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Oh, My Aching Feet! Tips for Choosing Shoes That Support You

Plumley IC HSE. Jason Plumley, DPM, is a podiatrist with Atrium Medical Center in Middletown.

Q. What causes pain in the foot? How can supportive shoes help?

A. Each of your feet has 33 joints and 28 bones. Over a lifetime, the average person walks a distance equivalent to three times around the earth, 10,000 steps a day. With every step, the amount of force equal to one-and-a-half to three times (depending on speed) your body weight goes through your foot. No wonder your feet may hurt!

Over time and as we age, cartilage wears away in the joints, leading to osteoarthritis that causes inflammation and swelling. Movement can become very difficult and painful. Bone spurs (excessive bone growth) can occur, usually most noticeable on the top or side of the foot, toes or ankle. The pain and swelling typically worsens with prolonged activity, and often the foot and ankle will continue to ache after excessive use.

Gout is a form of arthritis that also leads to foot pain, most commonly in the big toe joint, but also in the mid foot or ankle. Acute flares of gout result in intense pain, warmth, swelling and redness that may be severe, making walking or standing extremely difficult. Over time gout can severely damage joints.

Rheumatoid arthritis can develop at any age, with no known cause, triggering pain and swelling in the extremities, hands and/or feet. People with rheumatoid arthritis often develop severe forefoot problems such as bunions, an enlargement of the joint at the base of the big toe; hammer toes, when the end of the toe bends downward; claw toes that dig down into the soles of the shoes and create painful calluses; nodules (lumps) and pain in the bottom of the foot.

When they occur near or within a joint, infections and injuries also can lead to arthritis. Heredity or foot type (high or low arched feet) may cause conditions such as bunions, hammertoes and progressive joint pain which, if given enough time, will usually lead to severe arthritis, bone spurs and sometimes pain with every step.

Initial treatment at home should begin with proper footwear and inserts. The key to feeling better is proper fit for support and comfort.

Shoes should be wide and deep enough so they don’t irritate or rub against deformities. They should feel good immediately when you try them on. Break-in periods are a myth and are not recommended, despite the fact that leather and other materials will often stretch and may eventually feel good.

Shop for shoes after you have been on your feet, usually at the end of a work week, not on your day off. When your foot aches, you can better determine which shoes feel the best. Shop at the end of the day, when the foot is often 20 percent larger than in the morning. This ensures a better fit.

Most sandals, flat shoes and non-supportive flexible shoes are not recommended. If you can easily bend the shoe in half, it probably lacks support. If you must buy a sandal, look for ones with built-in arch supports.

A high heel is not always bad and may actually improve discomfort and pain in some conditions, but stay in the 1” to 3'' range. Running shoes have a slight heel raise and decrease pain in many foot conditions.

When trying on shoes, allow a thumb’s width of space between your longest toe and the end of the shoe. Just because you wore a size 7 at age 18 does not mean you still wear a 7 today. Depending on the manufacturer, it’s common to wear a half size smaller or larger, especially in European shoes. Many people have one foot that’s slightly larger than the other. If you do, go with the larger size.

Many people need more support than the shoe can provide. Quality, supportive insoles can help. In most cases, you do not have to change shoe size to fit the proper insert into the shoe. Try to avoid a gel or cushion-type insert. It is best to try on the insoles before purchasing.

If you have a bone spur on the top of the foot, one easy treatment is to skip the lace over the bone. Instead, cross the laces above and below the spur.

Your feet have an important job to do. See a foot doctor if pain persists or if you have difficulty finding shoes that fit due to a large bone spur, bunion or hammertoe.

This information is for educational purposes only. Please talk to your physician for advice in all matters related to your health.

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