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Hitting the Right Shoe

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What to Look for in Proper Tennis Shoes
By Ketan B. Patel, DPM, FACFAS

One of the most common questions I get is about problems in the lower extremities and whether they are caused by poor shoe gear. While ill-fitting shoes can be aggravating, it is a myth that shoes cause most of the deformities that our feet develop like bunions, hammertoes and corns.

If it were true that shoes caused all of these problems, every shoe-wearing person would have the same problems and every barefoot person would never develop any foot problems. Studies have been done on tribal communities in Africa and Australia who never wear any type of shoe. They showed that these groups have a lot of the same feet problems us frequent footwear lovers do — with one noticeable exception. Most of the problems in the tribal communities were not exacerbated or worsened by the presence of ill-fitting shoes.

In fact, most nontraumatic foot problems are hereditary. Like other parts of our bodies that we inherit from our parents, we also inherit the bone structure that makes up our feet and therefore the problems that go along with them. So you can thank your mother for your brown eyes and your bunion.

Traumatic foot problems like stress fractures, tendonitis and overuse injuries can often be related back to improper shoe gear. Someone who stands all day on concrete or walks around in high heels is bound to develop more problems than someone who sits at a desk all day or works in sneakers. The types of shoes you wear have a major effect on the amount of stress your foot has to absorb.

Shoe Anatomy

Sometimes common foot injuries can be attributed to improper or worn out shoe gear. Therefore, it is important people understand the many qualities that make a good shoe. If you wear shoes that are not comfortable or suited to your foot, you will definitely aggravate any problems you may already have. These tips below will help you select shoes that are supportive and comfortable.

Upper: The portion of the shoe that covers the top and sides of the foot should be lightweight, durable, breathable and stable. It is also important that the upper’s inside is made of a soft, nonabrasive lining.

Counter: Perhaps one of the most important features of a shoe, the counter is a rigid internal heel cup that stabilizes the heel of the foot on its sides and from behind the heel with the upper. The counter should be inflexible and firmly attached, and should fit snugly around the heel to limit the heel’s motion.

Toe box: There should be enough room in the toe box area for the toes to rest comfortably, allowing a slight amount of motion without any friction from the top of the shoe. The box should be slightly larger in length than the longest toe and slightly higher than the biggest toe.

Lacing and eyelet: A shoe’s lacing should snugly hold the shoe onto the foot and prevent excessive motion within the shoe. Together, the laces and eyelets (shoelace holes) must be strong and durable to provide needed support.

Insole: Also known as the sock liner, the insole is where the foot rests upon the shoe. The insole should be smooth, comfortable and cushioned enough to absorb shock when the foot hits the ground.

Midsole: The portion between the upper and outsole should be thick, durable and strong (yet still flexible) to provide cushion, protection, shock absorption, stability and a strong base to rest the foot on in the shoe.

Outsole: This is the surface of the shoe that contacts the ground, therefore it is important that the outsole is durable to resist abrasions and friction, but also flexible to yield foot bending motions.

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