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HELPFUL HINTS"

General Shoe Fitting Tips

  • Generally speaking, many folks like to wear shoes that are both stylish and comfortable. Sometimes, that is difficult and the user chooses which is more important, comfort or style.
  • A good "rule of thumb when style is important."
  • take another pair of "comfortable" shoes for the "style" event and slip into the more comfortable pair when convenient.
  • When shopping for "comfortable" shoes, where possible, match the shape of the shoe to the shape of the foot.

Buying Shoes Online

  • Buying Shoes Online can be both convenient and may be less expensive than shoes purchased in a shoe store. Today, buying online and having products delivered at the doorstep in fashion and convenient. Of course, this makes it harder for the shoe store to stay in business and some go out of business because of decreased in-store traffic. Truthfully, it is generally more enjoyable to be fitted for shoes by a professional shoe associate and the odds of getting a correct fit are likely improved.
  • How do you properly measure your feet when purchasing online shoes?
  • 1st best practice. If you know the brand, the style, and the size you need, stick to it.
  • 2nd best practice. Find the brand and style that you like, then go to a shoe store that sells that brand and try on the shoes to find the right size and width.
  • 3rd best practice. Using a "short" pencil, a sheet of paper, or a flat piece of cardboard, hold the pencil vertical and draw, or have someone draw, around your foot, including the toes while seated.
  • As assistant will be helpful. Draw both feet and use the longest foot (not unusual to have 2 lengths) for choosing the shoe size.
  • Measure the distance from the back of the heel to the tip of the longest toe on the largest foot. Write that number down.
  • Measure the distance from the base of the big toe (1st metatarsal head) to the base of the little toe (5th metatarsal head). Write that number down.


Diabetic Shoe Fitting Tips

  • Fitting shoes for a diabetic foot should allow extra depth in the shoe bottom for the foot. The diabetic foot is often without full sensation and this may worsens with time. When a person with diabetes can't feel high pressure areas or excessive rubbing, this may lead to serious foot sores and associated infections. The most common cause of foot amputation is from a diabetic sore that went unnoticed and untreated in the early stages. The most important points for the insensate (without feeling) diabetic foot are:
  • Wear shoes with a reasonable heel height, typically 3/8" (10mm) to 1" (25mm)
  • A high heel shoe increases pressure on the forefoot when walking, The 3/8 to 1" heel height has been proven to provide an optimal walking pressure on the foot while walking. Of course there are exceptions, especially with less than normal ankle motion (fused for example), but the 3/8 to 1" heel height range is a good starting place.
  • Allow a thumb's width extra room at the toe end of the shoe.
  • If you are really scientific about it, ensure it is about 3/8" - 1/2" longer than your longest toe. When we walk forward at a normal pace, the friction of the shoe when it strikes the ground will normally allow the foot to keep moving forward inside the shoe. The additional toe room helps prevent excessive toe pressure at the end of the toes. If this is a typical problem for someone, adding a "tongue" pad inside the tongue of the shoe may help keep the foot from sliding inside the shoe. This also helps keep the heel from slipping up and down when the heel slipping is a problem.
  • Wear shoes that are known as extra depth shoes.
  • The extra depth provides room for "removable" soft inserts that will provide more cushioning for the bottom of the foot. Additional cushioning helps lower pressure, especially on the heel and forefoot while walking. Medicare has strict guidelines that determine the "hardness" of the insert and is stated in terms of Shore A Durometer such as 30. A higher Shore A is harder than a lower Shore A. For example the hardness of your automobile tires are in the 70 range. If a shoe is Medicare approved, the Shore A durometer of the insert meets their guidelines for helping prevent excessive pressure on the bottom of the foot.
  • Make sure the heel does not slip up and down as you walk.
  • Sometimes, an extra depth shoe will allow the heel to slide up and down and cause friction with a resultant blister. A blister can also lead to infections and other issues with the diabetic foot. To help alleviate heel slipping, a "tongue" pad can be added to the inside of the shoe to help keep the foot from moving away from the heel of the shoe and slipping up and down.
  • Don't be mislead by the old adage "well I have always worn a size 8 medium."
  • Once again, if the shoe fits, wear it. Shoe manufacturers don't always follow the universal sizing standards that have been around for a long time. As such, if a size 8 wide width shoe feels better than a size 8 medium width shoe. Don't be offended. Take and wear the shoe that fits your foot. With the diabetic population, this is even more important.
  • A note about direct heat molded diabetic inserts.
  • It is the opinion of this writer that when diabetic inserts are heated and the foot is directly pressed onto the heated insert, the area where the thinning occurs is the area where the pressures are the greatest when walking. Common sense would tell you then that unless the surrounding area where compression of the insert does not occur can prevent pressure on the bottom of the foot, you have just lost the cushioning in the areas where the foot is likely most vulnerable to ulceration (pressure sores). It is the opinion of this writer that direct molded heat inserts are not a best practice procedure when trying to reduce pressure, especially over the forefoot where the metatarsal heads reside and where the "majority" of diabetic ulcerations occur. Make your own assessment, but that is the belief of this writer. Wilbur A. (Wil) Haines, CPO (Ret)