993 American Academy of Orthopaedic Surgeons
This material may not be modified without the express written permission
of the American Academy of Orthopaedic Surgeons.
(This info. is also from American Academy of Orthopaedic Surgeons; this
link will also bring you to their web site)